Religion and Global Health

by

Walter Bruchhausen

• LAST MODIFIED: 17 April 2025
• DOI: 10.1093/obo/9780197768723-0044

Introduction

Global health has developed into an umbrella term for many highly different international and national, governmental, as well as civil society, academic, and humanitarian activities that seek to improve health and health equity worldwide. For convenience and comparison, older activities, like international sanitary conferences, medicine in colonial territories, and medical development cooperation and international health, are taken as “global health avant la lettre” here. Considering the long “emancipation” of health care from religion, especially in the conflicts between scientific biomedicine and the Christian churches since the late eighteenth century, it might seem anachronistic to devote a whole article to religion and global health. Could and should a science- and evidence-based recent movement like global health not be studied without reference to old non-scientific concepts such as faith and belief? There are, however, several major reasons to include religion in a comprehensive perspective on global health, reasons that can serve for structuring the following bibliography at the same time. They include (1) Christian missionaries were among the first to globalize health care by transfer of staff and practices and partially also exchange. (2) In regions that had been either not colonized, not Christianized, or more colonized by indirect than direct rule, those authorities who wanted to introduce “Western” health care met with opposition from predominant religions and their involvement in health. (3) Due to its pioneering character and high degree of international organization, Christian engagement in health worldwide became influential in shaping health policies, not least at the level of the World Health Organization (WHO). (4) Faith-based organizations have played a major role in providing health care, especially in Africa. (5) Several founding and leading figures of humanitarian activities in global health are obviously motivated by their Christian or other religious convictions although they may regard their work not as, e.g., Christian charity but as an attitude to be expected from every human being. (6) From a global perspective, ample research work in anthropology and religious studies has demonstrated how central religious aspects are in issues of health and healing in most parts of the world. This bibliography does not cover all religious traditions equally. It does not do so, in part, because the origins of global health have been dominated by Christianized countries in Europe and the Americas. Thus, also prominent in the history of WHO are Christian figures, such as Mahler, Taylor, and Bryant, and nongovernmental organizations (NGOs), such as the Christian Medical Commission, that have no equivalents in other religious traditions. For the last two centuries in societies that distinguish between the religious and the secular, religious motivation is more easily discerned than in religiously dominated and defined societies. Furthermore, owing to earlier and more academic historiography in the above-mentioned countries, research literature on different religions and global health is unevenly available.

Christian Origins of Global Health

Even in world regions where the attempted expansion of Christianity remained largely unsuccessful, such as in China, Christian health facilities served as the starting point for health care beyond the previous national or regional confinement of concepts and practices. In other parts of the world, flourishing Christian mission hospitals increasingly collaborated with colonial states in establishing a health-care system based on what was still Western science and technology. Rapidly increasing globalization since the Early Modern period started mainly from countries where the leading religion was Christianity, which then dominated nearly all aspects of life. This revived a strong tradition of expanding the Christian faith by missionary activities in Late Antiquity and early medieval times, until its spread in southern and southeastern directions was halted by the rise of Islamic empires and expansion was restricted to Scandinavian and Slavic peoples. Whereas Christian missions in Late Antiquity had been often connected to faith healing by exorcism, modern missionaries also used products of European medical science for protection and treatment for themselves and their new congregations. Grundmann 2005 starts with a documentation that, even before colonial powers conquered territories in Asia and Africa during the nineteenth century, some Christian missions had launched first aid, nursing, and medical services that developed into important points for the globalization of health care. The first mission teams had experienced high mortality of expatriate staff in tropical regions, probably mainly due to malaria and dysentery for which they did not possess any semi-immunity. This led to the occasional inclusion of qualified medical and nursing staff as well as some preparatory courses in health protection for non-medical staff before departure. Only when tropical medicine and hygiene offered effective means to lower the incidence and lethality of these diseases did health care for missionary staff became a fixed part of Christian missions. There were, however, several conservative missionaries influenced by Christian inclinations toward naturopathy and a preference for remedies from God’s creation that rejected the results of secular, sometimes anti-religion-based arguments for medical science (Harrison, et al. 2009). Especially in China, Christian mission doctors even acquainted themselves with the medical traditions of the country, whereas in Africa the search was mainly for medicinal herbs used by local practitioners. Stirling 1947, Stirling 1977, and Stirling 1995 show in the author’s autobiographic notes how modest services offered by nurses often developed into health facilities that equaled or even surpassed those of the colonial administrations and experienced struggles for survival after political independence. Hardiman 2006 collects a broad range of studies on mission societies, hospitals, and their services in China and India as well as in eastern, southern, and western Africa. Schmid 2018 examines a mission hospital in colonial Ghana. Vaughan 1991 analyzes how, due to their life-long presence in foreign countries, medical missionaries made crucial and highly visible contributions to the construction and revision of such concepts as race, community, and culture. Hunt 1999 shows how, in a colonial region during the interwar period, mission health facilities served as major places for negotiations and hybridizations and as venues for middle figures that shaped the reception and adaptation of colonial imports.

