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What is the theological rationale for health ministry via the Faith Community Nurse?

WHAT IS THE THEOLOGICAL RATIONALE FOR HEALTH MINISTRY VIA THE FAITH COMMUNITY NURSE?
Dr. Antonia (Anne) Van Loon

"Great crowds came to him bringing the lame, the blind, the crippled, the mute and many others, and laid them at his feet; and he healed them." Matthew 15:30

The gospel is full of narratives of Jesus' actions of healing - physically, mentally and spiritually. Jesus instructs his disciples to 'go and preach the kingdom of God and to heal the sick' (Luke 9:2). The Christian church, as the incarnation of Christ, is to follow his example.

The Christian church has always been actively involved in health and healing ministries. It is still actively involved in tertiary health care through ownership of hospitals. It has a place in secondary health care through social welfare services, aged care facilities and some pastoral care activities with a community focus. However, it is virtually absent from the primary health care end of the health care continuum. Much Christian health care has become medicalised and in many cases it is difficult to distinguish how it differs from a secular health care facility. This is largely due to the fragmentation of the whole person and the disease-focused care afforded individuals. While it is important to prevent and cure disease, the focus of healing must continue to lie in restoring wholeness in all dimensions of care so that even in the absence of cure, healing may occur. This is possible if we return to a holistic approach to health and healing, as it is explained in Scripture.

Nursing has its roots in the deaconess role of the early Christian church and the religious orders of Roman Catholic and Protestant sisters in later centuries (see Bullough & Bullough 1979; Lyons & Pertucelli 1979; Donahue 1985; Olson 1992). This vocational calling into the nursing profession is documented throughout history starting in the Bible with Phoebe of Cenchrea (60AD) who opened her home to care for the sick (Romans 16:1-2). It moves throughout history, waxing and waning with the varying interpretations of the church concerning disease, suffering and the body. However, nurses have always had an active role on behalf of the church in caring for the sick and under-privileged. Thus it is fitting for nurses to be an active part of a health and pastoral care ministry working within the faith community and beyond.

The Christian worldview perceives health as a dynamic state maintained by nurturing relationships, pursuing justice and peace, and maintaining the integrity of the creation (CMC 1990, p. 1). For the Christian, health is a form of enabling, which with the help of the Holy Spirit, allows a Christian to fulfil God's purpose for their life and to experience a full and abundant life (John 10:10). This is a dynamic transformation of behaviours and patterns of living in all dimensions (body, mind and spirit) from brokenness, to becoming whole through Christ, thus growing closer to God. This reconciliation process is a lifelong spiritual journey that is a free gift by God's grace. The journey is personal and is significantly affected by relationships to others. Loving and just relationships are therefore integral to health. People enter and often leave this world dependent on other people, and the relationships we have between life's entry and exit, give our life meaning. These relationships occur between the person and God, the person and other people, and the person and creation. Out of these relationships humans experience shalom. This Hebrew word closely approximates the concept of holistic health, meaning a deep inner peace, integration and wholeness (Droege 1979).

To gain an understanding of the biblical basis of the relationship between faith and health, it is useful to discern the links between healing and salvation. In Greek translations of the Old Testament (OT), the word sodzo (meaning to 'save') is translated to 'be made well', or translated as 'heal' in one third of its usages in the gospels (for examples in Mark 5: 23, Luke 8:36) (Droege 1979, p. 16). Westberg (1979) notes that this single Greek word is translated in English using two words - 'save' and 'heal'. This translation creates sharp distinctions that are exacerbated by Greek philosophy's separation of body and soul. This separation has led to two discrete disciplines: medicine focusing on healing and caring for the body, and religion focusing on saving and caring for the soul (Droege 1979, Westberg et al, 1990).

Berends (1998 p. 4) indicates that the Old Testament word ho io menos, meaning the 'Healing One', is translated so ter, meaning 'Saviour' in the New Testament. Use of the word so ter involves more than physical healing, rather it incorporates salvation. The Hebrew word shalom, meaning fullness and peace, is translated as soteria, meaning salvation. Thus salvation has come to mean deliverance to a place of rest and peace, best illustrated in the Old Testament narrative of God's covenant with the Israelites and their exodus journey to the promised land (Lapsley 1972). In summary, healing as salvation means to save, to salve, to heal, to restore, and to make whole that which is disrupted (Hicks 1990, pp. 2-7).

The ministry of Jesus fulfils Old Testament prophecies of healing and shalom. Healing and wholeness of the whole person and their relationships bring inner peace. Thus, a Christian theology of healing does not imply healing only by faith, nor by only tending the body, rather it entails caring for the whole person and the relationships between the person and God, others and the creation (Westberg 1990, p. 72). Scripture does not use the word care, rather people are asked to hand over their worries (merimna) to God's providence as a part of the healing process (see Matthew 6:24-34). Healing is of the whole person, not just the spirit (Droege 1979, p. 15).

