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Serving the Poor through the Healing Ministries

Mark Raper SJ

Annual Board and Executive Retreat
10 March 2006


"Our greatest challenge at the beginning of the 21st century is poverty. Our greatest debt is the debt to our brothers and sisters in the poorest parts of the world. Our greatest hope is our common humanity and solidarity. And our greatest strength is our commitment to work together. I would like to think we can all take that message back to our communities, our institutions and our Governments ..."

Cardinal Murphy O'Connor

History says,
Don't hope on this side of the grave.
But then, once in a lifetime
the longed-for tidal wave
of justice can rise up,
and hope and history rhyme.
So hope for a great sea change
on the far side of revenge.
believe that a further shore
is reachable from here.

Seamus Heaney, Excerpt from The Cure at Troy


At the beginning of our prayer this morning we acknowledged the Cadigal people of the Eora nation. In this gesture we acknowledge a people. We also acknowledge a healing that awaits its completion in our society.

May I acknowledge you all, members of the Sisters of Charity Health Service which celebrates its first ten years of healing ministry this year, and anticipates 150 years since the opening of the first Sisters of Charity facility in Australia, St Vincent's Hospital, in 1857. Thank you for continuing the long and noble tradition of public service that began with the first arrival of the Sisters in the colony in 1838. May I also greet the members of other religious congregations. Your presence demonstrates the efforts all have taken towards collaboration in the healing ministry.

With amazement and admiration I examined the governance arrangements that you have developed. The institutional presence of the Church in health care has undergone immense change and growth in recent decades. In all, the not-for-profits provide around 40% of Australia's private hospital beds. From the 1980s, sponsoring congregations have realised that the continuance of their health care mission required uniting into systems with central management and central financing. As a consequence, we see the co-sponsored systems that are represented here today. There are two fundamental contexts for the growth. Government policies promote greater private sector involvement (eg, rebates on health insurance premiums make hospital care affordable), and there is a steady growth in and appetite for medical spending. Rising levels of prosperity and dramatic advances in surgery, medical technology, and pharmacology fuel this growth. But what makes your service different from government services, and indeed different from other not-for-profit health care?

The answer must lie in the mission that you have undertaken. You have asked me to speak about one aspect of that mission, the service of the poor. In fact you asked me to speak about poverty in Australia, but with your permission I speak more about serving those at the edges of our society. This talk is about your mission, which is the healing ministry of Christ, a part of the mission of the Church. Even from a governance point of view a clear mission gives needed focus. To be distinct as a Catholic health system, we need clarity of purpose. To collaborate in this common mission we need a shared vision of the caring and healing ministries. As a not-for-profit system, clear focus in governance is also indispensable in order to retain independence from government. Thus a focused mission gives both clarity and autonomy to governance.

The option for the poor is integral to the mission of the Church and to the mission of the Sisters of Charity Health Services. In today's conversation, therefore, we are talking about your fiduciary responsibilities as directors and key executives, to implement the mission of the Church, which is to serve the poor. You have this task regardless of whether you are yourselves Catholic, but in virtue of the governance roles you hold.

The Sisters of Charity Health Services mission is clearly stated all over the place, including on your website: "Our mission is to bring the healing ministry of Christ to all we serve. Our concern for others, especially those in need, permeates every aspect of the life and work of our services." The website also states your vision: "Working together for healthier communities for the love of Christ."

At the recent World Day of the Sick, health was defined as including physical, mental, emotional, social, spiritual wellbeing.

The healing ministry of Christ is demonstrated in the Gospels: "I was sick and you cared for me" (Matthew 25). Jesus healed a man with leprosy; he gave sight to two people who were blind; for one who was mute, he enabled him to speak; he brought a young girl back to life; he cured the woman who was haemorrhaging. He cured every kind of ailment and disease. His words heal the spirit, his touch heals the body. The two actions go together. It is useless to speak and to do nothing. Our mission in following the healing ministry of Christ is to be an approachable source of healing, because we go out to the sick, we help them to health in all its dimensions: physical, mental, emotional, social and spiritual.

