Healthcare and Healing in the Darkest Places

Dan Doriani: Hello, and welcome to Working with Dan Doriani, a podcast where we explore faith, work, culture, and the way believers can make a difference in their corner of the world.

Hello, everyone. It’s good to have you with us again today. My guest, I’m very happy to say, is Anne Reitsema, the chief executive officer of a Christian relief organization called Medair. Medair works to relieve deep suffering, hardship, and strife in some of the most difficult places in the world, including Afghanistan, South Sudan, and Sudan. If you follow the news, you know these are very difficult places to work. We’ll talk later about what you actually do and how you have hope for it, but first, a little background. You were trained as a social worker and counselor, and you have theological training, too. You’re a believer, and your organization is a Christian organization—not proselytizing. You work without regard to creed or nationality. But your work also flows out of your personal history. You grew up as a child in South Africa, in a strife-torn place. Tell us a little about that, and then we’ll talk about the work you do now.

From South Africa to Medair [01:30]

Anne Reitsema: Thank you, Dan. It’s a joy and a privilege to share with you today. I have fond memories of attending your class when I was a student here at Covenant.

My childhood indeed had a huge impact on what I’ve gone on to do in life. When I was eleven, fighting broke out in the area where my parents were working and where we were living, and a number of people we personally knew—people who had spent time in our home, close friends—were killed. That made me want to support communities affected by conflict, especially children. I thought about how some children cope and some don’t, and what makes the difference. That’s what motivated me to study social work and psychology.

But I was frustrated by the solutions I was finding, because they didn’t align with my worldview. They didn’t deal adequately with brokenness, and they didn’t acknowledge our need for grace and forgiveness. So I went on to study counseling here and to really think through how the world fits together. When I finished, I was looking for a place where I could work in conflict-affected communities. I knew I shouldn’t do it alone—that I would benefit from working in a team setting, and that it’s really in the spaces between us that God is at work. And I wanted to live out and integrate my faith in what I was doing. Medair was a great place to do that.

Signposts, Not Saviors [03:00]

Dan Doriani: That’s great. And of course, now you’re the leader of the organization, which doesn’t happen overnight. I’m intrigued by your comment that some children seem to skate through—it happened, and they live beautifully—while others are paralyzed or scarred, reliving their agony, unable to proceed. So you don’t just give material aid; you have a holistic kind of service. Obviously your work proceeds from your convictions, but you’re working with people who aren’t necessarily Christians. There are a lot of Christians in South Sudan, but not many in Sudan, and not many in Afghanistan. Describe how Medair operates in that unique space: “We’re driven by Christian convictions. We’re not atheists; we’re not Muslims. We don’t think the world falls apart because nobody’s in charge, or that there’s no hope and you should just distract yourself until you die.” But that may not be the view of the people you’re serving. How does that work?

Anne Reitsema: First and foremost, we seek to uphold the value of human life. I believe that brings God glory—that he made life with value. We go all out for the value of human life, bringing lifesaving humanitarian assistance to the most vulnerable people in the world, who are pushed to their limits and difficult to reach. We want to come alongside them and be instruments of God’s love for them. We believe that’s a signpost and a sign of the restoration that is coming.

We are not the saviors. When we think we are, we tend to hurt others, and we definitely end up hurting ourselves. We carry burdens that are too heavy to carry, especially when we engage with the extreme suffering and brokenness in this world. But we get to make ourselves available to the One who saves, and that’s a privilege. I have to say, when I get up in the morning, I have energy. I look forward to joining with other people who are focused on the needs of others. It’s a meaningful place to be.

Staying Power [04:55]

Dan Doriani: Everything you say gives me two questions, and I want to hold the second for a minute. We talked beforehand about the fact that you’ve been doing this for close to twenty years. A lot of people find it intolerable to continue for long. Many people do social work or counseling for five years, and then they can’t stand talking about suffering any longer, or working with people who are grieving and scarred and whom, as you say, we can’t save. That’s a false burden, of course. Why do you think you’ve been able to keep going for close to twenty years? And then, so we don’t forget, the follow-up: what’s it like now that you’re not engaging in the work firsthand all the time, but building and supporting teams? Let’s start with how you keep going.

