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Diaconia: Interregional cooperation in social service
Interregional cooperation - the present state and prospects
Programs of the Round Table for Religious Education and Diaconia
Interregional cooperation in training for medical attendance
Sts Martha and Mary Convent of Mercy and interregional experience

Interregional cooperation - the present state and prospects

The last decade has been marked with an intensive growth of the Church's social work. Along with the task to restore age-old traditions of this work, rooted in the evangelical teaching of love for one's neighbor, a stimulus for developing social work in this period has been given by the grave socio-economic situation in which Russia has found herself. In the last decade, dozens of Orthodox sisterhoods and other organizations with the primary purpose to give aid to the needy from the socially unprotected sections of the population have been founded in almost all the regions in Russia.

The social work of church structures has covered a number of areas, such as nursing of the sick and disabled, support for low-income people, organization of orphanages and asylums, arranging leisure activities for the youth, aid to the homeless and prisoners, work with drug-addicts, etc. In many cases, church organizations have achieved tangible positive results in giving real aid to thousands of people.

At the same time, church social services have encountered a number of problems in their work. In addition to financial limitations, they have often been impeded by insufficient experience, shortage of qualified personnel, poor informational and methodological support and difficulties in cooperation with governmental structures. Especially substantial these problems are for newly-formed church social organizations. In this situation, it is vitally important to establish close cooperation with organizations involved in similar activities. Now many church structures working in various parts of Russia have realized the need for cooperation in order to exchange experience and join efforts for solving common problems. Interregional cooperation has developed largely in the following basic areas:

  • Convening conferences and seminars on church social service.
  • Publishing informational and methodological materials on various areas of social work and distributing them to regions.
  • Exchanging the experience of practical work.
  • Assisting in solving legal and organizational problems.
  • Training personnel, such as nurses, for regional organizations in major sisterhoods, especially in Moscow and St. Petersburg.
  • Implementing joint social projects.

As is evident from this list, cooperation between church social structures has been focused on exchange of experience and informational and methodological support. This emphasis has been determined by objective reasons. A considerable number of brotherhoods and sisterhoods have just started their work or begun to take shape. Therefore, what they need first of all are advice on organizational matters, appropriate literature and trained staff. Cooperation with larger organizations in other regions can help them to raise the level of their work, optimize their organizational forms and establish interaction with municipal bodies. As an example of the support given to regional initiatives, one can cite the training of nurses for them by Sts Martha and Mary Convent and St. Dimitry's Sisterhood. There are also other examples of training regional representatives for social service through seminars conducted by these and other organizations. There is also an established practice of regular exchanges of experience between sisterhoods in various cities.

There are also examples of regional structures working together to implement social programs. For instance, Sts Martha and Mary Convent of Mercy together with sisterhoods in Rostov-on-the-Don and Vladikavkaz have organized the so-called "line of mercy" for nursing the wounded in the hostilities in Chechnya. The wounded when they are transferred from a frontline hospital to Rostov and then to Moscow are taken care of by nurses working in these cities.

As sisterhoods in various regions gain strength, the number of interregional projects will apparently grow. Among the questions often discussed today is the need to adopt special programs of interregional and nation-wide church cooperation in various areas of social work. Discussed are also various forms of organizational unification of church social structures, such as an All-Church Nursing Movement or an Association of Orthodox Social Services.

This issue of the Newsletter gives reports on the experience of several church organizations in developing interregional cooperation for social service and analyzes possible prospects for this kind of work.

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Programs of the Round Table for Religious Education and Diaconia

For several years now the Round Table for Religious Education and Diaconia (RT) has been engaged in implementing programs which have direct bearing on the development of interregional cooperation in diaconal initiatives.

The RT Newsletter publishes reports on the social work of church organizations in various regions in Russia. Usually these reports are thematically aligned according to areas in which social work is carried out. This approach makes it possible to analyze this work from different angles and to compare the experience of various organizations in its implementation.

