SAUL GONZALEZ, correspondent: If growing old means growing slow, well then 89-year-old Delmar Holbrooke hasn’t gotten the memo.

DELMAR HOLBROOKE: I’m really getting ready for 90, “the big 9-0.” My family is already planning it. I am going to ski up at Mountain High early in the morning, come down and play a round of golf, and then head out to the beach to surf.

GONZALEZ: You’re not a sit on the couch kind of guy?

HOLBROOKE: No way.

GONZALEZ: Holbrooke credits his energy to a life of exercise and healthy eating, but also his faith.

(to Holbrooke): Would you be as healthy as you are, in your opinion, without your faith?

HOLBROOKE: Oh, no, no. I am what I am because of my faith. To me that is just as clear as can be.

GONZALEZ: Like many other residents of Loma Linda, California, Holbrooke is a Seventh-day Adventist. That’s the Christian denomination that observes the Sabbath on Saturday. Adventists also emphasize a healthy diet and lifestyle as important expressions of their faith, and because of that emphasis, researchers say Adventists often have remarkably good health.

PROFESSOR LARRY BEESON (Loma Linda University): Adventists have an evidence of living longer and dying at a later age. They die of the diseases of the general population, but at a much later age—eight, ten years later.

GONZALEZ: Larry Beeson is an associate professor of public health and epidemiology at Loma Linda University. It’s a health and science institute affiliated with Seventh-day Adventists that’s been studying members of the faith since 1958.

(to Beeson): And they get to that age…?

BEESON: …through a variety of different things. It’s not just one thing. It is their religious—how they relate to God and their fellow man, their diet, their exercise, their avoidance of tobacco and alcohol. All of that collectively contributes to longevity.

GONZALEZ: And because it has such a high percentage of Adventists who live long and active lives, researchers have dubbed Loma Linda one of five so-called health Blue Zones in the world.

BEESON: A Blue Zone is just an area where there is an unusual occurrence or more than what we would expect of people who live to be the late 90s, early 100s.

GONZALEZ: Diet seems to be especially important to Adventists’ good health and long life expectancy. Nearly 30 percent of Seventh-day Adventists practice some form of vegetarianism compared to only about three percent for the US population as a whole. In fact, at many Adventist institutions, such as the Loma Linda Health Center, only vegetarian meals are served.

PASTOR DANIEL MATHEWS(Loma Linda University Church of Seventh-day Adventists): I do follow a plant-based diet and have followed a vegetarian diet all my life, and I know you and all your viewers are going to look at me strangely, but I never tasted any meat.

GONZALEZ: Dan Mathews is a third-generation Seventh-day Adventist and a pastor. We talked to him about the connection between diet, health, and religious belief within his faith tradition.

MATHEWS: Genesis 21:29 states that God gave mankind grains and fruits and nuts and herbs bearing seeds—the initiation of a plant-based diet. To not take care of our bodies, which is a part of the stewardship of the earth, to not take care of our bodies is an affront to our God.

VIRGINIA CROUNSE: I feel good. Yeah, I do. I feel energetic.

GONZALEZ: We met seventy-three-year-old Adventist Virginia Crounse as she was relaxing in a whirlpool. She shared her diet and fitness routines with us.

CROUNSE: I actually eat most of the time two meals a day. I’ll eat like granola or oatmeal for breakfast with two or three fruits, fresh fruit. As long as I can remember, I exercise daily, at least six days a week. I walk at least two miles, rain, sun, or snow.

GONZALEZ: It’s not well known, but Seventh-day Adventism has already made its mark on American culinary history in what millions of people eat each and every morning. It’s the creation and mass marketing of breakfast cereal by a guy named Kellogg. That’s John Harvey Kellogg and his brother, Will Kellogg, both Seventh-day Adventists who developed corn flakes, one of the first mass-marketed breakfast cereals, in the late 19th century. They saw cereal as a health food alternative to the fatty breakfast foods of their day.

BEESON: Corn flakes and the other kinds of foods that came out of the Kellogg’s industry was really trying to deal with the whole grain thing and not trying to throw away all the nutrients when you refine and become white bread. You’re throwing a lot of nutrients away.

GONZALEZ: In our own time, as Americans search for ways to improve their diets and health, some researchers believe they can borrow some simple lifestyle ideas from Seventh-day Adventists.

BEESON: Reducing your smoking, reducing your saturated fat intake, exercising more—all that can be done by anybody. They don’t have to become an Adventist to gain the benefits that we’ve observed in the Adventist health study.

GONZALEZ: It is accessible to all of us.

BEESON: Absolutely.

GONZALEZ: At the pool, Delmar Holbrooke has his own advice.

HOLBROOKE: You have to keep your mind alive and continuing to grow, and your body just as much.

GONZALEZ: For Religion & Ethics Newsweekly, I’m Saul Gonzalez in Loma Linda, California.

JUDY VALENTE, correspondent: He is one of the best known priests in America, a respected sociologist, researcher, and commentator, and author of dozens of best-selling novels. Father John Cusick has known Father Greeley for forty years.

REV. JOHN CUSICK: When the history of the American Catholic Church is written in America, I don’t know if you’re going to find a more significant name or a more impacting name on church than Andrew Greeley.

VALENTE: He was one of the first priests to criticize the Church’s position on birth control. He called for better preaching from the pulpit, a greater outreach to young people, and greater humility among the clergy. He promoted a more active role for lay people. Eileen Durkin is Greeley’s niece.

