Betsy’s home! Betsy returned this week after a long trip, which included a nice week-long stay in Lubango, where she was able to both make supply purchases to sustain us out here in Cavango for the next six weeks and connect with our many dear missionary friends. She’s hardly limping!
A fifty-year-old woman was preparing a meal outside of her house like she does twice every day, over an open fire. She was boiling oil when a nearby chicken was spooked and took a brief, panicked flight and landed on the handle of the pan, flipping the oil onto the woman’s face, chest and arms. She lived a couple hours by motorbike from the clinic and her friends attended to her while someone ran to get the single motorbike owner in the village. She arrived at our clinic shivering uncontrollably, grimacing and groaning with any movement. When I heard the remarkable story and touched her face and chest (looking for the burns), she recoiled, though I could see nothing because her trunk, arms and most of her face were covered in red sand. Never too shocked anymore by home remedies in a culture without evidence-based medicine, yet full of people with the best of intentions who want to do anything to help, I asked those accompanying her what her “dressing” was. Her trunk, arms and face were covered with butter, raw eggs and sand (I can understand the butter and even the eggs, but sand?). I didn’t ask. We spent a painful hour removing it all, revealing that she had almost 15% of her body covered with already-blistered, 2nd degree burns. We gave her fluids, tetanus immunization (the sand), and put on a proper dressing after giving her some oxycodone which I had brought back from the US (given to me by a friend for this exact type of circumstance). This brave and (very) tough woman has done well in her first few days of a long recovery from what we see far too often – significant burns from accidents around a cooking fire – but the cause in this case was pretty unique anywhere.
About mid-morning yesterday a young, 20-year-old woman arrived at our clinic hemorrhaging after giving birth on the dirt floor at home (most common birth place here). She had delivered a healthy baby girl, but delivered her placenta incompletely, and the village’s birth attendant (one of our beautiful nurses) wisely brought in the torn placenta in a cloth, which helped me to immediately identify a cause for the uncontrolled bleeding. Without anesthesia (and electricity), I needed to remove the part of the placenta that was still inside the uterus, which was preventing the uterus from clamping down to stop the normal post-partum bleeding. I described the necessary (and painful) procedure to this beautiful and tired young girl (she labored all night) and I tried unsuccessfully to get the offending piece of placenta with my hand and some gauze, as the girl screamed and writhed in pain (a moving target). I then used some dressing bandages on the end of a long forceps and, after “encouraging” the girl to remain still, I was able to scrape out the remaining placenta, causing the bleeding to decrease almost immediately. This poor young girl giggled and wept profusely after the horribly painful two-minute procedure and, as I leaned over her to hug her and pray for her in the middle of quite a mess, she vigorously rubbed my head for a good thirty seconds, thanking me over and over through her tears! As I prayed, I laughed out loud at such an intimate and animated expression of gratitude. It was so good to laugh! Laughter was good medicine for the care-giver that day!
Announcement in church this past Sunday: “A cow unexpectedly died this week so there will be a feast for everyone in the village on Tuesday.” This is a big loss for the owner (rural folks put their savings in cows) who is allowing the whole village to benefit from his loss. Where there is no refrigeration, it’s not possible to preserve foods well for any length of time, which is one reason that goats are preferred to cattle in remote areas, as a goat can be eaten by a family in a few days…
We never have good news without bad or bad without good. We currently have many people with challenging illnesses in our hospital dramatically improving, and we have plenty of arrivals who we simply cannot help. This was a tough weekend as I held three people as they died and they represent some of our more common causes of in-hospital deaths. We’ve watched 33-year-old Madalena die of liver failure over several months (we sure got to know and love her) from taking all-natural remedies from a “traditional medicine” practitioner (whom she visited because she didn’t get pregnant over a six-month period). A two-year-old died an hour after arrival with pneumonia, and a 12-year-old suffocated from profound heart failure because her heart valves had been destroyed by toxins released from the untreated bacteria that cause strep throat. Another beautiful woman (35-years-old) was taken home to die from kidney failure (no dialysis here), and a 20-year-old woman in a coma was taken home to die (against our recommendation) from cerebral malaria. We are called to care… regardless of the pleasantness or unpleasantness of the outcome… Sometimes we are called by our Father to participate in one’s exit from this life by serving, valuing, and loving them during their last days. We know we will all die, and I sure agree with Mother Teresa, who once said that everyone loved by our Father deserves to die with dignity.