The story of the healing of the leper is told through a crisp, economic dialogue: "If you will, you can make me clean", the leper said. "I do will it; be clean", Jesus answers, reaching out his hand he touched him and healed him of leprosy. (Mark 1:40-42) There is a movement: first a request, then the response stated with feeling; then Jesus reaches out and heals; because of this the former leprous person can be re-integrated into society. Christ is the hand, touching humanity. Through your roles in this service, you are that hand of Christ. Your mission is to bring the healing ministry of Christ to all whom you serve, to bring physical, mental, emotional, social, spiritual healing. Often the sick also suffer loneliness, poverty and marginalisation, and long to be re-integrated into society.

Throughout the Old Testament we are presented with a consistent test of the authenticity of our faith: how we treat the widows, the orphans, and the strangers in our land (See Isaiah 1:16,17; Jeremiah 7:5,6). Luke's gospel, with great clarity and compassion constantly returns to that theme of God's preferential love of the materially poor.

Clearly many of you have considerable opportunities to meet the poor through the daily experiences of your institutions. We saw examples of your work in the film Sea Crossings. You run diabetes education for indigenous people; HIV/AIDS services; psychiatric care for the de-institutionalised and homeless; home help services for the elderly; training in third world countries; public policy; support for the Asylum Seekers Centre and refugee health; free service to The Way and Corpus Christi, drug and alcohol counselling. Certainly a great number of your workers seek employment with the Sisters of Charity precisely because they share the concerns expressed and represented by your mission.

My own knowledge of the health ministries is limited. Instead my reflections are informed by two sets of experiences. First, for about 20 years I was engaged in the Jesuit Refugee Service, which is at work in face to face service of refugees in over 50 countries. Second, in my current role as Australian leader of an international religious congregation I am learning how to seek partnership in mission with those who are ready to share the same mission. Our mission, like yours a mission of the Church, is to seek a faith that does justice, to serve where the needs are greatest.

With the Jesuit Refugee Service, I was in many front line situations, such as with the Vietnamese boat people, with Cambodian refugees, then in Ethiopia, Liberia, Rwanda, Bosnia, Somalia, and Colombia. Our workers, who came from all across the world, accompanied the refugees, and inevitably this led them to experience a change of heart. In this experience, we Jesuits learned a new methodology for guiding our responses to those who suffer poverty and injustice. During the seventies as a religious body, we had undertaken a strong commitment for "a faith that does justice". Some wonderful initiatives were taken. Perhaps because of our training, however, many communities remained at the discussion stage, endlessly arguing with one another about definitions of poverty, or the precise meanings of justice. By contrast, the initiative of Fr Pedro Arrupe, our Superior General who launched the Jesuit Refugee Service in 1980, drew many of us into direct contact with refugees. We were not too distracted by ideological disputes in a world divided ideologically between left and right. We were moved instead by the refugees themselves, by our contact with and service among them. That moved us to reflect on why they suffered such injustice, to analyse the causes and to seek appropriate responses.

On one occasion in Burundi, planning our programs among the internally displaced people, with several companions I visited a rural hospital full to overflowing with the victims of recent attacks. Hundreds, perhaps thousands of village people were being tended by about four local sisters, who of course organised the people to help one another. In one bed I met a young woman whose Achilles tendons had been cut. In this way the attackers prevented their victims from running away, so that they could come back and kill all with machetes. This beautiful young woman had escaped that finality, but she was now crippled for the rest of her life. The story is ghastly, but I only tell it in order to give you some sense of my anger, and of the feelings of our whole team, and of our consequent resolve. We felt what Jesus must have felt when he was moved to ask his Father for the power to achieve a miracle. Moved by what we saw, we set up a base in Burundi for our work in Central Africa which still continues.

Controversy about definitions of poverty does not necessarily lead us to know the poor. Your workers know what poverty is because they know the poor. You cannot doubt the experience of a person whose wounds you dress. If we wish to serve the poor, we must meet them and know them. If we allow the poor to touch our hearts, there is no end to what we will undertake together with them and for them. "The memory is always under orders from the heart", said Antoine de Rivarol. The Holy Father in his recent Encyclical, "God is Love" asks that those engaged in the charitable work of the Church receive, in addition to their professional training, a "formation of the heart". He speaks of a "heart which sees" where love is needed and acts accordingly. Without that formation, let us not claim that our mission is to serve the poor.

