Medical ministry and schools: Help or hindrance?

Can institutions contribute to the health and growth of the Church?

Author Malachi Makhubela has been associated with the Church of the Nazarene and its institutions in what is now Eswatini (formerly Swaziland) and the Eastern Transvaal (R.S.A.) for all his life. He attended Nazarene schools. Then, after two years in a public Teacher's College, he began teaching at the Manzini Nazarene High School. That school is part of a campus that includes a hospital, a nursing college, a teacher's training college, three elementary schools, and boarding facilities.

A Swazi church leader responds to a key question about church health and growth question out of his own experience in southern Africa

by Malachi Makhubela

The Church of the Nazarene began planting churches in what is now Eswatini about 1911 when Harmon Schmelzenbach arrived at Endzingeni (then named Peniel). Over the past century, the church has steadily grown, with that growth accelerating in some recent decades.

Among the ministries established by Nazarenes in Eswatini have been several educational institutions and healthcare facilities. In the past several years some missiologists and experts on the growth of the church have criticized such institutions as being a hindrance to church health and growth. I have, however, seen with my own eyes how instrumental institutions like a Bible college, a teacher training college, a hospital, clinics, a nursing college, elementary schools, high schools, and an orphanage have been in the salvation of souls and the verifiable growth of the church. Let me highlight some universally accepted church growth principles I have seen at work in Nazarene institutions in Eswatini.

Principle One: Churches grow as priority is given to effective evangelism.

The early converts in Eswatini were largely illiterate. So, literacy programs were started right away to enable them to read the Bible. The first school at Grace Church (Phophonyane) and the Bible school at Pigg's Peak were both established with this purpose in mind. Grace church grew because the first twenty students of the school were among the first to be won to Christ. They witnessed to their families and brought them and others to church. Then, the students and other converts of Grace Church under Etta Innes helped clear the grounds for a church building at Pigg's Peak in 1914. Our historians consider this the first truly African project of the church.

Further evidence that the institutions give priority to effective evangelism can be seen in the careful selection of teaching staffs, nurses, physicians, and others. A conscious effort is made to select only committed and dedicated Christians who will use their contact with people to evangelize and win them to Christ and the Church. This pivotal factor in selection has been true even in those institutions where the government is paying almost all the bills.

Another area of evangelistic strength to which institutions have contributed has been in the training of skilled Christian workers like nurses who serve not only in Nazarene clinics but also in government ones. Likewise, the teacher college sends out qualified Christian teachers whose witness has strengthened the church and contributed to its growth even in remote parts of the country. At the end of each year, school managers from all over Eswatini scramble to get graduating Nazarenes, underscoring the quality of our institutional products.

One of the most recent signs of the priority given to evangelism has been the schools' evangelism program that is run in all 34 Nazarene primary schools, the three high schools, and the teacher training college. An evangelist is appointed to conduct school revivals through the year. About 1,300 are converted to Christ each year in these revivals. Not all join the Church of the Nazarene, of course. Still, church membership and Sunday school attendance have shown percentage increases since the hiring of a school evangelist.

Principle Two: Churches grow as they recognize diverse needs and opportunities within the community to which they minister and seek to focus their message for maximum responsiveness.

As part of its cultural mandate,1 the Church must seek to meet the physical and social needs of the society in which it operates. To this end, the Eswatini Church of the Nazarene has established orphanages, health centers, and schools. William Greathouse once wrote: "Compassion lay at the heart of Christ's ministry. It was an authentic expression of holiness. . . but the church was reluctant to embrace this ministry as a basic element in its mission. There was lingering apprehension that such activity might dilute the primary emphasis on evangelism. . . It was perceived that somehow the two were mutually exclusive."

Early Nazarene workers in Eswatini realized, however, that when the church abandons certain areas of human life, a vacuum is created which will be filled in one way or another. Thus, people are left to find solutions from unchristian beliefs like witchcraft and spirit worship.

So, medical missions work was introduced by Nazarenes into Eswatini in 1917. Not long after that, a hospital was built in memory of Raleigh Fitkin, son of Nazarene missions promoter Susan N. Fitkin. In a recent year that hospital in Manzini treated 55,000 patients, while its fifteen clinics served 120,000 more. It also enrolled 121 nurses for training.

Dr. William Ruche of the School of Medicine at the University of Pittsburgh has said that there are no two fields more closely allied than those of medicine and religion. He asserted: "There is no profession in which the professional man sees his clients at deeply religious moments so often as in the practice of medicine." This is because people in severe suffering or near death feel the need for religion. Our many medical workers have made their healing ministry a real effective vehicle for evangelism and church growth in Eswatini.

Even such need-meeting ministries like our orphanages and girls' homes have been important to the growth of the church. Out of them have come Spirit-filled evangelists, pastors, preachers' wives, and Christian laymen.

1The cultural mandate is humanity's stewardship obligation to care for the earth God has entrusted to it (Gen. 1:26-28). The cultural mandate is complementary to the evangelistic mandate.

Principle Three: Churches grow as they reproduce themselves through intentional parenthood.

Many waysides or preaching points in Eswatini which later became churches were started because someone who was reached by the institutions was followed up and he/she invited the church to come and start a work in their area. In some instances, these people themselves took the lead in starting a congregation as they began to witness for Christ.

Institutional workers, including students, are used in visiting, teaching Sunday school, preaching or interpreting for a missionary at outstation/preaching points. Missionary workers in institutional work often provide the transport to these preaching points which can be up to 20 miles from the mission stations. The church at Manzini (Sharpe Memorial Church) has been blessed with the largest amount of institutional work nearby. By utilizing the resources of these institutions, that church has been able to daughter 15 organized churches in the past two decades. Currently, it is nurturing seven more waysides and extension works. It has more than 500 members with a thousand enrolled in Sunday school.

In a recent year, the Eswatini Northern District had 595 "institutional workers," 41 ordained pastors, and 38 licensed ministers. These institutional workers have positively influenced Nazarene church growth in Eswatini. They are potentially capable of impacting church growth even more.

Principle Four: Churches grow as they concentrate upon receptive peoples.

People reached through the institutions come from diverse backgrounds. The Swazis are thirsty and hungry for truth and reality in their lives. Traditional beliefs in witchcraft, ancestral spirits, and demons have failed to satisfy their cravings. Such beliefs are also losing face because of the encroachment of a modern scientific worldview. This all makes them receptive to the Gospel.

The large number of applications to enter our Nazarene schools each year is evidence that many want their children exposed to Christian influences. These are "winnable people,' as A.R. Tippett put it.

Nazarene school evangelist Grace Masilela is a converted witch doctor and former prophetess of the cultic Zionist movement. She is a powerful witness of how Christ broke the bonds of demons in her life. Her personal experience has been convincing to young people from similar backgrounds. Many go back home to tell the story of Christ to their relatives.

Indeed, people who are sick, unsettled, illiterate, and seeking knowledge, and craving for meaning and answers to the ultimate questions of life are receptive to the Gospel of Christ. Such are most of the Swazi people who come to seek services offered by Nazarene institutions. Those seeking services have even included refugees from Mozambique.

In a recent decade, Eswatini Nazarene churches had an Average Annual Growth Rate of 5.76% and a Decadal Growth Rate of 74%. By global church growth assessment standards, that is good growth. This growth pattern has been more pronounced after some leadership changes.

I'm convinced that our institutions and the carefully selected Christian workers who staff them will continue to play an important part in Nazarene church growth in Eswatini. May God forbid that it be otherwise.


As Malachi Makhubela notes, providing social services and giving humanitarian aid can benefit a church in several ways:

You might also like these