Richard Smith: Why the faithless need to work with faith based organisations

richard_smith_2014Perhaps because Britain is a land of atheists, the British don’t understand the importance of faith based organisations as well as they should. Stephanie Ferguson, director of the International Council of Nurses’ Leadership for Change Programme and a member of the board of directors of the Catholic Medical Mission Board, urged the audience at the C3 breakfast seminar last week to reach out to faith based organisations.

Ferguson is exactly the kind of Holy Mary you’d welcome turning up if you were in the gutter. An African America from the South she made everybody at the seminar laugh while advancing her serious theme. She emphasised “not telling people what to do” and imitated somebody turning to a Holy Mary and saying “You’re not so happy. What’s Jesus done for you? We’d better get you some holy water.” Some people who work for faith based organisations don’t even know they are faith based, and when told, said Ferguson, respond with: “I wondered why Jesus was up on the wall.”

Three quarters of the people in the world are people of faith and often respond much better to religious leaders than to health or aid workers. Faith based organisations emphasise dignity, social justice, and hope and are often willing to go where other aid workers will not. They are not deterred by stigma and have played central roles in combatting HIV/AIDS, tuberculosis, and Ebola.

People of faith may also understand people and connect with them in a way that health workers may not. A woman in the audience described visiting a woman in Uganda with an Imam and discovering that she had five mosquito nets, none of which were being used to prevent malaria. The workers from NGOs had simply failed to communicate adequately with the woman, but the Imam could.

But faith based organisations can’t do everything themselves. They may lack technical skills. In the past they may have been reluctant to work with organisations that weren’t faith based, and the reluctance was mutual. Ferguson’s main message was the need to work together, sharing each other’s strengths and mitigating weaknesses.

You need patience, she warned, to work with faith based organisations. They often move slowly. “You want to get something done, and they say now it’s time to pray.”

One reason to work with faith based organisations, said Ferguson candidly, is that they have money. I was reminded of Don Berwick, the founder of the Institute for Healthcare Improvement, quoting a nun telling him “No margin, no mission.”

But a worry with faith based organisations is that they will push a particular agenda—like aversion to family planning—that will interfere with building health. Somebody asked Ferguson if she had the Pope’s number, and she answered “Actually I do.” I asked what she says to the Pope about family planning. She never uses the words “family planning” but talks instead about building strong families or developing the capacity of women. (I reflected that “family planning” does sound Orwellian and seem to leave little room for love and spontaneity.) Ferguson’s implication was that ways can be found to do what needs to be done. She emphasised too that the current Pope is a Jesuit, and the Jesuits have always been the leaders in working with the poor and the marginalised.

A convinced but spiritually inclined atheist, I arrived at the meeting knowing something of the work and power of faith based organisations, I left thinking that anybody who wants to promote global health needs to learn how to work effectively with faith based organisations.

Competing interest: RS is a trustee of C3 Collaborating for Health.

Richard Smith was the editor of The BMJ until 2004. He is now chair of the board of trustees of icddr,b [formerly International Centre for Diarrhoeal Disease Research, Bangladesh], and chair of the board of Patients Know Best. He is also a trustee of C3 Collaborating for Health.