The congregation as a healing community: The story of Bethel Baptist Church, Jamaica
Keywords: community health care, church ministries, holistic care, HIV AIDS
Jamaica's population of 2.6 million is composed largely of descendants of slaves brought from Africa to work in the sugar fields of British plantation owners. The repeated break-up of families as a result of the slave trade tended to marginalize men and leave women as heads of the households. Seventy per cent of Jamaican children today are born to unmarried mothers. Single parent families, multiple partners and teenage pregnancy are a historical legacy of this unsettled past. Recently, as a result of economic development, large numbers of young persons have been moving to the country's cities, leaving members of their extended families, including many elderly, to survive alone in the rural areas. Similar to the slave trade in its effects, mass migration to the United Kingdom, United States and Canada has divided families and scattered family members, leaving children in the care of those who remain behind.
These young people are set adrift in rapidly expanding urban centres, such as Kingston, Jamaica's capital. Community support systems in these areas are few. Drug and politically related violence, domestic violence, street children, child abuse and child neglect are on the increase. HIV/AIDS prevalence rates are second only to Sub Saharan Africa. In Jamaica our 2004 murder rate of 44 per 10 000, one of the highest worldwide, is largely inner city and gang-related, driven by drugs, extortion, reprisals and party politics. Injury-care and lifestyle related diseases overburden our hospital expenditures.
Another legacy of slavery is black self-hate, which ultimately acts to undermine social unity. The control of Jamaica's commerce by 'white-brown' minority elite has some similarities to the colour-class pyramid seen in South Africa. In the Jamaican setting, religious diversity has also contributed to social disintegration. Christian faiths alone number over 20 larger denominations and there hundreds of small sects.
Political and economic control, exercised by international banks through minority elite, also hampers equality and justice. Today, in spite of many strides towards progress, the country is still struggling to overcome poverty and underdevelopment. Traditional values have been largely undermined by the promotion of materialism through the Western media. Such media colonialism has worked against the traditional commitment to helping the poor, even within the church.
Those in Jamaica who have the money to pay go to private physicians and hospitals when they are sick. The impoverished majority, however, depend on understaffed and under equipped public services, where they can spend hours waiting to be seen or are put on waiting lists for services such as surgery. A common temptation for doctors and other health professionals is a tendency towards the authoritarian and condescending behaviour of both secular western medicine and the colonial days - treating patients as objects rather than persons. Despite the efforts of government health authorities, community-based activities and health promotion are still inadequate.
In 1974, a new paradigm or 'new way of understanding and practice' emerged, both in health care in Jamaica and in the ministry of faith and health in the church. One of the main settings in which this started was in the Bethel Baptist Church. In 1972, the church began a period of theological reflection on the role of the church in healing. Some members had become disillusioned with the influence of the mind/body and spirit/matter dualism, which has limited the effectiveness of both western scientific medicine and the church's mission in Jamaica and elsewhere.
The congregation felt a need to use the gifts of medical skills, pastoral care, counselling and prayer in a stewardship of what was to be called a 'Healing Ministry'. The church was concerned about having a meaningful outreach programme that would minister to the whole person within the church and in the wider community. After 2 years of planning and prayer, the ministry began in 1974 as an evening activity and in 1984, it became established on a full-time basis.
The concept of health used is demonstrated in [Figure - 1]. Here health is wholeness or harmony between body, mind and spirit, between the individual and the human environment, the natural environment and God as centre. Health is also a development issue, seeking liberation of the socially and economically marginalized. Thus for Bethel, persons at the margins are a priority.
The healing ministry provides services that are Whole Person in nature, comprehensive (being promotive, preventive, curative and rehabilitative) and community based. It serves three underserved communities, 'Ambrook Lane', 'Hundred Lane' and 'Park Lane', with populations numbering 1000, 3000 and 2500, respectively, the wider urban communities of over 700 000 persons surrounding the 'crossroads' church as well as the local congregation with over 2500 members . Personnel are largely lay volunteers who are mostly nonhealth or human service professionals. This overall service model is shown in [Figure - 2]. Currently there are at least 46 similar ministries run by 13 denominations in Kingston city with a population of 1 million.
Health promotion is seen as a priority, targeting the entire population served. Activities include education in healthy lifestyles, family planning, care for the elderly, women's and men's health. Exercise is stressed in 'Fitness and Wellness' classes. Sports and table games provide recreation. There is a 'Health Corner' for working members of the public who use our weekday cafeteria.
The family life programme is implemented within the congregation through lay leaders who offer counselling on preparation for marriage, a marriage enrichment group and parenting education and follow-up support for persons having their children dedicated in the church. Special support and counselling is provided to common law couples. Family Month presentations deal with topics such as family living, ageing, separation, divorce, retirement and violence in the home.
