We traveled in the MAF Cessna Caravan to what many in Angola consider “the end of the world”, the southeast desert province of Cuando Cubango, to explore the possibility of monthly clinics in several locations. We visited the towns of Mavinga and Rivungo and explored several areas around each for our clinic work. We began our trip in the capital of the province, Menongue, and met with the vice governor, who received us and our proposal with great enthusiasm, calling his Director of Health out of a meeting and explaining our vision to him. They both then called ahead to all of the places we had proposed visiting, continuing our trip “in the name” of those in provincial authority. We were also traveling with the leaders of one of the major evangelical denominations in Angola (all quite small), who also called ahead to each place.

 

At each stop, we were received with incredible warmth, a large delegation from both the local church and the local government meeting us at the airport. It was humbling to think that so many people interrupted their day to honor us. The desperate need for a doctor is acknowledged and truly appreciated by these rural folks. It was crazy to see the enthusiasm that a doctor can create in areas where one has never worked. We were then escorted to the local church, where singers gathered to greet us, where we met the leaders and, in several of the stops, we shared a service with the congregation (who showed up just to welcome us and share their enthusiasm for our work). The governmental administrators (in the US, we would call them, “Mayor”) also joined the service and this allowed me to share the vision for our work with both the government and church leaders, using the passage from John 9:1-7 to illustrate our philosophy. My ministry perspective revolves around several key points from this passage:

• It is entirely human/normal to have difficulty understanding suffering/affliction (as did Jesus’ disciples)
• Jesus indicated that suffering/affliction has purpose
• We are called to respond to the one suffering, as Jesus did
• Our response to suffering/affliction can bring glory to our Father
• Only God gives life and heals
• He loves using instruments (mud, spit, doctors, pastors, medications, friends, etc) to accomplish His work
• We have the incredible privilege of being mud and spit in Jesus’ hands, as He works in the lives of those suffering

 

It was an encouraging trip and one which will hopefully be the first step in a long journey together with the IECA church and the government of Cuando Cubango.

 

 

Rosaria awoke that morning like any other. Her crying and deformed daughter of 3 years worsening, her head size two times normal. She seemed to be losing both hearing and vision, but she sang, beautifully, quietly and without ceasing. Rosaria noticed, as well, that her own rash of three years seemed to be increasing and she had strange sensations on her skin and face. She had heard that a doctor might be visiting and, though she had never met one, she wondered if he could possibly help Tchungunja, or perhaps help her with this crazy rash that wouldn’t go away. She would walk to her town’s clinic and see. She arrived to a crowd of people who wanted to see the doctor, but found out that he was only visiting and not working today. An hour later she found out that a formerly planned part of his trip had been delayed because of a broken down car and, because of this unexpected turn of events, he would be doing consultations that day. She tried to push her way to the front of the crowd…

 

As of three weeks ago, we had no plan to travel anywhere in this part of Angola. Last month, I traveled to see this part of the country for the first time at the last minute invitation of Gary Goertzen, one of our MAF pilots, because he new I had wanted to see Cuando Cubango one day, and he had an open seat (unused seats are quite rare in these small planes). I was free in Lubango that day (and staying with Gary and his wife, Tammy) because my normal flight clinic for that day had been cancelled unexpectedly. On the trip to Mavinga, I met some church officials and, in conversational small talk, told them about my work. They asked if I would want to join them in a visit to the governor, where they just happened to be discussing health needs in this very needy province. I spent the day with them and found kindred spirits. They inquired as to how they might partner with me to serve the many people living remotely in their province and then, over the next three weeks, they lined up an official meeting with the vice governor, and set up a whole trip for me to the most remote areas in their province (they knew our hearts for people living in remote places), including the trip to Rivungo, where Rosaria lived, in the harsh, remote desert of the SE corner of Angola.

 

I brought no equipment and had no plans (or time) to do consultations, but we found out that our next planned stop (Jamba Luiana) had no car to transport us the 18km from the dirt airstrip to the town. The administrator from Rivungo sent a car to Luiana (a 7 hr drive through the night) to help us with this transport to Luiana the next morning and this freed up an afternoon to see people in the simple clinic in Rivungo (we stopped at 32 consultations because of darkness), including Rosaria and Tchunguja.   The Wind…

 

After seeing Rosaria and Tchungunja, we arranged for them to fly back to Lubango with us. Tchungunja would receive surgery for her hydrocephalus and Rosaria would begin treatment for Leprosy (there were no meds available where she lived).

