Category: Anita Rahma

Where There Is No Doctor (That You Can Trust?)

I moved to Indonesia fifteen years ago, before the age of smartphones in our pockets to help find advice on medical issues. Other missionary friends recommended a long-trusted book, Where There Is No Doctor. Perhaps you know it or even have it on your bookshelf.

First published in Spanish in 1970 by Hesperian Health Guides, it has since been revised and translated into almost 100 different languages — providing community workers with easy to understand, practical health information. The book was intended to help those working in rural areas, with limited access to medical care. I have read the book cover-to-cover and found it very helpful over the years — even in a large city, where there are medical clinics nearby. 

But these past fifteen years our problem has not been that there are no doctors. The problem has been knowing whether we could trust the doctors.   

Or whether the doctors care at all.

This has been the case while helping neighbors try to receive medical care. Too often they wait for hours and hours, only to see a doctor for a literal minute (I am not exaggerating here). A doctor might not even touch the patient, listening to the litany of symptoms while scribbling a prescription. Transaction complete, now go wait for the medicine another couple of hours. 

Is it any wonder that many of our friends prefer the local midwife as the front-line of medical care for any illness for women or children? At least a midwife will look them in the eyes.

A few months after moving to Indonesia, my teammate was hospitalized. She texted me the names of the medicines they were giving her, so that I could look them up on the internet (again, this was before smartphones). “Don’t take any medicine before you look up what they are giving you,” she taught me. Which is great advice — except often our neighbors return home from the doctor with unidentified pills in plastic bags. Not helpful.

I like following instructions. My personality is one that does not like going against the flow or standing out or causing problems. But I have had to learn to advocate for medical things. Sometimes this is challenging because I do not want to be the “ugly foreigner” or act like a “know-it-all.” I have not gone to medical school and the doctor has spent years studying and practicing. But I have found that the guidance provided by Where There is No Doctor has been very useful to help know what type of care to advocate for — or what tests to ask for.

Perhaps my angst with the medical system increased when I was pregnant with my first son. My blood is rhesus negative, and I needed a shot of Rhogam to protect my baby and future babies. This medicine was not even available in most hospitals, and we had to find it privately, take it to the hospital where I was getting prenatal care, and explain to the doctor what the shot was and why I needed her to inject me with it. 

We also had to hide the fact that I wore glasses — because then I would have been recommended for a C-section. Many doctors in Indonesia tell their patients that if you have poor eyesight, it is necessary to do a C-section (I am not making this up!). 

I have observed different levels of care in government clinics, public hospitals, and a variety of different private hospitals. More recently, we took our coughing son to see a pediatric specialist in a very fancy clinic. Walking into the clinic felt like stepping into another country: beautiful fish tanks, shelves with toys in the waiting room, and even a free library! 

Yet even at this expensive clinic, I was not sure the doctor was giving my son the care he needed. I explained how I thought my son was allergic to one nasal spray he was taking. The doctor dismissed my observations and prescribed a double dose of the nasal spray. We followed the doctor’s orders for only two days, and after a massive coughing episode we stopped that medicine.

My encounters with doctors in Indonesia have not all been stressful, however. More recently, we are very grateful for partnering with a Christian doctor to help address medical concerns in the slum community where we live. This lovely Christian friend works full time but is giving selflessly of her “free time” to help serve our neighbors and friends. I am so grateful!

The medical advancements over the past one hundred years are astounding. One hundred years ago there were no antibiotics. Let that sentence sink in. Penicillin was discovered in 1928 but was not produced affordably until the 1940s. Before antibiotics, any simple infection could turn deadly. In the 20th century, humanity has seen the development of vaccines, CT scans, the MRI, and successful organ transplants. All of this used to be impossible. 

As expats living overseas, we have choices that did not exist for missionaries a hundred years ago. We could go to the local government hospital. Or we could pay ten times the price at an elite hospital. Or we could hop on a plane and go to another country in search of better health care. 

I don’t judge the medical choices that any expat makes, but I do wrestle with the reality of disparity between the rich and the poor. Between the type of medical care available to some but denied others. What do we do with the disparity? What do we do with finding ourselves on the wealthy side? How do we make responsible choices — stewarding our money well, yet also advocating and seeking health for ourselves and our families? 