Preventive services include maternity monitoring, child immunization, dental, vision and medical screening. Counselling, prayer and referral are provided for persons with newly detected illnesses. Special Health Fairs and a Health Week offer screening and health education for the public. Outside the Healing Centre a first aid kit is available. Training in first aid and lay counselling is provided for use in the home, church and community.
A mentorship programme provides for the total development of youth at risk. In the area of crisis intervention a bereavement group supports persons experiencing the traumatic death of loved ones. Lay training has been provided for support in death and suffering.
Community outreach services are offered to the three low-income communities indicated and periodically to certain rural villages. These include a Participatory Learning and Action (PLA) approach for problem solving and the promotion of self-help development efforts. Such activities include a basic (kindergarten) school, a 'kids club', swimming classes, youth homework centre, adult literacy skill training, health care assistant training, environmental programmes and community advocacy.
A bakery provides employment and dignity for members of a rural community. A Summer Employment Programme including our inner city youth provides for job and life skills training as well as employment and opening the door for future work opportunities.
A Sunday school and prayer services provide for spiritual aspects of our Whole Person Ministry. Conflict mediation efforts and joint dialogue bring together rival communities.
At the Healing Centre, curative services are provided to the surrounding population, the congregation and our under-served communities on a multi-disciplinary basis. Waiting patients participate in a morning prayer service. New clients would be usually screened by the counsellor who notes mental, spiritual, social and physiological concerns, frequently with the aid of a 'Wholistic Assessment Questionnaire'. They are then referred as is appropriate, to the Healing Centre's medical doctors, psychological counsellors, prayer counsellors and the church's social worker. The counsellor also gets referrals from physicians including those from outside the clinic. This is illustrated in [Figure - 3]. The church also runs a pharmacy.
The Healing Centre provides services through professionals in the multi-disciplinary team such as counsellors, physicians and nurses. Pastoral counselling is provided by the minister. Most activities, however, are informal, using lay counsellors and lay health and community workers.
Lay counselling involves 'being with' persons and families where they are in the home, on the streets, in hospitals and prisons and as part of local church activities. This informality is an answer to the 'trust divide' and the reluctance of many of our people to open up and to be seen in areas where formal counselling is provided. The counsellor at the Bethel Baptist Healing Centre shares that 'forgiveness of self and others is an issue that several clients have to grapple with. I have had clients who have returned to report that the prayer of forgiveness works, they feel more focused and can move on with their lives'.
Community counselling mainly occurs informally in direct practice with community groups and organizations. Here, the church has a critical role in healing and reconciliation. Violence creates a vicious cycle of attack and reprisal, which can only be healed by reconciliation and restorative justice. Our team members aim to seek, love, justice and the dignity of each person beyond considerations of political party, money, class, colour, gender, status or family role. Thus they become involved in designated and informal ways as conflict mediators and act as models and mentors. Church workers functioning as animators seek to facilitate and to ensure the sustainability of peace and development initiatives. Referrals are made where professional and outside social development help are needed. Monitoring of lay activities takes place through regular team meetings.
Rehabilitation and palliation
Health care training for rehabilitation is provided. Rehabilitative and palliative services include a volunteer care team led by a community nurse and a church staff member. There are outreach services for the elderly, shut-in, mentally ill and persons with HIV/AIDS and their families. This includes wholistic care as well as referrals to and advice from mental health and other specialists from within the church and elsewhere.
Persons who are severely ill or dying in the hospital, hospice or at home are helped with medication, nutrition and finances for medical and home nursing services as necessary, in addition to prayer, regular visitation and pastoral counselling.
The rate of HIV infection in the Caribbean is second only to Sub Saharan Africa. In Jamaica, AIDS is the leading cause of death in the 15-40 age groups. The discrimination in our society against persons living with HIV and the increasing sexual irresponsibility present major challenges for our congregation's ministry.
Several lay persons receive training in, counselling, basic care provision and ministering to persons with HIV/AIDS. Awareness and basic support training is being provided to all healing ministry workers as well as to leaders of other church departments.
HIV screening is done at the Healing Centre on a limited basis. HIV positive persons are referred to government-run subsidized clinics or to private physicians for antiretroviral therapy. Patients are assisted with the cost of ART where necessary and possible.
The denomination trains home health care workers, who assist families with material and practical support. Where necessary bedridden AIDS patients are referred to a hospice run by Catholics. The workers also help facilitate orphans to be sent to their grandparents or other relatives and to provide food, clothing and other necessities.
