Month: March 2018

Healthcare Spending: Last Place


In 2018 patient numbers have been way up at Clinic Immanuel.  Part of that may be because the TL government spends so little on healthcare.

Well, evidently it’s official: Timor-Leste spends less money on healthcare than any country in the world. For 25 years courageous men and women fought for independence against an Indonesian military backed by the world’s most powerful nations. The Timorese won independence. I have nothing but respect for the common people of this nation (especially the women!) who struggle daily against poverty, patriarchy and entrenched hierarchy in every aspect of life. The political class that has been in power since independence are those people associated with the resistance. But ironically, they’ve decided that healthcare isn’t a priority.

Of course there’s plenty of rhetoric about how important healthcare is. But numbers don’t lie. According to the map published by Focus Clinic which used data from the World Bank, the politicians have decided to spend just over 2.4% of the annual budget on health care, the lowest in the world. It’s not that there’s no money available. To be sure, Timor-Leste’s people are among the poorest in world. But the government has resources. Timor-Leste has money in the bank from its oil production, so it’s not that there’s no money. It’s a matter of politicians making a list of what to spend it on. And here, as elsewhere, the health needs of the poor don’t make the list.

Today there were well over 100 patients lined up at Clinic Immanuel Lospalos, a modest outpatient church clinic with a dedicated staff. Some patients waited 3 to 4 hours for a few minutes of consultation. Many had awful cases of scabies and secondary infections related to it. Clinic Immanuel is the only clinic in town that has appropriate medicine for the current epidemic. Several patients were screened for tuberculosis, as well. It’s good and right that the church has a ministry of this nature. Care for the physical is every bit as important as care for the spiritual. They are interrelated and inseparable. And making a “preferential option for the poor” is what the church does in any time and place that it is faithful to the news of “Immanuel” – God with us.

Last Sunday I preached on Philippians 2:5-10 here at Immanuel Church Lospalos. It’s an ancient Christian hymn that talks about the humanity and humility of God in Jesus Christ. It speaks of God in Christ “emptying” himself of divine power and taking the form of a slave — an abused and rejected person — yet one unwavering in faithfulness to the Word. This, I said, is what Immanuel means for us today in Lospalos. God in Christ does not scorn, despise or ignore the suffering of the Timorese people, but enters it fully. That in itself is good news. God humbles himself to be with and for those the world despises and rejects. But for me, it’s not enough to say to people,“God is with you in your suffering”, and that’s not the only aspect of the good news of the gospel.

Karl Barth has a great reflection on the gospel news of “God with us.” He affirms it as the center of the gospel message: Christ is the enfleshed form of God’s radical commitment to humanity. That in and of itself is reason enough that something like healthcare should be a priority. But then Barth goes on to talk about how the claim “God with us” has a counterpart: “We with God.” That is, through the good news of “God with us” we are:

“…directly summoned…lifted up…awakened to our truest being as life and act…we are set in motion by the fact that God has made himself our peacemaker and the giver and gift of our salvation. By it we are made free for God…and our humanity is established.”  Church Dogmatics Volume IV, 1 (014)

Related to that, in the sermon Sunday I shared the story of Saint Bakhita. Bakhita was a Sudanese slave who was captured by Arab slave traders at age 8 while collecting firewood. Following that she lived a miserable, suffering life for 12 years under several different masters until a man who was the Italian consulate to Sudan bought her. He treated her with respect and eventually she herself asked to return to Italy with him. There she reportedly encountered a crucifix for the first time and was mesmerized by it. On seeing it, one story goes, she said, “Who is that?” Needless to say, she immediately “got” the message of the gospel.   Bakhita was “…lifted up…directly summoned, awakened and set in motion.” What happened to her is a witness to the liberating power of the gospel. Her humanity, dignity and truest sense of self was affirmed and she spent the next 50 years as a Catholic Sister serving the poor in Italy.

Similar stories could be told about slaves in America. Although their masters often mis-used the Bible to further oppress them, some slaves learned to read the Bible themselves. And when they did, they too heard the news about “God with us” and they too said, “We with God!” They made it into songs and stories and shared it because they knew it wasn’t an empty promise, a churchy doctrine or an abstract idea, but a reality that empowered bold action for freedom.

The latter days of Lent are, I think, a good time to reflect on the physical realities of life. One way to do that is by remembering that “God in the flesh” looks forward to “God on the cross;” realities that will not allow us to create a false separation between the spiritual and physical or dismiss something like healthcare as a low priority.

In Christian faith the physical body is not “just a shell” as gnostic spirituality was (and is!) inclined to think. And the conviction “I believe in the resurrection of the body” is not pie-in-the-sky or only about the future. It is, like the entire Creed, an affirmation of the goodness of the created world and the gift of physical life. Therefore healthcare cannot be only a privilege for the wealthy. It is a human right for all people in all places undergirded by the humanity of God in Jesus Christ.