Slate Article Re: Health Difficulties With Lds Missionaries

[Duncan]

Exactly.  A mission president who is among the top 10% in terms of correctly making medical triage decisions for missionaries is going to be very, very, different than one in the bottom 10%.  Everybody has anecdotes. Some are good, some are bad.  Some mission presidents do a good job at medical triage.  Other's do not.  The vast majority of mission presidents are well-meaning.  Not all are.  My wife swears that when she went to her mission president with a medical problem, the mission president responded, "I hate sister missionaries.  They are all too fragile and are all malingerers.  If it were up to me, I'd send them all home."  Professional care was denied.

 

In my opinion, missionaries shouldn't have to go to their religious leaders if they need medical help.  They should go to a doctor or nurse instead. 

 

The biggest problem might be that the missionary has no recourse if he disagrees with the mission president's medical decision to deny professional care. There is nobody to appeal the decision to.  Nobody from whom to get a second opinion.  As a religious obligation, the missionary is expected to follow the mission president's medical advice.  That's fine if the medical advice happens to be good, but the missionary should be able to get a second opinion from a competent professional without a religious leader serving as the gatekeeper.

 

 

I have a funny missionary story about an elder in my mission who was denied legal advice when someone was attempting to sue him, but he went beyond what the MP said and the situation got taken care of shall we say

[toon]

Reading through all the comments and Jana's article, it seems clear that much depends on the mission and the leadership. I think most are doing just fine, but I know that is not the case everywhere. It still seems very problematic to have a non-professional be the gatekeeper for medical care, and I can't imagine the rationale behind that policy.

 

 

My recollections from my mission in Guatemala in the mid-80s.

 

The vast majority of missionaries, especially those from the States, had varying degrees of intestinal disorders for the first several months of their missions.  To the point where for many it was a running joke, something you just lived with, but also something you would never complain seriously about.  There were some that had real serious issues, to the point of hospitalization, which in my is evidence that the mission to it seriously.  But the pressure was to suck it up as much as possible.  I can't say that this was anything coming from the mission president.  It very well may have just been a cultural thing among missionaries.  At no point, however, did we receive any guidance along the lines of "if you're sick, this is what you should do . . ."

 

Consistent with the above, there was a "suck it up" culture, to the point where when I had malaria, I never reported it to the mission office.  It was something that I just dealt with on my own, while trying to "work" as much a possible and feeling guilty for not being able to do so.

 

I don't believe there was any direct pressure to not seek medical care, nor was there ever in my knowledge any refusal of medical care.  But there was certainly a culture of sucking it up, to the point where it could have been dangerous.  In hindsight, seems like there could have been better communication from the mission president to missionaries about what to do in the event of an injury or illness, so that missionaries would feel more comfortable seeking help.

 

I'll admit that this is to some if not a large extent my skewed perspective and recollection from 30 years out.  I was also relatively introverted at the time and, for no reason that I could point to, intimidated by my mission president.  So that may explain my perceptions.

[jkwilliams]

As another anecdote, a missionary from a very poor family in Argentina had some moderate psychiatric issues throughout his mission, was totally ineffective as a missionary, and was a royal pain to everybody he came in contact with.  About half way through his mission he was diagnosed with a brain tumor.  The Church paid for his brain surgery in one of the best hospitals in Argentina, and then sent him home.  A leader in the mission office later told me, "his mission was to get his life saved."

 

I would guess that the church will pay for care during your mission, and will pay for it after you come home if you came home early because of the medical condition.  If you make it to the end of your mission like your wife did, there just isn't a number to call or a form to fill out to have the church help you get back to pre-mission health.  The Church might have a legal responsibility to pay for such things under worker's compensation law, but the returned missionary would probably have to be willing to sue the Church in order to get them to address such a responsibility.

What worries me is that some of the health issues she has now are possible symptoms of long-term damage from the Chagas disease. My health issues are pretty minor in comparison. We're obviously not going to sue the church, but if these issues are from the Chagas, then they are a direct result of her mission.

I should mention that her ward in Idaho loaned her the money to pay some of the medical bills, but her bishop told her he expected her to pay it back. So, she did.

[Analytics]

My recollections from my mission in Guatemala in the mid-80s.

