We shared a delightful retreat with missionaries from around Angola, camping in the Angolan winter nights, connecting around fires, playing games, and relaxing.  We then left as a family and enjoyed a nice vacation in Swakopmund, Namibia (one of our favorite places) before Ben, Mer and Bets returned to the US.  I then wandered around a large reserve in northern Namibia (Etosha) for several days of solitude before returning to Angola.

 

It was a restful time of visiting waterholes and observing wildlife in their natural habitat.  One day I watched a lion couple near a waterhole for several delightful hours near sunset (I’ve been to Etosha many times over 4 years and have never seen lions).  I stayed up almost all night near another waterhole listening to two lions roaring back and forth (a most incredible sound) while every type of animal paraded to the water, stayed around for up to an hour, then wandered off while another group arrived.  I saw rhinos, giraffes, elephants, Oryx, buffalo, springbok, duiker, dik-dik, antelope, impala, kudu, wildebeest, foxes of various types, ostrich, zebra (two types), warthogs, many beautiful birds and so much more.  It was truly a unique and beautiful experience over several days.  The animals are invariably slow, cautious and wary, sometimes taking over an hour to approach the water to drink for a few minutes.  The dry season is a good time to visit the park (about 1/3 the size of South Carolina) because the waterholes are the only source of water for the animals and the patient observer is almost always rewarded.  I was also able to purchase and bring back many medications and supplies that are unavailable in Angola.  The trip served such a nice dual purpose of rest and recovery, as well as bringing these supplies (including a solar system upgrade for the clinic) that will benefit many.

 

I had an interesting conversation one evening over dinner with a thoughtful couple from Germany who travel the world for work, having visited all but three countries (including Angola).  They shared their disdain for the colorful and emotion-driven US media with its extreme and obvious bias, citing Fox and CNN as extremes.  They said that because of the travesty of WWII (and the way the common man was deceived through the state-controlled media), much of the German press fights valiantly to remain as objective and unbiased as possible.  They said if I could read German (I studied it just yesterday in high school…), I would find the contrast in media coverage of the same events striking.  They said that the American people have no idea of the propaganda that we are exposed to daily and the bias through which we receive virtually every news item.  I left the conversation saddened re the state of my own country (and its media) as the American people are being influenced by various agendas, all claiming objectivity.  The more unlearned/unwise we are the more vulnerable we are to charismatic leadership and empty promises…

 

The clinic at Cavango has grown to a volume that is quite challenging.  With the end of malaria season (where we were seeing 30+ cases of malaria/day) and the increasing complexity of illnesses, I am seeing between 40 and 50 new people per day and we often have as many as twice that number arrive daily to be seen.  We also are averaging about 30 inpatients who need to be examined and evaluated daily.  This makes for quite a daily sprint.  I am needing to revisit the phrase, “Be quick, but don’t rush.”  I often feel rushed and know that this reveals either a lack of trust in my Father or a desire to please people.  I am learning again to “stay within my abilities”, knowing that my abilities are limited and this I must accept, especially in this environment.  I so want to see everyone well and pleased and this can border on fantasy and can cause frustration with reality.  Old lessons are surfacing for relearning, as I seem to be continually stretched to a place of discomfort.  I cannot know all that my Father is doing in each circumstance, and I must ask what He would have me do and leave the results to Him…   Rather than trust Him, I often “want” certain results, placing myself in the position of my Father and this is, of course, unhealthy for me and for the others involved.  “I trust you with this, Jesus” has been uttered quietly and with the patient more and more…

 

We have hired about ten more people to work at the hospital, as the burden was simply too much for our four nurses.  The new hires’ salaries average about $20US/month and they are thrilled to be working full time for this wage.  The community elders made all of the hiring decisions after we presented them with the various job descriptions and the men and women they chose are the “cream of the crop” in the village.  They are clearly pleased to be a part of this work, which they see as serving the region in such a vital way.  Their fresh presence and eagerness to serve has been a shot-in-the-arm for all of us.  It’s been a pleasure to see their enthusiasm and work ethic, as well as to see that the highest quality people in the village desire to join us in this effort.  A consultation costs about $2US and it is this money that we use to pay salaries.  The nurses’ average salary is about $100US/month.

 

We were so backed up this week that most people waited two days after signing in to actually see me.  There were no complaints, even as everyone had to sleep on the ground near a fire in the 40-degree night chill, most coming unprepared to do so, traveling many hours by motorbike to get here in the early morning, expecting to be seen the same day.  There were over 40 fires around the clinic each night, quite a sight as I walked away from the clinic in the dark.

 

Last week we had the privilege of hosting Dr Keith Kwok, a cardiologist from Toronto, to help me with our many cardiac cases, arriving by air via our great MAF team.  He and his wife, Ida, several medical students and Dr Steve Foster and his wife, Peggy arrived with such servant hearts to serve whomever they could.  Dr Foster did many consults and a full day of surgeries under local anesthesia, after driving all day Thursday and returning Sunday.  So many benefited from their work.  Dr Kwok and I traveled to a village about an hour away on Saturday (great village name – Chimbangombe – “Sheembongombay”) to do echocardiographs on 130+ kids to screen for rheumatic heart disease, a sadly common disease that kills many kids in this region.  This is the disease of the heart valves that strikes several months after untreated strep throat.  We had three kids die from this disease just in our village (of about 500 people) this past year and we are currently treating about 20 kids in our practice, most needing valve-replacement surgery that they will never receive in Angola.  With treatment we can add a few years to their life, where in the US they would receive this surgery and live a full, normal life…

 

The economic crisis in Angola is deepening.  There have been no medicines in any of the health posts for almost two years.  Because we have medicines in Cavango (purchased by all of you who contribute to this work), people are arriving daily, from as far away as 100 miles, to receive a consultation and appropriate treatment.  As our reputation for care spreads, more will come… and we need help.

