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Books for those in ministry organizations who desire to take their leadership, teams, governance, and ministry effectiveness to the next level.

02 Sep '08

Cruel Choices

Posted by T.J. Addington in missions, The heart, World events
Contributing writer
Michael Johnson
Medical Doctor, Nairobi Kenya

I open the refrigerator and think, I can choose either to treat this child for malaria, or put butter on my bread. The other alternatives is to fix this man’s fractured hip, or have another slice of yesterday’s pizza, with antacids. Decisions, decisions, decisions! What can I do with so many choices? Such are the challenges for a modern day missionary surgeon in one of Africa’s most prosperous urban centers.



Nairobi continues to be a place of contrasts in class and culture. As I am wonder what kind of ice cream topping I want, there are children waiting for me to decide how much, what type and when we will provide porridge for them. In my clinic at Saint Mary’s Hospital the choices are even more cruel. I have to decide who gets help and who has to…, suffer. Cruel choices come daily.

I only have a specific amount of money allocated to treat the ‘medically indigent’ (a politically correct term for those who must choose meals over medicines). If I fix that man’s hip, I won’t have enough in the account to treat the child’s malaria. The man has had a painful ride with his hip broken in two pieces, on the typical ‘public-means’ of transportation, a matatu (a van manufactured for six to eight people, but carrying 12 people). The child has had fevers, seizures and his mother is confused by the delay of the long clinic lines.., and of course she has no money.

“Make that chocolate topping with the little sprinkles please.”

My real problem is there are literally millions of people (probably 38 of the almost of the 40 million in Kenya), who have to decide which child to feed and which one to treat and which one to let die.

There is an insurance plan for the poor. The acronym is DEUWFOHMTMC (‘Don’t Eat Until We Find Out How Much The Medicine Costs’) plan. With that thought in mind, I close my refrigerator and think…, “Who was it that said; ‘I was hungry and you did not feed me, naked and you did not clothe me, in prison and you did not visit me?’ If I think long enough about this child with malaria, it won’t be a matter of treating the sick it will be; ‘I was dead and you would not even bury me.’ That’s right. Money for life insurance is better spent on those who still have life.

Decisions, decisions, decisions. What can a modern day missionary surgeon do with so many cruel choices? “Make that pizza to go please!”
Mt 25:45 "He will reply, 'I tell you the truth, whatever you did not do for one of the least of these, you did not do for me.'"

This story can be told all over the world. 54% of our world lives on $3.00 or less per day. Our gifts of compassion, combined with the love of Jesus can make the difference between life and death. Something to think about as we consider our giving.