Sharing knowhow and joining forces towards Health for All

Looking back to MMI history and philosophy

In the year 2000, at the occasion of the 75 year jubilee of our Dutch Branch MEMISA, we realised that the German Medical Mission Institute in Würzburg, the Catholic Medical Mission Board in New York, the Congregation of the Medical Mission Sisters, the Foundation Ad Lucem of France active in the Cameroons, as well as the Swiss Medical Mission Doctors Society had started at the same time, long before they collaborated with Medicus Mundi. Their foundation at the time was probably the response to the Encyclica “Maximum illud” of Benedict XV which in the year 1921 gave the initial start for Catholic Medical-Mission-Work, while Protestants had much earlier engaged in health.

Each one of the mentioned organisations worked on its own without actively sharing experiences, until 35 years later a first international gathering of medical mission doctors brought them together. They met in London in the year 1962. Exponents of this meeting were some heads of Tropical Institutes, such as Prof. Oomen from Amsterdam, Prof. Jannsens from Antwerp, Prof. Genitlini from the Salpétrière of Paris and Dr. Jentgens from Cologne and Dr. Manresa from Barcelona, both surgeons and Tb-specialists. These men had gathered experiences from the Congo, Cameroon and East Africa to the remote islands of Borneo, Sumatra, Celebes, Flores and New Guinea. They were questioning whether the pure charitable activities of missionary hospitals had a real impact on the health conditions of the surrounding populations. They felt that apart curative actions a wider approach was necessary and practical work in the field had to be linked to academic analysis. Co-ordination was needed.

Let us remember, in 1955, at the Bandung Conference 29 countries denounced colonialism and launched the Non Aligned Movement under the guidance of the presidents: Sukarno from Indonesia, Nehru from India, Nasser from Egypt and Tito from Yugoslavia. A page was turned in world history.

The decade beginning in 1960 was crucial for the independence of the Third World. Rapidly throughout the former colonies new relationships were established between foreign technical assistants and local professionals.

These were the contexts within which Medicus Mundi had its origin, when one year after the London Conference the International Organisation for Co-operation in Health Care was founded.

On December 8th 1963, Misereor hosted in Aachen the members of the organisation to be registered. Medicus Mundi International became a corporate body according to German law. Misereor had been created by the German Bishop’s Conference just two years earlier as an institution for assistance to the Third World. Misereor and MMI became partners and its first chairman, Mgr. Dossing for many years was our senior councillor and supporter of MMI. France, Belgium Spain, the Netherlands and later Ireland, Italy, Poland and Switzerland became national members of MMI and several international professional groupings became associate members of MMI.

Some years ago in a booklet we described the vision, intentions and the proceedings of our organisation. From the very first meeting, the members of the organisation agreed on the first objective: professional cooperation for development. From that time onwards, the ideals of MMI have been very similar to those of the World Health Organisation. But just as WHO depends on governmental policies, the medical assistance provided by the churches is not accepted everywhere. In addition nationalistic feelings which were very keen so soon after independence made it not desirable to employ doctors originating from the former colonial powers. This led MMI from the very beginning to the conviction that the organisation should be not only professional and international but also non-denominational and non-governmental. On the other hand, MMI wanted to be ready to offer its help to any private hospital or governmental service that could use it, given the great number of doctors posts which were vacant in the recently independent countries, and the dramatic absence of local staff to fill them in.

Another vigorously debated issue: Should MMI concentrate on financial and material assistance, or should it rather focus on personnel assistance? The first option was not rejected, since the material aspect can’t be avoided, but the emphasis should be on human contact and personal commitment. The main objective should be stated as follows: Let us offer to the most needy populations in the developing countries the abundance of medical technology and share our experience of developed countries. This was the way in which European doctors felt to be able to participate in the struggle for social justice on a planetary scale. It was not surprising that more and more an identification between Medicus Mundi doctors and the need felt by the poor population became the background for MMI meetings.

This vision might have been generous and comforting, but there was a great gap between these intentions and hospital traditions in Africa which have been casting wistful eyes towards Paris, London and Lisbon. The doctor’s role was before all charitable, at that time. First you had to be sick to be eligible for medical care. This system was widespread throughout Africa and tropical Asia, but had very little influence on the health status of the population. MMI wanted to change this approach by considering the community as a whole as the patient. No substantial improvements in health status could be expected without extending preventive care to all groups at risk, without protecting particularly mothers and children, without immunization campaigns, without recruiting local people coming from the community itself. This new “mission” implies that hospitals had to open their gates and engage in “extra-mural” activities. Curative work, as essential and inevitable as it is, had to go hand in hand with the prevention of disease and health promotion. Finally the old question charity asked: “For whom?” was changing and became: “With whom?” The main concern was no longer to work for the most needy but to work with them on equal terms. “Partnership” became the new key word in international co-operation. This was also why medical and paramedical training had to be given priority. The objective of MMI, as of all technical assistance, was to work itself out of job, by helping to establish professional cadres in these countries.

Discussions among ourselves and continuous dialogue with our partners at our international or national meetings, kept us à jour with the ongoing changes in health policies and development strategies. Free from centralistic bureaucracy our organisation remained flexible and able to actively participate in different world platforms, and keep being engaged in advocacy for the disinherited world. Throughout the passed 40 years MMI had been working together with partners in more than 60 countries. We have not counted the number of expatriate doctors we have recruited and accompanied during their stay abroad. Even if this could be an indicator of our work, we thinks the most important challenge we had was to try to enable local populations to become self sufficient partners in our globalised world.

Edgar Widmer, Medicus Mundi Switzerland, Member of the MMI Board, addressing the conference "40 years of fighting global poverty by promoting health", Berlin, 24 October 2003.

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