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Number 200 - September/October 2020
 Dear Friends,
As we move into September, COVID-19 is still with us. Many people experience fear and anxiety, and restrictions make life especially difficult for business owners, older people and those with underlying health conditions. At the same time we hear of the unstinting devotion of workers in the health sector, carers and families. Many people have found ways to respond creatively, developing new ways of keeping in touch, finding treatments and developing promising vaccines. MMMs and MMM Associates are among those finding new ways to cope in a variety of situations. With experience some are finding that 'a one size fits all' approach does not always work and we can learn from each other.
'Even if the last move did not succeed, the inner command says move again. Even if the hopes you started out with are dashed, hope has to be maintained' (Seamus Heaney).
International Day of Charity is marked on 5 September to honour the important work that charities do. The date is the anniversary of the death of Mother Teresa of Calcutta, who devoted her life to charity work.
World Suicide Prevention Day is marked on 10 September. Every year suicide is among the top 20 leading causes of death globally for people of all ages and millions of people are profoundly impacted by suicidal behaviour. This behaviour includes suicide as well as suicidal ideation and suicide attempts.
Suicide is the result of genetic, psychological, social and cultural and other risk factors, sometimes combined with experiences of trauma and loss, so people who take their own lives are a heterogeneous group, presenting challenges for prevention. A multilevel and cohesive approach is needed, with interventions at community and individual level, and social and policy reforms.
We can make a difference by educating ourselves and others about the causes and warning signs for suicide, and showing compassion and care for those in distress. We also need to question the stigma associated with suicide, suicidal behaviour and mental health problems.
International Day of Peace is on 21 September. Its website says that this yearâs theme is âShaping Peace Togetherâ. This day is devoted to strengthening the ideals of peace, by observing 24 hours of non-violence and cease-fire. Our common enemy is a now tireless virus that threatens our health, security and way of life.
In March 2020, UN Secretary-General AntĂłnio Guterres called on all warring parties to lay down their weapons and focus on the battle against COVID-19. Everyone is needed to win the fight against the worst public health crisis of our time. He asked if, at a time of ongoing conflicts, we can work together to deal with ânaturalâ disasters and a global health crisis, emerging stronger and better equipped - or will distrust and isolation grow further? âIn 2020 we must come together to discuss our priorities as a human family, and how we can build a better future for all.â
On 3 August, we heard the sad news of the passing of John Hume, a giant in the struggle for peace and justice. Perhaps we can take inspiration from Humeâs willingness to speak with whomever necessary to reach his goal of ending the violence fairly and peacefully and from his ideals of reconciliation.
International Day of Older Persons (UNIDOP) in marked on 1 October. According to its website, globally, there were 703 million persons aged 65 or over in 2019. The region of Eastern and South-Eastern Asia was home to the largest number of older persons (261 million), followed by Europe and Northern America (over 200 million).
Over the next three decades, the number of older persons worldwide is projected to more than double, reaching over 1.5 billion persons in 2050. The largest increase is projected to occur in Eastern and South-Eastern Asia. The fastest increase is expected in Northern Africa and Western Asia. The second fastest increase is projected for sub-Saharan Africa, where the population aged 65 and over could grow to 101 million. The increase is expected to be relatively small in the regions of Australia and New Zealand, Europe and Northern America, where the population is already significantly older than in other parts of the world.
It is important to recognize older personsâ contributions to their own health and the multiple roles they play in the preparedness and response phases of current and future pandemics. UNIDOP 2020 will highlight the contributions of the health care workforce to the health of older persons, especially recognizing the nursing profession, with a special focus on the role of women.
On 10 October we mark World Mental Health Day. Dr Ingrid Daniels, President of the World Federation for Mental Health, noted that the current global health emergency has impacted on the mental health of millions of people. With social distancing and restrictions as the world struggles to bring the virus under control and find solutions, anxiety, fear, uncertainty, feelings of isolation and emotional distress have become widespread
The current pandemic arose against an already poor global mental health reality. About 450 million people live with mental disorders that are among the leading causes of ill-health and disability worldwide (WHOâs World Health Report, 2001). Mental, neurological and substance use disorders exact a high toll on health outcomes (WHO, 2012). The World Economic Forum (2018) noted that mental health disorders are on the rise in every country and could cost the global economy up to $16 trillion between 2010 and 2030 if a collective failure to respond is not addressed.
