A beautiful 60-year-old man (Photo) who I encountered during my pre-dawn walk a year ago, lying on the bank of the river in respiratory distress, arrived last week for a follow-up visit for his heart failure. He said that it took him four days of travel, by foot and by motorbike, to arrive at our clinic. He is such a pleasure, so grateful for his care and his smile lights up the clinic when he is here. We now give him enough meds for several months, though he doesn’t consider the travel a hardship because he feels so much better and “has life again”.
An Angolan proverb/cliché I love is, “When it rains, we plant.” This illustrates beautifully the patience and humility of the rural Angolan and their attempt to marry what they can and cannot control…
A 2.5 meter Black Mamba (Photo) slithered toward the clinic one day and was discovered and beaten before entering the crowd of people gathered outside. We heard a lot of screaming and commotion outside and left the clinic to see what was happening, while our head nurse remarked, “Probably a snake”. We discovered a crowd gathered around a man beating the snake with a two-meter stick. There is no better weapon against a snake! We cut off its head to look in the mouth and saw that, indeed, the mouth was black. This is the identifier of this snake, one of the most venomous in the world. It can be aggressive if threatened and it would have, most certainly, felt threatened if it had reached the crowd of over 100 people waiting outside.
Termites are a serious problem here and nothing made of wood is expected to last more than a year. The local folks coat the base of their homes with burnt oil to help keep the termites at bay. Our part-time gardener/helper applied this reasoning to the mature trees around our house and coated the trunks with oil to protect them from the termites, killing all of them. There’s a message in there somewhere!
Every now and then (perhaps once/week), patients arrive at our little rural clinic by car from large cities, seeking an accurate diagnosis for their ailment after failing to achieve the same at the large, urban hospitals. These people are obviously wealthy in this culture where few have cars and usually have more of a “cause-effect” world view than the typical rural Angolan. This past week a couple arrived in mid-afternoon after an eight-hour drive. How many hospitals are within an eight-hour drive of your house? They were in their 60s and had heard many stories of people improving after a visit to our “bush” hospital. The man suffered from heart failure, likely after years of high blood pressure, and he had been short of breath for over a year (!) and never received an accurate diagnosis. We were able to identify his problem in about five minutes and within 24hr he was a new man.
We’ve enjoyed these past two weeks a visit by five young Angolan adults with “Youth with a Mission” (YWAM) who are passionate about Jesus and interested in learning to serve rural Angolans. The leader of YWAM in southern Africa has become a dear friend and arranged with us their stay in our village. They have missionary hearts and have abandoned their comfortable, urban lives (electricity, plumbing) to serve Jesus in difficult places. One beautiful, mature, solid young woman was rejected by her family because of her devotion to Jesus and is living apart from them, hoping to be accepted back, but choosing a life of poverty and devotion to Jesus and others over their acceptance. This group’s passion for Jesus has been a breath of fresh air in this culture where all devotion to anything is nominal, at best. They are actively meeting with youth and daily discipling several people each and their presence is transforming this rural village. They will be here about six weeks and have infected with joy all they encounter. One of the young women completed medical school in Angola two years ago and lost her passion to serve in medicine because of the apathy she encountered in the medical profession in this country. She told me yesterday that, after just these two weeks at our clinic, her passion has returned and she in now interested in serving Jesus among the sick, especially in places where access to medicine is minimal (a girl after my own heart).
As the rains here end until September, we have experienced a peak in malaria season and have seen so many kids survive inexplicably, including our neighbor’s twin child of one year who arrived after a week of fever and vomiting with severe involvement of her lungs, causing her oxygen level to decrease to 67% (normal > 93%). She arrived severely short of breath and breathing close to 100x/minute. I don’t think I’ve had a child survive such lung inflammation secondary to malaria (ARDS). We prayed and treated her and the next morning I was shocked to see her smiling and accepting a sucker, still short of breath but improved. She then recovered completely. I can’t explain the Wind, as I’ve held at least one dying child every day for the past two weeks. Why our neighbors, along with the others whose children die, wait a week to seek treatment is a cultural phenomenon I still can’t explain. When I show up in the morning these days I ask not if anyone died during the night, but how many… I delivered to his home village a couple hours away the body of a fit, 39-year-old man who arrived at our hospital and died of malaria within several hours. When I arrived in his village, his brother began yelling and screaming that he had been telling his brother for days to go to our clinic. Treatment works almost every time for those who take advantage of it early enough… but…
Trust is difficult to gain in a culture not accustomed to modern medicine. What does it take to trust enough that the clinic will help? We tell everyone that malaria begins killing after a couple days, but they wait and wait, because a trip to our clinic (the only one with a doctor and meds in this whole part of the country) costs them about $5US and is usually hours away by foot or motorbike. It’s like living in Columbus, OH, never having seen a doctor, and trying to decide when it’s worth making a 4-5hr trip to Chicago to see a doctor and spending a week’s wage for the consultation/meds! On top of this is the fact that they have no certainty that modern medicine has value. Exposure to “modern medicine” for most people has been a visit to government health posts which have no meds and are staffed by minimally trained personnel. By practicing sound, evidence-based medicine and genuinely caring, we’ve endeavored to earn the trust of the people of this region for five years and their trust is increasing, but it is a slow process, as it always is when it involves cost. I daily give talks to our patients and their families about physical and spiritual health and today I spoke with about 150 people about malaria (Photo) and only a handful knew that mosquitoes transmitted the disease! The people are extremely bright, but their education and understanding is so limited and we are beginning instruction at such a basic level. This is combined with a fatalistic world view that sees themselves as impotent against the forces of nature and they value bearing difficulty rather than seeking ways to change, or intervene in, their difficult circumstances.
