We recently went with a team of friends from our village to a village about 30km away (an hour drive). Our pastor and friend, Jeremias, gave a message to the villagers and then emphasized during a baby dedication how important it was for parents to take their sick children to our hospital. This is a needed encouragement because rural people do not think of modern medicine as better than other alternatives (all help is seen as minimal, at best). The only “modern medicine” they have been exposed to are the government health posts which typically have minimal medicine and are staffed by caring but minimally trained workers. When we first began to work in Cavango, the nurse director said that it was such a joy to see people arrive for an illness, receive treatment and actually get better. The pastor is now including this “good news” in his messages to nearby communities.

 

The health posts in most of the country have not received medications from the government since December. The low global price of oil has devastated this country’s already fragile economy (Angola’s main revenue is oil) and the national health care budget was significantly cut. I can’t imagine the number of people who have died because of these cuts, and because of a health care system under almost complete governmental control, dependent on global factors such as the price of oil.

 

Luke, Ben and Ellie have returned to the US after a delightful stay with us for a month in Namibia and Cavango. Luke and Ben completed a hilly, warm, trail half-marathon in the Cavango area prior to their departure. Luke will return for his final year at Ohio University in Athens, Ellie to Liberty University in VA, and Ben will begin his first year at Wheaton College in Chicago. Their departure highlighted perhaps the toughest part of our work – extreme geographic separation from those we love. It hasn’t gotten any easier, but we take Jesus at his word of life in His kingdom without end, without tears, without good-byes…

 

We just returned from our first clinic week in the extremely rural, desert southeastern province of Cuando Cubango. As we were experiencing the frustration of church and governmental indifference to our desire to help the rural people of the southwest, we had the doors of the southeast blow open through a denomination in Angola called IECA (The Congregational Church of Angola). They heard about our work and energetically initiated governmental contacts and cleared the way for us to work in this environmentally brutal part of the country. Our clinics went well and we were received by the local governmental leaders with enthusiasm and gratitude.   We are accepting this as our Father directing us as He will, rather than according to our best strategies (Acts 16). It’s so reassuring that God is sovereign over me and that He can guide me (or turn me 180 degrees) as I seek His priorities.

 

We traveled to a couple of villages located outside of Rivungo (a town in the SE corner, on the border with Zambia) and they were the poorest and simplest I’ve seen in ten years of cross-cultural work. We were told that there are 50+ villages like these in the large Rivungo municipality. I’m excited to return monthly and work in these villages and in other towns that have health clinics and no doctors (and usually no meds). One town we visited (Mavinga) had two doctors, so we will seek to travel 30-60 minutes by car outside this town to work with those who would not be able to access these doctors (most of these villages have no motorbikes, so the only transportation is by foot). We couldn’t travel this time to these villages because Mavinga was out of diesel (they don’t have gas stations, but a truck will monthly bring some cans of diesel from the closest city, about 14hr, for the 5-6 government trucks). In the Mavinga hospital, I was able to meet the docs, learn their system, and do many ultrasound exams to help the doctors with difficult diagnoses, as well as do about 60 consultations.

 

We are in the middle of winter in Angola and, in this region covered with several meters of sand and minimal vegetation, the nights were in the 50’s and the days in the upper 80’s. In a couple months it will be unbearably warm, similar to where we lived a couple years ago in Shangalala, in the southwest of Angola. Rivungo is located next to a large river basin, which is mostly swamp and one of the Angolan men traveling with us said he’s been all over Angola and has never seen the number of mosquitoes that he sees in Rivungo from September to May. Everyone typically has malaria several times/year!

 

The southeast of Angola demonstrates that people today are unreached and neglected by both the world and the church for a reason – they live hard lives in hard places, involving discomfort and/or danger from disease and their environment.  To love and serve them, therefore, involves discomfort and personal risk… and they are so worth it!

 

It is a unique satisfaction that anyone can experience; to serve the truly needy, to love those others will not love, to go where others are unwilling to go…

 

Mother Teresa did what the most unskilled could do; she and her colleagues left their homes and families and went to where the needs were great… they embraced, sat with, dressed, bathed and listened to those whose simple needs others wouldn’t meet… They simply sought out, found, and served those with needs that were not being met…

 

Jesus has called all who are His to do the same…

 

Jesus’ calling is so remarkably simple when I let go of my own desires, dreams, and ambitions; it’s impossibly complex when I try to serve others and me.