Dr. Daniels said that this is âalso a time in which we can capitalise on the resilience displayed by individuals and communities who relaunched, regenerated and rediscovered themselves and their communities to be responsive during a time of crisis. [It is also] a time of great reflection and finding creative solutions and interventions to facilitate a mental health response in an emergency context despite social distancing or âlockdownâ.... It is therefore of great significance and importance that the theme for World Mental Health Day 2020 will be: Mental Health for All.â
A virtual presentation on human trafficking
The Association of Sisterhoods of Kenya asked Sister Mary OâMalley to participate in a virtual workshop on 8 August 2020 about her work with Counter Human Trafficking Trust-East Africa. Over 250 Sisters participated and the coordinator of Religious against Human Trafficking in Kenya, Sister Laura Pllanes, of the Daughters of Charity, also gave input. Their presentations were featured in the weekly communication of the Association of Members of Episcopal Conferences of East Africa (AMECEA) on 14 August.
The article about the workshop, by Sr. Jecinter Antoinette Okoth, FSSA, said that religious women were challenged to be at the forefront in fighting human trafficking. Sister Mary reminded the participants that âtraffickers devise new tricks all the timeâ so Sisters should be alert and well informed to help victims. She reinforced Sister Lauraâs words that human trafficking is a modern form of slavery and that Sisters need great courage to move forward. She cited root causes of human trafficking including an âenvironment of corruption and greed, ineffective legal institutions, poverty and the demand for purchased sex ... With the internet and modern communications the recruitment is swift and efficient.â
In this newsletter you can read stories of four more women marking fifty years of profession in MMM this year. An MMM contributed a story to 'Global Sistersâ Report' and another participated in a forum on international health. We also tell you about one of our graduates who received a special award. Thank you for your support, which has helped to make all these possible. We remember you and those dear to you in prayer each day.
Sister Carol Breslin, MMM
âLet's work together and build together, and as we do that, the real solution will begin...The real healing process will begin, and we will erode the distrust of the pastâ (John Hume).
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God's Designs Were Made Known.
 The 27 July 2020 edition of The Life, published by âGlobal Sistersâ Report', comprised articles by Sisters based in several countries on the theme âGodâs designs were made knownâ. Sister Sheila Campbell was a contributor. She was one of a panel of Sisters who wrote articles for The Life from 2019-2020 and these were the final articles by this panel. 'Global Sisters Report' thanked the group of Sisters who participated during this time.
 Sheila reflected: âAs a young sister, I was trained as a nurse, but when I first arrived in Brazil, I was thrown into parish pastoral work with absolutely no training or experience. So I followed the advice of the local priests (mostly Irish missionary priests).
âI remember once caring for a woman, Dona Maria, who was dying from terminal cancer. I had been giving her pain medication but also bringing her the Eucharist, as she was weak and no longer able to come to church.
 âOne day, a neighbor told me that Maria wasn't really Catholic; she had been practicing Umbanda (one of the Afro-Brazilian religions inherited from the time of slavery) as well as going to Mass. I didn't know what to do, so I asked the priest.
â"No more Communion until she goes to confession,"â I was told.
 âIn distress, I went back and explained the situation to Maria. She just nodded and said nothing. Within a few weeks, she was dead.
âAs I grew in my understanding of Brazilian culture and religious traditions, I deeply regretted my decision of adhering so rigidly to church authority. For so many Brazilians, the African traditions are so much a part of their cultural heritage.  I began to ask myself: What Celtic pre-Christian traditions do I still cling to in spite of my Catholic upbringing? With Maria, I should have stood up more, been more confident in my own judgment â allowed Christ's teaching of love and inclusiveness to be my guiding light.