EILEEN DURKIN: He would write and write and write, and it was a part of his life. It couldn’t be separated from him. It wasn’t a chore for him. It just flowed out of him. Many people were touched by his stories and by his image of God as a God of love and a God of compassion and a God of forgiveness and a God especially of passion.

VALENTE: In November 2008, Father Greeley stepped out of a taxi in this Chicago suburb after a speaking engagement. His coat caught in the door, and as the taxi pulled away he was thrown to the pavement and suffered a traumatic brain injury. The prolific author who had written on so many subjects would write no more.

DURKIN: He’s suffering. Anyone who has had a traumatic brain injury to the extent that my uncle has, anyone who is a vibrant, intelligent, brilliant person who is now reduced to 24-hour care is suffering.

VALENTE: Father James Martin is an editor at the national Catholic magazine America.

REV. JAMES MARTIN, SJ: The mystery of suffering really does remain a mystery. There is no satisfactory answer to the question. It has bedeviled theologians and saints and scholars over millennia.

CUSICK: His attention span is certainly not what it used to be. He’s very slow. I mean, I think medical people have said it takes him a lot longer to process things.

DURKIN: Seeing his suffering has not necessarily affected my faith, because I know of his faith. For 80 years up until his accident I observed his faith, and I certainly heard about his faith because he shared so much of it and wrote about so much of it.

VALENTE: Father Greeley’s steamy novels won him both fans and critics. He wasn’t afraid to depict the sexual side of priests in his fiction and often included provocative sex scenes.

DURKIN: He would say all the other things he did as a sociologist, as a novelist, as a commentator were just his way of being a priest.

CUSICK: He would always stir things up, and people would be yelling and screaming and saying, how can he say that? How could he write that? And ten years later they’re saying it and they’re writing it.

DURKIN: Certainly the whole sexual abuse crisis in the Church—he was writing about that and identifying that long before it came out in most of the press in America.

VALENTE: Father Greeley warned of clergy sex abuse on national TV nearly a decade before the scope of the scandal became known.

Andrew Greeley on the Phil Donahue Show in 1993: I don’t think the Vatican cares. I mean they recently ordered the bishop of Pittsburgh to reassign a priest he had removed because he was a child molester, and so the Vatican doesn’t get it.

VALENTE: He has said that one of the church’s biggest problems is the status of women.

Andrew Greeley in 2002: The church just has not been able to cope with the demands for fairness and equality from women, so they’re very angry. For a long time, the bishops could console themselves, and I think some still do, that these are just your radical feminists. But the radical feminists include their sisters and their nieces and their mothers and all the women in their lives. They just don’t like the way the Church treats them.

CUSICK: He could drive the Vatican crazy, and I’m sure the Vatican could drive him crazy.

Andrew Greeley in 2000: The Vatican is cut off from the rest of the Church. It doesn’t understand. There’s no reason why it should, given its structure. It doesn’t understand what’s going on in the minds of the ordinary lay people or the ordinary priests.

CUSICK: When push came to shove, he said I’m not leaving and you can’t throw me out, and that was typical Greeley in his prime.

VALENTE: At a Mass celebrating his 50^th anniversary [2004] in the priesthood, Greeley, who said he had wanted to be a priest ever since the second grade, reflected on the controversies he had sparked.

DURKIN: He said I’m sorry for anything that I have done to people, and I’m not sorry for what I did in the name of people, in the name of helping people, in the name of challenging people, but I’m sorry for any relationships that were hurt.

VALENTE: After the accident family and friends wondered, would he ever again be able to say the Mass, which meant so much to him?

DURKIN: He has always written about the centrality of the Eucharist in the Catholic faith. We’ve reached out to his priest friends and tried to make arrangements for them to come to his home and to celebrate Mass with him.

VALENTE: Last year, with his family around him, Greeley helped celebrate Easter Mass at the home of his niece, Eileen.

Cusick presiding at Mass with Greeley: In the name of the Father…

CUSICK: I’m sad because such a brilliant mind and such a voice in the Catholic Church has been silenced by an accident.

MARTIN: When we suffer we are often made more vulnerable, and in our vulnerability God can break in more. But, you know, it’s up to us whether or not we accept those invitations to new ways of encountering God. But certainly Andrew Greeley is a deeply spiritual person, and I’m sure he is finding God in new ways in this terrible experience.

DURKIN: Does he have moments of grace, times when he flourishes? Yes, definitely, when he interacts with his family and with his friends, when he is still able to be a priest.

Cusick at Mass with Greeley: By the Spirit that is within us, grant this through our Lord Jesus Christ…

DURKIN: He is disabled, but he has been a witness to us in his attempts to celebrate the Mass. He is communicating in ways that have always been his priestly function.

Cusick at Mass: Can you bless them now?

DURKIN: The priest is still there. All those years of being a priest, all those years of blessing—they’re still there. They’re still connecting, and we don’t know what it all means, but we know that he’s blessing, and we know that he is blessed, and he’s blessing us, and it means a lot.

VALENTE: Though the public life of Andrew Greeley has come to an end, Father Andrew Greeley endures.

Presiding at Mass: The Lord be with you.

Response: And also with you.

Presiding at Mass: Almighty God bless you, Father, Son, and Holy Spirit.

Response: Amen.

For Religion & Ethics NewsWeekly, this is Judy Valente in Chicago.

FRED DE SAM LAZARO, correspondent: Minutes after delivering a slightly premature infant by C section, Dr. Nayna Patel was back in her office and on the phone to the parents.

Dr. Nayna Patel: Congratulations, it’s a baby girl. Where are you, in Mumbai right now?