The Social Service - Know-How section carries articles on nursing contributed by professionals in this field and based on their practical experience. This information is of practical interest for nurses, especially in provinces where this kind of information cannot be obtained from other sources.

The Newsletter also publishes announcements, articles on the historical and theological experience of social service as well as other materials of interest for people engaged in social work.

The Newsletter is distributed to all the dioceses of the Russian Orthodox Church and to many sisterhoods in various parts of Russia. This helps to spread information about the social service of the Church and to promote interregional exchange of experience in social work. We routinely receive responses from our readers in various regions who commend the Newsletter for the practical value of its materials.

The task of the informational and methodological support of interregional cooperation is also carried out by the RT site in the Internet. It contains materials on major social programs implemented by church organizations in various regions, as well as professional advice on nursing, announcements and other information. The visiting statistics shows that though most visitors come from Moscow, which is typical for most of the web-sites in the Russian situation, the geography of visitors from other regions in Russia is rather wide (see the chart). This points to the demand existing among regional organizations for our web-site materials.

Among areas in which the Round Table works to support regional diaconal initiatives is the publication of educational and methodological books, also to meet the needs of regional organizations. Some publishing projects are implemented by the RT on its own, while others are realized by diaconal organizations, such as Sts Martha and Mary Convent of Mercy, St. Dimitry's Sisterhood and others, with the RT's support. The same pattern is used to implement some RT projects aimed to support religious and theological education in provinces. For instance, a series of text-books on various disciplines for theological schools was prepared and published, including 11 one- and multi-volume editions in altogether 118,500 copies; the RT developed educational aids for teachers of Sunday schools, gymnasia and Orthodox kindergartens, as well as books for children, etc. All these editions were distributed to all the theological schools of the Russian Orthodox Church, Orthodox gymnasia and kindergartens, parish and diocesan libraries.

Among the most recent actions by the Round Table, which contributed to the development of interregional cooperation, was a series of training seminars for project work and information exchange conducted by the RT for representatives of various regions in Russia and the CIS. The four seminars held in December 2000/February 2001 were attended by 87 people from 23 cities in Russia, Central Asia, Transcaucasus and Estonia, representing 47 organizations including brotherhoods and sisterhoods, Orthodox foundations, theological schools, monasteries, diocesan departments for social and educational work.

The seminars had as their task to train people for project work as an instrument and organizational form of diaconal activity. The participants learnt the skills of drafting project proposals, such as presenting an application and budget, running a project, drafting account documents, fund-raising for a project, psychology of dealing with donors, using new communication technologies and emergency work. The program of the seminars also included a study of the legal basis for socio-medical and charitable work, as well as work with orphans in the context of church Diaconia.

The lectures were given by specialists from secular organizations, diaconal initiatives, the Theological Institute of St. John the Theologian and by Round Table staff. Along with traditional forms of seminar work, such as lectures and small group, the organizers used modern methods including in-process games and presentations. Each participant received a specially developed set of materials and aids on all the issues dealt with during the seminars, as well as information materials and publications on Diaconia published by the Round Table and its partners.

Among the most important elements of the seminars was an exchange of information about church charity initiatives in Russia and the canonical territory of the Russian Orthodox Church. Communities presented their work, exchanged experience and discussed possibilities for bilateral cooperation in church-wide initiatives. All the organizations presented written reports about their work. Participants filled in a detailed questionnaire on the areas and forms of the diaconal work of their organizations. This part of the program helped to replenish considerably the database compiled by the Round Table on the existing diaconal and educational initiatives in the ROC, as well as areas and forms of their work, their priorities, needs, etc.

The participants expressed a unanimous opinion that relations and cooperation between diaconal initiatives should be developed further. One of the areas in which this cooperation could develop is the creation of multilateral or church-wide programs, especially in the field of law. An acute need was voiced for establishing a one church-wide program to advance legislative proposals for settling various problems encountered in the work of parishes, brotherhoods and sisterhoods. This program could unite isolated efforts undertaken by communities in this field. A series of meetings on various legal problems encountered in social work was proposed as a "minimum program".