âMaria died without the sacraments, but she has been in my heart and prayers these last 40 years. Through her, God taught me to be more open, more accepting, more gracious - and thankful that God is more loving and forgiving than I could ever be.â
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A Time to Give Thanks
 We continue to share the stories of the sixteen MMMs who mark fifty years of profession this year. The four women in this issue have served in a wide variety of ministries in nine countries. Again, because of restrictions on travel and gatherings as a consequence of COVID-19, various planned celebrations with family and friends have been cancelled. Though disappointing for everyone,  several smaller events have been held in recent months in various MMM houses in Ireland.
Seven Sisters celebrated with the Beechgrove community on 22 July, the feast of St. Mary Magdalene. Mass was offered by Fr. Barry Matthews, a curate from the local parish. A delicious meal followed, with a cake of course! Despite the constraints it was a most enjoyable occasion. Congratulations all!
Among those celebrating in 2020 are:
 Sister Sally Davis
Sister Sally is from Kilteevan, Co. Roscommon. After training as a nurse in Baggot Street Hospital in Dublin she worked in Cherry Orchard Hospital and in Nigeria before joining MMM. During her novitiate she was sent to Nigeria to relieve during the Biafran war. She worked there until 1973, when she returned to Ireland for training in midwifery.  She was again assigned to Nigeria in 1974, where she served for about twenty years, especially in community-based health clinics in Abakaliki, Ikot Ene and Ndubia. Sally was also infirmarian in our Motherhouse.
After helping for several months in Ganta, Liberia, where we administered a programme for people with Hansenâs disease, she was assigned to Lagos, Nigeria. There she worked in a busy urban clinic and was involved in primary health care. Sister Sally returned to Ireland in 2004 and was a nurse in the Motherhouse clinic until 2013. She then helped with telephone duties and had a special ministry of visiting our MMMs in our nursing facility Ăras Mhuire. She moved to Ăras Mhuire for nursing care in August 2020.
Sister Sheila Devane
 Sister Sheila was born in Boyle, Co. Roscommon. When she was nine, her family transferred to Dundalk. She found this change challenging and a preparation for missionary life in Tanzania, Kenya and Ethiopia, with periods of study in the USA and UK. A qualified nurse before joining MMM, she trained in midwifery and later as a clinical psychologist. 
Some experiences Sheila gratefully looks back to are: working in the Turkana Desert, in a famine camp in Ethiopia, taking over a midwifery training school during the HIV pandemic in East Africa, assisting with the establishment of Ăras Mhuire Nursing Facility in Drogheda, setting up a community mental health service in Tanzania, and leading the evaluation of a counselling service set up by TrĹcaire in Rwanda after the genocide. Now she has become a frontline mental health worker in Trinity College Dublin during the COVID-19 pandemic.
  Sister Rita Kelly
Sister Rita is from Dublin. She trained as a nurse before joining MMM. After profession she completed midwifery training and in 1973 she was assigned to Kenya. After five years she trained in public health and worked in Kenya for another six years. In 1987 Rita returned to Ireland and worked in the matronâs office in the International Missionary Training Hospital for three years and then as acting matron.
Rita served in MMM leadership and accompanied our junior professed MMMs from 1991 to 1996, when she was assigned to our community on the USA/Mexico border. From 1999 to 2009, Rita was based in Dublin, helping returned missionaries through the Irish Missionary Union, especially those coping with traumatic issues, and doing vocation work. Since 2010 she has served in MMM leadership in our Europe Area.
Sister Patricia OâConnor
 Sister Patricia is from Athlone, Co. Westmeath. She trained as a nurse in England and worked there for some time before joining MMM.  After profession she completed midwifery training and was assigned to Tanzania in 1971. Over ten years she served in Makiungu Hospital and also helped for a year in Winchester, MA, USA. Patricia was then assigned to Dareda, Tanzania, as matron and then served in MMM leadership before moving to Kenya. In Aror she was in charge of a health centre for five years.
