I have to say, I have become increasingly conflicted these days about missionary work. I find it very difficult to balance the good that is done when missionary workers are able to provide food, health care, housing, and training against the way they blithely go in trying to change the existing cultures.
The best meditation on this topic is Things Fall Apart by Chinua Achebe. (Barbara Kingsolver's Poisonwood Bible deals with similar themes but is not as balanced as Achebe's book.) What is so powerful about the book is that Achebe, in showing the conflict between the existing tribal culture and religion in Nigera and the christian missionaries and colonialists that come in, does not hide either side's flaws. However, as a reader, I definitely feel that something is lost when Christianity supplants the existing culture and beliefs. (I often feel the same way about Celtic culture and practices, which were also replaced by Christianity.)
On the other side of course is the immense good that is done by missionaries. I need only read an article like this about college football star Tim Tebow or think about the work my Dad's church does in Mozambique to realize that there are a lot of people doing amazing things in the name of religion.
For now, the way I have reconciled this debate in my head is that the good that is done outweighs the bad. But we do need to realize that each culture has its own inherent beauty, and all aid workers need to respect that. There should be policies that prevent groups from requiring conversion to receive help (although I do not think many groups stoop to this). This of course does nothing about the coercion that is inherent when aid is distributed by people with a religious goal. And that I do not have any solutions for - at least at the moment.
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