I think there are some idols surrounding this issue that I need to lay down. Seeking hope and security in a trusted medical system can be an idol. I have to acknowledge that the medical system is not where my hope should be placed. While I am all for healthcare, I also have to acknowledge that there is only One True Healer. 

He is the Great Physician who can be trusted. 

I think of Jesus stopping for the one. Jesus taking children on his knees. I imagine Jesus looking people in the eye, asking them where their pain is, taking the time to really hear what is going on. Jesus touched those ostracized by leprosy. Jesus healed the crippled, the blind, the lame, the deaf, the hopeless. In these stories, Jesus offers a foretaste of the kingdom coming. Where there will be no more sickness or dying or tears or pain. 

Our bodies are finite. A few gray hairs appearing on my head are a mocking reminder that I am getting older. Life is fleeting, we are only a mist. And yet we have the joy of using our short lives in service of our King.  

I still have a lot of questions. Questions about doctors, access to medical care, the gap between rich and poor. Perhaps you do too. 

My prayer is that as you journey out of your passport country, you will be held in the hands of our Good Physician. And as you encounter the suffering masses of humanity — many without access to the standard of care you are used to — may God touch your heart to be a compassionate presence to those whom you may meet. 

And when you are at the end of yourself — since we are all finite and can only do so much in a day — may you learn to surrender it all into the hands of the One Good Doctor.

Photo by Patty Brito on Unsplash

Beyond Our Comfort Zones

Twelve years ago, I visited Indonesia for the first time. I was a twenty-two-year-old American citizen, freshly graduated from university, filled with hopes and dreams. I visited the Servants to Asia’s Urban Poor team, staying with them in a slum community. And I sensed Jesus inviting me to join them and make my home in a slum. My life would never be the same.

In our world today 1.4 billion people live in urban slum communities, and that number is constantly growing. Are Christians in the West even aware of this global reality? And, if so, do we have the faith to believe that Jesus’s good news is not only for Christians sitting on comfortable church benches, but also for those living in slum communities around the world?

I share my story of following Jesus into the slums in my new book, Beyond Our Walls: Finding Jesus in the Slums of Jakarta. My journey in Indonesia that began twelve years ago continues to this day, now with my husband and two young children. But this book is not a success story. Its pages are filled with pain and sorrow—and also the joys and surprises that come while following our good Savior.

Pain. The pain of fires, evictions, floods, sickness, and death. The daily sorrows of seeing beautiful people living in a physical reality that is not worthy of human habitation: haphazard homes pieced together, piles of rotting trash as playgrounds for children, rats and mosquitos and diseases running rampant. What could I possibly offer in such an ocean of pain and suffering?

But as I continued on year after year, learning and laughing and crying with my neighbors, I have found beauty. There is joy, even when surrounded by unspeakable darkness and pain. There is a juxtaposition of living in service of our King—seeking His Kingdom here and now and knowing that His Kingdom is stronger than all the pain and all the sorrow—but also knowing that the Kingdom is not quite fully here yet and that there is still so much that is not right with the world.

This book does not offer solutions to solve the urban crisis of billions of people living in slums. But it does invite you to come and hear stories, come meet some of the beautiful children and parents who have become my friends over the years. Come and experience Jesus outside the walls of our comfortable church buildings, gated communities, and comfort zones.

“As I live within this garbage collecting and recycling community, I am learning about God, the pemulung[1], who sorts through mountains of trash day after day, searching for anything of value. Back in first-century Palestine, Jesus called out to Simon and Andrew, ‘follow me and I will make you fish for people.[2] Two-thousand years later, I imagine Jesus coming to this place and saying, ‘Follow me, and I will make you pemulung of people!’

“Jesus tells those whom the world views as garbage, ‘You have value. Though others have cast you off, you are a treasure.’ As we follow Jesus, our pemulung, to the trash heap, he is longing for us to help him build up those who have been pushed down, plant and nourish those who have been uprooted, be merciful to those who have experienced disaster, and encourage those who are afraid.”[3]

         You can find the book here.

