1) Goal --
The goal of Community Health Evangelism (CHE) is to establish a development ministry whose purpose is to bring together Jesus' Great Commission (Matthew 28:19-20) and the Great Commandment (Matthew 25:37-40). This is accomplished by training community members as Community Health Evangelists (CHEs) who regularly visit 10 – 15 neighboring households, sharing the gospel and promoting principles of disease prevention and healthy living. The program is designed to be transferable, multipliable, and ongoing after the training team leaves the area.
2) Biblical Basis --
In addition to the Great Commission and the Great Commandment, Jesus made a startling statement in Matthew 25:34-40. He asserted that as we give food and drink to those in need, take in strangers, clothe the naked, look after the sick, and visit those in prisons, we are doing these things to Him. Jesus calls us to be His disciples, sharing the gospel and serving others in love, meeting them at the point of their need.
Jesus not only calls us to be disciples, but also to make disciples. He wants our ministries to multiply and His love and truth to reach the ends of the earth, touching individuals, households, and communities, now and eternally. Christian community development is rooted in obedience to the commands of Christ. It is driven by a desire to see individuals come to faith in Christ and to see lives, households, and communities transformed by obedience to the principles of God's Word.
We are told in II Timothy 2:2 to train faithful men to teach others who, in turn, will teach others. Here is multiplication as each one teaches those who will go on to teach others both spiritually and physically.
When Jesus walked this earth, He ministered to the whole person. As Christians, we too are responsible to meet both physical and spiritual needs and to train others to do so also.
When Jesus sent out His twelve disciples to minister to others, He commanded them to heal the sick, being concerned for the physical needs of others, as they preached the Good News of Jesus Christ. Today, if we are to follow Christ's example, we too must be concerned for physical and spiritual healing as were the disciples.
Traditionally, a number of missions have been committed to caring for people's physical and spiritual needs, but they use different people to present the evangelistic message from those who care for physical needs. Often in day-to-day practice, however, a missionary is faced with incredible physical needs. For many missionaries this leads to conflict of interest between urgent physical concerns and the spiritual needs of the people. Accordingly, CHE teaches that the basis for all health care should be a blend of curative and preventive care, balanced with Biblical instruction.
3) The Need --
Meeting Needs -- and there are immense needs in the two-thirds world. One-half of those who die in the villages of developing countries are under five years of age! Most of these deaths are due to a combination of malnutrition and infection. Diarrhea and gastrointestinal diseases abound, due to contaminated water and food, improper waste disposal, and poor hygiene, sanitation, and nutrition. UNICEF reports 40,000 children die each day of diseases that are preventable.
Serious respiratory diseases occur frequently because of overcrowded living situations, low resistance due to poor nutrition, and lack of knowledge of how to prevent transmission to other family members. Typhoid, diphtheria, tetanus, and whooping cough are common diseases that can be prevented through the use of inoculations (vaccinations). Environmental health diseases transmitted by snails, insects, and other animals can be prevented by the use of other modern medicines.
Good health is more than just medical elements. For a person to be truly healthy many elements are involved. To this end CHE attempts to deal with the elements presented below:
*** Emotional Self-Worth
*** Good Health
CHE is a multifaceted, community-based, development strategy that deals with the whole man – physically, spiritually, emotionally, and socially. CHE training teams equip local villagers as CHEs in the needed physical, social or emotional topics, and spiritual area. The CHEs then put into practice what they have learned in their own lives and share this with 10 – 15 neighboring families.
Historically, most of the available medical personnel and funds in the developing world have been committed to hospitals, which provide curative care for only five to ten percent of the population. In most of the two-thirds world countries, 80 percent of the health professionals are found in cities, while 80 percent of the people live in rural areas. The majority of the clinics and hospitals are also in the cities.
The best medical care is to prevent the disease before it occurs. Curative medicine seeks recovery from existing diseases rather than preventing diseases. It is expensive and not available to the majority of the people, especially those in rural areas and villages. Therefore, CHE places its greatest emphasis on prevention, which involves community development. However, there is still a need for resources of curative care, such as clinics and local hospitals for dealing with the more serious illnesses.