Patricia she was assigned to our Motherhouse in 1996. She was clinic Sister for eleven years and during that time also served in MMM leadership. Since training in chiropody in 2007 she has been providing this service for our Sisters in Drogheda.
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To Heal and Make Whole
 In November 2019, Sister Doctor Ekaete Ekop, MMM Assistant Congregational Leader, participated in the International Federation of Catholic Universitiesâ Annual Forum in Rome. The theme was âNew Frontiers for University Leaders: The Future of Health and the University Ecosystemâ. The forumâs aim was to work at the intersection of science, and societal transformation and strategic change at higher education institutions.
The participants were university leaders from around the world and representatives from the World Health Organization (WHO).  Sister Ekaete was a discussant and presented a paper âGlobal Health â The Challenges Aheadâ, which was very well received. This was a great opportunity for Ekaete and MMM to influence global health today. At a private audience, Pope Francis encouraged the university leaders âto develop not only the mind but the heart, the conscience as well as practical abilities, which will ensure that the fruits of study are not only to affirms oneâs professional position but have a relational and social purpose.â
Sister Ekaete, a qualified obstetrician and gynaecologist, raised a number of questions about the exercise of our healing mission today. She reflected on the challenges for training healing practitioners in a rapidly changing world.
 She pointed out the benefits of increasing online communication, which makes developments in health care available to remote areas. Clinicians have more access to consultation and investigations. On the other hand, human warmth and touch are reduced and business is often conducted anonymously.
The question is whether one chooses to engage in this new world or not. In a time of exponential change, how do we envisage the training of health care workers? We speak of âglobal healthâ, but this phrase encompasses differing and opposing realities.
 What is health?
The WHO defines health as: âA state of complete physical, mental and social well-being and not merely the absence of disease or infirmityâ. Ekaete asked: What is âcomplete wellbeingâ? What is âdiseaseâ? What do we mean by âinfirmityâ? We may speak about objective definitions but by whom - or WHO?
Sister Ekaete quoted Professor Norman Sartorius, who has done much clinical work and research on mental health around the world. He proposed defining health as: âa state of balance, an equilibrium that an individual has established within him/herself and between him/herself and his/her social and physical environment.â
 Ekaete pointed out that the meaning of health varies in different cultures. In African Concepts of Health, Disease, and Treatment: an Ethical Inquiry, Dr. Peter Omonzejele, a philosopher and bioethicist in the University of Benin, Nigeria, said that âgood health for the African consists of mental, physical, spiritual, and emotional stability of oneself, family members, and community. This integrated view of health is based on the African unitary view of reality. Good health for the African is not a subjective affairâ (Omonzejele 2008:120).
 Definitions in other cultures
Sister Ekaete said that the word ubuntu is used in South Africa. Archbishop Desmond Tutu explained: â Ubuntu is the essence of being human. Ubuntu speaks particularly about the fact that you canât exist as a human being in isolation. It speaks about our interconnectedness ⌠We think of ourselves far too frequently as just individuals, separated from one another, whereas you are connected and what you do affects the whole world.â
 Ekaete quoted the Australian National Aboriginal Health Strategy (1989), which stated that for the Aboriginal and Torres Strait Islander peoples, health is not just the physical well-being of an individual, but the âsocial, emotional and cultural well-being of the whole Community, in which each individual is able to achieve their full potential as a human being, thereby bringing about the total well-being of their Community.â
 According to these definitions, she said, the person knows there is a loss of inter- or intra-equilibrium, whether or not our modern high-powered investigations identify it. We need to understand this if we are to facilitate healing. Our MMM Constitutions state that we are âsent to proclaim the Good News among people of other cultures. We shall be sensitive to their beliefs and values and study their history, traditions and customs. In particular we shall seek to understand their interpretation of misfortune, sickness, suffering and death.â
The challenge of fragmentation
She highlighted that we are experiencing the consequences of Brexit, of stringent immigration laws, and of policies leading to family break-up. There is a loss of appreciation for wholeness and an attraction for fragments. With specialization we know more and more about less and less. Global health is a victim of these realities. As we become more adept at managing medical conditions the patient gets the best treatment, but is this the best response to the person as an entity?
