A 32 y/o woman came in to see us because of a miscarriage and she hadn’t stopped bleeding for three months. As we discussed her diagnosis and treatment, she asked about whether we provided birth control. I told her we did if it was necessary medically, but that it would be expensive (about $2.50/month). I asked about her pregnancy history and she said that she had 7 living children, 4 children had died within their first five years and she’s had 4 miscarriages. Her “stats” were pretty typical of the women that I regularly see in our clinics. The only difference between this woman and her neighbors is that, after 15 pregnancies in 18 years of fertility, she didn’t want any more pregnancies. I would estimate, in the populations that I serve in rural Angola, that miscarriages occur in about one of three pregnancies and that about 1 of 3 children born alive die before the age of five.

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In this culture, the marriage of a young adult is arranged by his/her parents. The betrothed have the final say and there is no dating before the wedding. There is virtually no privacy in this culture anyway, and everything is done in groups. This method of marriage selection is quite successful, depending on how one defines success, as virtually all relationships last until death of one of the parties. The young people I’ve talked to say that this is the biggest decision of their lives, so why would they want to make it independently of their parents, when no one cares for them more, and knows them better, than their parents? It is actually a decision typically involving many aunts and uncles and friends, as no decisions are made independent of the community. Most rural communities are family units and they are all involved in raising the children. They all really see all the children in the village as “theirs”.

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There is a small percentage of marriages ending in divorce, usually secondary to infidelity, but no cases of divorce from “irreconcilable differences”. Of course, they have no Hollywood expectations of love and romance… the couple is typically pleased with the choice of their parents and the universal humility of the people causes them to desire a “good” marriage, not the “ideal” spouse who will make them happy… This culture is quite similar to most cultures historically, regarding marriage selection, and radically different from the modern cultures in the west regarding marriage. I’ve seen nothing in the western cultures to suggest that their way of marriage selection and family identification is an improvement to the historical norm. In fact, from what I’ve seen here, the move from radical and intimate community to “rugged individualism” has been a historical lesson in the destructiveness of individual freedom without community…

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The typical gift from the groom to the bride’s family is three cows, as a gesture of honor to the bride’s parents and acknowledgment that they are “giving” their most precious daughter to the groom. Cows are how people here save money and a cow’s ability to reproduce is how “interest” is earned. Cows here are sold for about $800-$1000 and a current, high, daily wage is $5.00. So the wedding gift to the bride’s family is typically well over a year’s wage! The wedding ceremony is quite simple, but there is usually a celebratory gathering at the homes of the parents, lasting about three days, and consisting of music, dancing, food and drinks (all quite simple in this neck of the woods). There is no legal, religious, or governmental marriage certificate, but rather a community blessing and acknowledgment of the new family’s commitment and new place in the community. So much of what we consider “Christian/biblical marriage” in the U.S. is actually quite cultural…

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Verses not often quoted by “Bible-believers” in the U.S.:

Jn 12.25: Those who love their life in this world will lose it. Those who care nothing for their life in this world will keep it for eternity.

Lk 16.25: Son, remember that during your lifetime you had everything you wanted, and Lazarus had nothing. So now he is here being comforted, and you are in anguish.

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The rural people we work among here live like Lazarus in Jesus’ story in Luke 16. There is nothing material in this life that is attractive to them. They have NO earthly treasures… They have never gone “shopping”… Kids have NO toys… Women have NO kitchen utensils… They eat with their hands… Men have one tool, a solid “hoe” that they use for cutting wood, cultivating fields… Houses have dirt floors and don’t have furniture (perhaps bricks or tree stumps for sitting on) and there is NO consideration for decorating their house… They have never used running water… They have never watched TV or seen a movie… There are NO decisions as to where to spend vacations or Christmas… Transportation is almost exclusively by foot… They have NO options to travel and “see the world”… There are NO gifts on Christmas and birthdays… There are NO books, magazines, computers… Whether clothes match, are stylish or “fit well” is NEVER a consideration…

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Will they experience Lazarus’ eternal joy? What will we in the States, Canada and Europe, the richest cultures in the history of mankind, experience in eternity? There is today so much talk of grace and saying a salvation prayer and so little transformation that results in the joyful abandonment of this life as seen in Jesus, Paul, the apostles, and the early church during the reign of Nero…

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A wise question, with eternal significance, for every man and woman “Christian”: “Am I treasuring this earthly life or am I abandoning it to serve my Father and others, resulting in an eternal treasure?”

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About 30 men spent the past two weeks building a bridge (see “Photos” in the next couple weeks) over a river that rises almost three meters in the rainy season and will join two large regions together. It can be crossed only by foot in the dry season, and not at all when the rains begin (now through April). The bridge will allow motorbikes to cross year around and allow us to serve many more people in our clinic (the motive for the project). These men hauled river rocks to the site to build pillars with cement, cut trees for bracing, ate rice, fish and funge (“foonj”), and slept on the ground. One day, they were attacked by a swarm of bees (like the one near our house in “Photos”) and virtually everyone had multiple stings. They used gasoline to blow up rocks, which I had never seen done. It was virtually equal to dynamite (they poured gasoline onto the rocks they wanted to break, lit it, and it exploded the rocks). VCDC purchased the materials (cement, wood planks, food… and gasoline 🙂 for the project… this bridge will serve so many people for so many years…

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A 65 year old woman limped barefoot from 4a to 4p with excruciating back and leg pain with obvious weakness in one leg. She undoubtedly has a degenerated and/or herniated disc in her lower back (no evidence of a fracture), pinching her Sciatic nerve, and making life almost intolerable for the past several months. At the bridge site, she climbed down and up the rocks and crossed the knee-deep river by foot and then rode a motorbike for an hour on a washboard and rutted dirt road to arrive at our clinic. We gave her several medications (ibuprofen for pain) and she returned home the following day as she had come, after sleeping on the ground by a fire outside our clinic. She grimaced with every movement, but had an easy smile and was a delight to interview.