Anne Reitsema: A minute ago you mentioned that some children skate through and some get stuck in the trauma. What’s true for children is that when they have a secure base—a loving family, a loving community, secure relationships—they’re more likely to cope with trauma. When they don’t have that anchor, it’s much harder. That’s true for adults, too. I think it’s true for leaders: when they have a secure base, they’re better leaders. They have a healthier confidence and aren’t finding their identity in proving themselves through what they do.

That secure base has really helped me: a great, loving family, a great network of friends around the world from all my different journeys and places with Medair, and a real desire to keep growing in my relationship with the Lord. That has made a huge difference in coping with exposure to some significantly difficult things—working in places with shelling, mortar fire, and crossfire, and having to navigate how to keep teams safe.

The second thing I’d say is that I encourage all our teams: the bold and brave thing is to take care of your mental health. It’s not a weak thing. If you’ve gone through something difficult, stop and process it. Find somebody to talk to and talk it through. Recognize what’s happened. Don’t let it come back and haunt you later.

The third thing is that what drains people in this work is relationships they haven’t tended—relationships that start to develop tensions, where there’s what some would call a smelly fish under the tablecloth. Something is getting uncomfortable, but it isn’t being addressed. As I watch our teams function, that’s what gets people down. It’s not the workload. It’s not the pressure of being emergency responders who have to move with agility, meet targets, and reach people in time. It’s interpersonal relationships that have gone sour. So being proactive in dealing with that and seeking to resolve what’s getting in the way is really key.

Dan Doriani: That’s great. Of course, I’d imagine the hardest thing is for a child to be separated from their parents—to be an orphan. It breaks your heart to hear about people in camps for a long time, but far worse is the child in a camp with no parents, or one parent, or a parent who’s sick and can’t care for them, or won’t. So I’m guessing we agree on that. And I think a lot of people listening would say, “Oh, that makes so much sense. If I’m going through a very difficult situation with my spouse, my best friend, my brothers and sisters, my parents, it’s so much easier”—not easy.

But I do want to question you a little. You almost make it sound as if trauma is no big deal if you have your friends and relationships around you. It’s got to be difficult to watch somebody starve to death because you couldn’t get food there in time—or, even if you didn’t see it happen, to know that if you’d gotten aid there a little earlier… I’m sure that weighs on people. And maybe that’s what you’re saying: you’ve got to process it, tend to your own mental health, and not carry that burden. You did the best you could; you didn’t get there, quote-unquote, in time. Is that right? You can tell me I’m wrong, by the way.

Anne Reitsema: I don’t think it’s easy. But it is about choosing to be intentional. In coping with brushing up against the extremely hard things in this life—

Dan Doriani: Like South Sudan right now.

Anne Reitsema: Like South Sudan, or any of the contexts where we work—it’s helped me immensely to choose to invest in relationships and to choose to be disciplined in my rhythms and routines.

Not a Spirit of Fear [09:50]

Anne Reitsema: Something that helped me a lot was when I went to Darfur back in 2008. It was the most intense year I’ve had in my work with Medair: leading a team in active conflict and making complicated daily decisions about their movements. My first week there, I received the same verse seven times—in the Tim Keller sermon I listened to on Friday mornings, because that was our day off on the base, in my morning devotions, and from family members and friends. It was 2 Timothy 1:7: God didn’t give us a spirit of fear, but a spirit of power, love, and self-discipline.

Dan Doriani: Seven times—that exact passage—in the first week?

Anne Reitsema: In the first week. At the end of the week I said, “God, I get it. You’ve pulled out the megaphone. I’m not supposed to have a spirit of fear. I know this is going to be a tough one.” So I wrote it out with whatever I could grab—it was a pink crayon—

Dan Doriani: Oh, you’re a lefty, by the way.

Anne Reitsema: I am. Pink crayon on a torn piece of paper. I stuck it up beside my bed, and it stayed there all year. I needed it so desperately. I sat in front of so many officials who weren’t very friendly and of whom I was petrified—

Dan Doriani: And you were younger.

Anne Reitsema: I was younger. And I needed to keep remembering that I wasn’t given a spirit of fear, and that God is way bigger than anybody else, me included.