Although most diseases are preventable through health education and immunizations, we also train CHEs to recognize basic diseases and treat them in the home. As an example, in Africa worms can be treated with pawpaw milk. In addition, CHEs are taught how to recognize the signs and conditions severe enough to need treatment at the hospital.
CHEs also meet needs in another critical area – malnutrition. CHEs teach how to grow and properly prepare vegetables and other foods. The "Food 3x3" lesson plan is an easy way to remember what foods to eat at every meal: (1) an energy food – potatoes or bread; (2) a body-building food – beef or fish; and (3) a protective food – oranges or pineapples.
Sanitation can be a problem in houses made of mud and when access to water is limited. A crucial factor for health is to train people to build pit latrines and keep clean homes. Many villages have no running water, so people walk three to four kilometers to draw water from a dirty river. CHEs teach villagers how to find a clean source of water and how to protect it to keep it clean. They also teach ways to purify water. In addition to teaching the villagers about sanitation, the CHEs tell them how Jesus Christ can cleanse their lives of sin permanently.
4) The Community Health Evangelism (CHE) Approach --
CHE strategy is broadly aimed toward the whole community. This is done by training local villagers to share spiritual, physical, emotional, and social truths with their fellow villagers.
The CHE strategy includes the following primary characteristics:
*** Concentration on meeting priority needs keenly felt by the village through simple community projects. These projects are designed to empower the villagers to do as much as possible on their own. We attempt to begin at the ability level of the people in relation to their leadership, initiative, and self-reliance.
*** An integration of preventive medicine, health education, and sometimes curative care, into a total program. The emphasis is on prevention and education with expected results in changed lifestyles and conditions.
*** A vision and goal to reach the most people as possible.
*** A program of instruction that shows the people how they can participate in their own development. Lessons are developed that are aimed at simple health education, identification of major diseases, recognition of the need for medical care, and care of the sick (especially children).
*** Community self-help and community leadership emanating from the peoples' commitment to the program.
*** A commitment to delegate most of the tasks to local church leaders, community leaders, and the CHEs, who can best generate local support and commitment for the program.
*** An understanding that the content of the training must be transferable and multipliable.
*** A commitment to use readily available local resources as much as possible.
*** Provision for good working relationships with the nearest available hospital for necessary obstetrical, surgical, and medical care of severely ill patients.
*** Mass inoculation programs for measles, BCG, DPT, and polio. Such programs should be community sponsored.
*** Provision for sanitation training with an emphasis on cleanliness, safe water, and proper use of pit latrines.
*** Provision for easily accessible family planning instruction materials. An underlying foundation for a CHE Program is that the community sees a project as its own. Too many times outside organizations do something for the people, leave, and what had been accomplished disintegrates. The emphasis from the beginning must be on the community taking ownership.
5) Core Elements Of CHE
Community Health Evangelism is made up of three essential groups:
*** The Training Team -- The training team initiates the program and usually comes from outside the area. Each training team consists of two to four people with a combination of vocational skills (medical, agricultural, pastoral, social work, etc.).
*** The Committee -- A successful Community Health Evangelism Program that will be multipliable, transferable, and ongoing must be community-based rather than outside agency-based. The program must be integrated around community committees, which are chosen from community members. The committee carries out this goal.
The committee should be community-based. The members should be mature, well-respected individuals who represent different segments of the community (educational, governmental, business, agricultural, medical, etc.).
6) The Community Health Evangelists (CHE's) --
The Community Health Evangelism volunteer is the major worker in the program and is chosen by the committee. Adequate attention to their ministry will require about six to eight hours a week. As they are being trained they will:
*** Put into practice what they have learned around their home and with their family; modeling what they have learned.
*** Promote good health, prevent disease, and model abundant Christian life with their neighbors.
*** Practice evangelism and discipleship with individuals and groups.
*** Do home-visiting on a regular basis, sharing the spiritual and physical truths they have learned.
*** Teach in a way that will help others to become teachers.
7) Steps In A Community Health Evangelism Program --
The process and training courses below are designed to teach individuals and organizations how to put into action their own integrated ministry of Community Health Evangelism (CHE). Once the participants are trained, they are able to set up a CHE program and teach volunteers how to implement the work in their own village. All teaching is done in a participatory style; the learner is the center of attention, not the teacher.