 

The vast majority of missionaries, especially those from the States, had varying degrees of intestinal disorders for the first several months of their missions.  To the point where for many it was a running joke, something you just lived with, but also something you would never complain seriously about.  There were some that had real serious issues, to the point of hospitalization, which in my is evidence that the mission to it seriously.  But the pressure was to suck it up as much as possible.  I can't say that this was anything coming from the mission president.  It very well may have just been a cultural thing among missionaries.  At no point, however, did we receive any guidance along the lines of "if you're sick, this is what you should do . . ."

 

Consistent with the above, there was a "suck it up" culture, to the point where when I had malaria, I never reported it to the mission office.  It was something that I just dealt with on my own, while trying to "work" as much a possible and feeling guilty for not being able to do so.

 

I don't believe there was any direct pressure to not seek medical care, nor was there ever in my knowledge any refusal of medical care.  But there was certainly a culture of sucking it up, to the point where it could have been dangerous.  In hindsight, seems like there could have been better communication from the mission president to missionaries about what to do in the event of an injury or illness, so that missionaries would feel more comfortable seeking help.

 

I'll admit that this is to some if not a large extent my skewed perspective and recollection from 30 years out.  I was also relatively introverted at the time and, for no reason that I could point to, intimidated by my mission president.  So that may explain my perceptions.

 

The Church encourages the "suck it up" culture, and it's totally unfair to expect a missionary to go to the mission president for medical complaints.  In terms of caring about the well-being of the people serving, NASA makes a well-thought-out decision when they insist that astronauts in space have private, confidential conversations with a doctor on a daily basis.

 

If I were in charge of the health of 200 young Americans who were living in a third-world jungle for 2 years, I'd set them up with a doctor practicing in the area and would arrange mandatory physicals at the one month, three month, and six month marks, and then every six months thereafter. 

[toon]

We were sent a letter from the church along with the hospital bill after my son had several stitches on his forehead after an accident playing b-ball. But think the church would have paid had we not had insurance.

 

That seems cheap.

 

While I understand to some extent the desire to rely on insurance, shouldn't the Church be insuring or self-insuring for medical expenses of missionaries?  I would assume that this would be a given.

 

I understand it's volunteer work, essentially, so the comparison is not perfect, but if an employee gets hurt on the job, it's generally covered by workers' comp and not out of the employee's own pocket or by his or her insurance.  Since missionary work is 24/7, seems like most things should be covered.  (I understand possible exceptions for congenital or other issues, but isn't that in part why there's a physical before the missionary goes out.)

[jkwilliams]

My recollections from my mission in Guatemala in the mid-80s.

 

The vast majority of missionaries, especially those from the States, had varying degrees of intestinal disorders for the first several months of their missions.  To the point where for many it was a running joke, something you just lived with, but also something you would never complain seriously about.  There were some that had real serious issues, to the point of hospitalization, which in my is evidence that the mission to it seriously.  But the pressure was to suck it up as much as possible.  I can't say that this was anything coming from the mission president.  It very well may have just been a cultural thing among missionaries.  At no point, however, did we receive any guidance along the lines of "if you're sick, this is what you should do . . ."

 

Consistent with the above, there was a "suck it up" culture, to the point where when I had malaria, I never reported it to the mission office.  It was something that I just dealt with on my own, while trying to "work" as much a possible and feeling guilty for not being able to do so.

 

I don't believe there was any direct pressure to not seek medical care, nor was there ever in my knowledge any refusal of medical care.  But there was certainly a culture of sucking it up, to the point where it could have been dangerous.  In hindsight, seems like there could have been better communication from the mission president to missionaries about what to do in the event of an injury or illness, so that missionaries would feel more comfortable seeking help.

 

I'll admit that this is to some if not a large extent my skewed perspective and recollection from 30 years out.  I was also relatively introverted at the time and, for no reason that I could point to, intimidated by my mission president.  So that may explain my perceptions.

Yeah, that was pretty much how it was in my mission. We all had poor living conditions, most of us were sick a lot of the time, and we just sucked it up, as you put it. I think most people would stop working if they lost 30 lbs. in 2.5 months, especially if they were a little underweight to begin with. But I didn't stop working. I went to a doctor and got pills to kill the parasites, but I never stopped working.

[jkwilliams]

The Church encourages the "suck it up" culture, and it's totally unfair to expect a missionary to go to the mission president for medical complaints.  In terms of caring about the well-being of the people serving, NASA makes a well-thought-out decision when they insist that astronauts in space have private, confidential conversations with a doctor on a daily basis.

