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The Educational Value Of Medical Missions

( Originally Published 1913 )

There is hardly any single direction in which Medical Missions have claimed more attention or offered more striking and unique opportunities during the past decade than in educational work. On every hand missionaries have been faced with an awakening world. Nations that were hopelessly behind, and utterly outside the stream of modern learning but a generation ago, have been stirred with a mighty thirst for " Western Know-ledge," and are fast on the road to acquire it. Old ideals have been dethroned, ancient systems of know-ledge displaced ; and although a vast amount of inertia and conservatism yet prevails, it is fair to say that the world to-day is not far from being a world at school.

Now it will need no argument to point out how immensely important it is from the Christian standpoint that the sources from which the new knowledge is derived should be Christian and not agnostic or heathen. Indeed it may be said that from every aspect it is of supreme importance that the religious and moral element should enter vitally into the world's new era of education.

Never were there truer words uttered than those by Lord Macaulay when he said that " nine-tenths of the evils that afflict humanity come from a union of high intelligence with low desire." And once let the world quench its thirst at springs of knowledge which are in their essence materialistic and non-Christian, and the whole race will suffer from a great dehumanising influence and be removed yet further from God. Hence the pre-eminent value of the work that Christian missionary educators can accomplish, the need for which is clearly stated in the following words from the Report of the Third Commission of the World Missionary Conference :

" With due recognition of the many elements of truth and value in the non-Christian systems of religion and ethics, we should nevertheless be faithless—not alone to our religion, but to the facts of experience—if we did not at this time reaffirm our conviction that the education of the world demands for its highest and best development those elements of truth which are the peculiar contribution of Christianity to the world's thought and life."

Now if there is one branch of learning, one division in the great school of knowledge to which all these considerations apply more forcibly than to any other, it is surely to that of medicine. For, as one writer has said, whilst Medical knowledge can be put to the noblest purposes, it can also be degraded to the lowest. The ability to heal disease, the possession of skill to win back health to those from whom it has flown is something that confers enormous responsibility, which may be used or misused. If it be allied to Christian truths and principles it will be regarded as a solemn trust and discharged as in the sight of God. If it have no such alliance, if it be something which is held by itself alone, then it becomes an instrument of good which all too frequently undergoes a metamorphosis into a weapon of evil. Accordingly how vital is the necessity that medical education on the Mission Field should be in the hands of medical missionaries, and given by Christian teachers, who will bequeath the sacred possession safe-guarded and interpenetrated with Christian knowledge and principle.

Medical Missions therefore appear before us at this stage as a medical educational agency, and reveal their value in that connection in the two following ways :

1. By supplying Scientific Medical Knowledge.—To those who have followed the points brought out in an earlier chapter the need for such knowledge will come as no surprise. The vast heathen and Moslem world has been seen to be in the grip of ignorant, barbaric, and superstitious ideas concerning the human body and its ailments. Plainly therefore an agency which can clear away erroneous views and create a system of scientific medical practice is one which is bound to prove of immense beneficial value. Medical Missions can, and do, perform this very necessary function, and at the hands of men and women medical missionaries—many of whom possess the highest medical qualifications—the non-Christian world is receiving to-day the great and blessed gift of medical science.

2. By training Native Medical Students and raising up Native Medical Missionaries.—For it is not enough to carry to a people a system of knowledge, their own sons and daughters must be trained to propagate it. Only by so doing can the value of the gift be rendered permanent and enduring. It is therefore in this yet further way that Medical Missions prove their great value as a Christian educational agency.

Writing recently, Dr Duncan Main, of China, said :

Now is our opportunity, and our opportunity is our responsibility. China is awake, and she needs, and I believe, wants, Christian light and teaching, and I am sure that there is no better way of giving her them than through a Christian Medical School, which is truly missionary and evangelistic."

All that can be said in urging the need and value of Medical Missions as a whole can be said for this particular branch of that work " a fortiori." Indeed we would go further and say that there is here to be found one of the cardinal elements in the entire medical missionary plan of campaign. Never can it be thought that by the service of medical missionaries sent out from the home base all that needs to be done by Medical Missions can be accomplished. Pre-eminently there must be called into being the work of those sons and daughters of the Church on the Mission Field who, having been trained in medicine, can with the greatest effectiveness, and with the most enduring features, incorporate the service of Medical Missions in the world-wide spread of the Evangel of Christ.

