Fruit, Unseen, Elders, Disease…

 

I’ve lately been thinking about fruit…

 

No matter how hard we pull on a young plant, it will not produce fruit more quickly.  In fact, if we pull hard enough, we will damage or kill young, developing plants that otherwise would have one day produced good fruit, given more time and nutrition.  This is true in all fruit development, whether natural or spiritual.   How many people have been wounded by well-meaning Christians who have pulled and pushed young seekers instead of loving them as they are (flawed, error-prone, slow to change…) and instead of trusting God to lead them (in His time) to truth…  I’m remembering this morning the biblical truth that quick changes and rapid growth rarely last/endure…  Trees vs grass…

 

 

The time necessary to build relationship, based on trust, with Jesus and with others tempts one to short-cut the development of healthy/solid fruit and to rather seek quick and/or measurable results.  Consider the amount of time and effort that we put into crusades and church services that could be spent serving, listening to, or just hanging out with our neighbor (building relationship).  We can’t be someone’s mentor/discipler apart from respect gained via a relationship where we are transparently known.  We are to be always looking for opportunities to make disciples, through relationships, built on trust, over time.  Our lives and words are forever scattering seeds on others’ fields (inner person), and the more time we are with someone, the more opportunities we have to scatter Kingdom seeds (encouragement, love, affirmation, correction, words that point to Jesus, etc) in their “field”.  Our sphere of influence must prioritize the narrow and deep (fewer, more time), as these are the relationships that impact most, though every interaction involves the exchange of seeds…

 

 

With the best of intentions, many in missions (and ministry) try to produce much fruit quickly, and seek to measure the progress they make toward the goal of a fruitful harvest (real Kingdom fruit is mostly unseen and immeasurable).  Isn’t it true that we require more (measurable) accountability from those we trust the least?  When we have little trust (faith) in both Jesus and in our own intimacy with Him, we often try to build something measurable to validate the trust (faith) we wish we had.  We too often prioritize (measurable) change in us and in others, rather than seeking intimacy with Jesus, allowing Him to be the motivator for our changes and the source of our fruit. We become Martha so quickly and forget about the “one thing necessary”.  We forgo milk for meat and end up with malnourished “Christians” seeking nutrition from the things of this world.  Then we tell them that to grow they need to study “the word”, go to church, and do “Christian” stuff… when they need Jesus.  Life is Him!  In His love/grace for broken people, in His beauty, in His (unchanging) nature, in His character, in our trusting Him…  We find Him by abandoning the pursuit of the things of this life and seeking closeness with Jesus first, and so few realize this as they seek life in healing, acceptance, experiences, friendship, marriage, knowledge, prosperity, achievement…  Life is in Him! 

 

In our pursuit of a fruitful harvest in rural Angola, we are seeking balance in our many relationships (both deep and superficial) and in our tasks (within healthcare and without).  We live in a rural village and partake in the community, we work closely with a few people in each location to which we travel and this provides the ideal environment for relationship and discipleship – they will never forget the foreign doctor and his heart for them and for hurting people, though they will likely never remember his words…  We superficially touch thousands through our health care consultations and talks, as Jesus did the crowds on the Judean hills, the Lepers, the hemorrhaging woman, and the man at the temple pool…   We are daily hoping to help them know our Father’s compassion through us…  As Jesus prioritized various relationships (the multitudes, the Jews, the 72, the 12, the 3…), we seek the same, remembering the principles of fruit development and seed scattering.  Those of you supporting our work are participating in the development of Kingdom fruit in rural Angola with us, as we are only a small part of this ministry team, which consists of so many of you who are sending us here every day through your contributions and prayers.  That you are such a significant part of this work and are unseen and unknown, reeks of Jesus and His pleasure…

 

One morning…  I delivered large, healthy, full-term twins to a faithful, beautiful, caring woman I have known throughout her pregnancy.  They were challenging deliveries as they each arrived feet-first, but they wrestled and screamed their way into the world, needing little resuscitation.   As I was leaving for lunch (after 30+ consultations), a beautiful young woman who is a leader in the church/community, told me she was unexpectedly pregnant and asked me if I had the means of terminating the pregnancy because of how it would affect her life/role/reputation in the community.  This led to a lengthy conversation about how this was in no way an easy decision and that her response must be carefully considered.  I listened to her as she explained her dilemma, and then gently shared with her that her pregnancy is currently “accidental” and “tragic” to her but planned by the Author of life, that our ways are not His ways, that He regularly changes ashes (and sin) into something beautiful, that what we consider pleasant/unpleasant is a choice, that she would do well to spend much time with her Father before such a decision and that peace with Him was more important than circumstantial peace/happiness… that she could trust Her Father with where she now found herself… that He knows and isn’t surprised, disappointed or condemning…  She agreed to consider her decision with her Father further…

 

Our perspective as elders is needed.  We’ve seen and experienced (often through our own failures) what brings lasting peace/pain and we must share with those younger, always remembering that our daily integrity and care determine the weight of our words to the next generation(s)…

 

“Como é o mais velho?”  This is a common greeting that I encounter in this culture (How is the old man?”) and is one of respect and deference, always voiced with a positive sentiment.  How different the older generation is perceived here (and in much of the world) than in our home culture, and the younger generation of this culture benefits greatly from this prevalent attitude…  Are our lives as elders in the US worthy of respect and demonstrating care and concern for those looking to us?