The Round Table intends to continue its work for developing the informational and methodological support for regional social structures. Among new programs in this area will be the creation, in cooperation with St. Dimitry's Nursing School, of a web-site on the problems of nursing and medical attendance.

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Interregional cooperation in training for medical attendance

In the wide range of social services offered by the Russian Orthodox Church, an important place is occupied by the participation of church structures in settling socio-medical problems experienced by the less socially protected sections of the population.

Participation is such charitable tasks as nursing seriously ill people, the old and disabled requires not only the "compassionate heart" but also professional knowledge and skills. As Patriarch Alexy of Moscow and All Russia noted in his report to the Jubilee Bishops' Council of the Russian Orthodox Church (August 13-16, 2000), "we need professionals in various fields of social work and healthcare".

To acquire this knowledge and skills in the present-day situation is not only highly desirable but also necessary for gaining formal access to this kind of work in medial and social institutions.

In this regard, the important task of church medical and educational structures is to accumulate, test and hand down socio-medical knowledge to parishes, parish communities of sisters of mercy, medical attendance services and other organizations concerned.

To succeed in this task there must be correctly organized interregional cooperation on the level "educational institution - a sisters of mercy community" or "an educational institution - a parish medical attendance service".

As His Holiness the Patriarch pointed out in the same report, "in order to extend and intensify the charitable work it is necessary to hold diocesan and inter-diocesan seminars and conferences".

Forms of spreading the knowledge on professional nursing may be as follows: consulting; field training courses; conferences on practical issues; seminars; educational and methodological literature.

A certain experience in this kind of work has been accumulated by St. Dimitry's Nursing School established with the blessing of Patriarch Alexy of Moscow and All Russia in 1992 and licensed for educational and publishing work. The primary task of the school is to offer professional education to Orthodox youth specializing in Nursing. At the same time, the school has carried out considerable work for interregional cooperation, conducting the following activities:

  • consulting dioceses on such important matters of organizing educational work in provinces as organization of nursing schools and training courses for junior nurses, teaching Spiritual Basics of Charity, drafting curricula for nursing schools and medical programs for Orthodox pre-seminaries, etc.;
  • accumulation, approbation, adaptation and dissemination of special knowledge on nursing seriously ill persons, elders and the disabled;
  • developing curricula for field training courses for nurses. One of these curricula is called "The organization, forms and methods of medical attendance". It includes such important themes as the virtue of charity, forms of its expression and modern educational methods, professional training of a medical attendant, structural organization of medical attendance service, medical documentation, organization of nursing for bed-patients, nursing old people, aid to the sick and old in everyday life;
  • conducting field educational readings. Thus in December 2000, at a request from the Nursing Community of the Protomartyr Juliana of Olshany at Obukoho near Kiev, the school's teachers conducted a five-day seminar on "Pressing problems of the parish medical attendance service". The main purpose of the seminar was to give information about today's forms of the ROC social service, to give definition to the notions of "medical attendance service", "medical attendance work" and "medical attendant", to show the structure and functions of the medical attendance service, to define the duties of a medical attendant, to offer the necessary amount of knowledge and skills, to introduce the participants to modern methods of identifying socio-medical problems experienced by their charges and to some modern concepts of the rehabilitation of the elderly and disabled, and to teach them some methods of nursing bed-patients, massage and adaptation. The participants attended lectures and training lessons during which they used one another to work-off some elements of nursing, rehabilitation and massage. They used various training aids, such as slides, photographs charts, diagrams, as well as materials from books and periodicals. The participants were very active. The questionnaires distributed to them at the end of the seminar showed a changed attitude towards medical attendance work. More consideration was now given to the personalities, socio-medical and spiritual problems and needs of patients, and more opportunities were found to give them aid and more ways were identified for solving their problems. Many participants expressed the wish to conduct such seminars on a regular basis, devoting them to more specific themes, such as nursing neurological patients, nursing elderly patients, etc.;
  • conducting practical conferences and seminars. In August 1999, with the blessing of His Holiness Patriarch Alexy of Moscow and All Russia, the school conducted a conference on "Pressing problems of nursing patients at home and in hospital and the importance of medical attendance services in solving them". The conference was attended by 78 people from Russia, Ukraine and Belarus. It was resolved that such practical conferences should be held on a regular basis for those who work in Orthodox sisterhoods and medical attendance services of the Russian Orthodox Church both in and between dioceses;
  • publishing educational and methodological aids. With the blessing of His Holiness Patriarch Alexy of Moscow and All Russia, the school has begun publishing a series of educational and methodological aids, called "A Nurse's Library" to be distributed to regions. At present, three books of the series have come out, including "On bed-sores", "Basics of socio-medical rehabilitation", and "Essays on the history of nursing communities". The basic task of the series is to disseminate popularized medical knowledge necessary for the correct nursing of the sick and elderly. It is planned to publish books on the nursing of old people and those who suffered a brain blood circulation disorder and patients with progressively worsening illnesses.