At the Medical Missionary Conference held in Edinburgh, 1910, all that has just been said received ample confirmation by the following three Resolutions, which were unanimously adopted :

(1) " That more and more thoroughly equipped medical schools should be established in suitable mission centres, and that as many natives as possible should be trained for the various branches of medical missionary work, for the double reason :

(a) Because the work gathering round mission hospitals, and the work of medical evangelisation, can never be overtaken by foreign physicians ; and

(b) Because the native can reach his fellows in a way in which the foreigner can seldom do ; is more easy to secure ; is more economical to support ; and has proved, in various mission fields, to be capable of becoming an efficient nurse, hospital assistant, physician, surgeon, and medical missionary, and in many cases in China can occupy positions of importance in connection with Government and other public service, where Christian medical men could exercise a powerful influence for Christ.

(2) " The meeting also is of the unanimous opinion that the thoughts of some of the more highly educated natives should be directed in increasing measure towards the medical mission schools and colleges which are springing up in many lands.

(3) " That in the Christian medical colleges now being established in increasing number in China and elsewhere, the fullest co-operation possible between the missions working in any particular region is eminently desirable, and that not only because of the spiritual gain which is sure to accompany union, but also for the purpose of economy, efficiency and permanence in the preparation of native workers for the medical missionary field."

These striking and influential pronouncements may be accepted as the practically universal judgment of the whole medical missionary force, and it will thus be seen how strong is the feeling in favour of a development of Christian medical education. Since the date of the above Conference, the urgency of this important matter, particularly as it affects China, has made itself felt throughout all missionary circles, and at the Conference of Representatives of Missionary Societies in Great Britain and Ireland, held at Swanwick in June 1912, a report upon the subject of medical education in China was specially discussed. The matter is now receiving the careful consideration of the Continuation Committee of the World Missionary Conference, who have taken steps to investigate the whole question, and this by itself alone will convey a sense of its immense importance. It is to be greatly hoped that such will be the success attending the efforts to frame a policy for the future as shall ensure to the Christian Church the maximum value from this educational work.

In a book of this kind, it is not possible to enter into any elaborate detail regarding this aspect of Medical Missions, and we must content ourselves with a brief reference only to (1) the medical training of Indian Assistants, and (2) the problem of Medical Mission Colleges in China.

(1) The Training of Indian Medical Assistants (i.e. non-graduates).—It will be recognised at once that in India we have to do not only with the medical education that may be afforded by Medical Missions, but to a far larger extent with the education in medicine that is provided for by the Government. In other words, that the main question as it affects Medical Missions is not the medical education of the natives, but the training of a sufficient supply of native assistants for the present and future work of mission hospitals and dispensaries. At present there are four Medical Mission centres in India, where medical training of the " Hospital Assistants " or " Sub-Assistant surgeon " grade is provided for men students. Three of these, viz., Miraj (A.P.M.), Travancore (L.M.S.), and Jammalamadugu (L.M.S.), are Medical Schools established by and conducted under the auspices of Missionary Societies. The period of training is four years, and at the close a school diploma is awarded to successful students. The point aimed at on the professional side is equality, in the standard of qualification, to that of any similar Government institution ; and as the Christian medical school will have smaller numbers than the Government school, it should afford larger opportunities for personal attention. A system of Biblical instruction prevails throughout the course of study, and at the end of the training the " Medical Evangelists," using that designation in its missionary significance, pass into mission service and are eligible for the staffing of branch dispensaries, and for the work of assistants in mission hospitals. The Medical Missionary Association of India through its executive and principal branches has endorsed the suitability of the Miraj school for a union institution to be worked by various missions, and affiliated to the Bombay University.

The fourth training centre is found at Agra, and consists in an institute carried on as a branch of the Edinburgh Medical Missionary Society. Here the students do not receive their medical training under the auspices of the mission, but attend the Agra Medical School of the Government Education Department, from which they obtain their qualification. They pass through the medical course in exactly the same way as non-missionary students, receiving all the while Bible training in the institute for the missionary side of their vocation.

Whether, however, these " Medical Evangelists " obtain their professional knowledge in a medical missionary school or in a Government school, the great importance of aiming at the development of a class of assistants who will be actuated by true missionary motives cannot be emphasized too strongly. What are needed are not those who at the close of their training will enter mission service because they are bound over to do so for a given number of years, but those who will of their own free choice dedicate their lives to the work of Medical Missions. The late Dr Wm. Huntly, who was for so many years the able superintendent of the Agra Institute, drew attention to this point in the July 1912 issue of " Medical Missions in India," and pleaded that " if we are to aim at having assistants who will, in the best sense, be co-workers," then there must be generated in these training centres, as their very esprit de corps, personal loyalty to the cause of Christ.

Our Indian Medical Missions need medical evangelists of this type. The future success of the work largely hangs upon their efficient co-operation, both missionary and medical. Without their accession to the ranks, in far greater numbers than hitherto, it is difficult to see how the magnificent potentialities of Medical Missions can ever be adequately brought into play amongst the innumerable villages of India. But given their fellowship in the service, who can measure the contribution that Medical Missions might go on to make to the evangelisation of India ? We would therefore record our emphatic sense of the value of these Medical Missionary training centres for the equipment of a native agency.

