RE-FORM-ING IN THE WORLD OF HEALTH

In the first quarter issue of Camilliani 2009, the first article of the health and justice series was about “redeeming” the lack of attention to the structural causes of illness and inequities of health in our ministry to the sick person. The term “redeeming” is understood as an approach that compensates for what has been started but not sustained, i.e., confronting structures of injustices in the world of health. This second article will focus on the term “reforming” which is a fundamental approach used in the various programs of the healthcare ministry. Re-form-ing stands for the three-level ministry of responding, forming and influencing. It refers to the three distinct but interrelated aspects of healthcare ministry.

The relationship between the three elements of “reforming” can be compared to the dynamics of what Fr. Calisto Vendrame, M.I., called the tripod of religious life (experience of God, experience of fraternity, the mission and service in the Kingdom of God). This is only with due reference to the dynamics of the tripod, and not to its individual aspects, i.e., the interrelation of the aspects and its foundational character (i.e., one could not stand without the other). Responding, forming and influencing nourish and support one another, and find its concrete expression and embodiment in the ministry. “Reforming” takes its shapes in the acts of charity (responding), pastoral formation (forming), and social advocacy (influencing). The mission identity of the Camillian socio-health institutions defines it clearly: “to witness and incarnate in the world of health and sickness the salvific, merciful, therapeutic and salutary action of Christ. This is realized through the promotion of health, the prevention of sickness, the provision of care and rehabilitation.”

Responding

Any form of charismatic action, as an organized response to the promptings of the Holy Spirit, is borne out of a concrete historical situation. The dream of Camilla about his son Camillus was clearly interpreted and understood when Camillus found himself inside at St. James of the Incurable and the Holy Spirit Hospital. When Camillus saw and felt the sufferings of the sick person, he understood it as the call of God to do not his work or plan but the concerns of God. It was in this context that he developed charity as witnessing to the merciful love of Christ to the sick “like a mother caring for her only child” for he saw in the sick person Christ himself.

Today, this witnessing is sustained by the various works of charity through the socio-healthcare institutions, pastoral centers, chaplaincies, parishes, etc. All these came about because of exigencies that call for an immediate and an organized response. It does not arise only by pure desire or ambition of the individual to do something good for others. Any response in charity needs to be placed in context, otherwise, it will not be sustained or, will just end up contemporaneously as soon as the protagonist disappears. The factual circumstances serve as a barometer for a sound planning and effective implementation of initiatives.

This is a very vital form of ministry since charity pushes as to get in touch with the real sufferings and situation of injustices of the sick people. Its concrete contribution to the work for social justice in the world of health is the gathering of data and facts observed. People who are engaged in the ministry of charity can be a vital source of information for social advocacy in health ministry. The challenge then, is not just only to offer concrete responses to the present exigencies but also to record and document those cases.

Forming

The second aspect of ministry is formation. When Jesus began his public ministry, one of the first project he did, was to call disciples with a specific task of “to be with him.” (Mark 3,14). It was an invitation to experience and learn from Him. When St. Camillus has committed himself to stay at St. James of the Incurable, he gathered the first five devoted men wherein they prayed and work together at all times. Goodwill must be supported and equipped with competence, and competence must be guided with compassion. The first rules of the Society of the Servants of the Sick in 1584 clearly manifest the true intention of forming real ministers of the sick.

A relevant formation is one that is crafted out from the very situation in which the healthcare ministers are engaged with. In this way, direct and indirect information that has been gathered from the concrete experiences in the field are vital resources for a sound and relevant formation programs. Direct information is hands-on information while indirect information is information gathered from an in-depth studies and reflection, in other words written information. Pastoral centers are the primary users of the informations gathered from the actual ministry in the service of charity, as well as providers of prepared human resources and promoters of a competent compassionate love in the world of health.

Influencing

The third aspect of ministry is advocacy. David Cohen, a social justice advocate defines advocacy as “the pursuit of influencing outcomes — including public-policy and resource allocation decisions within political, economic, and social systems and institutions — that directly affect people’s current lives.” (Cohen, 2001). Fr. Frank Monks described this as “to be a credible voice for others” which is no other than reclaiming the consecrated persons’ prophetic identity. General Chapters produce normally substantial amount of documents that speak about advocacy coming from credible resource persons. The task of each one is to translate these voices into the language of compassion, commitment and courage in order to influence doable plans and sustainable outcomes.

What does advocacy in health really interest most? Its interest is to ask and to answer “Why?” The World Health Organization has this to say: “The poor health of the poor, the social gradient in health within countries, and the marked health inequities between countries are caused by the unequal distribution of power, income, goods, and services, globally and nationally, the consequent unfairness in the immediate, visible circumstances of peoples lives – their access to health care, schools, and education, their conditions of work and leisure, their homes, communities, towns, or cities – and their chances of leading a flourishing life. This unequal distribution of health-damaging experiences is not in any sense a ‘natural’ phenomenon but is the result of a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics.” (CSDH, Closing the Gap in a Generation…, 2008). The social determinants of health are vital instruments for any forms of health care ministry. Health issues are not natural but created. Thus, somebody is accountable to it and all of us are responsible for it.

Therefore, the experiences gathered (responding ministry), and reflected (forming ministry) need to be further analyzed and presented (influencing ministry) to whoever is accountable for it. The interplay of these three levels of ministry is vital and crucial. There are already several religious congregations and civil society groups who have representations as lobby groups in the wider international state organizations such as in the UN and the local state political organizations, who want to build better networks in order to strengthen their advocacies. They need more voices and commitments. To establish linkages and share capacities is among the best options that one can venture for a healthy world of health based on justice, solidarity and peace.