DE SAM LAZARO: They were en route from their home in England and didn’t reach the small town of Anand, India in time to watch a surrogate mother give birth to their child.

Dr. Patel: Surrogate is also fine. The baby is also fine. We have taken the picture.

DE SAM LAZARO: Dr. Patel has delivered some 400 surrogate babies since 2004. Her clinic implants embryos in surrogates she recruits from the area and pays around $7,000 for a pregnancy carried to term. Biological parents come from across India and around the world. Kirshner Ross-Vaden came here from Colorado to pick up her baby girl named Serenity. She was born four weeks premature, but after a week in neonatal intensive care she was ready to be discharged. Serenity’s 46-year-old mother traveled here with her nine-year-old son. She had tried unsuccessfully in recent years to conceive. Surrogacy was her last hope and India her first choice. The cost—$10,000 to $15,000 all told—is a fraction of what it is in the United States, and in America, she added, surrogacy contracts are not always air-tight.

KIRSHNER ROSS-VADEN: You can sign a hundred documents. It doesn’t matter. If that surrogate changes her mind she can sue you for that child, and oftentimes she will win, and coming here to India, these women, they don’t want my child. It’s very cut and dry. They do not want my child. They want my money, and that is just fine with me.

DE SAM LAZARO: It’s not fine with everyone.

DR. ARTHUR CAPLAN (University of Pennsylvania): The contracts usually are written, to be blunt, to protect the wealthy people who are commissioning the baby, so that if the woman suffers an injury, if the woman has a health problem due to childbirth, if there’s a long-term chronic condition, then what?

DE SAM LAZARO: University of Pennsylvania ethicist Arthur Caplan worries the relationship is inherently lopsided between poor, minimally literate women and well-heeled couples who commission them to have their children. For example, surrogates in India are routinely implanted with up to five embryos to improve the chances of a pregnancy. In the US, clinics usually implant no more than two, sometimes three.

DR. CAPLAN: Why would you use three, four, five embryos in India? Because you don’t want the couple to have to come back. It’s expensive, even for a rich person so you’re trying to maximize the chance of pregnancy, even if it might compromise the interests of the babies.

DE SAM LAZARO: Dr. Patel concedes that implanting five embryos heightens the risk for infants and mother and says she is now lowering the number to three or four. But she says the downside of fewer embryos is a lower pregnancy success rate. When multiple embryos develop into viable pregnancies, Dr. Patel’s policy is to reduce them by selective abortion. Aside from possible religious concerns, this process could present medical risk to the surviving fetuses.

DR. PATEL: Parents—yes, there are some who say right from the beginning, “Doctor, put less embryos because we are not for reduction, and we don’t this to happen.” So in those cases we definitely never transfer more than two. But there are certain parents who don’t have any objection to this, and surrogates—we don’t allow them to carry more than two.

DE SAM LAZARO: Dr. Patel insists that her facility protects the interests of surrogates as much as the clients of her commercial surrogacy program and the infants she delivers.

DR. PATEL: We do a lot of psychological counseling for the surrogate and the family before we recruit them. We explain to them the procedure of IVF, what all they’ll have to undergo. If she has had any complications during her previous pregnancy, we will ask her not to become a surrogate, because the same can repeat this time, to make it very sure and safe for her.

DE SAM LAZARO: The moment their pregnancies are confirmed, surrogates are required to move into this home run by Dr. Patel. They’re offered skills training in things like tailoring, but mostly it’s a quiet, sedentary life. The women who spend nine months in this surrogate hostel have all experienced childbirth with their own biological children. It’s a prerequisite for becoming a surrogate. What very few of them have experienced with those previous pregnancies is any kind of prenatal care. That’s in sharp contrast to the pampering they get here: meals provided and medical attention, should they need it, round the clock. Dr. Patel acknowledges the irony but says it is part of a thorough surveillance to ensure smooth pregnancies, for both surrogate and parents’ sake.

DR. PATEL: We have a fetal medicine specialist who checks all the surrogates every three weeks. We have been able to detect minor congenital malformations which we inform the couple can be treated post-delivery without any impact on the baby. We have had patients whose surrogates had babies with Down syndrome, which was detected, which was confirmed with amniocentesis, and we have aborted those babies after the consent of the couple.

DE SAM LAZARO: Well in advance, she says, parents are consulted on decisions like pregnancy termination. Similarly, parents must accept their babies, once born, whether healthy or not. Surrogates we spoke to talked about building a new home and using their money for their children’s education. The money—$7,000-$8000—would otherwise take them decades to earn. Most say they were happy to have helped infertile couples. The woman who bore baby Serenity who we met earlier, admitted to some sorrow at her separation.

DHANA: You can’t help it when you’ve carried a baby for nine months. I’d like to see how she does in the future.

ROSS-VADEN: I do have her address, so I can get a hold of her. And I hopefully will be able to maintain some kind of a relationship with her.

DE SAM LAZARO: We caught up with Serenity’s mother in Mumbai, about 500 miles from Dr. Patel’s clinic. She and son Brandon were holed up in a hotel awaiting DNA test results and myriad documents to satisfy the Indian and US governments that the infant could leave the country.

ROSS-VADEN: Am I living happily ever after now? I certainly hope so. I hope that I can get her home, and I hope that she is a happy, healthy little baby, and that is what I will have—a healthy, happy little girl.

DE SAM LAZARO: But will every surrogacy story end happily? Right now, India has only voluntary guidelines, and it’s not clear whether future laws would be adequately enforced, and standards vary widely. For example, Dr. Patel says she only serves infertile patients. But some clinics offer surrogates to healthy parents who, for career or convenience, want to avoid pregnancy. Ethicist Caplan worries about where all this is leading.

