Influence, Coma, Gratitude…


I have been greatly encouraged by this quote posted in the blog of Emily Herfel ( about her Angola adventure.  She was our visiting medical student from Ohio in April, whose beautiful presence impacted all of us during her stay,


“You may sometimes be tempted to say, ‘Will my influence make any difference? I am just one. Will my service affect the work that dramatically?’ I testify to you that it will. You will never be able to measure your influence for good.” -Thomas S. Monson


An encouraging and memorable moment this past month in Rivungo, with Urbano, the 65-year-old nurse who I work with there and who is charge of health care for the region…  He has a wealth of experience, working with Doctors without Borders throughout the long civil war.  He interacts with me enthusiastically during patient visits, asks questions and is always eager to learn something new to incorporate into his practice (he essentially functions as a physician daily in this town of 20,000+ with no physician).  When I was giving discharge instructions to a patient, I was distracted by another issue and as I turned back to the patient, Urbano had his hand on the patient’s shoulder, both with their heads bowed, asking our Father to touch him, using much the same language that I use when I pray for each one.  A beautiful moment, indeed, as (as the above quote indicates) it is sometimes tempting to question whether we are having any impact at all as we run this sometimes exhausting race…


There are four principal plants used here to make “fuba”, the powder used to make “pirao” or “funge”, the staple that these folks eat twice a day.  “Conduto” is a word given for anything that is eaten with the pirão (they only sometimes have “conduto” with their pirão).  They make their pirão with corn, massango (millet), manioc root, or massambala, another plant similar to millet.  They dry the corn (similar to what we would call “feed corn”), millet, etc and beat it into a fine powder (the women do this daily), which is then stirred into hot water until it reaches the consistency of mashed potatoes.  I was asked the other day by a local friend what the people eat in the US if they don’t eat pirão?  I was at such an embarrassing loss.  How could I possibly explain the incredible richness and variety of the American diet to a man who essentially eats grits twice/day and only sometimes has “conduto” (greens, chicken, goat or beans) to go with it?


Multitasking is a phenomenon of the modern, western culture and it is too new to know whether it is humanly healthy or unhealthy.  This “ability” is not present in our rural Angolan culture as nothing is done while doing something else.  Working quickly is also rarely seen, as each task is done thoroughly and deliberately before moving on to the next.  The strengths and weaknesses of such a cultural temperament are often clear, especially when in contrast to this type-A, never-working-fast-enough, multi-tasker!


I’ve tried to think of all of the animals that have hit my car since being in Angola… a snake, several birds, a warthog, several cows, a goat, a pig, several chickens, many lizards, a few rats…  My favorite animal has become the owl, as our skies are full of them in the dusk and dawn, likely chasing the other animal that fills our night skies, the bat, which is undoubtedly chasing the deadliest animal in the world, the mosquito.


In our morning discussions before clinic with the patients and their families, I’ve asked many times, “Who prays?” and every hand goes up.  Imagine if I asked publicly 100 random people at a clinic in the US?  Jesus sought out people hungry for Him and we are to do the same.


We’ve had many beautiful stories in these past few months of kids arriving to our hospital in a coma from cerebral malaria, only to walk out of hospital whole (and usually carrying a sucker) a few days later.  Last week 8-year-old Ronaldo (see photo) woke up after almost five days “asleep”, with intermittent, persistent seizures.  He was out so long that he developed blisters on his buttocks and ears (bed sores)!  Every one of these kids would have died without intervention and each one has given us the opportunity to participate in our Father’s temporal care for their precious lives.  Many of you have participated in their treatment through your contributions to our Father’s work through us.  They will never know you until one day around the throne when Jesus points out to them how He used you, like the mud and spit, to heal them.  How beautiful is His body!


This month we arrived in Tchincombe, one of our monthly flight clinics, where we normally see about 50 people who wait for up to a month to see the doctor for various acute and chronic ailments.  On the morning of our flight arrival via MAF, more than 250 people were waiting for a physician consultation.  They came to this location from many miles away because nowhere accessible-to-them were there medications or a physician to treat their illnesses.  They arrived in cattle wagons pulled by tractors and dump-truck-like-trucks full of standing people, having traveled over two hours in the morning cold (40F).  Over three days we treated and prayed with each one, most suffering from malaria, but also with a variety of other illnesses, as well.  It took us three hours to recover from the shock and create an organized way to address such numbers.  There were several remarkable things about this visit.


To serve this many people in three days isn’t so unusual, but to serve this many unexpectedly in a traveling ministry which requires much planning beforehand (especially re the quantity and types of meds) is crazy.  I arrived to Tchincombe frustrated because several of our flight visits from the previous week in the remote province of Cuando Cubango didn’t materialize because of a broken vehicle.  We normally visit 3-4 locations outside of the town in which we land the plane (this time Rivungo) and could visit only one of these (and only for a few hours) because of the vehicle malfunction.  We ended up working mostly in the town of Rivungo, where they had much malaria (some say Rivungo has more mosquitoes than anywhere in Angola as it is located next to miles of swamp), but they also had a recent delivery of malaria meds, so we saw mainly non-malaria illnesses.  The remote villages would have been mainly malaria consultations and would have exhausted our malaria meds, but because of our inability to serve in these locations, we arrived in Tchincombe with our med boxes full.