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I wonder whose life is richer, and who is living in freedom (those who strive to fulfill their desires or those who choose to consider fulfilling their personal desires irrelevant)? Those who can sleep anywhere, eat very little yet virtually never (or always) “feel” hunger, smile through pain without complaining, eat (and enjoy) anything (usually the same meal twice/day, every day), endure all manner of hardship and loss, and still live with more sober joy than I have seen in my 50+ years… or those in the US who must sleep with temperature control in a quiet/dark environment in a bed with a pillow, who do virtually anything to avoid pain, who eat only what tastes good at the moment (there is here no such thing as breakfast foods, lunch foods, dinner foods), and cannot walk several hours without proper clothing, shoes, repellent, etc. Is the one free who has learned to live anywhere in any conditions with joy or the one who is living in constant pursuit of ever more comfort, leisure and success? These folks have learned, like Paul, to be content in whatever circumstances life brings, whereas those living in prosperity must have things a certain way to be content. Most in the west have lost what these folks know…

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For years I’ve been saddened by the promotion of “healers”, “Healing Conferences”, and “gifts of healing” in some U.S. church circles. They put on shows in churches and auditoriums in N. America and Europe where a few sick are in attendance, while spending little time with those really ill (where there are no crowds). These “gifted” “heroes of faith” are invited to join me in my clinics and if they are legitimate (healing more than only subjective complaints), they could “perform” for a crowd every day where 100% of those attending have untreatable and objective illness/deformity…

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We had six new cases of symptomatic Rheumatic Heart Disease (RHD) in one week, ranging in age from 2 to 15 years old. We typically have about one new case/week, so this was quite a sad week. I have an echocardiography machine (part of my portable ultrasound machine – my only diagnostic tool) and it wasn’t needed to diagnose these kids. The stethoscope told the story and, with two of them, I could feel the heart’s murmur (extra sound) with my hand. This heart disease is acquired from untreated Strep Throat, where the toxin from Streptococcus bacteria damages joints, kidneys and/or heart long after the sore throat is gone. The toxins cause inflammation on the heart valves; they thicken, become stiff and don’t close completely, causing blood to flow in both directions (the sound of the murmur) when the muscle squeezes. This results in inefficient pumping of the blood forward and, eventually muscle weakening. These kids all have serious disease, already causing shortness of breath with activity and two of them have difficulty sleeping because lying down causes difficulty breathing.

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In the west, the strep throat would have been treated. There is virtually no death from RHD in developed countries – about 0% statistically, because if they do acquire the heart disease (quite rare), they would receive a heart valve transplant and likely live normal lives. RHD was the leading cause of death in people ages 5-20 in the U.S. 100 years ago and the statistics are today in Angola what they were then in the U. S. These kids will die within a few years, becoming less and less active, as the heart muscle weakens from inefficient pumping. We will use medication to help the heart pump more efficiently and antibiotics to prevent further infections, which worsen the disease.

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The “healers”, mentioned above, could have thriving, daily ministries here, even for just those with RHD, though they would have to love individual persons rather than crowds…

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We pray to our Father for every ill or injured person, and then do all we can to love and care for them. Many are healed, few “miraculously” (defies explanation)… and many are not. We are not gifted to heal, but we can serve the sick and bring them to the Healer; there is One Healer and Giver of all life. “Prayer” doesn’t work; God does. “Faith” doesn’t heal, God does. We are not called to perform “supernatural” “signs and wonders”, only God can do something outside of “natural” and when He does, He (rather than the man/woman with the “gift”) should get all the credit. We are called to serve and to love and bring every ill person to Jesus, who will do what He will, when He will, how He will. He reigns and rules, not us. He has power to forgive, to heal, and to grant eternal life… He is worthy to be followed, worshipped and served… we are not.

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Jesus asked His followers to ask God for laborers (Luke 10), not miracle workers. History has shown that His kingdom is advanced through humility, love and service (the fruit of the spirit) much more than through “signs and wonders”. Greatest in God’s Kingdom is the “gifted” miracle worker or the humble servant? According to Jesus, we need people through whom He will work miracles (His time, place, circumstance, etc), but more we need people willing to abandon self-pursuits and self-acclaim and go, care, serve, love, teach, wash feet, ask questions, listen…

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We need less people in front of crowds and more people on the streets in the hard places in the inner cities, in Sub-Saharan Africa, in southern Asia, in equatorial Latin America, and in the Middle East, in places where Jesus and His Kingdom are unknown… relating, loving, and spending time with those who don’t know Him…

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We need more people living out what they so quickly say they believe about the “lost” and the “least”… leaving home and loving and serving those in the heat and in the slums and in the jungles… As we look back in 500 years, will we be sorry or pleased with our pursuits and passions, and with our priorities and how we “spent” this single life given to us… There are so many ways to have an impact and, according to Jesus, serving individuals is primary…

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Those who follow Jesus today are worried and bothered by so many things (Lk 10), forgetting the example of the One they “follow”…

He left home to rescue, serve, teach, heal and free those in need, where they were and as they were…

He had no interest in personal comfort, success, retirement, longevity of life, food selection, style/decorating, financial security…

He did what His Father told Him to do…

He taught on His Kingdom…

He focused on relationship with a few key, solid, trusted followers, and

He sought out those who were failures, lonely, rejected, confused, disenfranchised, wounded, ill and broken, pointing all to His Father and His Kingdom…

We are to be about our Father’s business/pleasure…

In our families, in our neighborhoods, in our schools/work places, and in the more remote places in the world…

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