DR. CAPLAN: We may get into situations where people start to say, as genetic knowledge improves, you know, I’m not infertile but I’d like to make a baby with traits or properties that I want to avoid or that I desire. That day is coming. I think it’s important to keep in mind, as we watch the evolution of surrogacy as an international activity, what is really something that a tiny handful of people use who suffer from infertility tomorrow can be what more people are interested in because they have a more eugenic, more perfectionist interest in making their children.

DE SAM LAZARO: For her part, Dr. Patel plans a major expansion of her one-stop surrogacy shop, a leader in what’s now a half-billion-dollar industry in India. She makes no apologies for making a lucrative living and insists that she, the surrogates, and the new parents all come out winners.

For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro in Anand, India.

Minister leading church service: Let us stand and continue our morning worship.

DEBORAH POTTER, correspondent: Serving God and ministering to people is deeply fulfilling, pastors say. Yet studies have found that Protestant clergy also suffer from depression and obesity at higher rates than the population as a whole.

REV. JOSEPH STEWART-SICKING (Loyola University Maryland): Researchers like to joke that what we know about clergy is they’re satisfied, stressed out, and fat.

POTTER: Joe Stewart-Sicking is an Episcopal priest who teaches pastoral counseling and studies why clergy are more stressed than most of us.

STEWART-SICKING: What makes the clergy vocation and occupation really different is that you work for God ultimately. If that work environment isn’t meaningful to you, you’re doing a lot of things like, you know, doing budgets or checking spelling on a bulletin, or office management, that’s going to really hit home, because you think your job should be about God.

POTTER: Add to that a new source of stress for many pastors in mainline Protestant denominations: as church membership dwindles they feel pressured to reverse the trend.

STEWART-SICKING: And a lot of pastors think that church growth is really the measure of their success, you know, and a lot of people are having to learn to deal with shrinking numbers, shrinking budgets, even closing churches.

REV. LYNDA FERGUSON (praying in home of church members): Lord, we thank you for your grace and your mercy today…

POTTER: Lynda Ferguson is pastor of Salem United Methodist Church in rural Bostic, North Carolina.

FERGUSON (praying in home of church members): …in Jesus’ name we pray. Amen.

POTTER: She’s the church’s only pastor—most Protestant churches have just one—ministering to a congregation of about 300.

FERGUSON: Used to be the churches were filled, and now today we have to play a role of going out and bringing people into the church or actually taking the church to people.

POTTER: In the past three years, Ferguson has put 90,000 miles on her car, visiting the sick…

FERGUSON (praying with sick church member): I ask, Lord, that you would just fill her with your holy presence and that your healing power will just consume her body.

WOMAN (speaking to Rev. Ferguson): He brought a lot of joy into this world.

POTTER: …consoling the bereaved.

FERGUSON (speaking to church members): I appreciate you letting me be part of your life.

Clergy are different in that we are called to go to many dark places. We enter into sacred places with people, places that often are very difficult and, you know, we don’t do that from a distance. Jesus didn’t sit off in a corner and say “I feel your pain” from over here. Jesus very much reached out and touched, and he felt intensely for people, and we do, too, and so when you do that on a day-after-day basis, it is a lot of stress.

POTTER: Today’s technology just adds to that stress.

FERGUSON: I couldn’t do my job probably without my laptop and my Blackberry but I’m on call 24/7, 365 days a year. I receive probably an average of 30 to 35 phone calls a day, 60 to 70 emails a day, and just taking care of that takes a lot of time.

POTTER: Feeling called to serve, not to be served, Ferguson hid her stress from the congregation. She worked 60 to 70 hours a week for more than five years and took little time off. And then one Sunday night it hit her.

FERGUSON: I came into the parsonage, and I put my things on the kitchen table, and I sat down and I—my body, I just felt like I couldn’t move, and I just sat there, and I was emotionally and physically exhausted.

POTTER: For years, clergy stress was a little bit like the weather. Everybody talked about it, and nobody did anything. But now, more than 50 programs across the country are working to improve clergy health, from foundation-paid sabbaticals to peer groups and retreats sponsored by church pension plans. Here in the mountains of North Carolina, the Episcopal Church brings groups of clergy together for eight days to de-stress and re-center themselves. This program started a decade ago with one workshop. It’s now held more than 20 times a year.

Retreat leader: The official theme for today is “where am I going?”

POTTER: The sessions cover everything from finance to vocation, giving clergy who are often isolated in their work a chance to share their stories and learn from each other.

REV. JOHN THOMPSON-QUARTEY (St. Mary’s by the Sea, Point Pleasant Beach, NJ): I was left alone in a very large parish and I was doing everything, everything, all the six or seven services during the weekend, running to all the hospital, home visitation. The doctor said, “You must be stressed out.” I said, “You think?”

POTTER: For many, the session on work and meaning was revealing.

REV. NICHOLAS PORTER (Trinity Episcopal Church, Southport, CT): What this has helped me realize is that I’ve sort of been feeling starved in my primary position.

REV. KYM LUCAS (St. Ambrose Episcopal Church, Raleigh, NC): I realized that at work I spend the bulk of my time doing the things I hate and not the things that I love to do.

POTTER: Trying to do it all can take a toll on a pastor’s spiritual life.

THOMPSON-QUARTEY: I often carry the burden of being stressed from work because of such nasty emails and stuff, I bring it home, and I can’t even prepare myself to pray.

