I recently returned from our monthly trip to the southeastern part of the country where we held five days of remote clinics.  We fly into Mavinga and Rivungo on alternate months and then each day travel by car 1-3hr to a village (chosen by the local government, based on need) to hold a clinic.  The roads are rough (see video in “photos”) and the days exhausting, as we typically leave Mavinga (this month’s trip) at sunrise and return after sunset (we can only work with the light of the sun as none of the villages have electricity).  Twice this trip we arrived to an empty village and our organizer said with a shrug that word must not have arrived of our arrival.  During the rainy season, villages empty at sunrise as everyone walks to their fields and works their crops (turn soil, plant, weed, etc).  Word is sent via a person (or persons) days in advance, but sometimes the message doesn’t arrive (illness, death, motorbike breakdown, etc).  There is no phone or mail service in these remote areas…  We drove each time to another village and held a clinic, which immediately filled with those seeking help (most with acute cases of malaria).  There are no medications available in these villages and they are in the middle of malaria season, so lines for consultations form quickly as word spreads of our arrival…

 

The other three days of the week we arrived to large crowds waiting for us (where they were notified of our arrival) and the work was plentiful and many cases were devastating (the saddest for me are the many cases where people have easily treatable illnesses but, without access to care, they become disabled or don’t survive).  We now have five identified locations in each of the Mavinga and Rivungo regions, where we will return on a regular basis, as it has taken us six months to sort out the best places to work from each of the two towns.

 

The economic crisis in Angola is worsening by the month.  We seek to work in villages where they have a community health worker, so that he/she can prepare for our visit and follow up after.   The workers in these villages haven’t been paid for over a year and there are no medications – none (the “free” government health care has been drastically cut by the government).  And virtually everyone has malaria!  The numbers of malaria during rainy season feel like the number of people who pick up a “cold” during “cold” season in the US (everyone).  Yet, despite no wages, these nurses show up for work every day and offer whatever advice and help they can to those ill/hurting.  They often simply help people die well…  These workers tell us that they absolutely marvel at the number of people who get well after our visits.  They have simply never been exposed to someone who prays, practices good diagnostic care and treats with appropriate remedies!

 

As we watched it rain one day, our local team organizer, a beautiful man named Francisco, looked out over the fields and said, “There is no crisis here,” meaning that with rain (not an annual guarantee in the desert southern part of the country), the plants will grow and no one will be hungry.  With their basic need of food satisfied, these people are content, even though malaria, protein-malnutrition (dietary protein requires money), measles, TB, typhoid fever, etc will claim many lives….   It is so very difficult to find a discontented person in rural Angola!  In the modern western culture, “affluenza” has promised contentment but has rather done what Jesus said it would do – move people away from a humble dependence on Him – and to the discontentment that follows.

 

The economic crisis is more severe in Angolan cities where people depend on work and wages for food, and there is plenty of work but no wage…  We missionaries are not hurt by the crisis because the value of our dollar in Kwanzas has tripled along with the prices of most goods (we come out even), but the local Angolans (especially in the cities) have been hurt by the radical deflation of the Kwanza.

 

Virtually nothing is done solo in rural Angola, where privacy and individuality are not admired and rarely experienced.  Did you know that privacy is actually only available to the wealthy?  Life here is too full of known and unknown risk to tackle anything (even going for a walk) alone.  We foreigners often smile because of how much energy is devoted here to making sure that someone is always with us when we travel, walk, eat, sleep…  It is easy to criticize our hosts’ motive as fear-based, but their preoccupation with unforeseen danger is based on reality and experience.  This very practical dependence-on-each-other becomes a primary source of community, as it promotes treating each other with respect, kindness and deference, as everyone knows that they will need help from others to survive.  This dependence-on-one-another sense of community has been beautiful for me to behold (though at times uncomfortable) and is in stark contrast to the “rugged individualism” of the west.