 

If I were in charge of the health of 200 young Americans who were living in a third-world jungle for 2 years, I'd set them up with a doctor practicing in the area and would arrange mandatory physicals at the one month, three month, and six month marks, and then every six months thereafter.

From what has been said in this thread, things are clearly better than when I was a missionary, but I still disagree completely with having to get permission from a non-professional before even seeing a doctor. A mother may have intuition about her children, but as much as I loved her, my mission president's wife wasn't my mother.

[toon]

The Church encourages the "suck it up" culture, and it's totally unfair to expect a missionary to go to the mission president for medical complaints.  In terms of caring about the well-being of the people serving, NASA makes a well-thought-out decision when they insist that astronauts in space have private, confidential conversations with a doctor on a daily basis.

 

If I were in charge of the health of 200 young Americans who were living in a third-world jungle for 2 years, I'd set them up with a doctor practicing in the area and would arrange mandatory physicals at the one month, three month, and six month marks, and then every six months thereafter. 

 

To be fair, I don't know that the Church encourages that culture, at least directly.  I'll agree that 30 years ago in my mission, it was the culture whether encouraged or not.  But to the extent that the culture exists, I think there should be an effort to disabuse missionaries of the notion.

 

The message should be, "If you're sick, let us know.  And there's nothing wrong with being sick.  In fact, the work is better served by having healthy missionaries, and we want to do whatever we can do to make sure you're healthy."

 

There used to be an attitude a few years back that if you want to excel at school or at work, you need to suck it up and go even if you're not feeling well.  Fortunately, many employers have realized that it's more in their interest for sick employees to stay home until they're healthy than show up to work.  (In our office, if someone comes in to work with a severe cold or the flu, the question is often "why are you here" followed by a " you need to go home."  And while this opens the door to abuse, the benefits still outweigh the costs of that potential abuse.

Edited October 16, 2015 by toon

[Analytics]

What worries me is that some of the health issues she has now are possible symptoms of long-term damage from the Chagas disease. My health issues are pretty minor in comparison. We're obviously not going to sue the church, but if these issues are from the Chagas, then they are a direct result of her mission.

I should mention that her ward in Idaho loaned her the money to pay some of the medical bills, but her bishop told her he expected her to pay it back. So, she did.

 

That sucks. 

 

My health insurance company has a pretty aggressive salvage and subrogation program, and frequently send me questionnaires about whether medical issues have been caused by third parties or might be covered by another insurance policy.  If I were in your shoes, I'd be inclined to tell them that Chagas that was acquired while serving as a Mormon missionary was the underlying cause. 

 

I wouldn't expect them to go after the Church if it's been 20 years, but if it were less than 5 years, I expect they would.  If the Church were faced with the long-term health costs of its missionaries, they might take better care of them.

[Analytics]

To be fair, I don't know that the Church encourages that culture, at least directly.  I'll agree that 30 years ago in my mission, it was the culture whether encouraged or not.  But to the extent that the culture exists, I think there should be an effort to disabuse missionaries of the notion.

 

The message should be, "If you're sick, let us know.  And there's nothing wrong with being sick.  In fact, the work is better served by having health missionaries, and we want to do whatever we can do to make sure you're healthy."

 

There used to be an attitude a few years back that if you want to excel at school or at work, you need to suck it up and go even if you're not feeling well.  Fortunately, many employers have realized that it's more in their interest for sick employees to stay home until they're health than show up to work.  (In our office, if someone comes in to work with a severe cold or the flu, the question is often "why are you here" followed by a " you need to go home."  And while this opens the door to abuse, the benefits still outweigh the costs of that potential abuse.

 

The Church does encourage that culture because it asks missionaries to go with medical problems to the guy who makes decisions about areas, companions, and leadership roles.  In general, human beings will be much more likely to have an honest and open conversation about their health with a trusted doctor in a private and confidential setting than with their boss.  When they are with their boss, people who want to do well will put on a smiley face, lick their wounds, and hide their scars.  That's totally fine and appropriate.  However, you should go to a trusted and competent advisor who isn't your boss for advice about medical care.  That's why it's illegal for an employer to see the EOBs of their employees.  That's why NASA arranges for mandatory private and confidential visits between astronauts and their physicians.  If NASA required astronauts to take their health concerns straight to the mission control leader and have him decide whether to bring in a doctor, that would be strongly encouraging a culture of "sucking it up."

[Scott Lloyd]

That seems cheap.

