Hope for the Dying: The Work of Harvest USA’s Hope Ministry

In 1987 I was serving as minister of a Presbyterian church in Dunblane, Scotland. The country had been my home since 1972. One evening the news reported the emergence of a new and fatal disease in the United States that was affecting primarily gay men. Accompanying the reportage was a clip from a televised sermon in which the preacher affirmed that this illness was a judgment from God on gays. The manner of delivery was harsh and hateful, and I remember thinking this was not necessarily the best response of the Evangelical Church to an emerging problem.

Sometime later, while reading the Scriptures, the words “you will work with AIDS patients” came to mind. The impression was so strong and overwhelming, I actually said aloud, “No!” What followed was a remarkable series of coordinated events that made it abundantly clear that the words I heard in my mind were a call from God.

Sometime after the strong sense of call I experienced to work with AIDS patients, I was at a minister’s conference in London. In the course of a conversation with another pastor, he suddenly said that I should be working with AIDS patients. Another man who had just come back from America said he had recently worshiped at Tenth Presbyterian Church in Philadelphia, and at the morning service, an announcement was made about a collection being taken to start an outreach in the city to minister to those with AIDS. Shortly after this, I was invited to the Shetland Islands to address a medical conference on the subject of terminal care. As part of my research connected to this talk, I wrote to Tenth Presbyterian Church to find out what they were doing regarding the AIDS crisis. Sometime later, John Freeman answered and told me about the project. That began the process which ended in an invitation to return to the United States.

Harvest USA, in conjunction with Tenth, had gathered enough money to begin an outreach to people with AIDS in the Philadelphia area. There was funding for one year, but still it was unimaginably difficult to take my wife and family away from all that was dear to us in Scotland.

The beginning of what became known as Hope was extremely difficult. The gay community did not welcome the involvement of Christians in what was regarded as their issue, and we had to endure a measure of protest and hateful behaviors that were distressing and discouraging.

Everyone we served knew us as a Christian ministry, but the point of contact was not evangelism or Bible study; it was the illness.

At the time Hope began its work, the gay community was deeply committed to serving its dying members. When word of Hope’s existence spread, there was concern regarding the presence of Christians in this field. On one occasion a protest was staged outside the offices of Tenth Presbyterian Church. I was not present at that time, and the situation was defused by a pastoral staff person. But angry activists continued spreading the word to beware of anyone from Hope visiting sick patients. Occasionally our paths would cross in hospital rooms of individuals who had asked me to visit, and it was difficult to endure snide remarks and hostile looks. Eventually, however, through our relationship with a patient from Tenth, the secular AIDS agencies were told about the good work being done, and the hostility evaporated.

From then on, for the next fourteen years, with no advertising or programmatic plans, Hope ministered to a wide variety of men, women, and children affected by a disease that at that time killed most of them. Everyone we served knew us as a Christian ministry, but the point of contact was not evangelism or Bible study; it was the illness. The initial question we asked was, “What would you like us to do for you in this situation?” In retrospect, we saw over and over that what most wanted was companionship shaped by the changing circumstances of their lives.

And that is what we did, particularly with those who were dying. Each individual case was different. Some needed nursing care, especially at night. Others wanted a listening ear or someone to coordinate with other AIDS agencies. In essence, we were a ministry which offered friendship to those who wanted it. The degree of intimacy and demands of these friendships varied widely but, in some cases, carried us right to our friends’ deathbeds, gravesides, and beyond.

Not a few of our patients came from Christian homes and experience, and sometimes AIDS proved to be God’s way of bringing them back to the faith of their youth. 

To form relationships with the dying is both intense and emotionally stressful. With AIDS, it was particularly difficult at the beginning. Concerns about casual transmission meant visiting patients in the hospital wearing protective clothing, which added to the fear and anxiety. Eventually, though, as the disease became better understood, the difficulties for staff and volunteers centered on the distress associated with walking patients through the dying process.

And staying with the dying until the very end was never easy. Sometimes at the end, it was only immediate family members and Hope workers who were there to deal with the messiness of dying and all that follows. Given that some of our patients were from difficult and impoverished backgrounds, it was only the strongest of our volunteers who remained after working with someone who died. Looking back, I see that only God’s grace allowed us to do what we did for fourteen years. But the lessons learned, and occasionally the intimacy of relationship allowed with some individuals, were precious gifts for which we will always be grateful.

What did we learn during those fourteen excruciatingly difficult years? First, that the Church and Christian ministries can and must serve their own, even when sinful choices and destructive behaviors have left them bereft and needy. Not a few of our patients came from Christian homes and experience, and sometimes AIDS proved to be God’s way of bringing them back to the faith of their youth.

Secondly, Christians need never be afraid of engaging creatively with non-Christians in their time of trouble. Our volunteers, staff, and I often had access to situations and places where normally no Christians were welcome, nor our message believed. But as Ambassadors of Christ, we were allowed the privilege of representing him as best we could.

Did we help? Did we have an impact? We are never the best judges of the effectiveness or ultimate meaning of our service. We must simply follow where God leads, through good report and bad, trusting him to use what He chooses for His glory.  As one of our volunteers said after the death of a particularly difficult and angry patient, “Even changing diapers is a sacred act.”

And that was Hope. When it became clear at the beginning of the 21st century that AIDS was now a chronic and manageable illness, I realized the reason God called me to work with AIDS patients was over. We closed our doors in 2002.  Often we feel Christian work in which we are heavily invested must perpetuate itself, but the Lord may well have other plans. Now, many years later, I look back on Hope’s ministry with gratitude. All but a few of the Christians and non-Christians we served are gone, but their faces, stories, and the lessons learned are ineradicable. The world in which AIDS was the crisis of the moment has changed dramatically, and new issues have taken over the headlines. But the needs of sinful men and women are the same, the Gospel has not lost its ancient power, and Jesus still tells His people to go into that world as His ambassadors.

This article first appeared in the Spring 2019 issue of harvestusa magazine. You can read the entire issue in digital form here.