The second personal experience out of which I speak is as the leader of a religious congregation today. Our choice as religious is this: do we accept our falling numbers and gradually die out, or do we believe in our mission and find a way to pursue it? Our view is that there are many needs today, and for that reason we are still on mission. We are called to serve, so we continue until that vocation is fulfilled in the Kingdom of God. There are many religious who don't plan to die out. The reason we can continue, however, is because there are many lay people, like you, who are willing to share in that mission. More importantly, you are ready to assume leadership according to your own vocations as lay people. Further, religious are more ready and open to enter into partnerships today in order to continue the services of others that we discern to be urgent and needed. In our complex world many skills are needed to deliver effective service. We may have started this collaboration because our numbers were declining. But we continue it now because we have learned the rich benefits that flow from our complementarity roles.

The Sisters of Charity Health Service mission to serve the poor is inspired by the mission of the Sisters of Charity. The Sisters take a vow of poverty. They embrace poverty, because they follow Christ poor, because they give without expecting return, and because it leaves them free. The norm for the Sisters in choosing where they work is not the interest they have in that place, or the benefit it will bring them. Their poverty enables them to enter a work of service without calculation, reservation, self interest, or expectation of thanks. You lay members of the Sisters of Charity Health Service are not under a vow of poverty. But can you see the value of this partnership. You each bring extraordinary riches to the perception and understanding of a common mission.

For us religious, your role as lay persons in that partnership is essential. A newly discovered role for religious today is to help the leadership of lay persons in the Church to grow. All of our institutions are devoted to a single mission, the healing ministry of Christ, which implies a service of the poor. Whoever has a position of responsibility in that organisation will be judged on his or her effectiveness in fulling that mission. Any CEO in the Sisters of Charity Health Service, therefore, whether lay or religious, must also be a "mission leader".

Clear governance structures enable us to focus our mission and so to work effectively. Further, clear governance arrangements will protect us so that we can be free of excessive government intervention and so continue to implement our mission. You more than anyone are aware that in their relationships with government today, not-for-profits need clear institutional accountability.

The Church is institutional. What a surprise! That is how we have purchase in society. Yet if the Church's institutions are indistinguishable from other services in the market, what is the point? Nonetheless, institutions have their own logic too. With size and sophistication comes caution. Yet with ministry comes risk. Therefore the challenge is to structure our governance in a way that retains the freedom which mission requires. For this leadership is important.

Books have been written about what you are trying to do, namely to blend the best practice of corporate governance with the traditions of religious congregations. The attempts of the Jesuits in this area have been described by author Chris Lowney in the book Heroic Leadership. [1] Lowney, re-interpreting traditional religious language, speaks of four core leadership pillars: Self-awareness, Ingenuity, Love, and Heroism. He defines each of these as follows. Self-awareness: understanding your strengths, weaknesses, values and worldview. Ingenuity: confidently innovate and adapt to a changing world. Love: Engage others with a positive attitude that unlocks their potential. Heroism: Energise yourself and others with heroic ambitions and a passion for excellence.

A recent study [2] by the Australian Catholic University on socially responsible indicators for Church organisations addressed matters analogous to what you are facing today. The study looked at how such organisations have made their mission a lived reality, and how they address the tensions that arise from priorities and values that conflict with the organisation's mission and values. For making the mission a reality, the study proposes four strategies:

  • Make values and quality central priorities
  • Develop an inclusive culture
  • Commit to rights, responsibilities and empowerment
  • Develop a critically reflective organisation.

The study identified the following as the most common tensions:

  • commitment to those in need versus the commitment to financial sustainability
  • mission values versus the industrial paradigm of work
  • mission versus government policies
  • competition versus cooperation
  • delivery of quality services versus financial accountability
  • individual interests versus community interests
  • social needs of clients versus requirements of a business case

In its conclusion the study suggested seven key performance indicators which could help an organisation and its leaders to reflect a socially responsible role. These are:

  • The vision and mission are focussed and owned by all.
  • A culture of service, caring and trust as key motivating values.
  • The organisation is a learning organisation, and this is valued, supported, affirmed by its members.
  • There is shared leadership and responsibility.
  • Justice and equity underpin all policies and practices.
  • Stewardship: resources are obtained ethically and allocated wisely.
  • There is strategic and creative leadership.