 

While I understand to some extent the desire to rely on insurance, shouldn't the Church be insuring or self-insuring for medical expenses of missionaries?  I would assume that this would be a given.

 

I understand it's volunteer work, essentially, so the comparison is not perfect, but if an employee gets hurt on the job, it's generally covered by workers' comp and not out of the employee's own pocket or by his or her insurance.  Since missionary work is 24/7, seems like most things should be covered.  (I understand possible exceptions for congenital or other issues, but isn't that in part why there's a physical before the missionary goes out.)

Missionaries and their families are expected to fund their food and other living expenses (I understand about trans-mission equalization and all, but I still have to make that $400 payment every month). I don't think it inconsistent to expect missionaries to provide their own health insurance as well. This is an offering of free-will service, not a job. Most missionaries and their families count it a privilege to provide it. In cases of hardship, relatives and friends of the missionary -- or even strangers who are Church members -- could and should step in and make up any shortfall.

[Scott Lloyd]

From what has been said in this thread, things are clearly better than when I was a missionary, but I still disagree completely with having to get permission from a non-professional before even seeing a doctor. A mother may have intuition about her children, but as much as I loved her, my mission president's wife wasn't my mother.

But a mission president's wife is called and set apart to the particular role she fills in the mission, which would include, I presume, providing advice on matters pertaining to health and seeking medical attention. She would thus be entitled to the inspiration and other spiritual gifts appertaining thereto.

 

When my second mission president and his wife arrived, she was very concerned about how thin I had gotten (I couldn't cinch my tie up without crinkling my shirt collar). My first companion was very penurious about how much money we spent for food, and I lost a lot of weight.

 

i have long suspected that Sister Oscarson influenced President Oscarson to have me transferred into the mission office, where the elders bought their food in bulk and thus generally ate better -- and where she could more easily keep an eye on me.

Edited October 16, 2015 by Scott Lloyd

[jkwilliams]

But a mission president's wife is called and set apart to the particular role she fills in the mission, which would include, I presume, providing advice on matters pertaining to health and seeking medical attention. She would thus be entitled to the inspiration and other spiritual gifts appertaining thereto.

Being entitled to something doesn't mean having or using it wisely. Trusting my children's health care to someone else's spiritual discernment is not a risk I would be willing to take.

Edited October 16, 2015 by jkwilliams

[toon]

Missionaries and their families are expected to fund their food and other living expenses (I understand about trans-mission equalization and all, but I still have to make that $400 payment every month). I don't think it inconsistent to expect missionaries to provide their own health insurance as well. This is an offering of free-will service, not a job. Most missionaries and their families count it a privilege to provide it. In cases of hardship, relatives and friends of the missionary -- or even strangers who are Church members -- could and should step in and make up any shortfall.

 

Seems shortsighted and cheap.

[jkwilliams]

Seems shortsighted and cheap.

Seems to me that if you are expected to pay your own medical bills, you shouldn't need to get permission to get healthcare.

[Walden]

I wonder why the Church doesn't have a medically trained professional handling the medical questions for the mission. I don't see how MPs' wives can have enough training to determine even what questions are appropriate to ask in a lot of cases. Young adults often have a belief in their own ability to endure most things physical and can downplay symptoms. Someone medically trained is more likely to be able to dig in deeper in these cases. I think it is great for the MPW to be there as a resource and support, but making medical decisions?

 

 

The article is over-the-top and does a slight-of-hand exchange of the exceptions versus the rules; it seems like some isolated cases were presented as the norm.

 

That being said, I am surprised that someone would question why an MP's wife has the qualifications to make medical decisions; this is the same church that has a member in every ward serving as the bishop for that ward, and a member of each Stake presiding as Stake President, and the overwhelmingly vast majority of them have absolutely no training in counseling, sociology, etc., and yet they are charged with counseling entire congregations and stakes.

 

An MP's wife is about as qualified to make medical decisions as the carpenter, businessman, dentist, etc. who is serving as the current bishop is in counseling individuals and families during times of crisis.    

[toon]

Seems to me that if you are expected to pay your own medical bills, you shouldn't need to get permission to get healthcare.

 

Exactly.  And that parents and missionaries, especially those sent to missions where there is a significant risk of illness, should be informed in advance of this expectation.

 

I'm currently working on a service project that requires the use of volunteers.  We ask the volunteers to sign waivers and require proof of insurance.  If they don't have insurance, there's an additional acknowledgment they sign.  Seems like if you're going to expect missionaries to assume all the health risks of a mission, especially when they're being sent into areas where those risks may be significant, there should be a similar notice and waiver.  I'll admit I don't know if that's the case.

