Program Aims to Put Medical Missionaries Into the Field

Program Aims to Put Medical Missionaries Into the Field

Africa needs doctors, and in 1997 Tracy and Patty Goen were Christian physicians ready to respond to the need as medical missionaries. But like most medical school graduates, the couple was saddled with student debt. Together they owed $100,000.

Mission agencies, however, insist that candidates be debt-free before sending them into the field. For the Goens, that would mean a five-year delay to work and repay the money before they could move to Africa.

That is, unless somebody paid their debt.

Enter David Topazian, a missionary and retired oral and maxillofacial surgeon on Yale University's medical school faculty. He knew that if doctors such as the Goens had to go into private practice to repay their debts, chances are they would get settled into comfortable lifestyles and never make it to places that desperately need them.

So in 1994 he and Dr. Daniel Fountain founded Project MedSend. The next year, MedSend made Nepal-bound missionary physician Martha Carlough its first grant recipient. In 1997, MedSend accepted the Goens.

The deal: Project MedSend would partner with a mission agency -- in the Goens' case, the South Carolina-based evangelical SIM International – and take over their monthly student loan payments for as long as they remained in the field -- potentially adding years of service to a missionary's career.

MedSend has given grants to 185 other physicians, nurses, dentists, physician assistants and other health professionals, each of whom serves under the authority of one of 49 mission boards that now collaborate with MedSend. These medical missionaries work in more than 55 countries, many of which are "creative access," or restrictive of missionary activity.

Half of the world's people have no access to health care, yet dozens of church and mission hospitals have closed in India and Africa – including one in Egbe, Nigeria, that the Goens have reopened -- in part because of a lack of medical professionals to staff them. Diseases once thought to be virtually eradicated, such as tuberculosis, are on the rise. AIDS has killed 20 million people, and experts note that the worst of its death toll has yet to come.

Topazian, who has served as president of the Christian Medical and Dental Associations (CMDA), said that the association's missionary members took note of the crisis in the mission field -- the dearth of caregivers.

"We started receiving reports from missionaries in the field who were overworked, who were due for furlough, and couldn't come home on home assignment because there was no one to replace them," Topazian said. The rising costs of health education, and the need to pay that off before going into the mission field, were shrinking the replacement pool.

The association asked Topazian to look into the issue. He surveyed mission boards with health ministries, hospitals or health-development ministries. From the 33 mission boards that answered the survey, Topazian learned that 49 physicians were partly through the candidate process but had been told to go to work off their debt and then return. Meanwhile, 30 clinics and hospitals represented in that group of missions had no health
professional in charge. "They were empty and closed," Topazian said.

Topazian and some CMDA members asked those same mission boards to tell them what type of organization could best help relieve what he terms the "increasing educational debt barrier" for those wanting to be missionaries. What he and the others learned at the meeting laid the groundwork for Project MedSend.

MedSend isn't a sending agency, but rather partners with Christian ministries that send medical professionals. After a ministry pays MedSend a one-time participation fee, MedSend looks at the candidate's qualifications and financial situation. MedSend assumes the debts for as long as they're in the field. The average grant is $30,000, but grants for physicians can be more than $100,000. Most donors are Christian doctors.

Topazian said that two families left mission work for health reasons, but no one has left to pursue a more lucrative career once MedSend repaid their loans. "We're picking people who have an open-ended calling to a career in the mission field, and they just stay," he said.

Egbe Hospital, where the Goens practice -- he as a surgeon and she as a pediatrician -- offers the only health care available for nomadic Muslim Fulani cattle-herders in southwestern Nigeria. At first, the Fulani had nothing to do with the hospital because the Goens are openly Christian. They did, however, take up an offer by Tracy Goen -- who had finished part of a veterinary medicine degree before he switched to human medicine – to vaccinate and treat the cattle, which are key to the Fulani's culture and livelihood.

But not long after the physician couple arrived in the area, he saved the lives of a snake-bitten boy and a teenager bleeding to death from a sword slash that had almost severed his arm.

The boy turned out to be the grandson of a powerful Fulani leader. After saving the teen's life and arm in a five-hour surgery, Goen learned that he was a prince. His father was the new king, who then invited the Goens to share their Christian faith as they wished among the Fulani.

Now on weekends, Tracy Goen travels the area to vaccinate cattle and show a film on the life of Christ dubbed in Fufulde, the Fulani language. Although Nigeria is embroiled in violent Muslim/Christian conflict, Goen said he's never afraid of attack for his Christian faith because the Fulani are so grateful to them.

Without MedSend, the couple would have been working to pay off their loans until last year, when MedSend finished repaying them.

Tracy Goen says he has zero desire for the fruits of the lucrative private practice he was poised to build. Today, he and his family live with no electricity, phone or television. A teacher from their Temple, Texas, church recently joined them to educate their five children. That freed Patty Goen, who had been home-schooling them, to serve more hours with her husband in the hospital. "We've never felt like we're in need of anything," Tracy Goen said. "God has met our needs." In addition to an appreciative clientele, their practice has other perks: no lawyers and no insurance.

"We had built a house in the middle of a cousin's ranch in College Station, (Texas)," Goen said. "We'd have lived happily ever after. I really don't think we'd have gotten to the mission field had I gone into private practice to pay off the debt. MedSend made it possible."