(2) Medical Mission Colleges in China.—It is well, perhaps, that we should start by getting clear views as to what is meant by these colleges, seeing that, unfortunately there seems to exist a good deal of misconception concerning them. Too many friends of Medical Missions, it is to be feared, still have the idea that the work of a medical college in connection with a Missionary Society in China is something not genuinely missionary, something, quite true, that may be very good, and very necessary, but is not, after all, real missionary work. Yet nothing could be farther from the truth, nor more lacking in proof.

The one great aim of a Medical Mission college is " the furthering of the interests of Christian Missions." As has been pointed out already, their primary purpose is to prepare native medical missionaries. And so strong is the evangelistic note running through the work of these colleges, that it is the yearly experience that students who have been admitted as non-Christians become Christians in case after case, and are baptised ere their course is finished. Bible classes, definite Christian instruction and practical evangelistic work figure as integral parts of the curriculum of all these institutions, and so the only correct view to take of them is that they are clear and distinct missionary agencies.

Let us for the moment think of the evolution of these colleges. From the very beginning of medical missionary work in China there was felt the natural need for trained assistants. As Dr Duncan Main has said, " Without trained natives it is impossible to carry on efficient work ; we foreigners can do- very little without our native assistants, and they cannot be got unless we train them." And so the earlier medical missionaries began to gather and train their own assistants. In the words of the late Dr Stanley Jenkins, " Medical education in China is as old as Medical Mission work, and rests on a like basis of reason and necessity."

But presently it became very clear that though the results that were attained were of a most encouraging nature, and of a degree calculated to reflect great honour upon the energy and resourcefulness of the devoted men and women who took up this work, yet that the " one man medical school " attached to a busy mission hospital was hopelessly inadequate. The limitations of time and strength, the increasing complexity and tremendous advances of medical science, the undermanned state of almost every hospital centre, the incessant demands of the medical, evangelistic, and administrative sides of the work of Medical Missions, all united to press home the fact that medical education could not be given to the Chinese in any satisfactory manner if it had to be fitted in, so to speak, upon the top of all these other multifarious duties. Moreover, as Dr Jenkins pointed out, if the look were directed to the future, and it were 'remembered that very possibly, nay, almost certainly, the coming medical men in China will be required to hold a State recognised diploma, then unless the work of medical education, with its immense potentialities, were to be allowed to slip out of the hands of medical missionaries, it was of supreme importance to so consolidate and standardise the work of teaching, as to render it possible to win and retain the ablest students.

Accordingly, there arose a movement amongst medical missionaries in China for concentrating the work of medical education in a few centres, where the teaching could be given by a group of men or women doctors, and where suitable and efficient equipment for training purposes could be provided. The day of small things was recognised as past and over, and the need for taking in hand the work of medical education in a thoroughly effective manner, more particularly in view of the birth of a new China, was seen to be an urgent necessity. If this was, however, to be success-fully accomplished, it became perfectly obvious that any one society, under the existing condition of missionary resources, both of staff and means, could not undertake the task alone. To hope to attain, in any satisfactory degree, the end desired, it was clear that cooperation between Societies must be the watchword, and union medical colleges be the kind of schools established. The China Medical Missionary Association devoted special consideration to this problem, and in view of the danger that more of these schools would be brought into being than could ever efficiently mature, it first propounded a scheme whereby union medical colleges, as carried on and supported by the missionary body, should be confined to five centres, roughly distributed over the country. This idea of concentration was unquestionably a wise one, but it seemed probable, seeing that a few other schools beyond the five suggested by the Association had gone beyond the point of suggestion, that there would not be quite such a limited number as had been proposed. It was therefore no surprise that at the last Triennial Conference of the Association, held in Peking last January, the strong recommendation was adopted to concentrate upon eight Union Medical Colleges. The subject of the future policy that is to govern the work of medical missionary education in China is at the present time receiving special investigation by leaders in Medical Missions, both at home and in China. In this connection, special mention must be made of Dr Cochrane, of the Union Medical College, Peking, to whom this aspect of Medical Missions is greatly indebted for his tireless advocacy and splendid enterprise.

This, then, in broad outline, is the present situation of the educational work of Medical Missions in China. Of necessity there is a wealth of detail to which no allusion has been made, but sufficient has been said; it is hoped, to draw attention to the great value of what is being undertaken in this direction. Four points only require to be noticed ere we pass from the subject.

