What Motivates Health Care Workers?

A student's view of Makarere University, the largest and oldest post-secondary educational institution in Uganda. 

I walked home from school today with a 19-year-old biomedical studies student. He wanted to take the shuttle because he doesn’t like walking home through the slum, but I told him I like walking, so he walked with me. He’s a private sponsor, meaning his high school grades weren’t good enough to get government sponsorship, and his family has enough money to send him anyway. Most of the students, 85 of the 118 medical students, are government sponsored, and they’re ecstatic to be here, because it wasn’t guaranteed. The private sponsors typically, but not always, act like American teenagers in college, because it was more or less a given for them.

As we walked home, he asked me why I’m studying from here, as most people do. I told him because I have friends in East Africa who need a good doctor. He said most all of them would give anything to study from the States, that the opportunity to make money is the most important thing. Last week, I realized for the first time that these students were here to make money, to secure their future by getting into a profitable profession. I honestly hadn’t considered it until the teacher asked the class why they were here, and they all answered, to make money. They all kind of chuckled when I said I wasn’t. That’s never been my motivation to work in the medical field. But, I’ve also never lived in Uganda, where poverty is rampant and economic sustainability is scarce. But I also know the power of sin (Rom. 3.9) that makes people think that they have no other option other than the one that seems to enslave their present. But I know the Lord Jesus Christ, who gave himself to set us free from the power of our present evil age (Gal. 1.3-4). Life as it is currently doesn’t have to be the only reality.

For people in this country, money is the answer. My new friend made that very clear to me. I tried to give him a more accurate picture of America than he was imagining. I described the loneliness, the lack of community, the depression, and the self-induced disease that countless Americans experience. I told him that having everything he’d ever hope to have doesn’t make them happy. I told him that he serves money, and human beings who serve money aren’t happy. They’re greedy and selfish, and unhappy. He said there’s no hope for Uganda, that it just keeps getting worse and worse, that there’s no point in trying to do something I have no power to do. I told him that he’s doing exactly what the powerful men in their high places want him to do, to serve himself, to keep his eyes closed, just like they did to get where they are. I told him that such hopelessness and faithlessness is the reason why Mulago is in the shape it is in, and Uganda, and America.

With tears in my eyes, I told him that I don’t want to live in a world like that, and I’m looking forward to a new reality, not one that doesn’t wait on tomorrow’s politicians, but starts today in the decisions I make to love people and serve people, not money, not myself. He told me that there aren’t many people like me. I told him that I know. He told me that it’s not worth it. I told him that it is. He told me that I’ll need some money, and I agreed. I’ll need to make a living, but I won’t serve it. And I won’t rob people. And I won’t keep what I don’t need. And I won’t keep what someone else needs. He asked me what if I fail. I told him that I won’t. He asked me if I believed in myself, and I told him I believe in God. I told him, just wait, you’ll see, and if you don’t, your children will, because better days are coming, because God is still hoping.

When I returned to my room, I wept and cried out to God, saddened by the state of our world, which is lost in mindless self-service, and I was also burdened by the fact that God needs us, badly. Not even this young boy, who grew up in Uganda, who has walked and continues to walk by poverty-stricken people daily, can see. His solution is in his future hoped-for income. But my solution, our solution, God’s solution is in this present moment when we choose to have faith enough to love our neighbor. I loved this boy whom I talked to today, I loved him so much, and I’m gonna love him next time we talk. I look forward to it, because for now, this is my job, to be myself when conversations arise, and tell the truth.