Christianity Today July 22, 2026 6 min signal 2026-07-22

Where do mission hospitals fit in the 21st century?

Archived text mirror, captured for personal reading when the Signal ran. Formatting is approximate — read the original at the source.

Christianity Today

July 22, 2026

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Mahyub Hamida / Pexels / Edits by CT

Mission hospitals were a remarkably successful strategy in 20th-century mission work, especially in Africa. A century ago, the average mission organization would find the highest-elevation spot it could in a region (to reduce the risk of malaria) and build a hospital, a school, and a church on that site. Over time, those places became thriving centers of evangelism and discipleship as missionaries taught and provided medical care in the name of Jesus. Mission hospitals even influenced the fields of global and public health through several key World Health Organization meetings.

Nowadays, though, mission hospitals are far less central to missions movements for a variety of reasons: They’re expensive, it is difficult to get enough medical missionaries to staff them, and they must compete with government or private institutions providing medical care. They’re also locked into particular physical locations, prone to mission drift, and susceptible to unhealthy dependency. Some Christians question whether mission hospitals are even worth supporting anymore and argue they should go the way of the pith helmet. Is there still a role for mission hospitals in the 21st century?

In some ways, mission hospitals have been too successful, replacing the work of whole indigenous denominations. As a result, mission agencies have (quite understandably) shifted their focus to unreached peoples around the world who have no witness in their cultures or languages. After all, fully established churches don’t need missionaries from the West to come tell them about Jesus anymore.

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By keeping up with modern medicine, mission hospital services have become much more expensive. A century ago, a Sunday school class in the US or UK could contribute its pennies to pay for gauze and penicillin. Nowadays, CT scans and joint-replacement surgeries are far more expensive to support, and the communities around these hospitals are still too poor to pay cash for everything they need. Paying for staff and keeping the lights on while ensuring that fees are within reach of their local communities is a Herculean task for many of these hospitals.

The mission organizations that started these hospitals can’t afford to keep funding them. Some mainline denominations that had massive missionary enterprises have even shut down their mission-sending arms. Local denominations are doing what they can to support the mission hospitals to which they’re tied, but these hospitals operate in extremely difficult financial environments, and sometimes the best their affiliated churches can do is advocate for them to get paid by government-run insurance schemes.

However, mission hospitals are still essential: For many communities, especially in rural areas, they are the only decent providers. One of the mission hospitals I worked at in rural Kenya had a government hospital nearby with fancy equipment, but patients had to buy their own IV fluids from the pharmacy next door. Often, health care workers assigned to that hospital worked instead at a much more expensive private hospital half an hour away. While services at the mission hospital weren’t free, people preferred going there because it provided quality care 24/7.

So where do mission hospitals fit in the 21st-century paradigm of missions? And should Western missionaries and donors still support them? Mission hospitals deserve continued support from Christians in wealthier countries because they serve two vital functions.

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The first is training indigenous medical missionaries to take the gospel to very difficult places. Some of the least-reached places in the world are difficult for Westerners to access, much less inhabit. Many of these places also need quality medical care. A white American who goes to work in a majority-Muslim city in sub-Saharan Africa immediately rouses suspicion and death threats, but national doctors can get their government salaries boosted just because they work in “hardship” areas. Foreign medical missionaries need expensive visas, intensive language training, and more—things that local professionals don’t have to worry about.

Programs like the Pan-African Academy of Christian Surgeons are already training Christian surgeons to preach and heal in Jesus’ name, but a hospital training surgeons needs capital, equipment, and faculty to provide quality education. My own work is focused on training family physicians, and we’ve already seen graduates from the program go out as missionaries within our first decade. Even short-term missionaries can support these hospitals, either by augmenting their staff capacity or by providing critical training.

The second vital role served by mission hospitals is providing leadership in their local health care contexts.

Recently, famed author Chimamanda Ngozi Adichie lost her son in what appears to be a tragic story of medical negligence, even though he was in an expensive private hospital. No amount of money can compensate for careless medical providers working in a broken health system. I’ve heard countless stories about this broken system, with private medical clinics in Africa often attempting to defraud patients with unnecessary treatment, and government hospitals providing ostensibly free care but with a bring-your-own-IV-fluid requirement.

Mission hospitals have the opportunity to stand in the gap, providing the highest-quality care possible at the most affordable price and demonstrating to a watching world what it looks like to attend to “the least of these.” Churches must be careful: Sadly, I’ve heard of some hostile takeovers where church leaders have seen local mission hospitals as piggy banks for their own designs. But as a century’s worth of explosive Christian growth is now in danger of losing ground to atheism and Islam, mission hospitals are still vital to the church’s witness around the world. As Dr. Perry Jansen recently observed for CT, “None of this happened in a vacuum, nor can it be created overnight.”

I’m grateful for organizations like MedSend and African Mission Healthcare that are supporting mission hospitals as they train the next generation of health care leaders around the world, and I’m also thankful for all the individual Christians who sacrifice to support these critical institutions. Mission hospitals in the 21st century will serve a different role in the kingdom of God than they did in the 20th, but it’s not time to write them off.

Matthew Loftus lives with his family in Kenya, where he teaches and practices family medicine at a mission hospital. His book Resisting Therapy Culture: The Dangers of Pop Psychology and How the Church Can Respond is forthcoming from InterVarsity Press.

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