Also minimal is their exposure to the Good News of Jesus’ Kingdom, as Christianity has been sadly reduced to a moralistic religion quite in contrast to Jesus’ message (Jesus had quite a problem with religion) and today I spoke to the group about Jesus’ admonition to His followers that God was a caring Father. This concept is completely foreign to them and our discussion was lively and well received.
When beginning a medical work in a rural location such as this, many patients come to the clinic and die, because they wait so long and the disease to too advanced to effect a cure. Although most who come to the clinic recover successfully from appropriate treatment, far too many succumb to their illness to foster consistent confidence. It has been a slow, frustrating process, and these past two weeks have been a demonstration of this, with so many kids dying soon after arrival. I’m reminded that we are here to serve, and all results must be left in the hands of our Father, or I can easily despair. At times I’ve become angry at parents for waiting so long to bring in their kids, but I remember Jesus’ words on the cross and realize that they simply don’t know. Sometimes we participate in one’s recuperation and sometimes we love a person or a child’s family in death…
Our Angola medical mission leader, Steve Foster, led a group including myself, a church denomination leader, and several other community leaders (Photo), to a meeting with the governor of our province (Huambo) to see if he would allow the completion of an airstrip on the mission property in Cavango, to facilitate transport of urgent cases to our parent hospital in Lubango (see CEML above). He asked us to justify setting aside the mission property and to give him a plan for the land (there is no land ownership in this police state, only a grant from the government). In response, we are laying out a plan for how the mission can serve this region for the next 20+ years and how we can use the property to serve the people of this rural region, with the hope that he will see these potential benefits. Please pray for his favor.
This Sunday I challenged the church in this poor rural village (same economic level as the early church that turned the world upside down) as to whether they wanted to be a simple village and church or whether they wanted to be a mission, obeying Jesus’ mandate to His followers before He left – to live for the sake of introducing people to our Father and developing disciples of the Kingdom. Do they want to live their simple (and difficult) lives, raise crops, survive, live peacefully, and raise their family… or do they want to give their lives and their efforts for Jesus’ Kingdom, to make disciples and impact this part of the world for Him? They are, like so many, living to live, rather than intentionally giving their lives for Jesus and for others. It was nice to use the YWAM group as examples! Do they want to work so that more people might know Jesus or work to better themselves and their lives? We can make use of many skills to serve the people of this region, as in developing a school, building a hydroelectric dam on our river to provide energy, expanding the services at the hospital, yielding crops and raising animals for the region, training mechanics, teaching the Kingdom, instructing in public health, planting other churches, etc. The Kingdom of God, with its emphasis on service, is quite practical, but requires sacrifice because the priority is always “the other” and not self. Our community has a decision to make – a decision facing everyone who claims to follow Jesus. Will I live primarily for myself and include the Kingdom peripherally, or will I give up my own desires and life to live/work to see others experience a relationship with Jesus, whatever it takes? I’ll keep you posted. Would you join us? You could help with any of the above…
We work to bring healing to a world with still 100% mortality and this reality is clearer this morning after the past two weeks (another child died in our hospital during the night). This life is so brief, and briefer still in Sub-Saharan Africa, where life-expectancy is just better than half of that in the modern west. Jesus came to reveal His Father, reveal the truth about us and His Kingdom, and to communicate that life was found in relationship with Him and that an eternal perspective was wise, while prioritizing this (brief) earthly life was foolish.
We serve in health care to give people more opportunities to know Jesus. Only our relationship with Him will matter to any of us in 100 years. What is the emphasis and priority of our life today? Where is our passion? Will those in our little village continue to live day-to-day, surviving as best they can, making the most of their life, while giving Jesus a portion… or will they surrender to Jesus and passionately prioritize the eternal Kingdom of God? How about you?