• Grundmann, Christoffer H. Sent to Heal! Emergence and Development of Medical Missions. Lanham, MD: University Press of America, 2005.

  Based on a post-doctoral thesis in mission theology in Germany from 1992, translated into English, this study describes and analyses the origins and different strands of the medical missionary movement in the nineteenth century. It covers different world regions, institutions, and denominations with a focus on Africa and China as well as Protestant mission societies. The internal and external tensions between spreading the word and caring for the sick as well as those resulting from the increasing professionalization of the health services are analyzed.

• Hardiman, David, ed. Healing Bodies, Saving Souls: Medical Missions in Asia and Africa. Amsterdam: Rodopi, 2006.

  The papers in this volume from a conference at the University of Warwick in May–June 2002 are mainly based on mission archives and deal with conceptual as well as practical aspects; denominational, professional, and regional differences; and internal and external conflicts, including supernatural issues.

• Harrison, Mark, Helen M. Sweet, and Margaret Jones, eds. From Western Medicine to Global Medicine: The Hospital beyond the West. Hyderabad, India: Orient Black Swan, 2009.

  The volume of essays from a conference in Oxford includes case studies on missionary societies that established hospitals, among them British Anglicans and German Roman Catholics. They demonstrate the learning processes with regard to the integration of medical services and resulting tensions between respect for local customs, Christian doctrines, and medical “modernization.”

• Hunt, Nancy Rose. A Colonial Lexicon of Birth Ritual, Medicalization, and Mobility in the Congo. Durham, NC: Duke University Press, 1999.

  DOI: 10.2307/j.ctv11689mp

  Studying a Baptist mission in a colonial state, resulting in changes surrounding childbirth and so-called middle figures, the author in this unconventional book analyzes many developments of the interwar period. These examples include influences from different Christian denominations that contributed to a highly hybrid modernity. The study is extremely rich in materials from various archives as well as fieldwork and offers new perspectives on many well-known objects in and outside of health care, such as airplanes, bicycles, and forceps.

• Schmid, Pascal. Medicine, Faith and Politics in Agogo: A History of Health Care Delivery in Rural Ghana, ca. 1925 to 1980. Münster, Germany: Lit Verlag, 2018.

  Based on a doctoral dissertation at Basel University as an offshoot of the research project “A History of Health Systems in Africa: Swiss Mission Hospitals and Rural Health Delivery in the 20th Century,” this book compares cases in West and South Africa (Elim Hospital). It offers one of the most comprehensive histories of a (mission) hospital in rural Africa. It covers in a highly reflective and readable manner all aspects, including construction and development, staffing, local traditions, politics, health challenges and treatment options, outreach.

• Stirling, Leader. Bush Doctor: Being Letters from Leader Stirling, Tanganyika Territory. London: Parrett & Nives, 1947.

  Autobiographies of medical missionaries are important published sources for Christian health care in Africa and Asia. Initially Anglicanmission doctor Stirling describes his way into medical mission service in East Africa and the early experiences of establishing Christian health facilities, conflicts with the clerical missionaries and interactions with African staff and patients.

• Stirling, Leader. Tanzanian Doctor. Montreal: McGill-Queen’s University Press, 1977.

  DOI: 10.1515/9780773593930

  This enlarged and revised edition of the autobiography extends the story by accounting the time after his conversion to the Catholic church. This includes the building of further mission hospitals in other regions, and the struggles with the independent government for their survival as faith-based health facilities.

• Stirling, Leader. Come Over and Help Us: A Doctor in Africa. Dar es Salaam: AMREF Tanzania, 1995.

  This last edition of the Autobiography adds another 18 years, especially the experiences as white Christian minister of health in a multi-religious independent African government for five years.

• Vaughan, Megan. Curing Their Ills: Colonial Power and African Illness. Cambridge, UK: Cambridge University Press, 1991.

  A study of various, occasionally conflicting, constructions of Africa on issues of body, nature, social cohesion, and health care by European medical staff. The explanations for perceived differences to Europe on these issues shifted from environment to race and from there to culture. The book has a chapter on mission medicine in British Africa, mainly comparing and deconstructing accounts by medical missionaries themselves, including Stirling 1947, Stirling 1977, and Stirling 1995.