POTTER: Kym Lucas has four small children and ministers alone to a busy parish—a classic recipe for clergy burnout.

LUCAS: I felt like I had been burning the candle at both ends for a long time, for at least a year-and-a-half. And there was a part of me that felt a little guilty about taking this time, but I’m glad I did, absolutely glad that I did

POTTER: For Nicholas Porter, the retreat was a reawakening.

REV. NICHOLAS PORTER (Trinity Episcopal Church, Southport, CT): I love my job. Do I love all of it? No. At any given moment, if you were to have a little camera in my office, no. But I love my job. Healing lives, connecting people to eternity and eternal life and love—I mean this is great stuff. This is great stuff.

FERGUSON: That can be hard to remember when the stress of the job gets to be too much. Sometimes I’ll hear clergy, other clergy, not just Methodist clergy but other clergy, say to especially young people when they’re discerning a call to ministry, they will say to them, “If you can do anything else, do it.”

POTTER: After nearly collapsing from exhaustion and overwork, Lynda Ferguson finally took time off for a mission trip to Nicaragua and reset her priorities. She takes Fridays off now. Sometimes when her cell phone rings she doesn’t answer, and she’s lost weight in part by resisting the temptation to sample every dish at every church gathering.

FERGUSON (at church meeting): Bill caught me this morning running a little bit.

Church member: I saw you jogging.

Church member: Hey, she runs, she don’t jog.

FERGUSON: Just because I love the people, and I truly do, I cannot be there for everything, and they understand that, and they know that, and it is part of our job to set those boundaries, but it is very, very difficult to do so.

POTTER: Difficult, but essential for clergy to manage the stress that comes with the job and focus on the work they really feel called to do.

FERGUSON: There’s a lot of pressure that we put on ourselves as clergy because of what we’re doing, and we don’t want to let God down.

For Religion & Ethics NewsWeekly, I’m Deborah Potter in Bostic, North Carolina.

FRED DE SAM LAZARO, correspondent: In recent years, thousands of rural communities in Senegal have held extraordinary public rallies they call “declarations,” and they’ve declared an end to a deeply rooted practice, one rarely discussed in public, one commonly known as female circumcision.

MOLLY MELCHING: Never in my wildest dreams could I have imagined that I would be sitting here years later, saying that 4,792 communities in Senegal had abandoned. In the beginning it was just unthought of, unbelievable, because it was so taboo.

DE SAM LAZARO: Molly Melching founded a group called Tostan—“breakthrough” in the local Wolof language—in the early ’90s. She had modest goals: to educate people about health and human rights, especially in rural areas and in local languages. The Illinois native is fluent in the ways of Senegal but she keeps a low profile in the work of Tostan.

Tostan’s work often begins with an ice-breaker, like an old movie. Many in the audience have never watched a film. To overcome the language barrier, the selection is a Buster Keaton silent movie classic from 1923, and it’s a hit. A more serious film followed, on vegetable gardening. It’s all part of seminars on nutrition, health, basic human rights, and other issues—in groups, songs, dances, and drama.

Skit: She needs to be cut. All girls need that.

DE SAM LAZARO: It’s proven to be one of the most promising attempts in history to wipe out what Melching calls female genital cutting [FGC], a practice that dates back 2000 years. Each year, the World Health Organization says up to 3 million girls in Africa are subjected to genital mutilation, and up to 140 million women live with its consequences.

Skit: You can’t have a recognized marriage if she is not cut.

DE SAM LAZARO: That cut is a painful rite of passage for girls across a wide swath of predominantly Islamic African and Middle Eastern countries. However, the practice goes back hundreds of years before Islam or Christianity and is also practiced in both faiths and religions native to this region. It’s thought to have originated in the harems of ancient rulers as a means of controlling women’s fidelity, or as a sign of chastity among those who aspired to be consorts.

MELCHING: Those who were in the rest of society could move up, and you could marry someone who was more prestigious or had more money, more status, if you underwent this practice, because it was a sign of good reputation, and as the years went on, I mean 2,200 years, it became very much a part of what was considered criteria for good marriage.

DE SAM LAZARO: Melching came to this West African nation as a student in the 1970s and later as a Peace Corps volunteer. She stayed on to work on improving health education, which she found sorely lacking.

MELCHING: When you see a friend that you’ve known for several months and you’ve gone to her house for lunch, and then she tells you her child has some problem, that it’s someone who has cast an evil spell on the child, the baby, and that she’s going to take them to a religious leader to get the spell taken off, and you don’t know what to say, and it turns out the baby was dehydrated.

DE SAM LAZARO: But from the health education, women began to understand infection, and Melching says they began to connect the dots.

MELCHING: So suddenly as they started learning germ transmission and the consequences of FGC and how these infections occur and why they had more problems in childbirth than other women who had not been cut, they started saying wait a minute.

Seminar: People used to be afraid to talk about this before. Not anymore.

DE SAM LAZARO: But how did women in conservative, patriarchal societies become able to speak out, especially on a sensitive sexual topic? Melching says it’s because Tostan involves men and religious leaders who’ve confirmed that cutting is not required.

MELCHING: We share our modules with the religious leaders so that they see that everything that we do is for the well-being of the community, the health, and all these things are things that Islam espouses, and so they’re very happy in general, but first of all they’re happy because we start with them. We respect them.

DE SAM LAZARO: And that respect also carries over in the group’s message on genital cutting.

MELCHING: Tostan found that using approaches that shame or blame people really was just the opposite of what would work in changing social norms. When you say to someone, we know you love your daughter and you’re doing things because you love your daughter, but let’s look at this and let’s try to understand together exactly what are the consequences of this practice. But you are the ones who will have to make the decision. Then suddenly people are willing to listen. They don’t get defensive.