In conclusion, I would like to emphasize that further work to accumulate knowledge on socio-medical work and disseminate it in regions and to develop interregional exchange of experience in socio-medical work between nursing communities and medical attendance services would contribute not only to improving the professional skills of nurses in various regions but also enhancing the authority of these services of the Russian Orthodox Church in general, especially among the governmental structures and local administrations.

A. V. Flint,
St. Dimitry's Nursing School

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Sts Martha and Mary Convent of Mercy and interregional experience

1. Interregional cooperation between Orthodox organizations and institutions engaged in the social service of the Church as Orthodox social services is one of the most pressing problems today. After many decades of persecution and forcible removal of the Church from social service, the tradition of this service was artificially interrupted and its revival in our days has to begin from scratch, if not in spiritual, than in practical sense.

Each church structure beginning this activity inevitably encounters the same problems. This requires entering into cooperation with other actors in social service who have already overcome them and gained experience helpful to others. Therefore, cooperation between church structures in this area should have as its primary aim to combine the experience of Orthodox social services in common work.

Another problem is the need to take into account the specificity, including legal, of a given region in which a particular Orthodox social service works. The regional legislations differ. Therefore, a mechanical transfer of the experience of one region to another is simply impossible. However, it is quite possible to develop similar approaches to obtaining the same goals and to offer practical assistance to one another in organizational, legal, methodological and representational matters. All this makes it urgent to consider an organizational unification of the existing church social structures.

The form of this union can vary from a Church-wide Nursing Movement to an Association of Orthodox Social Services. This union could enhance to a considerable degree the efficiency of the Church in the area of social service.

At present, some shoots of this union can be seen in the practical work of Sts Martha and Mary Convent of Mercy for organizing and maintaining cooperation and interaction with sisterhoods, monasteries and other church organizations in Russia and the near abroad.

2. The Jubilee Bishops' Council has given a new impetus to the work of the Church in social service and to the implementation of the provisions of the Basic Social concept of the Russian Orthodox Church.

According to the Social Concept, cooperation between state and church in social service "belongs to the salvific mission of the Church embracing the comprehensive concern for manů and contributes to the welfare of the Church herself" (p. 59). Naturally, in this case church-state cooperation is perceived by the Church and understood by the state as the mission of the whole Church, rather than her individual and organizationally independent parts. In the present context, it implies possible unification of the social work of individual religious organizations and concentration of church-wide efforts and resources for making more effective, among other things, the church representation before the state in the matters of social service. Therefore, it appears necessary to set certain guidelines for this work of the Church as a whole so that the experience accumulated could be used and improved further.

In this light, the traditions and today's experience of Sts Martha and Mary Convent in social service acquire a special importance. The convent was founded as a church structure for charity and service of the neighbours. Since its inception in the early 90s the convent has gone through several stages in its development and accumulated an adequate experience making it possible to assist similar church structures. The sisters consider it their duty to develop cooperation and interaction with such services, and this work has been intensively carried out today.

