Monday, June 30, 2008

Cost-Effective Community

We live in a time where Herod is in control...If you stand up and do as John the Baptist did, say a few simple words- such as That is not right; this is not how it should be done; this is not how we should treat one another; this is not how we should life-you are risking death. Sometimes we forget that the Christian life is a risky life, a life that might cost you your own life. This is the context of the text, and also the context of the miracle....This is the Gospel. This is where it is preached, in dangerous times.

From Pathologies of Power:

These are indeed dangerous times. In the name of "cost-effectiveness," we cut back health benefits to the poor, who are more likely to be sick than the nonpoor. We miss our chance to heal. In the setting, we're told, of "scarce recources," we imperil the health care safety net. In the name of expendience, we miss our chance to be humane and compassionate. Herod remains in control, but this is also the context of the miracle: it is precisely such contexts that we have the privilege of reasserting our humanity. Against a tide of utilitarian opionion and worse, we are offered the chance to insist, This is not how it should be done. Indeed, this is always what healers were called upon to say, but now the stakes are even higher. The world is a very different place now than when the prophets roamed the land. Medical technology has changed. We have great laboratories, diagnostic capabilities, and effective medications for a host of diseases.

Certainly, distributing these developments equitably would be expensive. Certainly, excess costs must be curbed. But how can we glibly use trms like "cost-effective" when we see how they are perverted in contemporary parlance? You want to help hte poor? Then your projects must be "self-sustaining" or "cost-effective," You want to erase the poor? Hey, knock yourself out. The sky's the limit.

Similar chicanery is used with a host of other terms, ranging from "appropriate technology" to "community." Through analytic legerdemain- the world is composed of discretely bounded nation-states, some rich, some poor, and each with its unique destiny- we're asked to swallow what is, ultimately, a story of growing inequality.

Is this the best we can do? Attempting to provide a "basic minimum package" for the poor is something that should be done apologetically, not proudly. Even the WHO, which has invested heavily in promoting cost-effectiveness as a means of assessing health care services, recognizes the sharp limitations of this method in improving the health of the poor and thus addressing inequalities of outcome:

"Cost-effectiveness by itself is relevent for achieving the best overall health, but not necessarily for hte second health goal, that of reducing inequality. Populations with worse than average health may respond less well on an intervention, or cost more to reach or to treat, so that a concern for distribution implies a willingness to sacrifice some overall health gains for other criteria."
-Pathologies of Power. by Dr. Paul Farmer.

if you liked this snip-it, read this book! I started years ago and am finally finishing it. Paul Farmer is a strong believer in health care as a basic human right. Many medical professionals currently strongly disagree with this statement. I think the difference in opinion, and the vast array of opinions between Farmer's and medical professionals,' hinges on how 'health' is defined, and therefore what it means to care for the 'health' of a person or a people.

There is one thing Paul Farmer is absolutely right about: everyday we miss chances to heal, and those chances should be viewed as priviledges.

Friday, June 13, 2008

to care? or not to care?

One of the significant differences between my time in San Diego and time at school over the last few years is my exposure to what is going on in the world in a more global sense. Hopefully this will change next year. I really hate reading the news online...just a personal pet peeve...and I know that there are free newspapers available all over campus so I don't really have any excuses. But there is something so much more appealing at home to sit in the morning in the kitchen with a cup of coffee, bowl of mango crisp cereal, and read the newspaper. Or sit with my dad and watch the news at night, or turn it on while doing the dishes or cooking.

Needless to say, at school if I was knowledgeable about something going on in the world, it was largely because I had made some kind of specific effort to learn about it. Thus, I really got to filter what kinds of world events I heard about and let myself care about. I've found watching the news/reading the paper over the last two weeks kind of like a continual punch in the face in terms of all the crappy stuff that goes on in the world. In no way do the uplifting news stories balance out the tragic ones. hmm...uplifting news story...that's almost an oxymoron.

Natural disasters, environmental concerns, deadly diseases, freak tragic accidents, border trouble, global poverty, kidnappings, sex scandals...the list could go on forever. So the question I end up asking myself is, to what degree to I try to care about all of these things? What level of responsibility do I have to care about them? What is the ultimate purpose of reading or listening to the news?

Some obvious answers are: on practical level, no, I can't actively care for all of these things. In fact, I'll be lucky if I can wrap my mind fully around one of them. So my next thought then turns to, well, if I pour lots of energy into caring about one of those news items...say...healthcare [and by caring about in this case I also mean actively pursuing some way of working to better the situation], and a community exists in which each person cares in that active way about the causes they gravitate most towards, well that would seem to solves things. I do think that that is the kind of community we are called to be, and that peace-making and shalom-bringing is always a communal event [modeled after the ultimate community: Father-Son-Spirit], but easier said than done.