Dan Doriani: I talked to a woman who said that when she was 22, through a string of events, she found herself alone with the CEO of a billion-dollar corporation. She thought, “I guess I’m supposed to be here. I’ve talked to famous people before, so it’ll be okay”—but never as their employee.

Why Keep Going? [11:45]

Dan Doriani: Let me press in a tiny bit, and you can tell me maybe everybody’s different. People sometimes call the current conflict in South Sudan “the war about nothing.” There’s nothing to it of any ideological or political substance, at least according to what I’ve read in preparation for today. It’s a raw struggle for power: each side kills the other, and kills people on the other side, because if we kill enough people, we’ll win. Surely it’s harder when the war is about nothing than when something is actually at stake. That would be the case for me. But maybe for you, a person is a person is a person, and you’re there to serve that person. Why do you do this? I’m getting at that question.

Anne Reitsema: Just last year I was standing in a stabilization center—a center that cares for severely malnourished children with medical complications—holding a nine-month-old baby in my arms. I stood there and thought, “This baby doesn’t know there is a growing number of conflicts around the world. They don’t know this conflict has been going on for decades. They definitely don’t know why. They know they’re hungry, and they know they’re hungry now. And they know they want some human touch.”

Many people ask, “Why are you still doing this? What’s the purpose? Isn’t it pouring money down a black hole? The need just keeps being there.” If that child’s life doesn’t have value, why does mine? Either everybody has value or nobody has value, right? Either we’re all made in God’s image, or we’re just trying to achieve our way into being made in God’s image.

Dan Doriani: That’s good. We look at people one at a time. The fact that 400 people died yesterday doesn’t mean I can’t save this life today.

Stories That Give Hope [13:50]

Dan Doriani: All right—give us some stories that keep you going. We’ve focused on the hard things. Share with us the beauty of your work.

Anne Reitsema: One of my favorites is the story of Mama Eunice, a Kenyan health and nutrition worker in South Sudan. She worked for us for about twenty years—a very committed powerhouse.

Dan Doriani: Back up. She worked twenty years for Medair, and she’s Kenyan, which is a long way from home.

Anne Reitsema: Yes. A physically strong and courageous woman. We were responding to severe levels of food insecurity; there were abnormally high numbers of malnourished children in the north of the country. We had 5,000 children in four nutrition sites. That means hundreds of children coming through every day who need to be weighed and measured, get a health checkup, and receive nutritional supplements, and whose mothers need training in feeding practices.

Dan Doriani: So you give them food, too—you don’t just assess them. You act.

Anne Reitsema: Yes. And it’s hot—40 to 50 degrees Celsius.

Dan Doriani: Just to pause: that’s about 104 to 120 degrees Fahrenheit. Go ahead.

Anne Reitsema: A caregiver brought in an abandoned child. Mama Eunice weighed and measured the child, did the health checkup, gave the Plumpy’Nut nutritional supplement, and said to the caregiver, “Can you bring the child back tomorrow at 10:00 a.m.?” The caregiver said okay. The next day at 10:00 a.m., during her tea break, she went and sat out back on the mat and just cuddled the child. Then she said, “Can you bring her back again tomorrow?” and did the same thing. After about a week, her colleagues in the nutrition center asked, “What are you doing?” She said, “Somebody needed to show that this child’s life has value. I could see the caregiver wasn’t sure they were committed to following through for this child, so I needed to show them that this child’s life has value. I saw a chance to model that.”

As a team, we said, “Whoa.” Five thousand kids coming through these four nutrition centers, and you noticed the one who needed that little extra, and you gave up your tea break on a day when you’re going all day long to model that love and care. Things like that give me an immense amount of hope. There’s nothing like holding a child who needs to be held.

Dan Doriani: I’m convinced people knew that about Jesus. He touches lepers; he’ll talk to anybody. Parents said, “Can we bring our children to Jesus to touch them, bless them, and pray for them?” And the disciples, as we know, said, “Come on, we have bigger tasks in front of us.” And Jesus said, “Let them come to me,” and he touched them, prayed for them, and blessed them—which is what you’re doing. Of course you work with adults, too, but you’re modeling care for the child for the adults, not just caring for the child. It’s holistic.