a) First Step: A desire to make a lasting difference in the lives of people in developing countries is a prerequisite.
b) Vision Seminar: A 14-hour, two-day seminar is used to introduce the CHE concept in a new country or area. Organizations or key village leaders who are interested in an integrated approach to wholistic community-based development are the ones who should attend this seminar. The next step is to participate in a Training of Trainers I (TOT I).
c) Teaching Nationals to be Trainers: Training of Trainers (TOT) enables people to teach the workers in the field how to put CHE into practice. TOT I focuses on the philosophy of CHE, how to choose a location, and how to start a CHE program. Spiritually, it emphasizes evangelism. The training normally takes 4 1/2 days covering 32 hours of classes.
d) After TOT I: The newly qualified trainers are to return to their areas and form a three or four person training team.
e) Selection of a Village: A training team takes great care to select the most receptive village. Discovering the methods of how to select a village takes place through an evaluation process taught during TOT I.
f) Entering a Village: There are a variety of ways to introduce a CHE team to a village and these methods also are taught during TOT I. There is an entire series of activities available during this phase.
g) Awareness Meeting: These meetings create an understanding of the community needs and reveal which ones are of greatest importance. It is important to provide a structured time where people have opportunities to express and explore what they know about their community. Also, the community begins to learn about CHE.
h) Community and Worker Selection: Once the villagers express interest in adopting the CHE strategy, the villagers then elect their own committee which will oversee the program development. The villagers also choose their own Community Health Evangelists (CHEs) who will teach the principles to their neighbors, possibly through picture booklets. Both the Committee and the CHEs are trained over the next six months by the training team. During this time nearly all who are not believers in Christ come to a saving knowledge of Him, and those who do not know Christ lose their motivation and quit the program. Thus, the program is both community-owned and spiritually strong.
i) Committee Training: A six-day, 18-hour training curriculum teaches the village committee their responsibilities. By teaching the Committee first, the individuals begin to take responsibility in their leadership roles in their village.
j) CHE Training: The prime training targets are the CHE's. CHE lessons are taught by the training team. There are over 1,000 lesson plans from which the community can choose what they want to learn. This training team normally trains 15 – 25 CHEs in one geographical area, typically two days per week, until 40 – 50 sessions have been completed. Each session includes a spiritual/moral value lesson and a physical or health lesson.
k) Problem-Solving: Once trained, the villagers go to work to solve what they consider their most pressing community need. This need is voted by all committee members.
L) One-on-One: CHE trainees put into practice what they have learned in their own home. They then visit their neighbors and teach them what they have learned. A part-time CHE can work with 10 to 30 households.
m) Multiplication to Nearby Villages: These changed communities become models and individuals from these communities multiply their efforts to nearby towns and villages. Three to six local CHEs will be chosen from those trained by the initial outside training team to become trainers themselves. These local training teams will expand the program into adjacent communities within their area.
n) Funding: As much as possible, funding for the individual program needs to come from the local communities. Where local resources are insufficient, funds may be solicited from in-country agencies that are interested or working in community health, agriculture, etc.
o) Working In Creative Access Countries --
CHE is adaptable to meet needs of differing religious, cultural, governmental structures, and geopolitical situations. CHE trainers are now working in so-called "creative-access nations." Changes have been made to CHE so it will be better accepted by the medical professionals and religious forces in these sensitive lands. In these countries CDE stands for Community Development Education. This title replaces CHE. The workers are called Community Development Educators, rather than Evangelists.
p) Spiritual Ministry Through Moral Value Topics --
God's Word is introduced through storytelling and role plays. Moral value teaching is related to physical health as much as possible. If possible, the training team should be mature believers who will pray for the community they are working in and follow-up those who are seeking a relationship with God. Relationship development with religious leaders and health professional is key to successful introduction and sustainability of a CHE program.
q) Training Programs --
Training is critical for the success of any CHE Program. All of our training is highly participatory, no matter which group is undergoing training. There is a considerable use of problem-posing situations through role plays or pictures to start the discussion. Small group discussion is widely used as well as songs, stories, and demonstrations.