I then run into the question/tension that has been brought up for me in college more than any other: how to pursue the peace-making/shalom-bringing works of God while recognizing that we (individually and communally) are most definitely not God? How to pursue the process of becoming perfect, as our heavenly father is perfect, and living knowing that we are created in his image? How to have our power perfect in our weakness, and what kind of power does that create? Ecc 8:8-10, Psalm 90, and Luke 12:25 are examples of the kinds of power we don't have. There is lots more to be said about power, but I think that my original question is answered largely by Micah 6:8. He has told you, oh man, what is good: and what does the Lord require of you but to do justice, and to love kindness, and to walk humbly with your God?

That last one, walk humbly, is key. The first two are easy to understand and are seen as generally good things in the eyes of most people. So really, what the reading and hearing the news ends up doing for me, after the repeated punches in the face because of the crappy condition of so many peoples' lives, is that much softer but strongly persistent reminder that we're not asked to take on the burdens of the world. That was done. It is amazing how difficult it is sometimes for the good news of that statement to overpower my attitude of hopelessness for the conditions of the world. And while it is easy to think that I'm a good person for wanting to care and act on all these different issues, it is also really prideful to think that I can take any of them on as my burdens, let alone all of them. Yes, we are told to bear one another's burdens to to care for others, but never without first having humility, and acknowledging who the real yoke-carrier is.

Wednesday, June 4, 2008

A Community of Tree People

When I was little and would draw pictures in crayons of trees or hillsides or general outdoor scenery, my mom would always say, "Steffie, not all the trees are the same color. Use some different colors when you draw. It will look prettier and more realistic." My art career didn't advance much beyond that, but it reminded me this week about the diversity in nature that exists, and how it is pretty universally seen as beautiful.

No one looks at a hillside of spring or autumn trees, all different colors and heights, with no shade of green exactly the same, and says, "it would be way better if these were all the same color." The same can be said about almost anything alive in nature. Entire hobbies are devoted to discovering different bird types, flower species, whale songs, and even insect variations. Diversity, in nature, is not only beautiful, it is beneficial. There are volumes of sciency things that could be said about that statement, but to keep it pretty simple: the ultimate goal of living things in nature is to remain alive and produce offspring that remain alive. If it were true that all organisms of a certain species lived longest and produced the most offspring when they were all the same, then all those organisms would, in fact, look the same. Clearly this is not the case. And if it were the case that it didn't matter whether or not diversity existed within a species, then we would see some species look all alike, and some have diversity. This is also not the case. The remaining option, is that it is indeed a positive and beneficial living environment for all species when diversity exists amongst their own kind.

"the over three hundred thousand known varieties of beetles led biologist J.B.S. Haldane to consider that ‘God has an inordinate fondness for beetles.’ Why, one must ask, did God make creation so diverse? One can assume only that the wealth of life on earth is due to God’s extravagance. He created the squirrel not because of any real need for squirrels but because he liked the idea of squirrels. Looking upon the natural world, it is easy to sense God’s sheer joy in creation- you can imagine the delight he felt when he came up with the ridiculous idea of giraffes.

The diversity of creation is simply a reflection of who God is. God is diverse. God is triune- three in one. It is often said that the most profound theological statement in the whole Bible is that ‘God is love.’ The truth is that were God a single person, if he were one rather than three and one, we could not know him as love. As theologican Stanely Grenz put it, ‘Self-love cannot be true charity, supreme love requires another, equal to the lover, who is the recipient of that love, and because supreme love is received as well as given, it must be a shared love, in which each person loves and is loved by the other.’ It is only because the Father, Son, and Spirit respond to each other in constantly loving relationships that we can say that the very nature of God is love. The doctrine of the Trinity tells us that God is a community. God is in the constant eternal relationship."
-Intelligent Church by Steve Chalk and Anthony Watkins

Diversity generates stronger and more creative ideas and so produces more imaginative solutions to problems than are likely to result from the best efforts of a single mind. The result of being surrounded by others who will always agree with you is mediocrity. Personal growth and community creativity are born out of the tension of differing opinions, approaches, and insights.

But back to the original discussion of trees. Why is it that it is so easy for us to look out into nature and to see both the beauty and the benefits of diversity, and o difficult for us to do that with humans? Is it because we are less pretty to look at? Is it because we don't step back and look at society in the same way we look at a hillside? Is it that we have not felt the benefits of our differences? Is it that we think we are all the same?

Created things, whether books, paintings, or buildings, tell us about who created it and why. Biologists would call this relating structure with function. All basic biology books talk about how the structure of the natural world, from cells to planets, relates to their function. One does not come before the other, but rather structure and function are inexorably linked and shift together. God, as the ultimate creator, tells us about Himself through His creation. He has told us what our function is- to love God and love neighbor- and He gives us His Word to teach us how to do that, His Son to do it perfectly for us, and His Spirit to move us to do it.

So that takes care of function. What about structure? We can talk about structure in terms of our physical bodies and mental/emotional abilities. I'm interested more in structure as a society, since it communally that we make up the fullness of the image of God. If we see that differences between living things are beautiful and beneficial and tell us something about what God values, how do we structure our society so that it fits the function it has been given? God's Word says a good deal about cities, city structures, and living communally. What strikes me again and again is how He can look at individuals and communities and see the pure beauty He originally created, though fragmented, and ask us to see it too, so that we would understand Him, as our creator, more.

