COGH - Dr KRis Prenger

• ​About LAMB
• Full Interview with Dr Kris

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LAMB serves the most vulnerable people in the communities of North West Bangladesh, providing accessible and high quality health care and development services, serving in the Spirit and name of Jesus. Treating the poorest of the poor, LAMB works toward integrated health - physical, social, emotional and spiritual health in fullness of life, পরিপূর্ণ জীবন, for all, irrespective of their ethnic grouping or religion. While it is a Christian organisation, half the staff are of other religions, as are more than 90% of the patients.
 
1.       Community health & development

• Empowering people for sustainable development
• Teaching for health promotion, disease prevention
• Training for community leaders overseeing local health systems
• Working to overcome cultural barriers and fears associated with hospital treatment
• Primary care
• Community midwifery, TB, rehab, adolescent health
• Case finding - identifying women and children at high risk
• Community chaplaincy
• Collaborating with the Government of Bangladesh to build capacity for a reliable, functional rural health system
• Facilitating discussions to prioritise local health issues, and then design and implement local initiatives to address them​

2.       LAMB hospital

• The 100 bed hospital has a team of ~200 staff, mainly Bangladeshi with a small number of long-serving expatriates and visiting doctors.
• Provides a continuity of care from village health work and community clinics
• Recognised as a postgraduate training institution for doctors

 
3.       Training centre

• Over 30 different courses in nursing, midwifery, primary health training
• Sustainable Leadership Programme

 
4.       LAMB English Medium School

• Around 130 students from preschool (age 4+) to O-level (certified by the Cambridge Assessment International Education)
• Enables local students from families without adequate resources to attend
• Supports families of LAMB staff so they can continue their work

 
5.       Advocacy and Research

• Analysis of routine data from LAMB hospital & community health branches for monitoring progress, providing strategic guidance
• Generating research addressing health and development problems in rural Bangladesh

 
How you can help:

• Volunteering
  • Short-term: 6 weeks - 2 years, Long-term: > 1 year
  • Medical team: doctors, allied health specialists (PT, OT, ST), pharmacists, health advisor
  • Teachers
  • Epidemiologists
  • Administrators
  • Civil engineer, construction project manager
  • Financial analyst
• Donations
  • Financial
    • LAMB works in one of the poorest areas of Bangladesh for people least able to care for themselves. ⅔ of inpatients need subsidies for their bills, and ⅓ cannot pay anything at all.
    • LAMB earns about 85% of its running costs, leaving 15% dependent on donations. We have to raise around US$300,000 every year
      • $150,000 goes into subsidising medical fees for the poorest patients.
      • LAMB school stipend fund
  • Non-financial
    • Provide high quality used/surplus equipment and help with its delivery and transportation
• Prayers
  • “LAMB is a Christian organisation, and we believe that prayer focuses our attention on God as the sustainer of our work and provider for all our needs. It is a great encouragement and support for staff at LAMB to know that people around the world are praying for us.”
• Awareness raising

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Read more on the website: https://www.lambproject.org/

1. Please can you tell us about your role in LAMB, and how it plays into the bigger picture of LAMB’s work?

As a Family Medicine specialist, I am a generalist, and this is reflected in being privileged to work in almost all the departments at LAMB!  I worked in the hospital clinically in OB-GYN, initially full time, but later only at nights and weekends after I transitioned to a ‘day job’ of Community Health.  That was my primary heart and passion: to work with the volunteers and staff who engage with local community groups.  It reflects how LAMB describes itself, as ‘Integrated Health and Development.’ The community work is ‘upstream’ in health promotion and prevention while the hospital is downstream, providing clinical care primarily for women and newborns.  I was part of the team to set up community clinics, in a country where hospital and doctor services are more highly valued than paramedics or midwives. So much of my work also was with the community leaders—through our Bangladesh development staff—to work on social change to value both the women themselves as well as the local midwives who were trained to care for them.  Our work has always been grounded in a desire to bring wholistic health. The elements of spiritual, physical, social, and emotional health are all expressed in work with those fearful of illness and death in the hospital, and those fearful of neglect and yet hopeful to become mothers of healthy children. It was a joy to share life with Bangladeshis.
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2. Can you share about your motivations for working in LAMB/global health in general?

When I was 13, I saw a movie about Jesus which brought him to life for me, and showed me he had obeyed his Father and died for me, so I knew that night I needed to give my life to him.  That same night I knew that if I ever went overseas to tell people about Jesus, I should be a doctor, to give practical help. Now I would articulate that as ‘wholistic health!’  As a medical student, I attended a conference where the speakers were some of the key architects of the World Health Organizations 1978 Alma Ata Declaration of ‘Health For All’ which laid out the core principles of Primary Health Care for the poorest. These included refocusing health systems to prioritize not just hospital care, but accessible equitable care available near where people live, and engaging communities in planning and implementing their health care.  I did an elective medical school rotation in Bangladesh, and knew from my experience there that I wanted to serve the underserved, in particular women, whose value was so dependent on their ability to have children.  The global inequities captured my heart, so I offered my part in seeking the justice God so earnestly desires for the poor wherever they live in the world.
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3. How did you prepare yourself to serve in a global mission? (Career-wise, financially, emotionally etc)