 

The governmental leaders in the other Angolan provinces have been offended that we charge for our medications (average about $2.00US/patient), but the leaders in this region were grateful for both a doctor and the meds we brought for such radically minimal prices (we charge cost without concern for profit). The pharmacies in the cities will charge about 10x cost and these rural regions have been without meds from the government since December.

 

In our first clinic day in Rivungo, a 35 year old man was our first patient. He had severe chronic heart failure, with an O2sat of 60% (normal is > 93%) without difficulty breathing at rest. Heart failure is so common in young people here because of untreated strep throat, which can then go on to damage the heart, joints or kidneys. We put him on a “cocktail” of meds for heart failure and gave him an injection of penicillin, which is commonly given to these patients monthly for several years.

 

Within 30 seconds he began to wheeze significantly and soon passed out, moving little air. By the time we moved him to a cot (a few more seconds), he had stopped breathing and was pulseless, so we began CPR. I had some epinephrine in my boxes (no other equipment or meds for acute resuscitation) and we administered 3 doses, got a pulse back, and gave 4 additional doses before the wheezing began to decrease (his O2sat was 28%). When we left for lunch about 4hr later, he was sitting outside talking with friends and said he “felt great” (see photo).

 

What a way to begin a clinic in a new place! I was grateful for his life, as I would have given him perhaps 10% chance of surviving this reaction, considering the state of his heart at the outset and the simple location in which this occurred. The Wind…

 

I was joined on this trip by Sandy, a beautiful 3^rd year surgical resident from Canada. She was enthusiastic, helpful and a joy for the patients and the local health workers, and especially the children. It was great to have her travel with us. The students and residents that we have the privilege of working with in this cross-cultural work are truly a blessing (we get the best of the best) and continually challenge my knowledge and perspective.

 

As we were working into the night at Mavinga, a woman entered our exam room who had waited 10hr to be seen and had no previous prenatal screening. She was 7 months pregnant and had a blood pressure of 240/150 (dangerously high), had no symptoms, but just didn’t feel right. We were able to get her started on meds and plugged in to the local doctor the next day.

 

The indifference of both government and Angolan church leaders to our work over the past three years has been a source of frustration for me and my passion to be an advocate for the rural poor has grown. These beautiful people have no advocates, are truly impotent and are neglected by both the church and the government. At various times I’ve become so angry at the apathy of the leaders who seem content with the suffering and pain of so many… and I can become so tired when confronted with the seeming futility of so much effort to bring change…

 

I’ve grown in my understanding of what Jesus felt when He overturned tables in the temple as He saw “His people” caught up in profit and comfort while unconcerned for the heart of His Father. Where are God’s people today? For all of history, like Jesus, His people have been drawn to the forgotten, the hurting, the displaced and the disenfranchised, with radical lack of concern for personal safety, ambition and comfort. If we are not preoccupied with the same people that concerned Jesus, mustn’t we ask ourselves if we are really His?

 

That the US church is so radically concerned and upset about a supreme court decision and not in tears about the majority of our world dying from hunger and preventable disease with no one to introduce them to Jesus is almost too much to bear…

 

I’m concerned that, like the people in the temple who upset Jesus, so many in the American church today are more preoccupied with their job security, their three meals/day, their latest technology, and their “dreams” for this life than they are concerned for the temporal and eternal health of their “neighbor”.

 

Are these beautiful hurting and neglected neighbors not worth the sacrifice of our pursuit of personal happiness?

 

 

Today, the opportunity is yours…

 

It will be the most difficult thing you’ve ever done…

 

to you abandon your current life, and that which is comfortable and familiar…

 

to embark on a difficult and uncomfortable journey, filled with frustration, misunderstanding and loneliness… but

 

the wounded and confused…

 

in your neighborhood, in your town, in Africa, in Asia, in the deserts and swamps…

 

are crying out for simple help and direction…

 

You…

 

can serve them… live among them… bring Jesus to them…

 

You will never be closer to your King… than when you are, with Him, embracing the smelly, sweaty, dirty, broken, weeping, confused, disagreeable, offensive, unappreciative, beautiful “least” that He so cherishes…

 

 

 

Then I heard the voice of the Lord, saying, “Whom shall I send, and who will go for Us?” Then I said, “Here am I. Send me!”