Anne Reitsema: And encouraging them. I was in South Sudan three weeks ago, watching our team interact with a mother who was hearing that her child wasn’t improving and needed inpatient care at the stabilization center. Our nutrition worker, David, said to her, “You’ve shown amazing commitment to your child’s life. It’s beautiful. Unfortunately, he’s not better yet, so we need to go a step further—but we’re going to journey with you. Here’s what you can expect. You’ll get three meals a day. You’ll be able to have visitors. The treatment will probably take about this long. If you go to the stabilization center, you may struggle with what to do about your other children back home. We’ll send a nutrition volunteer with you and help make arrangements, so that you can give the extra care needed now to help your child get healthier sooner.” He was really encouraging her.

At Medair we say we go the extra mile: when the road ends, we keep going. We have a real passion for going to hard-to-reach places. But actually, we meet mothers who have gone beyond the extra mile. I saw this in a clinic in Kandahar last year.

Dan Doriani: Kandahar, Afghanistan.

Anne Reitsema: Yes. I was sitting in the waiting room and asked whether any of the mothers would mind sharing their stories with me. One feisty mother said, “Yes, I’d like to.” She was fully covered, and she lifted her burqa, and underneath was a tiny little baby who looked as if it had just been born. I said, “Wow, when was that baby born?” She said, “Just three days ago.” I said, “How did you get here?” She said, “I walked for hours through the mountains.” I said, “You just delivered a baby, and you’ve come here? How? Why?” She said, “The baby’s umbilical cord is infected. I knew it needed extra care.”

Dan Doriani: She heard, and therefore she acted.

Anne Reitsema: “I heard, and I’m coming.” And I thought, what commitment, what dedication to her child’s life. We meet mothers who have gone beyond the extra mile to get to care.

Working with Communities [19:10]

Dan Doriani: Your stories are immensely encouraging to me, because in the West—among skeptical people, at least—there’s a concern that NGOs are just pouring money in: we feed people for the day, and they come back the next day, and nothing changes. But what I hear in your approach is a profound holism. You don’t just tell this mother, “You need to go to the hospital.” You’re not just giving imperatives. You’re speaking heart to heart, soul to soul, whole person to whole person. Is that your answer to people who say, “What are you doing giving food to starving people? There’ll be more tomorrow”?

Anne Reitsema: That’s part of the answer. The other part is that we’re really passionate about engaging well with communities. It’s their crisis, and they know it far better than we ever will. They can be a massive multiplier of the impact the funds can have when we join forces with them. I have so many examples from recent trips to our programs where a one-hour meeting with a group of community representatives multiplied what we could do with the resources we had. In this season of reduced funding in the humanitarian sector, it’s important to find ways to be more efficient and more effective. Really respecting communities—taking the time to listen to them, honor them, and join them in their struggle to cope—makes a huge difference.

For example, our team in Ukraine was asked to provide shelter for people displaced from the east. The city council in Khmelnytskyi gave us a building and asked us to secure it for the most vulnerable displaced people—

Dan Doriani: Secure it from drone attacks, you mean?

Anne Reitsema: No—to insulate it against the weather, put in showers and toilets, and make it livable.

Dan Doriani: Got it.

Anne Reitsema: Then there was an attack that damaged the building, which increased the amount of work needed. Our team calculated how many units they could prepare for people with disabilities, the elderly, the chronically ill—the most vulnerable in the population. Then they paused and sat down with community representatives and said, “This is what we were asked to do. This is what we’ve calculated we can do. What do you think?” And the community representatives said, “We have carpenters, plumbers, and masons among us. Why do you want to use contractors? Let us participate.” Our team said, “Fantastic.” And we doubled the impact.

Leading a Christian Relief Organization [21:55]

Dan Doriani: That’s good. I want to go back to something we barely touched on. You seem like a hands-on person, literally and figuratively. The stories you tell aren’t about meeting a donor who gave you money. They’re about a child, or elderly people. But you are the chief executive. Tell us, from your angle, what we need to know about leading a Christian relief organization.

Anne Reitsema: When I was first asked whether I’d apply for the job, I said no.

Dan Doriani: Of course—because you wouldn’t get to do the actual work anymore.