The Convent's cooperation with regional church social services consists mainly in giving them information and methodological assistance. Sisterhoods, monasteries and parishes send their people to us for advice and consultation. In most cases, they would like to use our constituent documents to put in shape their own work in social service. At present, many sisterhoods in Russia, the Baltic States and Ukraine function according to the Convent's statute. We have an experience of giving assistance in establishing local sisterhoods. One of the sisterhoods, namely, St. Elizabeth's Charity Society in Orel, has been transformed, at the request of its members, into a branch of our Convent.

Orthodox religious organizations would like to use the practical experience of the Convent in realizing charitable and other socially significant programs. Thus, the Convent has developed a Provision for the Specialized Institution for Children in Need of Social Rehabilitation. Several monasteries in the Moscow region, which are just beginning this work, asked us to give them this Provision. The Convent has helped the Monastery of St. Savva of Storozhka and the Khotkovo Monastery of the Intercession to organize in them children's institutions of this kind. Several parishes in the dioceses of Orel and Tver also received from the Convent answers to their questions concerning the organization and running of social rehabilitation institutions for children under age.

As a rule, this interaction is not limited to one-time piece of advice. For instance, the children's concern presupposes organization of a permanent social and legal work with children in institutions run by church social services. The Convent has a certain experience in it, and cooperation continues now on the level of joint efforts in similar work, which is beneficial for all the participants. One of the examples of such cooperation is joint work with the Neyasyt Orthodox charity in the Vladimir diocese.

This cooperation deserves to be described in more detail. The Raduzhny private joined-stock company working in close cooperation with the Vladimir diocese in social rehabilitation of under-age children helped the diocese to establish a Neyasyt church charity as an implementer of the municipal charity program for these children. The Convent and the charity have concluded a long-term agreement on cooperation providing the charity Convent's support in social and legal work with children who found themselves in a tight situation.

Some sisterhoods have arranged for cooperation among one another in provinces using their contacts with the Convent, which also helps to propagate its experience. Thus, the nursing sisterhood in Shakhty, organized on the basis of the Sts Martha and Mary Convent's Statute, has in fact merged with the Nursing Sisterhood of St. Seraphim of Sarov in the diocese of Rostov-on-the-Don. This merger has considerably increased the efficiency of the latter in giving aid to the wounded in Chechnya at the Rostov military hospital. Both sisterhoods have maintained close contacts with the Convent, and their merger was in many ways facilitated by these contacts.

On the whole, the cooperation and joint efforts of the Convent and the Rostov sisterhood have become extraordinarily fruitful. The point is that the Rostov nurses work in a military hospital with soldiers who are sent afterwards to the Moscow regional hospitals, including the Central Interior Troops Clinic, in which nurses from the Moscow sisterhood work. The wounded are given by nurses in Rostov over to nurses in Moscow as if "from hands to hands", thus making soldiers feel continuous care for themselves irrespective of the place of their treatment. The Rostov sisters often come to visit the wounded during their visits to Moscow, and it is worth seeing with what joy and tears the soldiers meet the "little sisters" who had restored them back to health. Moreover, after the sisterhood in Vladikavkaz, where the front-line hospital is located, joined in taking care of our soldiers who were wounded in Chechnya, a unique Orthodox charity structure has emerged, which, by common consent, has been called "The Line of Mercy".

The Convent is always ready to share its working-outs on social service. Thus, after a training course was held in the Convent for mastering the Danish methods of nursing and medical attendance, the Convent published a respective educational aid entitled "Nursing and Medical Attendance". It has been distributed free of charge to organizations concerned. Most copies have already been sent out. The distribution of such methodologies will certainly enrich and broaden the arsenal of Orthodox social services and, on the other hand, will contribute to the general improvement of their work in provinces.

