At some stage all people ask this question and there are as many proposed solutions as there are religions and ideologies.
Muslims might well say, 'It's the will of Allah. He has willed it, and who can resist his will. It's just fate.'
Hindus may reply 'No, you misunderstand. Man is locked in a cycle of birth, death and reincarnation. Suffering in this life is simply a consequence of bad karma accumulated in the last one. It's retribution.'
Buddhists could protest, 'No, man's suffering is the result of desire. If we truly expected and wanted nothing, if we could extinguish our desires, then we wouldn't suffer. It's all in the mind.'
Naturalists might scoff, 'Man is simply the product of matter, chance and time in a godless universe. We have to expect suffering in a world where only the fittest survive, where dog eats dog.' To quote evolutionary biologist Richard Dawkins, 'DNA neither knows nor cares. DNA just is.' In other words, 'It's only random molecules.'
Fate? Retribution? All in the mind? Random molecules? These are some of the explanations the world offers, but Christians cannot take refuge in them. We believe in a God who is omniscient (knows everything), omnipotent (can do anything) and benevolent (he cares). Herein lies the problem.
Suffering: A problem for Christians
If God knows everything, then he must know about suffering. If he can do anything, then he must be able to eradicate it - and if he cares for his creatures then surely he would want to. So, why doesn't he? 'It's obvious,' sneers the sceptic. 'He either doesn't know, is powerless to stop it or doesn't care. The God Christians believe in can't possibly exist.' Many have lost their faith through this sort of thinking. Bernard Shaw put it rather cynically:
'How are atheists produced? In probably nine cases out of ten what happens is something like this. A beloved wife, or child or sweetheart is gnawed to death by cancer, stultified by epilepsy, struck dumb and helpless by apoplexy or strangled by croup or diphtheria. The onlooker, after praying vainly to God to refrain from such horrible and wanton cruelty, indignantly repudiates faith in the divine monster and becomes not merely indifferent and sceptical but fiercely and actively hostile to religion.'
Is there an answer? We need to start by saying that faith and suffering have always co-existed, and that while the existence of suffering has caused great men and women of faith to ask questions of God, it has not shaken their belief in his knowledge, power or love.
The Bible details the suffering of God's people throughout the centuries. David wrestles with it in the Psalms in the depths of his own defeat and despair. Job devotes forty chapters to the problem. The prophets repeatedly quiz God as to why he allows evil apparently to triumph while the godly and innocent remain unvindicated.
According to tradition, eleven of the twelve disciples met a painful and ignominious death and today there are 150,000 Christian martyrs each year. Jesus' own death on the cross was one of prolonged torture, not just physical but mental and spiritual as well.
Many have suffered and not doubted, but this still leaves us with question of why God allows it. While it is dangerous to speculate on God's reasons for each and every tragic event, we can still give general guidelines. Although ultimately we must say that 'God has his reasons which reason cannot know', God has given us enough light in his word to put together some coherent arguments.
Let's consider the problem under the four headings of Free-will, Fall, Faith and Future.
As Christians we believe that God created man in his own image. This involved, amongst other things, giving him free-will and responsibility. Man is not a robot. He is God's appointed guardian of the planet (Gn 1:25-30), but free-will implies the possibility of choosing evil.
How much suffering in this world occurs as a direct consequence of man exercising his free will? Suffering due to war and violence is an obvious example. Most famine can also be attributed indirectly to war. Refugees have food-stocks looted, supply lines destroyed and can't plant crops. They are pushed onto unproductive land and may even produce environmental change themselves through deforestation and desertification.
A stroll around any hospital ward confirms that much disease is a direct result of human choice. Many patients are there because their own (or others') actions: alcohol, tobacco, stress, diet. The AIDS epidemic, with 30 million people infected worldwide by the year 2,000, is largely a consequence of sexual choice.
Why are holes appearing in the ozone layer? Why is global temperature rising? Where does acid rain come from? These phenomena are all broadly the result of human activity. Man has caused a lot of suffering.
Let's turn the question around and ask how much suffering man could have prevented? Why is it, for example, that there are 30 million people in the world who are blind according to WHO definitions? Blindness is largely preventable (trachoma, avitaminosis A), treatable (onchocerciasis) or surgically correctable (cataracts). Why is it that three million children die each year from diseases for which immunisations are developed and available (polio, tetanus, measles, diphtheria and whooping cough), and that four million under five years die from diarrhoea when in most cases simple oral rehydration would suffice? Why do a further four million die from respiratory infections when antibiotics exist? According to the WHO, the vast majority of the 15 million childhood deaths in the world each year are unnecessary.
Even suffering from so-called 'acts of God' is made worse through human negligence. Deaths from flooding in Bangladesh are compounded by tree felling up-stream and the fact that the poor are made to live in dangerous low-lying areas. Earthquake fatalities are potentiated by Jerry-building or location of cities on fault-lines.
John F Kennedy put human negligence in perspective when he said in the 1960s that we had the knowledge and resources to provide food, water, clothing, health and education for every man, woman and child on the planet. All we lacked was the will. In Jesus' parable, the goats were condemned for negligence, for what they did not do (Mt 25:31-46).
If we could remove all the suffering that man has caused or could have prevented, there would be substantially less.