First, that at the present moment the union medical colleges established by the various missions in China, practically hold the whole field of medical education in that great land. There are, it is true, two Government Colleges, and the Hong Kong School of Medicine, but for all practical purposes, the Medical Mission colleges are the centres which to-day constitute the source of China's medical education. And therein lies at once a great opportunity and a solemn responsibility. To the Christian churches of the West has been given the almost boundless opportunity of raising up in China not a medical profession merely, but a medical profession on the side of Christianity. Instead of the future doctors of that mighty land being educated by teachers who have no religious belief, and who will materialise their students, Christian missions have now the sublime occasion for impregnating the new medical era of China with Christian truth and teaching. Can it be questioned but that in this lies a matchless opening for the furtherance of the Gospel ? But there is this grave responsibility coupled with the opportunity. Everything points to the fact that ere long China will establish enough medical schools of her own, and her students of medicine go to those institutions. Once that point has been reached, China's plastic stage will be over, and Christian higher education will be reduced to the negligible quantity that it is to-day in Japan. Hence the urgency of the present situation cannot be over-emphasised. We are in a position of leadership and influence now. A few years hence and those functions may no longer be ours.

Secondly, the aim of this work is not to found British, American or Continental medical schools in China, but to train and guide the people of China themselves to found their own medical schools. We are indebted to Dr Duncan Main for laying stress upon this important fact. It would be altogether alien to the spirit of missions, and would do their cause a great dis-service were the Medical Mission colleges to proceed upon the line of maintaining foreign ascendancy in the teaching work they establish. Obviously, at first, the main brunt of the training and the heaviest end of the responsibility must rest upon the medical missionaries, but the object will always be to train those who, as soon as they are able to do so, will take over the burden and the work of training their own fellow country people. They will be able to do it far better, and with greater ease. And herein will be perceived the ultimate aim, not only of our Medical Missionary colleges, but also of the Medical Mission hospitals. The gradual transference of such institutions from our hands to those of our Chinese Christian brethren must be regarded as the great end towards which we have to strive. Thus it will be seen that the responsibility of the Christian Church is all the more at the present moment, inasmuch as the work of medical education is the training of medical teachers, those who in coming days will be the professors and lecturers in the medical schools of China. How immense then the importance that these first teachers should be rightly taught, and above all, established in the Christian faith.

Thirdly, the course of training gone through in these Medical Mission colleges is in every respect as thoroughly designed and executed as is a full medical course in the Homeland. The work of the colleges is not a partial training in medicine ; it is a full one, both in duration and scope. The students are conducted through just the same subjects as their western confrères. They have to pass examinations in early science subjects, anatomy, physiology, medicine, surgery and all the varied subjects of a modem medical training. Their text books, thanks to the admirable work of the Publication Committee of the China Medical Missionary Association, are largely the standard text books of Western Europe and America. It is therefore manifest that the work of these Medical Mission colleges is planted upon the soundest basis, and that it is calculated to inspire the fullest confidence.

Fourthly and lastly, the primary purpose of this medical educational work is to send out native medical missionaries, and Christian medical practitioners who will spread the Gospel through the healing of the sick. It will be readily admitted that the particular value of the training work of medical missionaries lies not so much in the production of a succession of well-educated Christian native practitioners as in the raising up of a sufficient and ample supply of native medical missionaries. The great mission of the Christian Church is not to educate but to evangelise, and its share in the propagation of learning must ever be viewed in the light of the contribution which such work can make to the spread of the Gospel. To supply properly qualified Christian doctors is, in some lands, and may be in others, a perfectly justifiable inclusion in the scope of the church's missionary duty, but it can never claim a first place in the thought and effort of those engaged in the work of Christian Missions. On the other hand, medical educational work that is directly aimed, in spirit as well as in letter, at multiplying the number of indigenous medical missionaries who will devote their lives to preaching and healing, is a sphere of missionary service which is of first importance in the claim it makes upon the prayers and sympathies of the Church.

Yet not all the students of these colleges will become medical missionaries. Indeed that would not be the greatest service were they all to so employ their lives. Many of them can do a most valuable work as Christian doctors, unattached in any direct way to the missionary enterprise. Others, as we have seen already, will leave the colleges to become government medical men. Several are the ways whereby they may lay out their knowledge for the service of Christ and their own people. But whatever is done the foundation principle of their Medical Mission colleges will be served, provided they go forth as propagandists of the Gospel, by means of their healing skill. For that end the work of the colleges that have trained them has been solely brought into being, and to that lofty goal are its grandest energies unswervingly directed.

With all our hearts do we therefore commend and support the work of the Medical Mission College in China. Its mission is of the greatest. Its record already is most encouraging. And given only that the Christian Church at home flags not in its contribution of life and treasure, this department of Medical Missions in China will prove, in coming days, one of the most fruitful agencies for the evangelisation of the new Republic of the East.

It is therefore easy to see that the value of Medical Missions, from the standpoint of a Christian educational agency, requires but little demonstration to attest its supreme worth and its essential importance.

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