1. Leadership for Christian Healthcare A case study of Bulgaria 2004 Matthew 28: 18-20

2. The Great Commission, Matthew 28: 18-20  A Commission for Global Transformation  Christians: change agents of God (Salt and light)  Transformation through relational networks (love God and love your neighbor as yourself)  Covers all areas of life (all authority heaven/earth)  Signs of the Kingdom signaling Christ’s victory on the Cross, also in the health field = our responsibility  work is ministry  Not heaven on earth / no Utopia / no triumphalism / no mere horizontal activism

3. Seven Characteristics of Christ’s Commission 1.Authoritative – exousia = dignity, authorization, glory 2.Mobilizing – poreuthentes = literally: having gone / as you go 3.Discipling / Mentoring - mathiteusate  multiply leaders 4.Incorporating – baptism: presupposes evangelism and intercession 5.Cross-cultural - panta ta ethni 6.Educative – didaskō – teach all things… 7.Encouraging – I am with you all the days…

4. Christian leadership  Leadership = influence + focus  Leadership development is a lifetime learning process that goes through various phases  Six development phases: 1.Phase I ‑ Sovereign foundations 2.Phase II ‑ Inner ‑ life Growth 3.Phase III ‑ Ministry maturing 4.Phase IV ‑ Life maturing 5.Phase V ‑ Convergence 6.Phase VI ‑ Afterglow or celebration

5. Phase I: Sovereign foundations  God is developing the leader by laying foundations in his life, this is a sovereign operation.  God works through  Family / tribe / people / nation: even if your family/tribe/people/nation was not perfect / Christian / rich etc  Environment: even if some think it was wrong environment  Historical events: God wants to use whatever happens to us to shape us as leaders.  The potential leader  has little control  should learn to respond positively  take advantage of what God has laid in these foundations.  Prayer of surrender and acceptance of the foundations God has sovereignly laid in your life

6. Phase II: Inner life Growth  Getting to know God better  Learning the importance of prayer and obedience  Growing in discernment and understanding  Getting involved in ministry and learning by doing  new inner ‑ life lessons.  Being put to the test repeatedly. God wants to use testing experiences to develop character:  Good response  learn the fundamental lessons God is teaching you. Result: expanded ministry and greater responsibility.  Poor response  waiting till another time to be tested again in the same areas.

7. Phase III: Ministry maturing  Ministry is the big focus.  Experimenting with gifts and talents.  May get training to be more effective.  Also reaching out others.  God is developing the leader in two ways:  Through ministry the leader identifies gifts, talents and skills and learns how to use them with increasing effectiveness  Learns more about relationships in the Body of Christ. These relationship experiences teach both negative and positive lessons. The negative experiences in our relationships with co ‑ workers are critical to our maturing. The lessons bring personal inadequacies to the surface so that God can deal with them

8. What is the focus of first three phases?  God is working primarily in the leader, and not through him or her.  Many emerging leaders don’t recognize this and become frustrated. They are constantly evaluating their ministry through productivity and activity while God is quietly evaluating their leadership potential and working character in their lives for He wants to teach us how to minister out of what we are in Christ  Ministry activity and fruitfulness are not the focus of these three phases, although we can be very busy in ministry all the way

9. Phase IV: Life maturing  Uses talents / spiritual gifts in a satisfying and effective ministry  Has prioritized the best use of talents / gifts because learning what not to do is as important as learning what to do.  Result = mature fruitfulness  Isolation, crisis and conflict are valuable learning experiences  The principle that ministry flows out of being has new significance as the leaders character mellows and matures.  Leader’s experiential understanding of God is being developed.  Communion with God becomes foundational; it is more important than success in ministry.  Through this change, the ministry itself takes on an increased relevance and fruitfulness.  The key to development during this phase is a positive response to the experiences God ordains. This response will deepen communion with God that will become the base for lasting and effective ministry.

10. Phase V: Convergence  Convergence of life maturing and ministry maturing  God moves leader into role that matches gift ‑ mix and experience so that ministry is maximized.  Many leaders do not experience convergence because:  hindered by own lack of personal development,  organization keeps leader in a limiting position where gifts/talents are not optimally utilized  The major development task is to guide leader into a role and place where he can have maximum effectiveness.  Leader to trust Gods guidance, rest in faith and watch as God moves him toward a ministry that embodies all the development of preceding phases.