 

In this past month, I’ve had three women present with problems requiring urgent surgery.  All refused transfer for surgery because of inability to pay for the hospital care.  Two have survived and one has died after I told each that they wouldn’t survive without surgery…

 

The man (noted in my previous post) with the broken hip returned today from his trip to obtain an x-ray, confirming the obvious.  It took him 35 days to return with a very poor quality x-ray that revealed that he needed the surgery (a displaced fracture).  He remains in excruciating pain and is still considering whether he can come up with the $300US for the surgery.

 

We currently have five patients with horrific burns who also cannot afford care beyond what we can give them.  Three fell in their cooking fires, experiencing burns on more than 20% of their body (2nd and 3rd degree burns) and two experienced severe burns from an exploding pressure cooker over the fire.  One is a five-year-old child whose face is completely covered with 2nd and 3rd degree burns (doubtful to survive).  It looks like the others will survive, yet not without severe, deforming scars.  Our treatment consists of Vaseline dressings (cheap, available), which work beautifully, although the dressing changes are frequent (every other day) and only with Advil and Tylenol for pain control, and we rarely hear a complaint…  So tough…

 

We have pigs and dogs wandering daily around the cooking fires.  I have complained and warned of the contamination they bring to the hospital grounds, but it all falls on deaf ears in this culture where these animals are a constant and accepted presence (in and around homes).  We have so many cases of cysticercosis, tapeworms, round worms, etc that are transmitted by the waste of these animals…  So easily eliminated…  Some day…

 

A woman of about 50 years presented with multiple complaints and didn’t even mention her strikingly deformed wrist from a Colle’s fracture.  If you have ever seen one of these reduced, you know the pain that I put her through in the next 30 minutes to align her radius and ulna with a “hematoma block” that is essentially local anesthesia.  She was soaked with sweat when we finally finished with her reduction and casting, and looked at me, smiled, and asked about her abdominal and knee pain…  So tough!

 

We see so many illnesses foreign to many docs in the US, such as Leprosy, TB (our little rural hospital is currently treating 29 people with certain TB), Cysticercosis, Schistosomiasis, Malaria, Trachoma, Typhoid, Onchocerciasis, Filariasis, etc.  We also see many with illnesses at advanced stages rarely seen in the US, especially tumors and infections, because of lack of access to care, and we see illnesses common anywhere.  This week, I had a 6-year-old with a first bout of asthma, who arrived almost unconscious after three days of severe dyspnea.  His oxygen level was at 40%, with normal being 95%.  After a full morning of resuscitation with the little medication we have (in between the other consults), he pulled through.

 

I saw a 23-year-old young man with elephantiasis in one leg for 5 years.  His leg was about three times normal size and we were able to see the adult worms in his femoral lymph nodes via ultrasound.  We don’t have first-line treatment but hope second-line will grant some improvement (we’ll see over the next few months).  We currently are treating four young adults with Pott’s disease, TB of the spine, two of whom have lost strength in their legs and are unable to walk, as the disease progressed from back pain to this weakness over several months.  We have a young man with an orbital abscess, which we drained with local anesthesia and much pain.

 

We have been treating two kids for two months with huge abscesses in their buttocks because they were given injections without simple cleansing of the area prior (one arrived with “gas gangrene” and almost died before recovering).  One teen has had seizures for ten tears because of cysticercosis (pork tapeworm in his organs and brain that we were able to see in his liver via ultrasound).  Two women had perforated intestines because of Typhoid, one died and one will pull through without “necessary” surgery.  Especially in my travels to the southeast, we see many older people with onchocerciasis (river blindness), caused by small worms which invade their eyes and cause a chronic inflammation which leads to blindness if untreated.  A woman had a severe infection after delivery (endometritis) which invaded her abdomen, causing a large abscess.  She also survived without “necessary” surgery.  The Wind…

 

We have three women with Gestational Trophoblastic Disease, a tumor in their uterus which has grown for months to years and will likely kill them without surgery (we are trying to talk them into traveling 10 hours to the city for surgery).  We currently have 16 people with Leprosy and no meds available in the country (we are trying to import).  We’ve had about a dozen kids arrive in coma from Malaria this week (when the child loses consciousness, it is time for the trip to the clinic by foot and/or motorbike – if available – of several hours to several days), a few have died and most have pulled through (one day last week began with a 2-year-old death and ended with a 5-year-old death).  If we can only get word out that Malaria is not dangerous if treated in the first couple days (we rarely see anyone with an illness of less than a week).  We need so much help from medical and non-medical, caring people…  We need you!

 

We have so many young adults with heart failure from untreated strep throat (one young man of 23 years died today).  We have several right now with liver failure and bellies full of fluid after receiving “traditional (natural) medicine” from a neighbor or “friend”.  We see many blind from cataracts and eye infections, left untreated.  So many more.  For a physician, the pathology is challenging and fascinating (and overwhelming, at times), but mostly sad because we encounter them after the passage of too much time.

 

It is such a joy to be serving people who otherwise have no access to care.  Please pray for us and for them…  Please join us…

 

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