 

The type of people that we deal with here can be exemplified by Pedro, a 58-year-old man who came in this week (and waited two days to see me) with a fractured tibia, which occurred three months ago from a fall on his motorbike.  He sustained 2^nd and 3^rd degree burns on most of his lower leg along with the fracture.  He knew the leg was broken (which we verified with ultrasound), but he had no access to care (he visited a health post and had his wound dressed and was sent home).  He has been caring for his burns with home remedies and walking very gingerly on his fractured leg.  His other leg was amputated in the 90s after stepping on a mine during the war.  He couldn’t stop uttering gratitude and praise to God for our presence and our ability to help his leg heal.  There was no complaint or frustration in this man, but so much gratitude that his leg was healing and would continue to do so under our care.  I had to take a break and go to the bathroom (isolated place) to process this man and his attitude…

 

As we pray here for people who are ill, there is always a hope for recovery, but never an expectation for the same.  There is a humility and a realism that these folks have that has largely been lost in the west.  It’s also not uncommon for tears to flow during the time that I pray for the person ill.  This week I prayed for a woman who has lost 4 children consecutively, each born dead at nine months of gestation.  She is pregnant four months and will see us monthly (she lives 4 hrs away by motorbike) until delivery.  Please pray for Margarida.  Another woman began crying while I prayed for her.  She is 26 years old and has never been pregnant since losing her first child at one year of age.  She has permanent scarring in her Fallopian Tubes secondary to an STD, likely contracted from her husband.

 

We see so much sexually transmitted disease (STD), but no more than we would see anywhere where treatment is difficult to access.  The most common long-term result from the infection in women is infertility, which is devastating in a culture where raising children is the principal means by which a woman sees herself as having value and purpose.  Rarely do I discuss a diagnosis of STD with a woman, without needing to navigate through a discussion about her man’s multiple wives.  This is an accepted practice in this culture, where the woman’s value is found in raising her children, where romantic love isn’t valued, where the children are raised by the community, and where the men are a limited presence in caring for the children.  The beautiful men who I work with in my clinic, for example, work seven days per week, are virtually never home until late at night, and leave for work early in the morning.

 

It’s been fascinating to observe so many solid young men and women emerge from this setting where the nuclear family isn’t at all “ideal”, in that care isn’t received from two solid, loving parents.  It seems to me that children need either a solid community or a solid nuclear family, from which to gain a sense of identity and security.  I believe the US is seeing so many immature and insecure men and women entering adulthood because we have lost both the sense of community that I see here and the nurturing that can be received from a solid nuclear family.  Here the nuclear family isn’t strong, but the sense of family gained from the community is nurturing and obviously sufficient, as demonstrated by the quality of the young men and women.

 

Our numbers of Tuberculosis (TB) are skyrocketing.  The government exercises tight control over TB meds and they are nowhere to be found.  We have people arriving daily who had begun treatment at a government facility and are unable to continue treatment.  The number of deaths from this crisis that will never be counted because of both the deaths from this awful disease and the resistance to the TB meds that will kill many for years to come because of partial treatment of their disease…  I am treating one pregnant woman with pulmonary TB and her teen daughter who has lost her ability to walk because of Pott’s Disease, inflammation of the spinal canal from TB infestation of her vertebrae, likely acquired from her mother, who had begun treatment at a government facility before the medications ran out last year.

 

I am so privileged to work with MAF, an aviation ministry that has been serving remote people globally for many years.  The enthusiasm of these three men (two from Canada and one from Holland) to serve has humbled and greatly encouraged me.  They always respond enthusiastically when I call for a flight, they buy meds for us, they transport ill patients to our city hospital (CEML) for surgery, and they return the patients after surgery.  Their joyful enthusiasm for service is Jesus-like and benefits so many, most of whom will never know all that went into their access to care through this ministry.

 

The man I wrote about previously who took over a month to obtain an x-ray of his hip returned this week, still in pain and unable to walk without crutches.  It’s now been four months since his injury and he has still not taken advantage of his ability to receive a relatively inexpensive surgery at our mother hospital in Lubango (CEML).  The rural people simply cannot appreciate what modern medicine can do and those that recover at our facility have little appreciation for all that goes into their treatment and recovery.  I wonder how like them we are when it comes to our Father and all He does for us daily in caring for us and in guiding us to Him.  As I age I realize more and more that understanding, as with these rural people, simply isn’t possible.  It seems to me that it isn’t understanding of our Father, of life, of circumstances, etc that gives life (which many still seek), but rather it is daily appreciation for His care and His affirming presence that drives a life-giving relationship with Him, the foundation of which is His care and grace, so freely offered…