I went to the cheapest medical school I could find at the time!  Throughout training I have tried to keep expenses low and not accumulate much stuff.  I feel my family medicine training served me well in providing a broad perspective on health care needs throughout the lifespan of people. It also gave me a foundation to understanding the family and relational elements of social determinants of health. Post-residency, I worked through the Indian Health Service (USA) on the Navajo Reservation in New Mexico and was able to pay off med school debts there.  It was a great opportunity to continue to learn clinical and cross-cultural skills in a fascinating culture.   I did public health training at London School of Hygiene and Tropical Medicine because I wanted a direct engagement where there is a national health service. I wanted to understand more of how most of the world operates in a system so different from American health care financing.  

Emotionally and financially, I feel I worked hard to maintain friendships from various stages of life, and those friends became my supporters when I transitioned to career mission work.  I remained single, and God has given me gifts of contentment and good friendships with men and women—professionally and through church relationships.  My closest friendships combine the 2 (medical friends), but God calls interesting people to cross-cultural work—from many countries and into many contexts, and it has been my joy to know and have friends across the world.  Friends, relationships, have also been the cause of plenty of pain from misunderstandings of each others’ world view and gifts, but that is the context God calls us to as well—to demonstrate and be faithful in love and forgiveness.

4. How have you had to restructure or adjust your life around working for LAMB? What sacrifices did you have to make?

This is an interesting question—I feel my whole life has indeed been structured around planning and preparing for work at LAMB.  From the age of 13, basically I felt all (or at least most of) my choices were directed at preparations for eventual work overseas.  So there was never a different ‘structure’ to be ‘restructured.’  I sought people, groups, conferences, and training that would help prepare me.  When I chose breakout sessions at conferences, they were geared toward exactly the kind of questions you are asking here: how to prepare, how to be financially wise, how to grow spiritually in ways that would prepare me to reach out to and disciple people of other faith backgrounds. My biggest choices in preparation were whether to spend a year prior to departure for Bangladesh studying the Bible or public health or doing an OB fellowship.  I chose to study the Bible, as I felt that was where I needed to be the most solidly prepared for the life I would live.

Sacrifice is actually quite a hard word for most people I know called to mission, myself included.  Most of the time it is just obedience, with the inevitable grief and sadness of separation from people you love.  But it isn’t superhuman, though it is supernatural, to be compelled by a call.  I certainly missed my family and events like weddings.  Probably the biggest US event with world-wide impact that I missed being in the States for was 9/11, missing being part of the corporate grief.  However, I watched the towers fall in the apartment of a Bangladeshi Muslim colleague who cried right along with me, and I watched Bangladeshi Muslims line up to give blood in case it would be able to go to America to help the victims. That will forever be part of stories I can tell about Muslims to help people know people are people.

5. Can you share about how the experience has been for you? (Feel free to take this in any direction - personal growth, professional development, spiritual growth etc)
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One part of the experience in terms of community, relationships among foreigners and nationals has been both exhilarating but also exhausting.  There are so many things to learn about each other, and how our different views of the world help us see different aspects of God.  But we can also hurt each other deeply, and in a setting where it feels the stakes are ALWAYS high. Anything Christians do can impact how neighbors view Jesus and Christianity, so when we have different ideas we hold passionately about various things and what we should be doing, things get hard.  But Jesus calls us to live lives of love and forgiveness, so I came to see the ‘fishbowl’ element of my context as a good thing (where we live on an ‘old-school’ mission compound with hospital, housing, school, training center all on a 13 acre campus).

I learned so much about myself, how God gifted me and where the negative elements of some of those gifts also came to the fore.  Yet I learned to simplify simplify simplify my communication, my expectations of myself and others.  I learned to receive not just to give to Bangladeshis.  That the richest parts of relationships came from shared experiences of fun and shared grief. Always be ready to give an answer for the hope that is in you—but also be ready to sing and even dance at public events! 

I feel so much more a citizen of the world, in terms of my own pursuit of public health, and all that has meant in contact with many nations’ bilateral donor agencies (USAID, UKAid, JICA, CIDA, etc.) and the sincere people working there.  I have friends now on all continents except Antarctica, and I want to be able to gently and humbly offer different perspectives to those of friends, family, future colleagues here in the States.  I am thankful for experiences that were very much like being in a National Geographic article, and for knowing people who have lived through Afghanistan, through earthquakes in Nepal, civil wars, and lived to tell about it.  To know the amazing entrepreneurial spirit of Bangladeshis, the resilience of people, the hunger for peace and security is an amazing privilege.​

And finally, to know God and to make him known is the greatest purpose of our lives.  I believe I was called specifically in all my weaknesses and despite failures, to participate as a servant in bringing his Kingdom of freedom, love, power, and forgiveness to restore and reconcile us to Him, and to each other.  I now have a deeper understanding of the book of Job, and of Revelation as a book of worship where all the nations will life our voices together and sit at the marriage supper of the LAMB. Hallelujah!