1 The Mighty One, God the LORD,
speaks and summons the earth
from the rising of the sun to its setting.
2Out of Zion, the perfection of beauty,
God shines forth.
-Psalm 50

Sunday, June 1, 2008

networking

Starting the fund development process has been a cool way of seeing how different people, places, and organizations have become connected to one another, and have each given me different tid-bits of knowledge, experience, and concern, that have shaped the things that I care about now. If find it hard sometimes to really take to heart the often tossed-out verses of Jer. 29:11" For I know the plans I have for you," declares the LORD, "plans to prosper you and not to harm you, plans to give you hope and a future." And Philippians 1:6 "that he who began a good work in you will carry it on to completion until the day of Christ Jesus." Ironically, hope in the future can be firmly founded in God's faithfulness in the past, and the "plan" and "good work" has really always been taken care of and grown. At the most basic level, raising support in San Diego [which has really just barely started], is like connecting the past with the present. The fact that I am even in contact with this many people form pre-Penn life is a testament to the hope/future/plan for completion. It is fun to look back [and forward] and see how the people and places here in San Diego have changed me and to return to those people and places a very different person, and show them concretely what has changed and even how they've had a part in that.

A few examples...

In high school I worked for San Diego Youth and Community Services. Next week I'm meeting with their CEO, who was just a board member like me 5 years ago, to talk about IV and them maybe supporting me. Turns out that Dr. Ross, the CEO of the California Endowment and my general hero [look down a few posts], is the biggest financial supporter of SDYCS, and so he's going to join Walter, the SDYCS guy, and I for that meeting. I only met Dr. Ross because of being an RA in Ware, and because of being on Helen Davies floor. Dr. Ross went to Penn and worked for Helen as a freshmen. It is also Helen that gave me a TA job next year for her Infectious Diseases class, and an academic job like that is one of Howard's requirements for letting me defer. So anyway, in high school when I was on the SDYCS board, one of the board members introduced me to the president of San Diego's Soroptimists chapter. They gave me a scholarship for Penn, and are actually based in Philly, and are also potential donors. SDYCS showed me the incredible brokenness of the inner city for the first time, but I wouldn't have applied for their student spot on the board if I hadn't already been interested in social justice type stuff. That part of life was influenced largely by Girl Scouts and Sue. Girl Scouts taught me about leadership and Sue, along with a few others, taught me about the importance and joy of living out the Gospel. She also gave me the application for SDYCS. The Meinert family, who are good friends with Sue and took me to church, gave me a picture of Christ-centered family and community. That community became the image of what I wanted to find in college, and that landed me looking for Christian fellowships, which brings me full circle to IV. So now, I return to San Diego, with new connections like Dr. Ross, and old ones like SDYCS and Sue, but they're all connected. And really, I could keep going with the connections.

So while the Jer 29:11 words are very true, I actually have been connecting most with a different part of Jer. 29. Before promising the exiles hope and a future, God says this: 5 "Build houses and settle down; plant gardens and eat what they produce. 6 Marry and have sons and daughters; find wives for your sons and give your daughters in marriage, so that they too may have sons and daughters. Increase in number there; do not decrease. 7 Also, seek the peace and prosperity of the city to which I have carried you into exile. Pray to the LORD for it, because if it prospers, you too will prosper."

All of these people and organizations are seeking the peace and prosperity of the city, and they have taught me to do the same. They all address different facets of city peace, and so looking at them as a whole [though they don't all know each other], is beautiful. And these people HAVE prospered, oh so much, because of what they are doing. They have fought for peace, and lived out Micah 6:8 and placed their hope in Isaiah 65; they have sought God and lived because of it.

The network is intricate. More intricate than I could have ever planned out, or than even the best career services seminar on networking could imagine. It emerges from an economy of grace.


16For by him all things were created: things in heaven and on earth, visible and invisible, whether thrones or powers or rulers or authorities; all things were created by him and for him. 17He is before all things, and in him all things hold together. 18And he is the head of the body, the church; he is the beginning and the firstborn from among the dead, so that in everything he might have the supremacy. ~ Colossians 1


God could have chosen other people and places to teach me about Him [and being infinitely good, I'm sure those other paths would have been fine :)], but I am oh so glad that He gave me the people and places that He did. Many of these people had no idea that they were moving me towards God, and while my initial reason for meeting up with them in the next three weeks is to talk about them supporting me on IV staff, pretty solidly connected to that is the chance to tell them how they've been important in my journey of faith for the last several years. 11 Yours, O LORD, is the greatness and the power and the glory and the victory and the majesty, for all that is in the heavens and in the earth is yours. Yours is the kingdom, O LORD, and you are exalted as head above all. 12 Both riches and honor come from you, and you rule over all. In your hand are power and might, and in your hand it is to make great and to give strength to all. 13And now we thank you, our God, and praise your glorious name. ~1 Chronicles 29