You have clearly already absorbed such approaches in many of your organisations, for example in the Sisters of Charity and Holy Spirit Health Services report, outlining "Performance areas for mission in 2006—2008", I noticed the following goals or performance indicators:

Proclaiming our mission: Goals:

  1. Facilities ...(are) clearly recognised as part of the healing ministry of the Catholic Church and are identified with our founding heritage.

  2. Work with others to provide the best possible care to the community within the resources available to us.

  3. Service of the poor and marginalised/ working for the common good: Understand and are committed to the needs of the poor and marginalised.

  4. Stewardship and good governance ...

In many ways you have incorporated the five core values proclaimed on your website: compassion, justice, human dignity, excellence, unity.

In your Social Accountability and Community Benefit Report, I found the following statement:

"In exercising our stewardship of resources with which we have been entrusted, we are held social accountable. One of the ways we are accountable is to organise our facilities to benefit our communities. We do this not only with the benefits directed primarily to care for the poor, but also with benefits to the broader community. In doing this, we fulfil our mission." National Director of Mission Report 2004.

Those who have come closest to poverty are often the most reticent to talk about it. If you know how terrible are the lives of the poor, often without hope, with a daily, relentless violence, boredom, insecurity, dependence, then our conversation can sometimes seem empty rhetoric. Moreover poverty from one society to another, in different economies, is quite a different reality. You speak today principally of your service among the poor within Australia. As you plan for this, you will surely be led to develop your strategy of service in other places of need around the world.

Jim Wolfensohn, the Australian who then led the World Bank, spoke on a visit here in 2004 about how the world responds to poverty and inequality. He was referring to certain practices in Australia (in particular to the policy of closing borders as inadequate to the present and most certainly to the future). What he said could well be taken as a warning to us also. He said: "The way the world is dealing with problems of poverty and peace seem to be disconnected... If you cannot deal with the question of hope or economic security, there is no way that with military expenditure you can have peace."

Cardinal Murphy O'Connor gave a similar explicit message: "Our greatest challenge at the beginning of the 21st century is poverty. Our greatest debt is the debt to our brothers and sisters ...(who are poor). Our greatest hope is our common humanity and solidarity. And our greatest strength is our commitment to work together. I would like to think we can all take that message back to our communities, our institutions and our Governments..."

Benedict XVI, quoting Pope Gregory the Great, reminds us: "When we attend to the needs of those in want, we give them what is theirs, not ours. More than performing works of mercy, we are paying a debt of justice".

The film portraying your service of the poor was entitled "Sea Crossings". This morning Sr Elizabeth Dodds spoke of her "bridge crossing". I had contemplated calling this talk "Beach Crossings" [3], borrowing from the title of a book by historical anthropologist, Greg Dening. Professor Dening takes beaches as a metaphor for living on the edges, for what happened before and what will happen after, for the place between arriving and departing, a place of crossings. Many places within your institutions have that feeling. You are constantly meeting people who have come to a limit in their lives. They have only just made it to Emergency, or they have just been informed of their terminal condition. Like those who are poor, they do not elect to be there. Many of the people whom you serve have never been elsewhere but at the edges, and that is where you have to go in order to meet them.

You make your plans, three year and five year plans. But as Eugène Ionesco said, "You can only predict things after they have happened". So let us get in and make them happen. When you engage with the poor, as you do so well, the world will be revealed in wholly new perspectives, the perspectives of "hearts that see".

May I wish you much encouragement on the path on which your brave chairman, Tony Killen, is now leading you. As John Henry Newman said, "Ten thousand difficulties do not make one doubt".

[1] Chris Lowney, Heroic Leadership, Best practices from a 450-year old company that changed the world, Loyola Press, Chicago, 2003.

[2] Socially Responsible Indicators: A Framework for Action for Service Organisations, 2005. Undertaken by the Flagship for Creative & Authentic Leadership in association with the School of Education NSW, ACU, Strathfield Mount St Mary Campus, PO Box 2002, Strathfield NSW 2135.

[3] Beach Crossings, Greg Dening, The Miegunyah Press, Melbourne, 2004.

Mark Raper SJ AM is Provincial of the Australian Jesuits. He worked for twenty years with refugees, serving as International Director of Jesuit Refugee Service from 1990 to 2000.

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