Anne Reitsema: Being on the front line, closer to the people we come alongside, is my heart and passion. It gives me a lot of energy. But I was asked to take the question seriously, and as I prayed about it, I was convicted that people are people. Whether it’s colleagues in a global support office, donors, or authorities in different countries, they’re all people made in God’s image and all in need of his grace. We have an opportunity to bless others in the way we engage with them.

When I’m asked what it means that we’re a faith-based organization, I say it doesn’t mean we force our faith on others. We don’t make aid dependent on conversion or on having the right creed. We’re not partial in delivering aid. We intentionally say that everybody who is vulnerable—no matter what they believe or whom they represent—

Dan Doriani: —no matter what country they’re in—

Anne Reitsema: —if they’re the most vulnerable, they’re our target group. Those are the people we serve. But our faith informs how we view others—everybody.

I’m excited about leading teams in difficult places. Leading a global team running humanitarian operations right now is challenging: funding reductions, having to reduce teams and let people we love go, figuring out how to balance the budget and stay financially stable so we can do more of what we do, and wanting to make sure we’re growing in depth and strength. At the end of the day, if we aren’t being instruments of God’s love, or if we aren’t treating children for the right illnesses with the right medicine, why bother with anything else we’re doing? So I can see that the organizational elements matter, and I can feel passionate about them and pour my energy into them—

Dan Doriani: As long as you have some time on the front lines.

Anne Reitsema: As long as I get to dip in occasionally to get a fresh story that inspires everyone working with us, and anyone who wants to join and partner with us. Then I can stay happy.

Dan Doriani: Leadership has a multiplier effect. If you train five people to work better, you’ve multiplied your labors by five. But it is hard to give up the front lines.

Anne Reitsema: It is. But in a leadership position you get to set the tone, and you get to grapple with how to help the sector be better. I get to speak into discussions and global coordination mechanisms—

Dan Doriani: Oh, I want to talk about that.

Anne Reitsema: —and that’s challenging, but it’s a privilege.

Working with the UN [24:50]

Dan Doriani: The UN is basically a secular organization—I think that’s reasonable to say—but you work with the UN fairly often. Some people would ask, “Why would you work with the UN?” And some people have a negative view of NGOs, too. I think you’ve allayed that concern; maybe some NGOs aren’t great, but yours sounds wonderful. What’s it like to work with a secular organization like the UN, and with a giant bureaucracy in general?

Anne Reitsema: It’s definitely a bureaucracy—not the fastest-moving machine. But many people working within the UN really have a heart for caring for the most vulnerable. It’s a matter of aligning with them, finding common ground, and grappling with how to do things better. Really robust conversations happen at the highest levels.

Dan Doriani: Like what?

Anne Reitsema: Like grappling with why we’re not getting assistance to people in the hardest-hit areas of Sudan. As a collective of humanitarian actors, we profess to be neutral, impartial, and independent. But when a crisis doesn’t have the same political or economic value, we sometimes find ourselves not giving those lives the same value. Some crises around the world are becoming forgotten crises. We shouldn’t allow ourselves to act as if we’re partial and those lives are less valuable than others. So we challenge each other: “We’re acting that way. We need to show up and find a way through the challenges. It’s not acceptable that we’re being blocked.” The blockages make aid less cost-effective, and we need to address them and figure out how to engage productively with everyone involved. So I’m encouraged that the right conversations are happening, especially now, when we have to navigate far fewer resources and figure out how to make what we do more cost-effective, prioritize the right things, and make sure the people who need assistance most are getting it.

Can the Cycles Be Broken? [27:00]

Dan Doriani: Let me ask about long-range effects. Suppose somebody says, “Let’s not work in South Sudan, because the conflict is so deep-seated.” For one thing, if you go in, you may get shot or killed; you may actually lose people. There’s so much violence, and it’s not always clear where it will break out, at least based on what I’ve read. That’s one factor. The other is that you’d be tempted to go into triage mode: “If we go to this other place, they have less history of conflict. It seems more abnormal to them, and they’ll reset faster. Let’s not go to South Sudan, which has been riddled with conflict for almost its entire existence.” Why not just go to places that are more able to straighten themselves out?

