Ted Lankester is one of the founding members of Thrive Worldwide as well as the Co-founder of Arukah Network. Prior to that he founded InterHealth, an organisation dedicated to providing health care, travel medicine and psychosocial support to missionaries and humanitarian workers, especially those working in difficult and dangerous parts of the world. He is also one of the early pioneers in community health. He is the part- author and editor of the upcoming book, Setting up Community Health Programmes in Low and Middle-Income Countries. This will be available later in 2018, open access from Oxford University Press. Ted and the 20 co-authors will distil the best thinking and practice in various aspects of community health.
Ted began his career as a family doctor the UK and then spent 7 years working in remote Himalayan communities funded by his church, Tearfund and the UK government. Ted also practises as a doctor with a special interest in travel medicine and the health care of leaders, one day a week at a clinic in London as part of Thrive Worldwide.
Nanci: Ted, given your wide and varied career as an expert in community health and travel medicine, what prompted you to get involved in the start-up phase of yet another organization, Thrive Worldwide?
It’s actually quite simple. Having travelled lots, I have seen people doing incredible things, helping other people in terrible situations, but often neglecting their own health or not being cared for adequately by their own organizations. I enjoy caring for the carers. I know it’s a cliché term, but it’s crucial. I want to provide compassionate sensitive care, the best care I can give to those people who are putting their lives on the line, whether motivated by faith or humanitarian ideals. I want to work with people who are working in places like Syria and Yemen, DRC and Myanmar. I want to help them survive and re-thrive.. And to continue to do this I still have a lot to learn myself! ”
Nanci: What do you mean by re-thrive and how do you, as part of Thrive, facilitate that?
First let me say that people who go into these situations are already very resilient. They self-select, and they often have very strong survival mechanisms. Having said that, those who thrive, or re-thrive, are the ones who, after experiencing a difficult situation, are removed from that situation to a safe space where they rest and relax and get appropriate listening therapy.
I spent time with an individual recently who was working as a journalist in Iraq, reporting on a particular event. They had no equipment, the interpreter disappeared, and they were left with no support structure. What this person went through was dire. I never heard a story like that. That person has survived and re-thrived. They were already resilient, when they came home they took time out, came for some listening therapy and were helped to recover their self-belief and the passion in what they were doing.
Nanci: What is the golden thread in your life that brings all the different things you’ve been involved with over the years together from being a medical missionary, to developing community health clusters as part of Arukah Network, to Thrive.
Various things came together for me and coalesced into a real passion---whole person medicine.In other words caring for people in mind and emotions, body and spirit. For example, early in my medical career along with my wife, Joy, we drove a Land Rover out to Kathmandu and then worked in the Himalayan Kulu valley, in northwest India. We had a guru style Bible study for any world travellers (let’s call them hippies!) and we also provided medical care to international travellers with drug addictions as well as to local people from surrounding villages.
Later, because of my other passion to link up my new found faith with my medical career I spent a year at an Anglican Theological College, initially to see if I should become a vicar. However, I quickly realized I wasn’t cut out for that! During this year I did emergency night calls in and around Nottingham. I remember being called out to help someone who was having a heart attack By the time I arrived, I found a man sitting in a chair, dead, holding an encyclopaedia with his finger pointing to the word angina, at the very moment he had died.
As a doctor It’s a privilege (usually!) to enter people's’ lives and families. You are in a sacred space and it motivates you to do your best.”
Nanci: What do you see as the biggest issue for staff care in the humanitarian and mission space and how does this inform what kinds of things Thrive Worldwide will be doing going forward?
I like to talk about this in terms of working at the bottom of the cliff versus working at the top. Working at the bottom of the cliff involves caring for individuals who are suffering from physical and mental issues that are usually a consequence of their work. Working at the top of the cliff involves prevention---how, working together with organisations we can prevent things that cause ill health from occurring in the first place. Or if you like how we can keep Humpty Dumpty sitting firmly on the wall with with less danger of falling off.
At Thrive we aim to do both. We need to work at the bottom of the cliff to provide the services that organizations are currently asking for. But what we most need to do is to shift the emphasis to the top of the cliff. And of course we need to make links between both.
At the cliff bottom we want to encourage people to speak freely about the physical and psychological issues that they might be suffering from. In the humanitarian and mission worlds, the culture is typically that you need to be either macho - or that your faith is all you need. We want to assure people that you don’t have to pretend that you are okay. It’s normal. Most of us will not be okay some of the time. It’s okay to talk about mental health issues that you might be struggling with.
One of the main reasons people leave the field is not due to illness, but because of team issues. They can’t get along with their country director or a team member. There is always a reason people come home early so every time I see someone when they come back, I ask them two questions:
- What could you have done to prevent this—the illness or situation that caused you to come home early-- from happening?
- And then, ‘What didn’t happen—that or you, or others didn’t do --that could have prevented this problem. ‘ Besides not taking their antimalarial tablets, the most common answers have to do with organizational or team issues.
At the top of the cliff, we want to help mission and humanitarian organizations s identify and deal with these issues so that they can improve the health of their teams and strengthen their staff care programmes.
Nanci: Tell me more about the new edition of the book, Setting Up Community Health Programmes in Low and Middle-Income Countries, that’s going to be published by Oxford University Press this summer?
It’s basically a book on how to do community health at the grassroots level in low resource settings. The emphasis has always been about accompanying people, so they can learn to do things for themselves rather than us doing things for them.
The last version of the book was published in 2007 and it needed updating. The World Health Organization originally picked up the first version and included it in a hamper of 20 books on health when it first came out, which was surprising. I was a novice writer. We picked up principles of community health at that time by doing it from the ground up. We learnt from scratch.
The best thing about this new edition is that it will be available open access so that anyone can use it. Right now, we’re raising the money so that this can happen.
Nanci: Finally, what is your biggest hope and vision for Thrive.
First that Thrive as a new organisation Thrives!
And as it does, that we prevent as much ill health as possible. And that we provide the most relevant, compassionate and far sighted care that we can. Basically we want organisations and their members to thrive.