Injustice, violence, and social determinants of health

The presence of injustices including violence and poverty affect global health on a large scale. This issue features five original articles addressing these effects. A guest editorial which highlights the concept of moral injury experienced in the setting of cross-cultural global health service introduces a new call for papers for 2024. Also included is a commentary on disability and the imago Dei, a description of a program to catalogue faith-based healthcare facilities globally, a poem on stewardship, and an international conference report on healthcare missions, held as a preconference to the ICMDA World Congress in Tanzania earlier this year. We are looking forward to publishing a special issue on faith-based healthcare in the African context in the coming months.

Jason Paltzer, James Ritchie, et. al. first offer an exploratory qualitative cross-sectional study of moral injury among western healthcare missionaries and identified seven themes which could inform further research as well as preparation and care for cross-cultural global health workers to enhance resilience and sustainable service.

Alison Youdle, Beryl Vali, Nathan John, and Pam Anderson surveyed villages in Telanga, India where the practice of religion-based prostitution continues. Although officially the practice is illegal, various factors including religious tradition, poverty, family custom, and social expectations have seen it persist. This article demonstrates how some embedded cultural practices can contribute to human exploitation and suffering and need to be challenged rather than condoned through cultural relativist reasoning.

Safder Husain and Arish Sherwani have studied school children in Karnataka, India for the prevalence of anemia and associated factors. Intervention efforts have been in place to deal with iron and other nutritional deficiency, but 20% of those studied remain anemic. A number of social, nutritional, and clinical associations were found that suggest further possible approaches for diagnosis, prevention, and treatment.

Emily Eldred and her colleagues describe an effort to prevent school-based violence in church-related schools generated from within the church itself. Current Zimbabwe law regarding school violence is ambiguous in several respects as it applies to teachers as well as parents. An initiative in child protection is being taken in this context, which is consistent with papal statements and Catholic values.

Studying to become a doctor can be a stressful experience. Arini Saputri and Imelda Ritunga studied a random sample of third- and fourth-year medical students at the medical faculty in Surabaya, a city at the eastern end of Java, Indonesia. Their results showed that, indeed, stress along a broad scale was associated with sleep disturbance, yet academic performance did not seem to be affected.

The Christian view that human beings are made in the image and likeness of God has broad and significant implications for human life and culture. It is a view that justifies review and renewal because challenges to it can arise. David Deuel and Nathan Grills remind us that people with disabilities are made as completely in the image of God as everyone else and can contribute to society and mission.

Our colleagues at Christian Connections for International Health (CCIH) have initiated the creation of a database of Christian assets and resources in healthcare globally, described in a persuasive field report by Samone Franzese, Carolyn O’Brien, and Doug Fountain. The effort is supported by a consortium of leading organizations in global health and promises to facilitate financial support, planning, and coordination of healthcare initiatives where the needs are great.

Managing editor Daniel O’Neill attended the ICMDA 17th World Congress in Tanzania earlier this year and participated in leading a preconference on healthcare missions. His conference report provides an excellent overview of the theology behind healthcare missions, a brief missional history, challenges facing that mission today, the place of documentation of these efforts, cross cultural issues, leadership, and decision making, and themes that contribute to a compelling vision for future efforts. The report can stand alone as a summary of the place and purpose of healthcare missions in today’s world.

Finally, Fotarisman Zaluchu, from Indonesia, reminds us through poetry that God waits for our repentance from the ways humanity has treated the delicate ecology we are privileged to steward.

I encourage readers to look out for the forthcoming special issue on faith-based healthcare in Africa. It will contain a forthright apologetic for healthcare missions as well as descriptions of continuing efforts by Christian Health Associations to relieve suffering amid conflict and illness in communities where great needs persist despite unprecedented prosperity in other parts of the world and great transformational potential for faith-based healthcare. We are also issuing a new call for papers on “Failing Faithfully in Global Health Service” which seeks honest evidence for the mitigation of fallout in Christian global health service for the first quarter of 2024.