 In current medical practice, management is based on objective, palpable evidence. So Ekaete asked, 'Is our clinical acumen undergoing global atrophy? This acumen is the knowledge, insight and experience that allows decision-making on complex issues, where information might be incomplete or unknown. It meets the need of the moment but cannot always be objectively proven. In a litigious society, this is a red light for many health practitioners. It is the dark side of advanced technology, in which human beings have become casualties. What does this mean for missionaries trained in institutionalized health care?â
Principalities and powers in the healthcare system
Training health care practitioners needs to take into account that the physician, nurse, pharmacist, etc., is not only managing the patient. There are many powerful presences to deal with - insurance companies, lawyers, the media, funding agencies and pharmaceutical companies - that influence daily decisions, so the patient is short-changed.  Could this have resulted in the erosion of trust between the patient and the care giver? Is this lack of trust manifested in such issues as euthanasia and âdo not resuscitateâ, litigation, and the rise in patients defaulting? Is this why there is a return to more traditional health practices?
Sister Ekaete emphasized the need for environmental education and a restoration of ecological equilibrium.  In Laudato Si, Pope Francis writes of Saint Francis, who âshows us just how inseparable the bond is between concern for nature, justice for the poor, commitment to society, and interior peace.â
We need to ask: Are we healing or treating? We treat diseases, eliminating all evidence of a condition. We heal persons, to make whole. How does a drone pre-programmed to collect blood samples make whole? How does having no physical contact with a dying patient make whole?
Sister Ekaete said she has learned that we need to recognize and ask fresh questions; that we can and will make mistakes; and that it is important to live a rounded life. She has found that the ultimate rewards in medical training come from âknowing togetherâ, in a respectful interaction between the carer and the patient. Knowing is intimately interwoven with caring, and it is caring that ultimately makes whole.
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Taught to Make a Difference
 The World Health Assembly has named 2020 the International Year of the Nurse and the Midwife. The World Health Organization website points out that ânurses and midwives play a vital role in providing health services.  These are the people who devote their lives to caring for mothers and children; giving lifesaving immunizations and health advice; looking after older people and generally meeting everyday essential health needs. They are often, the first and only point of care in their communities. The world needs 9 million more nurses and midwives if it is to achieve universal health coverage by 2030.â
Sister Theresa Adewole, MMM, graduated from the University of Benin, Edo State, Nigeria, on 2 July 2020 as a registered nurse and registered midwife, with a Bachelor of Nursing Science. She also received a prize as the best graduating student in clinical midwifery for the 2018/2019 session. Reflecting the challenges imposed by COVID-19 safety protocols, part of the ceremony took place virtually via Zoom.
 Describing the event, Sister Theresa said, âWe were presented to the official of the Nursing and Midwifery Council of Nigeria by the dean of the Faculty of Basic Medical Science, who acted in place of the provost via a Zoom platform. We took our oath and promised to protect life and uphold the dignity of the nursing profession. The award, a plaque, was presented by the Director of Nursing Services for Edo State.â
 In her acceptance speech, Theresa said, âI thanked God for His love and mercies. I thanked the head of the Department of Nursing Science and all the lecturers in the department for their dedication, selflessness and commitment to nurturing us to be the best we can be. I challenged my colleagues to make use of all we have been given and have been taught to make a difference and uplift the nursing profession, to believe in ourselves and make good use of any opportunity to challenge ourselves to be better nurses. The sky will not be the limit but a starting point.â
 Afterwards there was a group photograph and the graduates left the hall. All this took place with no family member or guests allowed but some of Theresaâs community members were seated outside. They brought refreshments that she shared with her colleagues.
Sister Theresa wrote, âI am indebted to the MMM Congregational Leadership Team for all the years of support and care and to those who sponsored my studies. I am also grateful to the Area leadership team, my community and other MMMs, and all the other people who have helped me thus far, praying God's blessings on them all.â
Congratulations to Sister Theresa and her colleagues, who persevered in their studies in these challenging times.
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