As practice has shown, personnel represent the most difficult problem of social service. The shortage of properly trained workers - nurses, mentors, social workers - has considerably impeded the development of social service in provinces. In this connection, the Convent has undertaken an unprecedented action for charitable training of nurses at the medical college of the Russian National Training Center for Continued Medical and Pharmaceutical Education under the Health Ministry.

For a third year now, girls from many regions in Russia, Baltic States and Ukraine have been trained in this college, taking, along with medical disciplines, a course in Spiritual Foundations of Charity and church music. It is planned to introduce a legal training course for organizing the work of sisterhoods and other social services in provinces.

Nurses studying in the college are fully supported by the Convent. They are provided with board and lodging and city transport tickets. They assimilate the Convent's experience of everyday life and prepare themselves for social service. We realize the great importance of this aspect of cooperation and try to do all possible to support this project as the nurses who have been trained there will go to provinces where they will embody in their work the spirit of the Convent and the commandments of its Founder.

Cooperation and joint efforts with regional social services have points that at first sight may seem to be far from the conventional sphere of social service. For instance, the Convent participates in settling the problems of Russian migrants, first of all from Latvia, giving them an opportunity to study at the medical college and helping them after graduation to find employment in Russia. It also helps to overcome the vital problems of refugees from Tajukistan by taking their children to its own orphanage. It gives young people from troubled and low-income families, living in Russian provinces, an opportunity to learn a trade and thus find their own place in life. All this is a contribution within our powers to the revival of church social service in regions.

3. The basic mechanism of the Convent's cooperation with regional social services is an Agreement on Cooperation. The Convent has developed a draft Agreement and has used it for quite a long time.

A special feature of this Agreement is a Program of Cooperation to be adopted by the sides as an integral part of the Agreement. It enumerates a specific number of projects of mutual concern to be implemented together. Specific projects, such as training for nursing according to the Convent's curriculum, are formalized in supplements to the Agreement.

The Agreement defines a concrete set of projects, aims and tasks of the sides, as well as commitments of the sides in maintaining cooperation and the procedure for financing the cooperation and other essential points. It should be mentioned that this Agreement does not provide for common work, nor does it involve inconveniences and restrictions envisaged by the law with regard to participants in joint enterprises.

Speaking about the legal problems of interregional cooperation, I would like to mention first of all the problem of the status of its participants. It lies essentially in the fact that most of the participants in social service sometimes find it difficult to be registered locally as a structure enabled to carry out social service in accordance with regional and federal legislation. Perhaps, a certain super-regional structure, such as an Association of Orthodox Social Services, could assume the task to give concrete assistance in obtaining the status appropriate for unimpeded social service.

Another problem is the financial and economic support of cooperation. Unfortunately, the federal legislation does not recognize the right of religious organizations to enjoy the status of "charitable organization" - the fact that reduces their opportunities for fund-raising among sponsors. The situation is better in the regions where a more direct access may be gained to privileges granted to the religious organizations involved in implementing regional social programs, for instance in Moscow and the Moscow region.

The Convent, being a charitable organization according to the Moscow city law, helps regional social services to gain access to the system of regional privileges and thus facilitate the financing of their social service work. The Convent has developed a model of entering the privileges system on the bases of its own experience. However, in those cases where a regional legislation does not allow to solve this problem in favour of a religious organization, the Convent, together with it, considers setting up intermediate charity structures outside religious organizations, such as autonomous non-commercial charity organizations, charitable foundations, etc. and helps to organize them.

4. Everyone agrees that interregional cooperation between church social initiatives is only beneficial. But unfortunately, no rapid development of such cooperation is seen today either on national or interregional levels.

The reason for it seems to lie in the fact that every church structure works in isolation, without showing any desire to "let in" a similar structure either for the fear of competition or reluctance to split up its own modest resources.

However, many small and isolated things can make up something big, if there is a will to unite efforts, and later resources, for the great cause of reviving the social service of the Church. Let us hope that the present situation is only a cost of growth and development and put our trust in the will of God for Whose name we serve our neighbours.

O. M. Trainin,
Legal adviser to Sts Martha and Mary Convent

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