8) Three Phase Training Of Trainers (TOT) --
The training process is broken into three, one-week phases with several months between each phase to allow trainees to practice what they have learned.
Phase I -- Focuses on development philosophy and how to start a CHE Program. Spiritually, the emphasis is on evangelism.
Phase II -- Focuses on developing teaching materials, methods, and curriculum. Spiritually, the emphasis is on follow-up.
Phase III -- Focuses on evaluation, project expansion, multiplication, and management. Spiritually, the emphasis is on discipleship.
9) Committee Training --
The committee is trained in six, three-hour sessions, learning to take responsibility for what happens in their program. The training gives the committee members a clear understanding of how to establish a personal relationship with Christ. By training the committee first, the members begin to take more responsibility and leadership, and chose better people to be trained as CHEs.
10) CHE Training --
Group involvement is a key factor. The methods used are highly participatory teaching techniques using role plays, stories, songs, visuals, demonstrations, and large and small group discussions. Volunteers go through 40 – 50 sessions, each including a physical/health and spiritual/moral value lessons. The training is spread over three to six months. Each day they receive one physical and one spiritual subject. They then put into practice what they have learned as they visit in neighbors' homes. After the initial training is completed, they receive two to three days each month of additional training for the next twelve months.
Medical Ambassadors International Training
To learn more about Community Health Evangelism, please see the What We Do link on the website above. The Training and Resources links in the pull down menu will give more information.
11) How To Integrate The Physical And Spiritual --
CHE workers have found that it is one thing to see the importance of a program that integrates both physical and spiritual truths, but it is another matter to implement such a combination. The integration of spiritual truth into a physical outreach is a way of thinking, which must be constantly reinforced.
It is therefore important to spend as much time on evangelism and discipleship as on physical subjects. One-half of the class time is spent on physical teaching and the other half on spiritual teaching. The danger is that CHEs may spend all their time meeting physical needs, which are highly visible, to the exclusion of meeting spiritual needs.
The trainers must be good models of an integrated ministry by teaching both physical and spiritual topics. They should expect the CHE will do the same and not specialize in a specific area.
To be effective, CHE training must focus on spiritual integration and actively address worldviews which prevent physical, emotional, and mental changes. Physical change without spiritual change is not long-lasting. As we see spiritual changes taking place, excitement and momentum grow.
Encouraged by CHE
Nepal (MNN) - What happens when missionaries see a need for more than the Gospel in areas they serve? Unreached communities often lack sanitation and medical resources. "We see a lot of poverty; we see a lack of understanding of health." That's when Community Health Evangelism shows missionaries how to combine outreach efforts with health programs. An Operation Mobilization team leader says this training helps their ministry in Nepal. Pray that God shows them how to support the local church. "How we can really empower them: that's a huge prayer request for us." OM Nepal works with churches in discipleship, training, orality and youth programs. Right now they're gearing up for the Winter Outreach Program. "The church in Nepal is exploding in numbers. We really need to help and assist the church in discipling these new believers." About 150 Nepali believers will share their faith in unreached areas of Nepal. Ask God to give them boldness. Pray for guidance and wisdom for the OM Nepal team.
FOCUS ON COMMUNITY HEALTH EVANGELISM (CHE) -- Community Health Evangelism (CHE) is a ministry strategy that addresses the root causes of poverty, disease, and spiritual darkness by training local leaders to share the gospel and mobilize community action. Communities learn to prevent disease, enhance agriculture, and generate enterprise. Vital biblical faith is nurtured at every step. People become followers of Jesus, existing churches strengthened, and new churches planted. More than 250 organizations are using CHE in 81 countries worldwide. The Alliance for Transformational Ministry (ATM) and the Global CHE Network offers CHE training to people serving in rural and urban poor settings worldwide. For more info, please visit these websites.
Alliance for Transformational Ministry
Global CHE Network
Medical Ambassadors International
To learn more about Community Health Evangelism, please see the What We Do link on the website above. The Training and Resources links in the pull down menu will give more information. This is another ministry that does community health evangelism.