Collins, Beds, Bribes, Rats, Chaos…


We celebrated the 80th birthday of our dear friend and mentor, Dr Steve Collins (photos), one of the most remarkable people I’ve ever had the pleasure to know.  You can read briefly about his incredible life by clicking here.  He is from Canada and was a pastor in remote Newfoundland, Canada when he realized the tremendous global need for evidence-based medicine, so he went to medical school to become a general doctor (does anything/everything) in Angola during the war.  After the war (while in his fifties), he saw so many people in this country blinded from cataracts and knew that relatively simple surgery could restore their sight, so he trained for a year in several places to learn how to do the surgery and then how to improvise and do the same surgery in rural settings.  He then began doing cataract surgeries in remote places and has restored sight to thousands.  He still restores sight to those without, through 600 cataract surgeries/year, mostly in remote locations where he creates a surgical space in non-medical buildings (schools, churches, houses) and does as many as 10 surgeries and/or 100 consultations/day.  His enthusiasm for service, his boundless energy to serve those with desperate needs, his gift of encouragement, his ever-present sense of humor, and his love for bacon and eggs has endeared him to so many.  I am so grateful to know this man and I sincerely hope to have him rub off on me, if even a little!


We have had the pleasure of hosting the Diggins family, Levi for a month and his parents, BJ and Kris, for a week.  They are long-term missionaries with Wycliffe JAARS (including 10yr in the Amazon), BJ – a pilot/mechanic/instructor and Kris – a nurse practitioner, and their hearts for service, their contagious joy and their remarkable trust in our Father endeared them to us all.  They were unable to obtain a visa to enter Angola (so common) and chose to try to enter without (unheard of).  Here the eyes of the beholder might differ (foolish vs courageous/faith-filled).  They prayed and our Father obviously wanted them here to see our work, as they were let in without a visa, with no trouble and no fines which, in Angola, is about akin to walking on water.  Their “situation” allowed us to meet and interact over several days with the man in charge of visas at the airport (BJ and Kris even bought him a nice pen for his trouble) and this relationship will benefit our visitors for a long time going forward.  They accompanied us to one of our remote clinic locations for a couple days and encouraged everyone they encountered.  Levi, an enthusiastic learner, and is with us in Cavango, soaking up all he can about practicing medicine in a rural, low-resource setting.


We were visited this week by our denomination’s two medical directors and their wives (Photo) to give an excellent, two-day seminar for our nurses.  They were full of praise for what they saw in Cavango.  Lucas works in a large city hospital and he said that the city hospitals are staffed largely by foreign doctors (from Cuba, China, Russia) who see their minimum required 10-20 patients/day and no more.  He said they sit behind a desk, never touch the patient and work little, with even less compassion.  When Lucas saw that we began our day with 30 hospitalized patients (most slept outside in 35deg by a fire) and then saw about 30 new patients that day, he was shocked.  With our ultrasound machine, a few point-of-care tests and a well-stocked pharmacy, he said we had more resources to offer patients here in the middle of nowhere than the huge, 10-floor urban hospitals, many of which have no physicians (or few as above), no medicines, and few resources (the economy here remains awful and the “free” health care system has been bankrupt for years).  It’s a joy to offer excellent care in Jesus’ name!  If you support this work, please be encouraged by Lucas’ observation, as so many benefit from your sacrificial giving…


A striking comment was made by one of our visitors after a meal when he offered their wives to clean up after the dinner.  He said boldly, and in the presence of the smiling women that, in this culture, the only “visitors” of any significance are the men.  The women are only to serve.  I wonder if cultural significance or serving more pleases our Father?  “If you want to be great in my Kingdom…”


At about midnight last night, a 2y/o child arrived who had been having constant seizures for 12hr at home secondary to cerebral malaria.  We prayed for her, initiated treatment and gave her medicine to stop her seizures.  After morning consultations and lunch, I arrived to a group of people outside of her room and I thought that she had surely died.  As I approached, however, I was greeted by warm smiles and enthusiastic hellos and I looked down on the floor and this little girl was sitting on the floor eating lunch!  She energetically snatched a sucker from me for dessert.  The gathering was nurses and family, none of whom could believe the transformation of this girl in such a short time.  We lose sleep over the poor outcomes, but we see so many recover like this girl.  What a joy to be able to participate in such remarkable and inexplicable healings!


Our work here is hugely supported by our surgical hospital in Lubango (click on CEML above) and our MAF colleagues (click on MAF above), who are on call every day to transport those who need urgent surgery.  Every time we call them, it’s at least 8hr of work – four hours in the air and four hours of preparation.  It is invariably the first time flying for the patient and their caregiver (the hour-long rocking and rolling trip on dirt to the airstrip is also, for most, their first time in a car) and the pilots regularly deal with ignorance, fear and vomiting (our car is also often left with urine and vomit on the seats/floor).  Our MAF pilots, mechanic and staff serve these folks graciously every time…  I can’t say enough about them and our surgical colleagues who are always ready to receive some of our sickest rural patients on top of an already exhausting daily surgical schedule.  Thanks to all of you for benefitting so many!  To those who financially support our ministry – we are presently more often paying for these transports and surgeries because fewer and fewer can pay for their care in this horrid economy.  On behalf of the patients you will never meet –


Thank you!


