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医療宣教・医療伝道

途上国での医療プロジェクトに先行する形態としての ——

Medical Mission for "under-developed" area as Proto-type project of applied medical anthropology

池田光穂

"Medical missions is the term used for Christian missionary endeavors that involve the administration of medical treatment. As has been common among missionary efforts from the 18th to 20th centuries, medical missions often involves residents of the "Western world" traveling to locales within Africa, Asia, Eastern Europe, Latin America, or the Pacific Islands." -Medical missions.

Why did they participate?; "In the New Testament, Jesus Christ repeatedly calls for his disciples to heal the sick and serve the poor, but also for them to "make disciples of all nations". In striving to obey such commands, Western Christians have debated the nature of proper evangelism, often emphasizing either eschatological, or material realities within missionary efforts. Much of Euro-American Protestantism has emphasized Jesus' eschatological and soteriological statements in developing theologies that emphasize personal salvation over the provision of material needs. The origins of medical missions are found in a sort of fusion of these two perspectives."

Legacy of the Edinburgh Medical Missionary Society, (i) EMMS International, (ii) The Nazareth Trust.

Controversies in medical missions, 1) Orientalism in medical missions; 2) Science vs. spirituality; 3) Role of language in medical missions; 4) Social gospel vs. strict evangelism.

1) Orientalism in medical missions The historian David Hardiman identifies the lasting Orientalist impact of medical missionaries. "The image of the social and cultural malignancy of the 'Other' that was propagated and popularised by the missionaries continues to resonate in the West to this day."[8] The perceived superiority of Western medicine by missionaries perpetuated stereotypes that Western societies were the "gold standard" of civilization. Rationalized understandings of illness and healing were considered more sophisticated and informed than those of non-Enlightenment oriented cultures. Therefore, it was the duty of "informed", "rational", "civilized" Westerners, to bring such values to the rest of the world.
2) Science vs. spirituality For Western missionaries, the "Christianization" of a place often meant more than the conversion of its residents. Western, Modern ideologies were commonly imposed upon non-Western societies and the Christian message was conflated with Modern values. Among these values was a rationalized understanding of the cosmos, that seemingly necessitated skepticism about supernatural realities. Efforts to "modernize" or "civilize" went hand in hand with efforts to debunk what missionaries perceived as superstitious and mythological (i.e. irrational) understandings of health and healing.
3) Role of language in medical missions Walima Kalusa writes about medical missions in colonial Mwinilunga, Zambia, and illustrates the difficulties that western missionaries had in achieving their goals of transforming the moral understanding of Africans. Kalusa highlights missionaries’ dependence on the linguistic knowledge of Zambian medical auxiliaries as preventing such transformation. According to Kalusa, "European practitioners of medicine envisaged that vernacular translations [of medical terms] would be drained of 'pagan' connotations and loaded with Western notions of medicine and disease."[9] In the case of Mwinilunga, we see the western assumption that "universal truths" of sickness and disease would reveal themselves through the implementation of western means of healing. Such perspectives, however, dismiss the possibility of different understandings of illness and health. In Mwinilunga, local people attributed supernatural properties to Western medicine, much to the chagrin of missionaries to the area.
4) Social gospel vs. strict evangelism Within Christian communities there has been some debate regarding the role of evangelism within medical missions. As seen in the example of David Livingstone, who questioned efficacy of medical practice as a means of evangelism, it was not uncommon to separate healthcare and proclamation of the gospel as distinct means of obeying the commands of Christ. Hardiman identifies that, "... missionaries in the field became more and more involved in social work, and they often saw this as their authentic life mission. In the process, preaching became secondary."[10] As a result, missionaries commonly received criticism from fundamentalists for proclaiming a social gospel or a secular humanitarian agenda that undervalued the primacy of the conversion experience. Debates around these issues continue today.
Source
 https://en.wikipedia.org/wiki/Medical_missions


以下では、ウォルター・R・ランバス（関西学院大学 の創始者でアジアにおける医療宣教の第一人者）の『医療宣教：二重の任務』（原著は1920年；邦訳は2016年）をとりあげる。

Walter Russell Lambuth, 1854-1921

まずは本書の章立てからである（情報源：http: //www.kgup.jp/book/b220048.html）

■第４章志願者から宣教師へ：第４節「直面する諸問 題」

医療宣教師が直面する問題を、当該箇所では、６つの 点にわけて解説している。これは、現在でも、開発途上国の異文化の土地に赴く医療ミッション（宗教ではなく近代医療の）においてもつとに強調されるところ である。