“Someone” was planning our trip in advance and knew the meds we would need when we arrived.  It was an example of the loaves and fishes, as our meds were never exhausted despite the overwhelming needs.  We monthly pack enough meds to serve about 300 people during the 6 days of clinics, and over the week (because of Tchincombe), we saw over 400 and still had medications left over.  We also had the gracious service this month of a selfless medical student, Emily Herfel, who (without knowing the language) contributed in so many ways to allow me to work more efficiently.


If I would have trusted my Father’s planning and His control of my days in the midst of my disrupted plans, I would have experienced much less frustration in Rivungo over the broken vehicle.  I’m so glad that our Father delights in using such flawed tools (me)!


People shared blankets, the villagers brought food and invited people into their homes, and in the morning at our 7a arrival on days two and three, everyone was lined up in the sunshine trying to get warm.  It was an event that will be remembered here for some time (if we don’t now repeat it monthly)!


One of the lessons re this work is that those we serve cannot possibly realize everything that goes into our service.  The money contributed by people unknown to them, the hours that go into purchasing and organizing the necessary medications, all that goes into the flights/planes/pilots through MAF, the calling of those who serve, etc.  Gratitude is virtually never expressed (similar to anywhere else in the world), and our presence and effort is rather taken for granted and quickly becomes “normal”.   This so reminds me of me with my heavenly Father.  I have no idea all that goes into His care for me and I so often take all of His work, effort and affection for granted…


When we began our cross-cultural work, I was advised to let go of any expectations re gratitude.  This was healthy and appropriate advice and time after time I am reminded that we work for One, and it must always be, and only be, His pleasure that we seek.  To seek the pleasure of those we serve is to invite frustration and misunderstanding, and this is still a battle for this often-weak servant of Jesus, who still revels too much at times in the praise/gratitude of men.


There are, however, exceptions.  A 40-year-old woman came to us in the town of Tchifuaco with malaria, smiling.  She warmly and excitedly expressed gratitude for our work and for coming to her village.  She said that at our last visit she had severe malaria and couldn’t keep anything down and no longer could walk.  We gave her an anti-malarial injection to get treatment started and antimalarial pills to continue the following day.  She said she worsened all day and thought she surely would die (these words have substance when spoken by someone who has experienced the disease perhaps 30-40 times).  But the next morning she awakened improved and continued to heal over coming days.  Urbano was with me and said she was telling everyone in Rivungo about how she was saved from death by the visiting doctor.  What made the interaction quite special was her knowing response when I advised her to remember that only Jesus gives us each breath and that He had healed her, using various tools (including the doctor, the meds, the makers of the meds, the driver, the planners of the trips, the church leaders who invited us, etc, etc) to do so.  She smiled and moved closer to me, tilted her shoulder for me to lay my hand on, and bowed her head to pray.


We returned to Cavango last night (Sunday) with the young man that we enrolled in driving school in January, 2015.  He finished the course in the allotted three months and still doesn’t have his license.  He has spent the last four months away from his family in Lubango seeking his license, without success (he was away from his family for 9 months last year for the same).  The scene of his arrival was special.  We drove up to his family’s three shacks and about 20 adults and children poured out and there were hugs and laughter all around for five minutes.  They spontaneously broke into song in their own language which is essentially a song of thanks for a loved one’s return and safety.  One’s continued survival over several months is never a guarantee for any of us, but especially in rural Angola.  They then all wrapped their arms around each other and the patriarch prayed, thanking our Father for their son’s return, expressing love for their son and for their heavenly Father (and for the doctor).  He drove the final, rough two hours of our journey home and did wonderfully.


I then drove over to our clinic and walked in the darkness through about a dozen cooking fires, each with many people huddled close, who greeted me warmly and asked about my trip.  The hum of evening conversation and the aroma of the burning wood and the evening meals on the fire took me back to my first medical mission trips to Haiti in the 1980s, and has now become a familiar sense of “home”.  The first of the month in Cavango is always similar with many waiting for a consultation for up to two weeks (the last two weeks monthly I fly with MAF to other remote settings).  Last night, however, there were more than usual, with over 300 patients and family members (we’ve had more than 200 registrations for Monday and Tuesday) gathered in the clinic buildings and around the fires.  Every bit of floor space in the in-patient ward and in the clinic was covered by someone sleeping on the cement floor under a blanket (it gets into the 40s here at night as we enter winter).  As I walked through candlelight to warm greetings, our nurse pointed out 6 kids under the age of five who had arrived comatose in the past two days (who I briefly examined) and he said the flow of seriously ill people (especially from malaria) has been constant throughout my absence.   He did a good job of screening them all!


Our 150+ consultations from the last two days (we still have over 50 waiting to be seen tomorrow – Wed) ranged from TB to malaria (most) to injuries, to pneumonia and to two cases of peritonitis who needed urgent surgery.  They ranged from serious to benign, all serious enough in the eyes of the patient to travel great distance at great cost.   We had 12 kids arrive today (Tues) in coma and five of them were having seizures that wouldn’t stop (status epilepticus) at the same time (craziest day yet)!  A set of five-year-old twins came in and one had generalized seizures for about 30 minutes, after which the other promptly began seizing.  The first died and the second is still alive as of 7p.  Everyone waits for hours to be seen and multiple times during the day a parent will bring us their child seizing or with lost consciousness asking if they could be seen soon.  They are generally so polite and patient and when someone becomes impatient and says something, everyone jumps all over them.


Thanks for walking with us in this crazy journey and for your expressed encouragement and support!


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