 

In Mavinga, a woman is assigned to me for the week to cook and clean (there’s no running water or electricity).  She cheerfully and quietly slips into my room at sunrise (about 4:30a) without knocking and asks me how my night was and if I need anything (if it wasn’t my habit to rise before this time, this might be uncomfortable).  This is culturally strange for me, but I’m sure her house has no doors and she has likely never known anyone to sleep in a room alone (most families sleep everyone in the same room, as many as 20 people.  We once had a very rainy day in Mavinga (the clinic was actually in the town of Mavinga) and returned to our rooms at noon and many times that day someone entered my room (without knocking) to see how I was.  I spent the day enjoying the break and reading a novel (no internet), cherishing some solitude, which I rarely experience when traveling.  To sit and do nothing is common here, but always in a group!  I am likely quite a curiosity for these folks, as I embrace solitude when I can grab it…

 

We begin each clinic day with a talk on how we can improve our physical and spiritual health and at one of our stops, the health care worker introduced me by saying, “Listen to what this white man is saying, as he can help us live better lives.”  Skin color differences here are just an identifying feature and nothing more.  He could have said bald guy, big guy, guy with glasses, etc and all would have had the same significance as “white man”…

 

I always enjoy the long conversations (4-5hrs) in the plane with our pilots.  My pilot on this trip, Marijn (mar-īne) from Holland, and I spoke about our elections in the US and he marveled at the priority we have in the states about individual “rights”.  He said he doesn’t understand this preoccupation and his perspective is common outside of our US borders, where the emphasis is more often on community well-being rather than individual well-being.

 

In January, I facilitated a delightful 3-day retreat with our SIM missionaries at a remote beach about 3-4hr from Lubango (on paved roads!), around the topic of how we can function better as a “team”, rather than as a group of individuals/ministries.  We are all often overwhelmed as we seek to meet the tremendous physical and spiritual needs around us.  We acknowledged our need and appreciation for each other and had about eight hours of discussion as to how we can improve as a team, as a “body” and as a missionary “family”.  Our SIM Angola team consists of about 20-30 beautiful missionaries (depending on who is present in the country at any one time) from many countries and there is a wealth of experience and wisdom among us.  This wisdom and experience were shared extensively over the three days and it seemed we all returned to our respective ministries more united and enthusiastic about being a healthy support and encouragement for each other.  The setting was nice, too!

 

On my return to Cavango on Monday morning, after a 10hr drive home on Sunday, I learned that a 56-year-old man had died that morning from an “intestinal infection”.  He undoubtedly had an intestinal perforation from Typhoid Fever and had been treated with antibiotics for a condition which could only be remedied with emergent surgery.  With no means of transportation in our absence, the nurses treated him with medications and it wasn’t sufficient.  Because I have a car donated by our home church, VCDC, for such service opportunities, I was asked if I would take the body back to the man’s home village, so I left a full clinic of patients and began what would be a 4hr drive through pouring rain, on sloppy and muddy roads, to his village, getting stuck several times, but making it out each time.  On the way home in the afternoon, we made a “wrong” turn and, in so doing, missed the worst part of the morning trip (an hour to go about 2-3km) and made it back without incident by dark.  We used the Angolan GPS – asking people along the “road”.  The trip was awful, but I kept thinking that this man had made this trip with peritonitis (a disease which causes excruciating pain with each jar and jolt) several days prior, squeezed between his two adult sons on a motor bike, groaning at every single bump on the dirt roads, falling several times…

 

Three days after his death, the man’s two sons made the trek again to our hospital to pay for his hospital visit and for all the meds used to try to help him!  Incredible in this very poor, rural culture, where daily basic needs are often lacking.  Such beauty is rarely seen anywhere, especially when facing devastating loss…  I’m reminded also that we are here to serve, sometimes in ways not so exciting or noteworthy (as in healing/success stories)…

 