[1] Pemulung means scavenger, someone who looks for recycling
[2] Matthew 4:19
[3] See Jeremiah 42:10-11

Some Seeds Die

When I was growing up, my family often sang prayers before mealtime. Our repertoire included “God is good and God is great,” “Hands, hands, hands,” and “I owe the Lord a morning song.” Another family favorite was the “Johnny Appleseed” song. Perhaps your family also sang this song. Based on the historic figure John Chapman, the legend of Johnny Appleseed has made its way into Disney movies, folklore, and prayer-songs[1].

The second verse of this song has not been sitting well with me for years. We sing:

“And every seed I sow, will grow into a tree.
And someday there will be apples there,
For everyone in the world to share.
The Lord’s been good to me.”

While I appreciate the encouraging, hopeful words, in recent years I have found that they grate at my soul. Is it ok to teach our children lies or half-truths, even in the context of a children’s song? Not every seed will grow. Jesus was clear about that. But this song gives us a nicer, cleaner, easier way to teach our children that seeds grow. We do learning activities with our children, and we assume that the seeds we plant in the little pots on our porch will grow.

But often they don’t.

I have learned this over the past decade of ministering in a slum community. Quite literally, many seeds do not grow. There is a grassy field only a stone’s throw from our house. We would love to plant small trees there, or flowers, or vegetables. But the roaming sheep and goats immediately devour anything edible. We recently tried transplanting a fairly good-sized tree from a pot to this field. Within an hour the goats had devoured all the leaves and left it a bare stick. Our six-year-old son cried as he watched our plant get eaten.

Even the pots on our porch often fail to produce the plants we were expecting to grow. Whether it is the neighboring chickens that wander onto our porch to eat the new seedlings or a curious child who decides to pick at the pots, new seeds often have no chance to grow. We did a gardening activity with thirty of our elementary school students recently: planting spinach, chili peppers, and kangkong. We faithfully watered the thirty little pots. Hopeful sprouts sprang up. But now a month later, two small pots are all that remain.

Sadly, ministering in hard settings often yields similar results as our gardening efforts in the slum. Have you been in your location for years but not seen anyone come to know Jesus? Do you know the heartbreak and despair of sowing for years but not seeing any fruit? Have you poured yourself into the work and not seen what you had hoped to see? Or perhaps the pain and disappointment is related to your team? Have people you trusted and mentored not produced the fruit you were hoping for?

These past few months have felt like a season of pruning for me. Teammates have left. We had to send an intern home suddenly because of a breach of trust. And multiple students that we had poured into have stopped coming to lessons. Sometimes the heartbreak feels too much to bear.

So I have started singing a new version of the Johnny Appleseed song with my children:

“And every seed I sow will grow into a tree.
But that is not true, ‘cause some seeds die.
And then I’ll sit on the ground and cry:
‘The Lord’s still good to me. Even when the seeds die.’”

This feels more in line with Scripture. Some seeds die. Three quarters of the seeds, in fact, if Jesus’s parable of the soils is mathematical. Some seeds fall on the path and are eaten by birds. Other seeds fall on rocky soil and cannot grow. Some seeds begin to grow but are choked by the worries and riches of this world. Only a quarter of the seeds fall on good soil. (See Matthew 13 for more details.)

Wherever you are, wherever you are sowing seeds, may you be encouraged today. Not with an “everything will be ok” or “every seed will grow” lie. But may you be encouraged to lament the areas in your life and ministry that are disappointing. May you know today that God sees, God hears, and God cares.

And may we be able to join our voice with the voice of the prophet Habakkuk and proclaim:

“Though the fig tree does not blossom and no fruit is on the vines; though the produce of the olive fails and the fields yield no food; though the flock is cut off from the fold and there is no herd in the stalls, yet I will rejoice in the LORD; I will exult in the God of my salvation. God, the Lord, is my strength.” (Habakkuk 3:17-19a)

[1] As I wrote this article and googled the song, I discovered that it was actually created by Disney in 1948, originally titled “The Lord is Good to Me.” However, the words that I grew up singing are different than the original.