 

Two weeks later (yesterday), they were transported back to their home by MAF (same plane, same pilot – Gary Goertzen – that had brought us) after a successful surgery at CEML for Tchunguja and the initiation of 12 months of Leprosy treatment for Rosaria.

 

She awoke one morning like any other and two weeks later had traveled by air to the other end of the country and back (she had never been to a city, to a hospital, in a car or plane…), her daughter had received what would normally be an impossible surgery, and she had begun treatment for a case of fulminant leprosy. The incredible, indescribable, never-to-be-understood (or predicted) Wind…

 

 

We have had the pleasure of hosting two medical students from Ohio University for the past month. Their inquisitiveness, enthusiasm and hearts to learn have left us so encouraged. In a couple months both will graduate and Nigel will enter residency for Internal Medicine in Dayton and Kyle will begin residency in Pediatrics in Akron. I don’t think I’ve seen wisdom demonstrated so clearly in young men… they asked questions, listened, and asked more questions. Their humility combined with a passionate hunger to learn, about medicine and about life, will serve them well, and will direct them to wise decisions. The common, arrogant, and ignorant, “I have it all together and don’t need advice” pride of youth was nowhere near these guys. I was refreshed and encouraged by their hearts and minds and enjoyed every minute in their presence.

 

 

When we returned to Cavango, we had two deliveries in the hospital, both appearing healthy, one a granddaughter to one of our nurses and the other a son to one of our nurses. We also had a 12 year old boy, Jelito, who had had both legs and one arm amputated over the previous two years because of infections. He presented to us with a large smile, a huge abscess about his only forearm, tight effusions in both shoulders, a respiratory rate of 60, a fever of 102, a pulse of 150… very sick. I didn’t think he would survive the night but we treated him aggressively with antibiotics, drained his abscess and prayed for this beautiful boy, who was suffering like few can imagine and at risk of losing his only remaining limb, as well as his life. He greeted us every morning with a huge smile in exchange for a sucker…

 

On his arrival, we suggested that he would be best served at a surgical hospital, but his mom had had enough of surgical hospitals, watching her son suffer three amputations and such persistent pain over the past two years, never seeing any sign that the infection in him was diminishing. She was quite obviously at the end of her proverbial rope, tearful, and mostly silent. She refused transfer (I had offered to drive them the 5-6hr to the city of Huambo) and asked us to do the best we could. As is so often the case in health care, she wanted someone to care for her child rather than find someone who might be more skilled. We prayed, cared, changed his dressings, prayed and cared. The next morning, this mother was a different person as she pleasantly and soberly smiled to greet us.

 

We were also greeted that following morning with the tearful and wailing mothers and families of the two infants, who had both died during the night. Appearing healthy, with normal exams and vital signs on day one and dead before day two. This was unique and hit me like a punch. What could I have missed? What could I have done differently? These are questions that are not new to me and always dreadful to encounter in my profession when faced with an unexpected poor outcome. As I soberly reviewed the situation with Kyle and Nigel, I wrestled with the temptation to despair. My dear friends had birthed their children at our hospital because they had confidence in us (virtually all children are born at home and it is normally not seen as beneficial to come to the hospital for delivery), and now the babies were dead, likely from congenital malaria. We had cared for them and prayed for them… The Wind?

 

Upon my return after traveling for a week, Jelito smiled to greet me (and my sucker) and seemed somewhat better, though still quite ill. I was so pleased, and surprised, that he was still alive… then he died suddenly during that night. Today I drove his body, his mom and his three young sisters to their home village, about 45 minutes away, where we were greeted by severe wailing and mourning. His village had journeyed with this family for the past two impossible-to-imagine, years of one painful loss after another…

 

On the way, I passed a village holding a huge funeral for a beautiful woman who, two months ago, was bitten as she got between a wild dog and a small child (saving the child’s life). She came to our hospital and I drove her 4hr to Cachiungo to get the rabies vaccine, we brought back to our clinic the rest of her needed vaccinations, and she came faithfully on the exact days to be vaccinated. She died from rabies yesterday (likely the vaccine was bad – if it isn’t cared for, refrigerated properly, etc, it breaks down… nothing is diligently cared for here). We currently have several rabid dogs in the region of our village and a boy came in yesterday with an unprovoked bite from “a sick dog”…

 

This is life, and death, in Angola (and in so much of the world). Many young, healthy people die acutely from preventable, treatable diseases. We help such a small few…

 

Jesus, how can you use us today to make a little difference in this painful world, as you used the mud and spit years ago?

 

“My Kingdom is not of this world…”