１．言語の習得

２．現地人のものの見方を学ぶこと

３．医療宣教の動機を現地人に誤解されること

４．現地の設備の不備

５．仕事が苛烈であること

６．現地の習慣や宗教が近代医療の施術に障害になる こと。

この中で、もっとも興味深いことは、２．現地人のも のの観方を学ぶことのアドバイスであり、ランバスは、ダニエル・クロフォードの著作を引き合いにだし、アフリカ人の間での施術に対して、『黒人のことを考 える＝黒く考えること（Thinking Black）』が重要だと指摘し、自分のアジアでの経験を「黄色く考えた」と次のように記述している。

「現地人のものの見方を学ぶこと。現地人と外国人は その考え方において対極にある。数千年に渡って発達してきた慣習、民話、生活や思考の習慣。それらは異なった丈明を代表している。ダニエル・クローフォド （Daniel Crawford, 1870-1926）はそのすべてを、『黒い思考（Thinking Black）』というアフリカに関する著書のタイトルに要約している。それはまた、著者の中国における若い時期の経験からも実証することができる。私は痔 に苦しむ患者に砕いた氷を処方した。驚いたことに、翌日見せられたのは数オンスの砕かれたガラスであった。ガラスは患者のためのものであったが、幸いにも 家族は医師が戻って正確な用量を確認するのを待っていてくれた。彼らは「黄色く考えた」のだった。当時の中国中部では、これらのことばの発 音が同一であっ たので、砕かれたガラスを砕かれた氷として与えようとしたのも無理からぬことだったのであろう。また、現地の思考法のもとにある患者たちは、医薬品を、ボ ウル一杯一度に一度に服用しようとする習慣がある。強力な医薬品をグレイン単位（grain, 約0.065グラム）で、あるいは滴剤で処方することの危険性に気づかされる。引き返せ、全部が 一服で飲まれてしまうから」（邦訳、堀忠訳、p.116）。

"Learning the native view point. The native and the foreigner are at opposite poles in their thinking. They represent different civilizations-the growth of a .thousand years of custom, folk lore, habits of thought and of life. Mr. Dan Crawford* has summed it all up in the title of his book on Africa, " Thinking Black.” It might be illustrated by an experience of the writer early in his practice in China. He had prescribed crushed ice for a patient suffering from hemorrhage. To his amazement, on the following day, he was shown a couple of ounces of pounded glass. The glass was intended for the patient, but fortunately the family had awaited the doctor’s return to ascertain the exact dose. They were “ thinking yellow.” In Central China, in those days, they would as readily have thought of giving pounded glass as pounded ice, the sound of the words being similar. Again, patients under the native system have been in the habit of taking medicine a bowlful at a time. One soon learns the danger of prescribing powerful medicines by the drop or by the grain. Turn your back and all goes down at a single dose." (Lambuth 1920:93-94).

*Thinking black : 22 years without a break in the long grass of Central Africa / by D. Crawford, George H. Doran (1912)

これは、レヴィ＝ブリュル流の「未開人の思惟（mentalité primitive）」を、医療宣教師が現地の文化や言語を学ぶことを通して学ぶことを示唆している。

●曺貞恩『近代中国のプロテスタント医療伝道』研文 出版、2020年——2014年度に東京大学人文社会系研究科に提出した博士論文「近代中国におけるプロテスタント医療宣教の展開 : 中国医療伝道協会を中心に(1886-1932)」を修正・補完したもの

序論 　

一　研究史の整理と課題の設定 　

二　主な史料と本書の構成

第一章　医療と伝道の間 　

一　医療伝道とは何か 　

二　医療や教育活動における伝道 　

三　理想と現実 　

四 　医療宣教師から中国人へ

第二章　博医会から中華医学会へ 　

一　博医会の誕生 　

二　医療伝道団体から医学団体へ 　

三　中華医学会との協力 　

四　合併の要因

第三章　医療と教育活動からみた土着化 　

一　ミッション系病院の経済的な自立を求めて 　

二　医学教育をめぐる議論

第四章　医学用語翻訳活動 　

一　医学用語委員会 　

二　中国人との協力　 　

三　医療宣教師の用語翻訳活動に対する評価

第五章　医療宣教師と中国伝統医学 　

一　医療宣教師の中薬研究 　

二　中薬研究の目的 　

三　中国伝統医学に対する多様な観点 　

四　医療宣教師と中国人

結論　 　

一　博医会と医療伝道の土着化 　

二　土着化に対する医療宣教師の懸念 　

三　教会医事委員会の活動 　

四　韓国における教会医療伝道事業の土着化 　

五　医療伝道への評価

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