Commentators claim one fifth to one third of the gospels relate directly to Jesus' healing ministry, the purpose of which is to demonstrate that Jesus is the embodiment of God's kingdom on earth (Mark 1:14-15) proclaiming God's reign on earth has arrived (Kelsey 1973, p. 54; Droege 1979, pp. 16-17). Illness is not always cured, because it may be there for the glory of God (2 Corinthians 12:7-10). However, Jesus promises all people will be healed, meaning they can draw closer to God during their life and be restored to wholeness in Christ after death. Illness is not God's will, nor the direct result of individual sin, as the story of Job illustrates, but God allows it and can use it for his divine purpose. Thus God expects his followers to respond to illness not in judgement, but with grace and mercy. Jesus' healing ministry culminates at Calvary when, as suffering servant, he is crucified taking upon himself our sins and our sickness, to heal our diseases and provide for our salvation (Matthew 8:17; Isaiah 53:4). Droege (1979 p. 18) concludes 'The cross represents not only the death of sin, but also the death of sickness, not only salvation of the soul, but also the healing of the body'. Jesus' death and resurrection is the culminating event of the healing and salvation process.

Jesus' healing ministry is now his church's shared work with God (see John 9:1-41). Jesus returns to his disciples after his resurrection and they are given power to preach the kingdom of God, to forgive sin and to heal (see Acts for examples). The gift of healing is often expressed in 'the laying on of hands', 'anointing the sick with oil', and 'prayer'. The importance of prayer and forgiveness of sins to healing is highlighted in James 5:13-16. Healing power is passed on to those who believe in Jesus, who are promised they will do greater works than Jesus did (John 14:12), because they are empowered by the Holy Spirit to be instruments of God's healing (John 20:22). Thus the healing work of Jesus is continued through his incarnation, the Christian church. The New Testament relationship between salvation and healing is one of participation in the salvation/healing process, rather than a singular healing experience (Lapsley 1972), or as Westberg et al, (1990 p. 76) says 'healing is a part of the process of living'. Droege (1979 p. 20) sums up by saying:
The health and wholeness to which Jesus called people was not simply restoration of function or restored equilibrium or the elimination of the symptoms of disease. He invited people to a life of service to both God and man... This is the significance of Jesus' asking his followers to take up his cross.

Healing is viewed as a progressive response to God's irresistible lure toward perfect wholeness and peace of life with God. This peace and fullness come about by knowing God participates with humanity in their suffering. God is still actively working to restore and care for the world, helping people actualise their potential and fulfil his purpose. Health simply enables people to achieve life's purpose (Westberg et al 1990, p. 75). Thus health is not an end, but a means to an end (Droege 1979, p. 20).

These verses explain that the Jesus clearly summarises the focus of his ministry and consequently that of his followers in Luke 4:18-19, when he says;
The spirit of God is upon me because he has anointed me to preach good news to the poor. He has sent me to proclaim release to the captives and recovery of sight to the blind, to set at liberty those who are oppressed to proclaim the acceptable year of the Lord.

. Geneva, Switzerland: World Council of Churches, pp. 1-3.
Donahue, M. P. (1985) Nursing the finest art: An illustrated history. St Louis, USA: Mosby.
Droege, T. A. (1979) The religious roots of wholistic health care. In Westberg, G. E. (Ed)(1979) Theological roots of wholistic health care. Illinois, USA: Wholistic Health Centers.
Hicks, S. G. (1990) Introduction: Health and healing for church and community, Address to the Metropolitan Chicago Synod Assembly. California, USA: Health Ministries Association.
Kelsey, M. (1973) Healing and Christianity. Illinois, USA: Harper & Row.
Lapsley, J. N. (1972) Salvation and health: The interlocking processes of life. Philadelphia, USA: The Westminster Press.
Legge, D. (1997) How can local projects effectively tackle issues at the macro level? Paper presented to, 'Challenging broader social and economic inequalities and issues', 3rd April 1997, Adelaide, South Australia: South Australian Community Health Research Unit.
Lyons, A. S. & Pertucelli, R. J. (1979) Medicine: An illustrated history. Sydney, Australia: Macmillan Publications.
Olson, J. E (1992) One ministry, many roles: Deacons and Deaconesses throughout the centuries. St Louis, USA: Concordia.
Westberg, G. E. (Ed) (1979) Theological roots of wholistic health care. Illinois, USA: Wholistic Health Centers.
Westberg, G. E. & Westberg McNamara, J. (1990). The parish nurse: Providing a minister of health for your congregation. Minneapolis, USA: Augsburg Press.

The above paper was developed for this website from extracts of the doctoral dissertation: Van Loon, A. M. (1999) Developing a Conceptual Model of Faith Community Nursing in Australia. Unpublished doctoral dissertation, Adelaide, Australia: Flinders University of South Australia.

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