Anne Reitsema: Without unpacking all the conflict drivers in these different contexts, let me try to answer quickly. South Sudan is tough terrain. There are more disease outbreaks than you’ll ever experience here in St. Louis.

Dan Doriani: The climate leads to that, partly.

Anne Reitsema: The climate: extremely hot, extremely difficult terrain, very swampy. Lots of malaria, dengue fever, yellow fever—diseases we don’t even know here. And conflict comes in cycles. You have revenge cycles. You have resource scarcity. People are pushed into closer proximity to one another because they’re afraid; then they can plant fewer crops; then they have a harder time surviving because they don’t have enough food; then they fight over what there is, and the cycles continue.

Dan Doriani: But you’re saying they can be broken.

Anne Reitsema: I think they can be broken. I may be a bit of an idealist. Last year I was reflecting with some doctors in a clinic in Afghanistan. They said, “It seems like there are more and more wars around the world.” And I said, “I’m just amazed at your courage to come to work every day.”

Dan Doriani: So maybe your message is, “Let’s not worry about the world. Let’s worry about the work God’s given us today.”

Anne Reitsema: My message goes a bit further. If you add darkness to darkness, you have more darkness. If you add hatred to hatred, you have more hatred. But light even the smallest match in a dark room, and it permeates the darkness. Light always wins, and that’s one of the biggest motivators for me to keep doing this work.

Dan Doriani: Light always wins. That’s a Christian principle. “I am the light of the world.”

Anne Reitsema: And if you add love to hatred, love overcomes. So by expressing love through caring about people’s physical needs, we are that match. It may sound a bit idealistic, but it’s one act of care for another at a time, and those are the signs of restoration that give hope.

A Word to the Church [29:55]

Dan Doriani: That sounds like what people call a mic drop: a little bit of light overcomes darkness. But I’m going to ask you one more question. Address the church. Imagine a group of pastors and elders and Christian women who are leading and care deeply about ministries of care for the neediest—whether directly in their neighborhood, their city, or their state, or through their giving. You have an audience right now. What would you say to them about the importance of caring for the weak and the vulnerable, and of loving people because they’re made in God’s image?

Anne Reitsema: When Jesus was training his disciples, he gave them what we at Medair would call their induction before sending them out. In Matthew 10:7–8 he said, “The kingdom of heaven has come near. Now go, heal the sick.” Jesus made that link between the kingdom coming near and our caring about people’s physical needs. And he went on: “Cleanse those who have leprosy,” and so on. “Freely you have received—”

Dan Doriani: “—freely give.”

Anne Reitsema: “Freely give.” The days of relying on governments to be the expression of our compassion are dwindling. I think there’s a time now when we have the opportunity—even the privilege—to join together in expressing care for one another. Earlier this year a humanitarian leader asked me, “Anne, we haven’t lost the battle for compassion, have we?” I said, “No, we haven’t lost it, because it’s already been won.” Compassion is beautiful. Caring for one another is beautiful. Just look at somebody taking care of someone else—it’s a beautiful thing. Selfishness, on the other hand, is ugly. The battle has been won, and we get the chance to express care for others and be blessed by it.

Dan Doriani: So true. You reminded me of something, roughly like this: the Bible doesn’t say, “God so loved the world that he wrote a check.” It doesn’t say, “God so loved the world that he formed a committee.” “God so loved the world that he sent his Son.” And then he, in turn, sends us, doesn’t he? It’s the personal touch that I hear so loudly in you—though we can still serve at a distance by giving resources. Thank you for your stories. Thank you for your work—for the work you’ve done with your own hands and for the way you’ve built teams. It’s been great to talk with you again.

Anne Reitsema: Thank you.

Working with Dan Doriani is a production of the Center for Faith and Work St. Louis. We seek to promote faithfulness in the workplace, in education, in discipleship, and in the stories of believers who’ve applied their faith at work. If you want to put your faith to work and change your corner of the world, visit faithandworkstl.org. We’ll help you start a cohort with like-minded believers who also want to practice their faith at work. This podcast is donor-supported; to keep us going, please donate on our website. Maybe more importantly, you can support us by listening, subscribing, sharing, and posting about us on your favorite platform—or go old school and tell a friend.