11. Phase VI: Afterglow / celebration  The fruit of a lifetime of ministry and growth culminate in an era of recognition and indirect influence at broad levels.  Leaders in afterglow have built up a lifetime of contacts and continue to exert influence in these relationships.  Others will seek them out because of their consistent track record in following God.  Their storehouse of wisdom gathered over a lifetime of leadership will continue to bless and benefit many.

12. Checkpoint: Where are you? 1.Phase I: Sovereign foundations 2.Phase II: Inner ‑ life Growth 3.Phase III: Ministry maturing 4.Phase IV: Life maturing 5.Phase V: Convergence 6.Phase VI: Afterglow or celebration

13. What is Christian Healthcare?  Before we seek to answer that question, let us first take a closer look at the relationship between world view and healthcare

14. World view (basic beliefs) + healthcare God Human being Ethics/Values/Norms Truth/Science/Research Health/Disease/Death Vision of healthcare Healthcare practice

15. Christian healthcare: TPC  God: Theism; for Christian: Christ-centred  Human: imager  10-facetted whole  Ethics: authoritative framework re good/evil  Spirituality: In relation to God through Christ  Health: 10-facetted shalom  Healthcare: focused 10-facetted ministry  Aim: specific contribution to shalom  Driving force: agape-love  Care-giver: called professional steward

16. Total health: Optimal shalom in all of life MinimumMaximum 1.Faith 2.Ethical 3.Judicial 4.Aesthetic 5.Economic 6.Social 7.Linguistic 8.Cultural/technical 9.Psychological 10.Somatic WHO: Only 4 of 10

17. A national healthcare system Levels  Elements  Macro (national / global) Meso(institutional)Micro(interpersonal) Policy Technology Structure Finance People

18. Bulgarian healthcare: developments 1.Some new very modern specialized clinics 2.Specialists well-trained 3.Many new / modern medicines available 4.New / modern technologies have become available

19. Special problems in Bulgaria  Staff discouraged  Financial problems  Lack of finances  bad situation in many hospitals  Low income some categories of healthcare workers  Many without health insurance (unemployed, students)  Management problems  Corruption  Inadequate healthcare reform program  Care delivery problems  Disappointment with official medicine  flow towards alternative practices

20. How to solve Bulgarian healthcare problems?  Secular approaches  Usually begins with policy, structure, technology  Healthcare = managed system for healthcare delivery  Major problem 1: not enough money  Major problem 2: the people  Christian approach  Begins with people in the Great Commission context  Healthcare = complex matrix of relational networks  Major problem 1: Dualistic Christianity  Major problem 2: Reductionistic Christianity  Major problem 3: Great Omission Christians

21. Your answers: How to solve… 1.Do not know what to do…

22. In what areas can our organization help transform the healthcare system? Levels  Elements  Macro (national / global) Meso(institutional)Micro(interpersonal) Policy Technology Structure Finance People Which two areas can we start with? Appointed authority XX X X X X X

23. What can our organization do at a Micro level?  Get to know one another, exchange info  In work: be faithful; learn from non-Christians;  Problems  Trying to solve problems in own strength without God  Staff exploited: junior doctors, nurses,  Action  Build relationship with the Lord / Prayer for wisdom to solve problems  Take initiative for comprehensive approach  Fight for truth / rights / Obtain legal advice to counter exploitation

24. What do at meso level?  Make effective network of Christian doctors:  Make list of Christian specialists  Build relationships between them:  Interpersonal  Inter-practice / inter-clinic  Meetings  Action:  Better PR/FR of CMA  Better link CMA – local churches  Christian doctors: free outreach ministries  Christian hospices

25. What do at macro level?  CMA organization needs to improve  Prayer: mtg q 1/12 (Anni); prayer coordinators in big towns;  Organization structure renewed: regional / local  Better PR/FR: churches, media, professional journals  Ethical concept for CMA  Relationships medical workers – patients  Contact parliament / ministry / other institutions: internet etc: presentations to govt and other officials  Networking with other organizations / NGO’s (Christian and non-Christian

26. Things to do  National committee to encourage:  Working group: anti-exploitation A+A  Christian h/c workers networks in: Sofia, Plovdiv and Assenovgrad, Varna: start with list : name profession e-mail or tel  PR/FR action group  National policy group: privatization of hospitals; bankruptcy;  National networking group