DE SAM LAZARO: It’s far more effective than the approach of many aid groups—religious, government, and private, says Princeton University professor Gerry Mackie.

PROFESSOR GERRY MACKIE: Not hectoring and preaching but having pro and con discussions. When we think of an ideal way of making a change, we’d say it’s democratic. We all get together and talk it over and decide what the best thing is to do. Whereas some development approaches would, say, force them to do it, pay them to do it, trick them into doing it.

DE SAM LAZARO: Tostan’s volunteers and staff who conduct its seminars all hail from the local communities. Often they are leaders and elders speaking from personal experience or anecdotes. Diarre Ba used to make a living as a female circumciser.

DIARRE BA: I was part of this process. I felt bad. This is not right. But I didn’t know anything at the time. I had no learning.

DE SAM LAZARO: Others have painful, vivid memories. Ibrahim Sankare was very close to an older sister growing up. He walked into her room one evening.

IBRAHIM SANKARE: I saw her lying in a pool of blood. I thought someone had really hurt her. I screamed. My father explained to me. Since then, even now I get goosebumps thinking about it.

MARIAM BAMBA: It was very painful. I will never—you ask me if I can forget it? I will never forget the pain. So painful.

DE SAM LAZARO: Marieme Bamba is a long-time campaigner against genital cutting, and she’s spared her ten-year-old daughter the trauma. Yet before she became involved with Tostan and early in her marriage, she was determined to keep up the tradition. Even her own husband was opposed to genital cutting.

SULEYMAN TRAORE: She insisted that she had to do it. There were so many problems if you didn’t do it. If you cooked meals, no one would eat your food. It’s because we didn’t know. People told us that it was our religion. If you don’t do it, you’ll be going against your religion. All this is false. But I alone can’t do this in the village.

DE SAM LAZARO: They say Tostan was able to insure they were not alone—that communities in which they intermarried were also thinking alike, that their daughters would still be marriageable. The large declaration ceremonies have been critical.

MACKIE: One part of bringing about a change like this is to get everyone to change at once, what we call “coordinated abandonment.” Everyone has to see that everyone else sees that everyone is changing.

DE SAM LAZARO: Genital cutting is not the only tradition they want to change. Many communities have vowed to end the frequent practice of allowing older men to marry adolescent girls, acknowledging both the health risks and the girls’ human rights. Molly Melching says there’s plenty of historical precedent for abrupt changes in social norms and attitudes. She sees a very current example every time she comes home. That’s in American views about smoking.

MELCHING: People were smoking, and nobody said anything about it much through the ‘50s, the ‘60s, and even the ‘70s. As people became more and more aware of the harm that it causes, more and more people—there was a critical mass of people who started really protesting. It was amazing for me, coming from Senegal to the United States, to see how quickly things turned around.

DE SAM LAZARO: Tostan’s efforts have now expanded to 14 other African nations.

For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro in Kaolack, Senegal.

Watch more of Sunday morning worship services at Parc Chretien Free Methodist Church; in a tent next to the ruined Roman Catholic Our Lady of the Assumption Cathedral; and in an open-air structure next to the destroyed Holy Trinity Episcopal Cathedral, and see more of correspondent Kim Lawton’s interviews with Rick Ireland, administrator of the Free Methodist Haiti Inland Mission, and Bishop Jean-Zache Duracin of the Episcopal Diocese of Haiti. Edited by R & E news researcher Emma Mankey Hidem.

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“You cannot understand caregiving unless you do it,” says Arthur Kleinman. “Acts of caregiving come as close to what I think religion is as I could name.” Watch more of Bob Abernethy’s conversation with him.

JUDY VALENTE: Mary Jo McMillin is a cookbook author from the Chicago suburbs. When she shops, she looks for fruits and vegetables that are in season, preferably locally grown. She doesn’t buy processed foods or fast food and makes sure she knows where the meat she’s buying comes from. It’s not just about green eating, or even healthful eating, but eating ethically.

MARY JO MCMILLIN: I’ve been using this brand of chicken for a long time and I’ve researched them and I know that they come from not very far away, and they’re produced on small farms. It’s done with high standards. They’re fed a vegetarian diet. They’re raised on these Amish farms. They’re sort of religious chickens, you know.

VALENTE: But there’s nothing funny about the way some large factory farms operate. Advocates of ethical eating protest the way animals are often kept in crowded, unsanitary conditions and injected with growth hormones and antibiotics. Norman Wirzba is professor of theology, ecology and rural life at Duke University.

NORMAN WIRZBA: Cattle are meant to eat grass, to live in pasture. Chickens are, are meant to roam and be outside, and when you think about how industrial eating practices, right, stifle that inner drive, this natural drive that these animals have, it’s a violation of their ability to be what they are.

VALENTE: Another frequent criticism of the food industry is the widespread use of preservatives and artificial flavoring to prolong shelf life.

WIRZBA: That’s not to say we don’t do any processing, right, or any refrigeration or any preserving, no, we have to do some of that, but we don’t need to do it to the degree that we do, because as we do more of it, what we’re discovering is that we are paying for it with our own illness.

TARA SMITH: We have the safest, least expensive, most abundant food supply in the world, and that’s no accident.

VALENTE: Tara Smith of the American Farm Bureau Federation:

SMITH: You can find nutritious food year round in the grocery store. And if you look, and you’re willing to buy certain products, you can find relatively inexpensive healthy food products year round.

