Spreading Grace: Common Grace and Doctors Without Borders

One of the more distinctive doctrines of Reformed Christianity is that of common grace. Michael Horton defines it as “God’s bestowal of a variety of gifts and blessings on Christians and non-Christians alike, such as health, intelligence, friendship, vocation, family, government, art, science, etc. Common grace upholds fallen humanity, but it is not saving.”[1]

As a physician working in a secular environment, I daily see wonderfully gifted non-Christian colleagues who provide expert care and love. They seem in my eye to be making this a better world, and doing much of the work that should be the greater passion of the Church. God in His sovereignty can use anyone to advance His Kingdom and to spur His own. Although they would not endorse my explanation for their humanistic motivation and zeal which I so greatly admire, those in the international “movement” of Doctors without Borders (MSF) exemplify both the strengths and limitations of common grace. The Church of Jesus Christ has much to learn from MSF as warmly chronicled by famed sociologist Renee C. Fox in her social history, Doctors Without Borders: Humanitarian Quests, Impossible Dreams of Medicins Sans Frontieres (Johns Hopkins Press, 2014).

As a secular Jewish sociologist, Fox was inspired to investigate “the most crucial social and moral issues associated with health, illness, and medicine; the relationship of disease and sickness to poverty, inequality, and social injustice, and to human suffering associated with them.” When MSF was founded by a small group of French physicians and journalists in 1971, she was prompted to be both a sociologist and historian of the organization, standing at some distance, but coming close enough through periodic in depth studies along their 40+ year history to remain “strongly drawn” to their simultaneously realistic and idealistic way in which its members saw the world as it is-a world of suffering and injustice, …sickness and premature death and natural disasters while energetically refusing to let go of its vision of the world as it ought to be.”

Fox’s composition is an unfinished musical with overture and three acts. Its and MSF’s theme song is “The Impossible Dream” (music by Mich Leigh, lyrics by Joe Darion), from the 1965 smash Man of La Mancha. The Overture is a pathos-filled collection of email correspondence from care providers in the field, sharing their impressions and experiences. Fox catalogs and sorts the themes: Why am I doing this and what is this all about? Angst, anger, hope and limits of care, gifts, giving, and taking stock of what has or has not been accomplished are all discussed. Act 1 is about the conflicted beginnings of MSF as founders broke from the Red Cross in favor of temoignage, “witnessing” to the world abuse and atrocity instead of following a policy of quiet neutrality in the Biafra civil war. Since then the vision and mission has been to both provide excellent medical care and public health and speak out about the causes and effects. This has been difficult to fully achieve due to both internal and external opinions and conflicts regarding too much or not enough of either and exactly how they should be operationalized. Act 2 is the dubious distinction of MSF’s unexpected and ambiguous fame, specifically in receiving the Nobel Peace Prize in 1999. Act 3 describes the complex challenges of an organization that spans the globe and now attempts to care not only for acute emergencies such as Ebola (with appropriate distinction) but increasingly chronic conditions associated with severe social and political contest, such as HIV, drug resistant tuberculosis, and homelessness. The final chapter is yet to be written and could end in a number of ways.

International Christian para-church organizations like World Reformed Fellowship and the Church as a whole have much to learn from this book and MSF. All are comprised of flawed human beings who are made in the Image of God, trying their best to alleviate pain, suffering, and bring mercy and justice to a hurting world. As such, they face similar internal and external challenges and complexities from any and all of the following:

1) differing interpretations of doctrine, goals, mission, and means and  emphasis of execution;

2) top down versus bottom up, centralized versus decentralized, authoritarian versus lateral communication;

3) disparities and differences in resources, talents, strengths, and weaknesses among member branches;

4) the meaning of being “without borders” in a world still with profound walls and barriers;

5) meaning of donor, sender, indigenous, and other implementing roles, to include recipient in a world not only shrinking but transitioning in every what from the north and the west to the south and the east; and

6) balancing doing good works with proclaiming the truth of a Gospel that often is offensive.  

The church has struggled with these same issues in missions for almost 200 years and, like MSF, will continue to do so as people work within their own strength, if even with the passion and zeal of Don Quixote.

Many deep minor chords of foreboding music rumble in the background of Fox’s and MSF’s humanistic score. This is even heard in the very modestly hopeful tone of the final lines of “The Impossible Dream” that one man, striving with his last ounce of courage, though scorned and scar-covered can make the world a better place. Or maybe not, for the stars still are unreachable—unless.Ironically, in the same song, at its climax at the end of the third verse is the answer:                      

                  This is my quest, to follow that star…

                 To be willing to march into hell for a heavenly cause. The one scorned and scar-covered man who can and has made the dream possible is the one who in fact has marched into hell for a heavenly cause, Jesus of Nazareth, the Son of God. Humanism without faith in Christ’s crucifixion, burial, and resurrection has only false hope, since it is the hell of sin and demonic depravity which is the real enemy. The Church knows the heavenly cause and is empowered by Christ through the Holy Spirit with special saving grace of faith and weapons and gifts that will unequivocally make the dream a reality. 

The reality and telos of MSF’s goals will be eternal life with God in a new Kingdom on earth when Jesus returns. That grace and those spiritual weapons and gifts of faith will overcome conflict, growth pains, complexity and all challenges as God’s complete grace covers and redeems the entire earth as well as the stars.

Until that day, we who believe and hold the full and true hope will work alongside and even within providentially given organizations such as MSF who unbeknownst share in the Kingdom Quest. Even as Jesus commanded his disciples to pray for their enemies, so shall we pray for our allies:

Heavenly gracious, sovereign Father, thank you for raising up Doctors without Borders (MSF) to assist in building your Kingdom. We thank you that you created all of us in your Image to do good works and seek health, justice, and comfort with all of our strength, if even for motives we don’t understand. We especially thank you for those in MSF who have sacrificed their lives as caregivers and witnesses. Do grant them mercy. May MSF continue to grow and prosper, be infiltrated with your disciples as salt and light, and continue as well to be teacher and ally to the church, even if it does not endorse faith in you. Open their eyes to the meaning of their own theme song and give us all, disciple and not, your love to share with each other and a fallen world, to the fulfillment of your glory and honor, Amen.     

[1] Michael Horton, The Christian Faith: A Systematic Theology for Pilgrims on the Way,  Zondervan, 2011, p. 992.