Free-will aside, as Christians we also believe that the world we see today is not the world that God originally created. In the beginning all relationships were in harmony. We now live in a changed world where relationships are broken at all levels: between God and man (Gn 3:23-24), between man and his fellow man (Gn 4:8), and between man and the planet (Gn 3:16-19). The whole creation 'has been groaning' and is in 'bondage to decay' says Paul (Rom 8: 21-22). Disease, death and even natural disaster are symptoms of this. These changes are indirect consequences of the Fall: a rebellion against God by both human and angelic beings. (The devil and his angels are part of this rebellion too - Rev 12:7-10.) Of course Satan can only do what God allows him to. In the Bible we see him having to ask God's permission to afflict Job (Job 1:12, 2:6) or to sift Peter (Lk 22:31). However like man, he is able to exercise his free will within the bounds God grants him and so wreak much havoc.
We should not be surprised that our world is full of suffering as a result.
Through the eyes of faith, suffering can be seen to have real value.
Sometimes it can protect us from far greater disaster. The mother who plucks her child from the path of an approaching car may cause a little suffering in the process. But she averts far greater tragedy. Surgeons cause injury to prevent something far worse. Our God-given sensation of pain protects us from traumatic ulceration and infection. If we need any convincing of this, we need only look at the feet of a leprosy patient whose normal sensation is gone. C S Lewis has called pain 'God's megaphone to rouse a deaf world'. Suffering can protect us, not least from the greater suffering of being alienated from God. It is not evidence of God's lack of care for us,but rather of his love and concern. This is why Paul says, 'Endure hardship as discipline; God is treating you as sons'. The Lord disciplines those he loves (Heb 12:6,7). Suffering may be God's way of protecting us.
It may also have good effects. Training as doctors is not easy, but the hard work we put in now will later bring great benefit to those we help. God works for good even in the most desperate situations. If a piece of coal is put under great pressure at the right temperature, a diamond may result. On the other hand we may be left with coal-dust. People under pressure behave similarly. Suffering may produce strength of character or may cause a person to collapse. Those who have been through war, famine or prolonged imprisonment testify to this. Such experiences can make us or break us. The Bible describes these effects of suffering (Rom 5:3-5, Jas 1:2-4, 1 Pet 2:19-22). God works through suffering for our good (Rom 8:28), and uses it to strengthen us in his service. Knowing this, we can be grateful and even rejoice through it.
Finally, we need to see suffering in the context of the future. The presence of suffering reminds us that one day God is going to put everything right. Justice will finally be done. As Christians we look forward to 'new heavens and a new earth' (Is 65:17) where there will be 'no more death or mourning or crying or pain' (Rev 21:4). We await a world where 'the wolf and lamb will feed together and the lion will eat straw like the ox' (Is 65:25), where 'they will neither harm nor destroy... for the earth will be full of the knowledge of the Lord' (Is 11:9).
It is only this perspective of how things will be in the future that makes real sense of suffering in the present. Paul, who suffered so much (see for example 2 Cor 11:22-29) could say that 'our present sufferings are not worth comparing with the glory that will be revealed in us' (Rom 8:18). He declared, 'No eye has seen, no ear has heard, no mind has conceived what God has prepared for those who love him' (1 Cor 2:9). It was this same 'joy set before him' that enabled Jesus to endure the cross (Heb 12:2).
This may make us wonder why God doesn't bring in the 'new heavens and new earth' now. Aren't things bad enough?
We need to realise that God's perfect new world will only come with the destruction of the old. This will involve the annihilation of all evil. It is God's mercy which is leading him to delay (2 Pet 3:9). When the author walks back onto the stage , the play will be over. When he returns to put things finally right, everything evil will be destroyed. Those who have rejected him will be banished from his kingdom forever. Just as the glory of the new world far eclipses the best of this, so the horrors of Hell, of separation from God forever, make any suffering in this world pale into insignificance. This is why God delays, to allow us a chance to join his side before it's too late.
God understands human suffering intimately because in Jesus Christ he has taken the worst this world has to offer: rejection, humiliation and an ignominious and painful death. He did it for us. It was the only way that we could be rescued from this world which is heading for destruction (2 Pet 3:10) into the perfect world that is coming. This is why we need to accept the wonderful gift of forgiveness, new life and assurance for the future which Jesus' death on the cross offers us - before it is too late. The offer is made now.
We cannot (and must not) seek the reason for every tragic event which happens to us or others. Much will remain a mystery. But when we understand that God has given man (and the Devil) free-will, when we recognise that we live in a fallen world. When we see suffering through the eyes of faith and in the context of the future, it does begin to make sense. The existence of suffering should not be a stumbling block to our faith. We don't have to dismiss it as fate, retribution, 'in the mind' or random molecules. Christianity grapples with suffering and conquers it in a way that no other philosophy, religion or ideology does. Christ defeated sin and suffering through the cross.
How should we respond to suffering as Christians?
First, it should be a constant reminder to us that we live in a world which is transitory. Judgment is coming and God is only delaying it out of mercy. This should encourage us in evangelism and godly living, because 'the time is short' (2 Pet 3:11-14; Col 4:5).
Secondly, we must realise that the only way of conquering suffering is in the way Jesus did, through the cross. Jesus relieved suffering in others - he restored peace in nature, brought healing to the sick and mended broken relationships - at great cost to himself. He calls us to follow him in this same path of the cross (Lk 14:27).
As Christian doctors we will want to take up our cross: to use the skills he has given us to relieve the suffering of others, to bring patients and colleagues the good news of God's grace and to take our own share of suffering in his service (2 Tim 2:3).