As I neared the half-way point of my daily walk on a well-worn path to the river and back in the quiet pre-dawn, I neared the river bank and was (quite) startled by a deep male voice calling out for help. I don’t know how far I jumped, but as I recovered and looked in the direction of the voice, I saw some movement in the tall weeds and moved closer in the dim light, somewhat fearing what I might find (in and around the river live crocodiles, snakes and other potentially dangerous animals). An older man (about my age) was half sitting/half lying in the tall grass, propped up on a feed sack (normal “luggage” here) and absolutely swarmed by mosquitoes. He was speaking weakly but immediately smiled as I drew near. In broken Portuguese, he said he was on his way to the clinic and couldn’t make it. He was brought to the river the previous day by motorbike over eight hours on crooked and bouncy paths through the wilderness and left there, as the driver had to begin his return to make it back home before dark. Adriano was able to cross the river (about 30m across) using a beat-up dugout canoe that he found on the bank, but then he made it up our side (not a steep bank) and laid down, unable to breathe well enough to go even a few more steps). It was about 3p. He stayed there through the night (with the hungry mosquitoes) until he saw me approaching in the morning mist at about 6a and called out. I walked home, drove my car to the river on the crude walking path, took him to the clinic and discovered that he was in fulminant heart failure and likely would not have lived much longer that morning. He is responding excellently to treatment and he expresses his gratitude enthusiastically every morning from his log-bench in the sun as he rises to greet me with a warm smile and crushing handshake. The Wind…
I was walking a bit earlier than usual when I found Adriano because I was carefully watching Luciano in the hospital, a very fit 47-year-old man with what appeared to be pneumonia and peritonitis, which is an inflamed abdominal lining secondary to one of many potential causes, including pneumonia and abdominal illnesses, such as perforation of the stomach or intestines that requires surgical repair, which we cannot do here. I was daily checking him at 7a to see if he might need emergent transport via MAF to CEML or if he might show signs of recovery without surgery. He said he simply couldn’t afford the surgery in the city (and he exhibited the always-present reluctance of a rural person to go to the city). I told him on his arrival, when I recommended transfer to our hospital in Lubango with excellent surgery capabilities (CEML), that I have a fund created by our gracious supporters that will pay whatever he is unable to pay, but he really didn’t want to go unless it was life and death (and even then with much trepidation). After four days without improvement, we shipped him to our colleagues at CEML via MAF, who determined, with a simple x-ray, that pneumonia was the sole cause of his illness and he is recovering well without surgery. One day we will have x-ray capabilities out here! Luciano’s brother told us before his departure that their family will sell a cow to pay for his medical care in the city.
One reason these folks don’t want to go to the city is finances, but the other is because in the city they are strangers in their own land. They don’t speak Portuguese (language of commerce and the educated), they are barefoot, they smell badly (there is little access to soap), they are dressed in dirty and worn clothing and they are never treated respectfully. They are immediately judged in so many ways (all negative) by their appearance and manner of speaking, and are objectified and dismissed as less-than-human.
The present mantra in the US about racism is not nearly as much about race as it is about the very-present evil in each and every one of us, manifested in how we treat our fellow man. Luciano faces in the city all of the fears and concerns expressed by people of color in our racial dialogue in the US, but in Angola, as in the rest of the world and throughout history, this mistreatment is rarely because of differences in skin color. People have objectified, demeaned and mistreated other people since Adam’s kids and we’ve all been on both the giving and the receiving end as children (bullying, ridiculing, mocking…) and as adults. Slavery (most often among people of the same skin color), people groups conquering and killing other people groups (most often among people of the same skin color), abuse of women and children (same skin color), wealthy governments neglecting their own populace (same skin color), etc. have existed since the beginning of recorded history, rationalized and justified by those in power while the powerless suffer. Racism is a subset of a far greater problem, the evil objectification of others for one’s own benefit (I am still awakened some nights ashamed by a memory of how I horribly mistreated someone). To focus on race is to overlook the primary problem, which is accurately addressed in only one world view or belief system – the honest (and belabored) portrayal of the human condition from our Creator’s perspective, as expressed in our Father’s revealing, amazingly consistent, recorded communications to us, the compilation of which we call the “bible”, from the Greek word, “biblia”, meaning “books”.
We are desperately sick (there is plenty of historical and current-day evidence to support such a claim) and, without this realization, we cannot get well, as a culture or as an individual. Jesus addressed this reality quite plainly when He entered our mess and voiced our need to be rescued from ourselves. He stated plainly that only in humbly recognizing our screwed-up-ness and accepting and embracing His unearned favor, His affection for the unlovable, and His forgiveness for our genetic corruption, can one’s heart gain the ability to humbly love others as fellow people in need of grace and forgiveness. His kingdom is so not about morality (becoming a better person), church services, living uprightly, prospering, etc. but it is about the Father’s embrace of the broken, the cruel and the obstinate (me). It is collapsing in His embrace that changes us and it is our embrace (more than our words) that has the power to soften another. Jesus also said quite plainly that only when He comes again would the evil within us be finally, and completely, obliterated. Until then, Jesus indicated that most people will refuse to see themselves as corrupt and needy (broad road), yet we are to be humble, undeserving, screwed-up, rescued, adopted and cherished sons and daughters, loving the unlovable as He did us.