VALENTE: Ethical eating means looking at food as more than a commodity and eating as more than a biological function. Eating, it is said, connects us to the mysterious and miraculous character of life.

STUDENT: Oh, my gosh. This one is a little larger than this one, as you can see…

VALENTE: Many Americans are getting back to the garden. These students in Cedar Grove, North Carolina brave intense summer heat as they learn to grow fruits and vegetables in a community garden.

STUDENT: You can just pull it right out, and just rinse them off and you can eat them.

KATE FORER: Right here we have sweet potatoes, that are doing fabulously, as you can tell.

VALENTE: Kate Forer, who manages the garden, is also an ordained minister.

FORER: Having the experience of planting a seed and having the faith that it’ll grow into a plant that will eventually sustain me is a spiritual experience. And ultimately I really, really feel like food is a sacred gift from God, and that’s something that we tend to forget about in our culture.

VALENTE: Small faith communities like this one are sprouting up all across the country to advance the cause of ethical eating, teaching more than just good gardening practices.

FORER: I also feel like we’re teaching people how to cultivate peace in their communities just by working together. Just by dong a task together that’s not always easy or fun. I mean, sometimes gardening is hot and frustrating and stressful. But being able to work through those things together can be really powerful.

VALENTE: For others, personal gardening is also an opportunity for spiritual growth. Everyday, Mary Jo McMillin walks about a half mile to a public park where for a yearly fee of $32, she can cultivate her own plot of land and her prayer life.

MCMILLIN: Going to the garden is part of a spiritual practice for me. I use that time to think about what I’m thankful for, and to try to remember people in my past that I’m thankful for, and my family that surrounds me now. It’s just my daily meditation. I feel I’m in a place where things are really alive and growing. We’re all so busy, adding extra hours to our fitness routine, adding an extra hour to our e-mail, Twitter, and Facebook, whatever. But maybe we need really to sometimes add that extra hour to what we’re ingesting, what we’re feeding ourselves.

SMITH: I don’t know about you but I don’t have time to make every loaf of bread I eat.

VALENTE: What about the person who says, “I’m busy. I don’t have time to worry about where my food comes from”?

WIRZBA: I think we need to make food a priority because food touches so much. It touches personal health, it touches education, the social development of people, right, as well as touching economic issues and ecological issues. So food needs to be a priority.

VALENTE: One downside to eating ethically, at least these days, is that it’s probably going to cost more, as shoppers often discover when they buy organic food, or from local farmers’ markets.

SMITH: Right now, during these economic times, we have one out of every eight Americans is currently on food stamps. Budgets, when it comes to purchasing food items, are very important to most American households.

WIRZBA: I know that there is a lot of concern about the fact that if you want to buy organic food it’s more expensive, or you want to buy locally produced food it’s more expensive. But we have to ask the question, well, what do we really value? Do we value healthy land, clean water, vibrant farm communities?

SMITH: I certainly feel my nutrition is my personal responsibility and I think that folks should take some personal responsibility for being sure that their diet is the way that it should be. There is no lack of option for food products here in the United States. If you don’t choose to eat those healthy food products, though, no one can force-feed them to people.

VALENTE: The importance of food, or sharing a meal, is deeply rooted in religious tradition. McMillin, for instance, bakes the fresh bread her congregation uses at its communion services.

MCMILLIN: It takes us back to the point that this really isn’t just a big symbolical ritual, it’s also a meal that feeds both the body and the spirit. So many families have come up to me at church and said “our children just love to have real bread at communion.”

FORER: (speaking to students) It’s good to see everybody here.

VALENTE: In most of the world’s religions, eating traditionally involved a blessing, and an expression of thanks, a practice Forer and others say has become all but lost in our mass-production, fast- food culture.

FORER: All right, let’s pray. Gracious God we give you thanks…

Grace is a way of pausing and remembering the creator who has given us this. But for me grace is also a way to acknowledge the other people who have brought the food to us.

WIRZBA: Saying grace, besides being a sort of ritual act, I think is also a political act, because if you’re truly saying grace and you’re remembering this food that you’re about to eat, you should also be committing yourself to the well-being of the sources of that food.

MCMILLIN: I remember my mother sitting in front of a perfectly ripened peach, We had peach trees, the first ones that we had — and saying, “I’m going to eat this very slowly. Just think how long it took to grow.”

VALENTE: Advocates of ethical eating say if we pay more attention to where our food comes from, we will begin to see it not as something that just happens, but as a gift.

For Religion & Ethics NewsWeekly, this is Judy Valente in Cedar Grove, North Carolina.

BOB FAW, correspondent: At Le Bonheur Children’s Medical Center in Memphis, Tennessee, four-year-old Ethan Barker might seem carefree. But his parents, Chris and Tamara, are frightened about Ethan’s upcoming brain surgery. So when neurosurgeon Dr. Stephanie Einhaus asks if the family would like to pray, they readily agree.

DR. STEPHANIE EINHAUS (praying with family): We come before your throne today, Lord, asking for your blessing on this sweet child of yours.

FAW: Ethan’s surgery is delicate. Einhaus takes a bone from his skull and modifies it to cover a space created by an earlier surgery.

DR. EINHAUS: (in operating room): …the bone of the skull is kind of in two layers and so you can split it like an Oreo cookie…

FAW: For this skilled practitioner, praying benefits her as much as the patient’s family.

DR. EINHAUS: If I’m having a hard time doing something, getting a catheter in a fluid space, I’ll just pause and in my own head I will pray, “Please, Lord, help me get this right.”