[Stargazer]

That sucks. 

 

My health insurance company has a pretty aggressive salvage and subrogation program, and frequently send me questionnaires about whether medical issues have been caused by third parties or might be covered by another insurance policy.  If I were in your shoes, I'd be inclined to tell them that Chagas that was acquired while serving as a Mormon missionary was the underlying cause. 

 

I wouldn't expect them to go after the Church if it's been 20 years, but if it were less than 5 years, I expect they would.  If the Church were faced with the long-term health costs of its missionaries, they might take better care of them.

 

And oddly enough, I agree with Analytics on this issue. 

 

I do feel that the Church does share some responsibility for this, having placed her in harm's way in this regard.  I had been about to say "culpability", but that is far from appropriate, I feel.  The thing is, there is not now a preventive vaccine for Chagas, and the most effective preventative is to avoid being bitten by the insect that transmits it.  But if the Church had been aware of the danger 20 years ago, and had made sure that missionaries were aware of the danger, then she might have been able to get proper treatment (instead of the totally useless treatment she did get in Idaho when she was first affected) and thus had the disease taken care of in its early stages, when it is much easier to treat.

 

I do wonder how aware the Church is now about the danger?

[toon]

That being said, I am surprised that someone would question why an MP's wife has the qualifications to make medical decisions; this is the same church that has a member in every ward serving as the bishop for that ward, and a member of each Stake presiding as Stake President, and the overwhelmingly vast majority of them have absolutely no training in counseling, sociology, etc., and yet they are charged with counseling entire congregations and stakes.

 

I don't think the comparison is correct, at least to a large extent.

 

I think it's reasonable to have a bishop, stake president, etc., counsel a member or spiritual matters.  I would be less likely to defer to their counseling on other matters, such as marriage, finances, etc., except to the point that the counseling was limited to the spiritual aspects of those issues.  And, depending on the person's expertise, I would take with a grain of salt advise and counseling on medical and psychological issues, except when the advise was to see a qualified professional.  And I think most members feel the same way.

 

In other words, I think a MP's wife's opinion on medical matters is different that the typical counseling members get from a bishop or stake president.

[jkwilliams]

I don't think the comparison is correct, at least to a large extent.

I think it's reasonable to have a bishop, stake president, etc., counsel a member or spiritual matters. I would be less likely to defer to their counseling on other matters, such as marriage, finances, etc., except to the point that the counseling was limited to the spiritual aspects of those issues. And, depending on the person's expertise, I would take with a grain of salt advise and counseling on medical and psychological issues, except when the advise was to see a qualified professional. And I think most members feel the same way.

In other words, I think a MP's wife's opinion on medical matters is different that the typical counseling members get from a bishop or stake president.

I recall Elder Packer telling members not to go to their bishops for counsel.

[Scott Lloyd]

Being entitled to something doesn't mean having or using it wisely. Trusting my children's health care to someone else's spiritual discernment is not a risk I would be willing to take.

Well I don't buy this whole scenario anyway about not seeking medical attention on your mission without express permission. Never was a problem when and where I served.

 

Tell you what. I have a son soon to depart the MTC. If and when it becomes an issue with him, I'll let you know. For now, I'm not too worried.

[Scott Lloyd]

Seems shortsighted and cheap.

And expecting the Church to pay your health insurance seems like entitlement mentality to me. So there you are.

 

Why not have it buy your food and pay your rent as well?

Edited October 16, 2015 by Scott Lloyd

[jkwilliams]

Well I don't buy this whole scenario anyway about not seeking medical attention on your mission without express permission. Never was a problem when and where I served.

Tell you what. I have a son soon to depart the MTC. If and when it becomes an issue with him, I'll let you know. For now, I'm not too worried.

I thought someone had quoted the MP's handbook saying that was the policy.

[Scott Lloyd]

Seems to me that if you are expected to pay your own medical bills, you shouldn't need to get permission to get healthcare.

I don't disagree with this. Like I say, if I see it becoming a problem, I'll let you know.

[toon]

And expecting the Church to pay your health insurance seems like entitlement mentality to me. So there you are.

 

Why not buy your food and pay your rent as well?

 

Yep.  That entitlement mentality of young kids who give up 18 months to two years of their lives in 24/7 service, at their own expense.  Oh brother.