If you are a reader and not supporting this ministry, please consider that this is what your hard-earned donations can provide – the ability for the poorest of the poor to receive excellent, urgent care.


This past week, we sent several patients to CEML (Photo) via MAF who would not have survived without surgery.  A man with a perforated stomach, a 14y/o girl with a baseball-sized cancerous tumor in her humerus, a baby who had lost one whole buttock to infection (dirty needle at a “health” post) and a woman needing a Cesarean who presented to us in labor with an arm protruding from her vagina.  All are recuperating well after surgery.  Sometimes I’m just a gate-keeper, directing patients to the best care.  In the Kingdom of God, we are the same, directing people to our Father.


Our tuberculosis population continues to grow, in this country with no available treatment from the government and only a handful of private hospitals like ours who have medications available.  We have 30-40 patients at our hospital as they receive their first two months of treatment here (we have 12 TB beds), as it is the most critical phase of TB therapy.  It’s beautiful to see so many arrive gravely ill with this deadly disease (they wait so long to come) and go home after two months completely new, to complete their remaining 6 months of treatment at home.  About half of our TB patients have pulmonary disease and about half have disseminated disease affecting other organs (1 of 5 is a child).  With our spreading reputation and increased numbers, we need to continue to find beds for them.   We have 50 donated beds arriving soon from SIM (you wouldn’t believe the resistance (and cost) we face to import these simple beds) and they won’t be enough.  In September, we will begin a construction project for some new hospital buildings through AGA, a group of beautiful people from the US dedicated to the huge needs in region of Cavango.  We will then dedicate our current hospital to TB patients and it won’t be enough.


Please pray with us for wisdom and resources to care for so many in a country that is many years from having the ability to provide any kind of decent health care.


Like my experience as an American physician… Today, a man from a city 6hr away returned after beginning treatment at our clinic two days ago for back pain.  He walked in with no difficulty, smiling, sat easily in a chair and presented to me a form for a doctor’s note from his government desk job (a familiar form) for paid time off due to illness.  I asked him how he was doing and he said he was already much improved.  I then inquired when he thought he could return to work, thinking perhaps next week.  He thought for a moment and responded that he would like to be excused from work until the beginning of 2019!  I didn’t reveal my thoughts and wrote him off for two weeks…


Our patients are each given a folded cardstock chart with our notes re each visit to carry with them and these charts return with the patients in variable condition.  Many arrive with parts eaten away by rats in the home (easily recognized), some are just worn from being carried in pockets and some are meticulously cared for in plastic wrap.  Today a woman arrived and said hers was destroyed by water when a river she crossed to get here rose to chest level as she waded through.  Public health statistics indicate that of the available, edible food in the world, a third is consumed, a third is wasted, and a third is eaten by rats…


It’s been so special to have our son, Ben, with us in Cavango.  Yesterday he and Levi drove to Huambo (5hr) with 11 people to return our beautiful visiting Angolan YWAM team home after 6 weeks of evangelism and discipleship in the “bush” and to get supplies for the hospital.  They left at 6a and returned exhausted after 8p.  I sheepishly awakened Ben today at 6a and asked him if he would possibly return again today with our clinic director to pick up the government document he had requested yesterday that is necessary for us to import the above container of hospital beds.  When Ben requested the simple document yesterday and stated that they had come from a great distance, the government official said that he needed 24hr to complete the simple document stating that we were an accredited clinic/hospital under his jurisdiction (perhaps 10min of work) and he then had the gall to ask Ben for money to buy fuel for the generator which was needed to run the printer – a common backhanded bribe). Without hesitation, Ben agreed this morning to go again and was able to obtain the document after waiting for several hours (the official hadn’t begun when Ben arrived today), after waiting several hours.  I don’t know how we could have obtained this document without Ben’s beautiful, gracious servant heart (I’m glad it wasn’t me interacting with the government official as I wouldn’t have been nearly so gracious).  Our Father orders our steps in the chaos, including having Ben here just when we needed him…


We had the YWAM team over for dinner the other night (Photo) and asked them about their experience in the “wilderness” of Cavango.  They shared what they would remember about the challenges they had to overcome while living in Cavango for six weeks.  These three women and two men in their 20s were all from the city and had never lived rurally and without modern conveniences.  Firstly, they said they would remember crossing the river (known to have crocodiles and hippos) in a canoe (for the first time) and walking an hour uphill to get here.  They also smiled and said they will never forget walking several km to a “mountain” to get cell reception to make a call home.  Then they shared other challenges: carrying water on their heads (first time) from the community cistern, cooking all their own meals with no stores anywhere for buying even the simplest of foods, going without food and praying and many times having someone then provide food the same day (they came to Cavango as Jesus told them to – without resources), each experiencing malaria for the first time, working as a team through disagreement and difficult days/moods, experiencing both acceptance and rejection from those they served in the community, not bathing as often as they were accustomed (hardly ever), etc.  They were overflowing with other ways the trip impacted their lives and their own relationships with Jesus, because they had discovered


the key to life… obeying Jesus’ admonition to His followers to go (to those in your neighborhood, your work place, your own country/culture and/or another, to forsake what is “familiar” and easy, to love and prioritize those with needs and to share with anyone/everyone the Good News of our Father’s affection for them…



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