FAW: Einhaus says praying with families helps them with the stress and gives them hope.

DR. EINHAUS: It helps them to hold on to something to get through, you know, that crisis that’s going on. Most people want to do it. They’re like, they’re so relieved.

FAW: Eleven-year-old Holly Barkley, about to undergo surgery to drain fluid from her brain, does not face a crisis.

DR. EINHAUS (to patient): How’s your head feeling?

FAW: But her family also wants to pray.

DR. EINHAUS (praying with family): I pray that you will let this family feel your power, let them feel your peace, Lord…

FAW: Prayers like that, family members agree, can bring comfort.

CHRIS BARKLEY: It puts a sense of comfort in you. Normally, doctors don’t do that, and it probably makes people feel closer to the doctor. You want them to care just as much as you do.

LAURA YOUNG (Holly Barkley’s mother): It was more of the Lord was on our side, and it told me then it was going to be okay, and you know I was ready to—if anything came out negative, I was ready to face it.

DR. EINHAUS (to Ethan’s family): Hello. We are all done, and it went great.

FAW: Einhaus, raised Catholic and now a Southern Baptist, was once reluctant to pray with patients in the beginning for fear of being ridiculed. But as time went on she felt more comfortable asking patients if they would like to pray.

DR. EINHAUS: Once you start doing it you realize how much people really like doing it and how powerful it can be as a support for not only the patient but for the families.

FAW: You regard your role as a physician as a kind of ministry.

DR. EINHAUS: I do, I absolutely do.

FAW: In this part of the Bible belt, many patients—like Marletta Scott, facing difficult triple bypass heart surgery at Methodist South Hospital—say they would welcome a chance to pray with their doctor, even though Marletta Scott’s doctor, heart surgeon Alim Khandekhar, happens to be Muslim.

MARLETTA SCOTT: He did explain to me that, overall, that, you know, it was in the Lord’s hands and that he’d be watching over him as well as me during this procedure. I mean, and that’s all that we can ask for.

FAW: That makes you feel good, that gives you comfort?

MARLETTA SCOTT: Yeah, it does.

FAW: in his 32 years of professional experience, Khandekhar says he has found that patients with faith often recover faster.

DR. ALIM KHANDEKHAR: Because they rely not only on the doctors, the medicine, but they rely on a power that is more powerful than all of them, that puts them at ease with themselves, at ease with the decision they are making.

FAW: What all this suggests, especially in this part of the country, is a growing trend by physicians to treat physical and spiritual problems together. After all, says the founder of this Memphis clinic, 50 percent of the patients who come here for primary care do not have medical problems.

DR. SCOTT MORRIS (Founder, Church Health Center, and United Methodist Minister): Many of our physical complaints come about because of our spirits being broken. What they need is a way for us to help them deal with this spiritual devastation.

FAW: So here at the Church Health Center, which since 1987 has treated 60,000 low-income people without health insurance, the spiritual needs of a patient are addressed before they ever see a doctor.

DR. MORRIS: From my point of view, if we want to be healthier, you must have a healthy spirit as well as a healthy body. We know, I think, in our heart of hearts, that being at peace, being bathed in what a person perceives as the love of God, makes people healthier faster.

FAW: But mixing prayer with medicine can cause problems, especially when the goal of reducing suffering conflicts with the wishes of devout patients. For example, a recent AMA [American Medical Association] study found that patients of faith demand and get more aggressive treatment than is medically warranted, and there are also concerns that a patient can be exploited if a doctor uses prayer to proselytize, to promote certain beliefs.

PROFESSOR MARK MUESSE (Associate Professor of Religious Studies, Rhodes College): It might take the form of a particular kind of prayer that the patient might be uncomfortable with. It might include accepting certain kinds of creedal statements that the patient would not otherwise accept.

FAW: At Rhodes College, where he teaches comparative religion, Mark Muesse also worries that praying with a patient could compromise a doctor’s relationship with a patient.

PROF. MUESSE: There could be a boundary crossed there, that a doctor begins to lose his objectivity in relationship to a patient. You’re losing some of the critical distance, I think, that’s oftentimes necessary for proper medical treatment.

FAW: Physicians like Einhaus counter that even if that boundary is crossed, no harm need result.

DR. EINHAUS: No matter what, you’re going to develop a relationship with your patients, okay? So the fact that I’m praying with them may make that bond a little stronger, but in no way would it affect my judgment.

FAW: And that element of compassion, physicians argue, is what is often missing in the training many doctors receive.

DR. KHANDEKAR: During my training, you know, being a cardiac surgeon, I don’t think that part has been stressed enough. It helps me to have another power behind me to do what I do. I do not think enough doctors use this power.

FAW: Here, though, that recognition—that the spiritual can affect the physical—seems to be growing.

PROF. MUESSE: In the past, you know, doctors would take care of the body, and the ministers and the chaplains would take care of the soul, but now we’re seeing that those two things cannot be separated.

FAW: Shortly after his surgery, Ethan was almost as playful as before. Holly, too, was doing just fine. For each, medical technology prevailed.  But in this medical theatre, more and more physicians seem to be sharing a belief that there is more at work here than science and skill.

DR. EINHAUS: We’re not always in control. God’s always in control, and so things may not turn out the way we want them to. We may not like it.  We may not understand it this side of eternity. But we have to trust that he is still in control and that if they go and they die, that heaven is really a good place.

FAW: Here, where there is recognition that when in comes to healing, fixing the body alone is an incomplete, indeed, flawed approach.

For Religion & Ethics NewsWeekly this is Bob Faw in Memphis, Tennessee.