I returned to clinic the next day to 60+ patients, some of whom had been waiting for more than a week for a consult with a doctor (unheard of outside major cities).  We had a man of 26 who had ridden three hours on a motorbike with severe shortness of breath and chest pain for over a week.  We removed more than four liters (one gallon) of fluid from his left chest, he hopped back on his bike (against our counsel) and rode home because his family needed him there.  He promised to return in three days to continue treatment for TB (which we initiated that day), the cause of his malady.  A year ago, this man had acute rheumatic fever with valve inflammation in his heart that resolved with our treatment.  Two deadly diseases in a year…  I wonder what is God’s purpose for this man?  The Wind…

 

We saw cerebral malaria in three kids in comas, all of whom recovered, along with many other cases of malaria.  I had empathy for each as I personally dealt with this disease all week (again), beginning with a feverish Monday drive to/from the village of the man who had died.  I’ve picked it up two weeks after almost every trip to the southeast, despite using a mosquito net and repellent!  I’ve been asked how I can go to places where I get malaria so often.  It’s because many people live in these places, and they need help.  I’ve had malaria six times and many of them have malaria six times every year!  It’s because my life is not more valuable than the lives of these kids, in the same way that Jesus didn’t consider His life more valuable than ours.  Because of love for the world, He left home to give His life for the benefit of others (you and me), and we are called to follow Him.  When Jesus’ followers follow Him, they do as He did/does…  Malaria is a drag, but it isn’t a cross (if Jesus can embrace a cross for me…).  Like Jesus and because of Jesus, I know where I’m going, but many of those I serve do not… and they must have the opportunity to meet Him… and any risk to me in this life is small, because of what awaits me in my Father’s eternal home.

 

 

We also saw three babies with likely meningitis (no way to confirm), all recovering nicely.  A woman with Leprosy who has begun treatment three times over ten years and has been unable to complete a year of treatment because the medicine runs out at the government hospitals (always).  She has a severe case, with much deformity, and has watched it progress, through no fault of her own, while seeking any/all available treatment (we cannot get this medicine as it is tightly regulated by the same authorities who never have the meds).  We saw five new cases of TB, several kids with typhoid fever, several babies with severe pneumonia, several nasty abscesses, several cases of heart failure in young people, etc, etc.  All preventable with decent access to basic health care, nutrition, vaccines…

 

We had one man with a hemorrhagic fever (who looks like he will survive), while Angola is facing a yellow fever outbreak (one of several hemorrhagic fevers), because of lack of good vaccinations.

 

Thinking of the woman with Leprosy, the inadequate supply and/or bad YF vaccinations and the TB patients (we are using expired TB meds because it’s all the government will give us), I wish everyone in the US during this election cycle could come to Angola for a season and experience a country with high government control/regulation.  Both government control and freedom have strengths and weaknesses, but freedom, with all of its messiness, looks pretty attractive when experiencing the reality of control…

 

Our clinic in Cavango has remained quite busy during these past two weeks and we’ve had many delightful early morning conversations with inpatients and their families on physical and spiritual health.  The interaction is a joy, and reveals that these rural folks are truly interested in their earthly and eternal well-being.

 

This morning we had another intestinal perforation because of Typhoid Fever, this time in a 16-year-old girl, who had ridden to our clinic in the dark over four excruciating hours on a motorbike.  We were only able to examine her, treat her with fluids, pain meds and antibiotics and advise her family that she needed emergent surgery.  Her father and uncle put her again between them on the motorbike and departed for their four-hour journey on dirt to an ambulance which then would (if operational) take her another four hours (on pavement) to a hospital in Kuito where she could (maybe) receive the necessary surgery.  Their journey on dirt was four hours instead of eight because of the bridge built by local people with funds sent by our supporters (see in “Photos”)…

 

None of our interventions (some dramatic, some benign, some “successful”, others not) would be possible without all of you who are responsible for our presence here, through your financial and prayer support.  If any of these people could meet you, they would express their gratitude to you as they do me…  One day you will see your reward, in the form of their presence with you around our Father’s throne…