The “Fish” Model of Project-based Outreaches

A model for doing not only medical missions, but many forms of short-term projects (partnered with a long-term ministerial presence) looks a bit like a fish (or an ICHTHUS if you prefer). It is based somewhat on the model used for CPM (Church-Planting Multiplication). The same basic principle can be utilized.


Rapid Seed Sowing




This comes from my book “Principles and Practices of for Healthy Christian Medical Missions: Seeking the Church’s Role for Effective Community Outreach in the Philippines and Beyond”


A: The idea of a medical mission comes to one person or a small group, and there is the decision to attempt to move forward with the idea.

B. This is the team-building phase. Buy-in is developed within the community and with outside help. Partnerships are developed and plans are worked out.

C. Others are told about the mission. The community is invited and the outside team supporters are told and encouraged to pray and help in tangible ways. Eventually a maximum number of people are involved as the entire community (ideally) is involved or invited, and the outside team is sent off.

D. This describes those involved in the medical missions. This number is smaller because not everyone who is invited actually comes. In the Philippines approximately half to 2/3s of those invited actually come (at least in rural areas).

E. This describes those who respond to the Gospel based on assent. In some cultures, this assent is to the Gospel (expressed perhaps in saying the “sinner’s prayer,”) In some cultures, such as the Philippines, this sort of response may be made without any real conviction. As such it may not be the most useful guide for follow-up. However, it is important to keep records of all who attended and all who made this decision.

F. It is also useful to find a narrower filtering of those who come. This may be with a desire for Bible Study, or for home visitation. In the Philippines, for example, many will express an interest to “pray to receive Christ” as a way of expressing gratitude for the medical care provided. However, there is no such feeling of debt to agree to a Bible Study (for example) so it is often a better guide for community spiritual response.

G. After the medical mission, the hosts can do follow-up. They would probably start with Group F as priority, then to Group E, and finally Group D. However, in all likelihood those who actually act on their spoken decision will be smaller than the other groups. So for example, in the case of a Bible Study, one may have hundreds attend the medical mission, with dozens responding in faith, and perhaps 2 or 3 dozen desiring a Bible study. Of these, perhaps 10 or 15 actually respond. These can be put into 1 Bible study, or perhaps 2 growth groups, or maybe a handful of accountability groups.

H. It is from the core group G that growth will occur with multiplication of small groups, or development of house churches, or creation of a church, or whatever.

Missionaries to 3 Churches and the “Can Do” Church

Four ChurchesThere has been a growing trend to raise up the importance of short-term missionaries. Nothing wrong with that, except that it has often been tied to a de-emphasis of long-term missionaries. Related to short-term missionaries has been the church’s move toward short-term thinking. This has seen itself in the increase of “project missions.” In this, churches do not send or support missionaries, but support individual short-term projects.

There are problems with overemphasis on short-term missionaries and projects. Some are, I would like to think, fairly obvious. Problems include

  1. the breakdown of relationality between churches in different parts of the world,
  2. need for people to coordinate short-term projects and personnel for long-term transformation,
  3. the necessity of a bicultural bridge.
  4. a dual role (emic and etic) viewpoint of needs in the mission field, tied to understanding what outsiders can and cannot help with.

But there is more.. Consider where missionaries, on some level are needed. See the above Figure. Think of each hexagon as a type of church.

  • The first church is the Church that Is Not. This church does not exist in the real world, only in the mind of God. Missionaries are needed to evangelize, churchplant, disciple, establish leadership (and move on). This Missionary Role is shown by Arrow “A” moving people to the second church. One could call this PIONEERING.
  • The second church is the Church that Is but Has Not. This church exists, but some aspects of its God-ordained ministry it has not embraced… yet. Some of these may may be pastoral care, theological education, community development, social justice, evangelism, ministering to sub-cultures and missionary outreach. There are many more. Missionaries can inspire, train and provide “tooling” for the church to embrace its role (moving from has not to has). This is shown by Arrow “B” moving people to the third church. One could call this PARENTING.
  • The third church is Church that Has but Cannot. This church can take care of its own people, as well as do a wide variety of ministries in its community. There are, however, some ministries that it doesn’t do, because it cannot. It lacks specific materials, as well as financial and skilled human resources. Some of these might include radio ministries, orphanages, livelihood centers and hospitals. In these cases, missionaries may need a longer presence, but with the intentional plan towards gradual transfer of resources and skills to this church to move it to the fourth church. This is shown by Arrow “C”, and could be described as PARTNERING.
  • The fourth church is the Can Do Church. The church has moved to the point that it has no real NEED to receive missionaries. That does not mean that there cannot be missionaries helping in some way with some aspects of the work. In this case the missionary is not doing classic missions but is assisting or PARTICIPATING in what this church is doing. This is shown by the broken line Arrow “D”.

Where can short-term missionaries come in? All four arrows, all four “churches.” However, how many of these can a short-term missionary (or STM team) serve without long-term missionaries supporting and bridging their activities? Really only Arrow D. Arrow D is where the STM team participates with the work of a Can Do Church. There may be some very specific ways in which short-termers can do Arrow B (parenting) without long-term missionaries, but for the most part, Arrows A, B, and C really need long-term missionaries working with both STM and the associated “churches.”

Where can project mentality really work? Again, Arrow D is the most obvious one. Mission projects can be linked to the Can Do church to participate in their broader and longer-term vision and mission. To a lesser extent, projects may be able to effectively Parenting in some ways under Arrow B with the Has Not church. However, projects are not appropriate for Arrows A (Pioneering) and C (Partnering).

NOTE: I am using the four Ps (Pioneering, Parenting, Partnering, and Participating) a bit different that in used by others. They link it strictly to church planting and building. I am tying to the broader church cycle. As such the terms are a wee bit awkward. Especially awkward is “parenting” when it pertains to projects and short-term missionaries. However, when connected to longer-term missionary programs, this one also makes sense… sort of.