A special AIDS policy stresses a commitment to complete inclusiveness in all aspects of church life and nondiscrimination. Efforts such as talks, displays, and drama presentations are made to dispel the myths and discrimination concerning the disease.
HIV/AIDS services are a part of our promotive, preventive, curative and rehabilitative programmes in the congregation, Healing Centre and community outreach. In all of this, strict confidentiality is maintained. Nevertheless, at times, individuals will disclose their status in educational groups, towards creating mutual openness.
This AIDS policy has provided a model receiving interest in the Jamaica Baptist Union and elsewhere among Caribbean churches.
The Bethel Healing Ministry has been developed in a country that is predominantly Christian. Nevertheless, these are persons who do not share a Christian faith. A few may be Rastafarians. This is an Afro centric group believing in the deity of the deceased Emperor Haile Selassie of Ethiopia and in repatriation to Africa.
Occasionally, local Muslims, Hindus from our small East Indian population and Jews may use our services. There is no coercion for non Christians to attend Christian services or prayer. In countries, with a significant multi-faith context the needs of different religious groups will require special approaches.
Within the Christian congregation and its related communities, the church offers a special prayer ministry for divine healing, where immediate recoveries from an illness, which is outside medical understanding, may occur. There are worship services and prayer groups for the sick, individuals with personal problems and the elderly shut in.
The Bethel Baptist Church seeks to minister certain special aspects of healing for the Whole Person directly through a special Healing Ministry Team. Nevertheless as can be seen, the church is organized to be the 'church as a healing community' by involving the whole church and virtually all of its auxiliaries in some way.
Besides our 17 paid staff there are over 50 volunteers involved directly in the Healing Ministry. Many more are involved from other auxiliaries such as the Missions and, Homework Study Centre, Adult literacy, Skills Training, Men's and Women's groups, the AIDS Committee, Sunday School and Youth Related Ministries and contributing 'Friends of the Healing Ministry'. These work in mutual support with the Healing Ministry Team, have their own wholistic activities, or promote some aspect of the whole. Apart from our subsidized fee system, most of the financial support of the Healing Ministry comes from the membership's direct and indirect input.
Partnership in financial sustainability
We seek partnership from our Healing Centre users through partial cost recovery for services. Healing Centre and pharmacy fees are subsidized as necessary. Thus, no one needs to be turned away without attention.
The church networks with 'Friends of the Healing Ministry'. It also reaches out to service agencies such as the Lions, Rotary and Kiwanis clubs, the Cancer Society, YMCA, the Kingston Bookshop and to government agencies in a 'healing partnership for the underserved' where special services are provided. Funds are also raised through the Bethel Foundation, through community-based advocacy and an Annual Ash Wednesday brunch.
The partnership that most sustains the ministry involves the giving and bequests of its members. The church also provides a multipurpose building and utility costs. The pharmacy also supplements financing. With all of this, Bethel has long ceased its dependence on donor agencies.
Undergirded by prayer
The ministry is undergirded by prayer. We depend on the empowerment and daily guidance of God who makes us whole and binds us together . Prayer groups meet regularly to pray for the ministry.
An inclusive community
The Healing Centre and Community outreach activities seek to include persons at all stages of life: children, youth, the premarried, common law, married, divorced and elderly receive ministry. Both genders are catered for according to their special needs, so are all social classes. The typically marginalized such as the mentally ill, the shut-in and persons living with HIV/AIDS are healed into community life and the mainstream.
One constant challenge to our ministry is to maintain the traditionally high level of volunteerism. Another is to maintain the centrality of the power of the Spirit in all that we do. It is easy for these critical aspects of any healing ministry to wane with time and with the influence of an increasingly secular society influenced by postmodernism and the 'market ethic' of globalization.
Nevertheless, the church has consistently sought to address these issues through continued focus on prayer and growth in spirituality and a Lay Training Institute . Twice a year, the Church Council meets to evaluate and improve the Church's Ministry.
As a healing community we at Bethel seek to be open to practical human need and to be inclusive. Over the past 30 years our ministry has stood the test of time as many report transforming benefit and thousands continue to experience the healing of God through medicines, persons and miracles.
By means of consultation, visitation to the Centre, word of mouth transmission and the evident benefits of the Congregation based Whole Person Healing Ministry at Bethel, the model has spread throughout Jamaica. Many denominations now have various elements of a Whole Person Healing Ministry. In the Island's capital alone with a population of over 1 million, there are at least 46 such ministries run by 13 denominations, most being in poverty-stricken areas.
The Baptist Union alone has over 19 such churches and mans a training programme for church health workers and lay counsellors. We are grateful to God for giving our members the opportunity to exercise the stewardship of our natural talents and gifts.
[Figure - 1], [Figure - 2], [Figure - 3]