Return, Containers, Adaptations, Vision, Elbows…

My heart is full this morning as I look at the blank page before me.  Our Father’s pleasure in serving these people is becoming more evident to me all the time.

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We returned to Cavango after a month away to many seriously ill patients and a volume barely manageable. We’ve faced some long days and our “sprints” require some long “winter naps” to recuperate.  It seems some days I don’t stop talking and bouncing from one person to the next from 7:30a to 6p. It’s a delight to see so many crazy-beautiful recoveries, though we’ve also seen several deaths in those who simply waited too long to arrive. In Cavango, we always witness both joy for those who walk home and mourning for those carried. There are no cars here so a special intimacy is shared in death as the body must be transported home, often over several hours, carried by foot or sandwiched between two riders on a motorbike.

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Health care is truly a partnership between each of us and the One who grants us life, shared responsibility in sustenance, maintenance and repair.  As care-givers, we enter this partnership and the patient places his/her trust in our experience, knowledge and care and we are endeavoring to honor this trust in remote Cavango as best we are able, with our limited resources.  The people of this rural, African culture have been abused for so long by those trusted with their care.  People flock to Shamans who profit from mixing herbs and roots, and who-knows-what-else, promising cure-alls and achieving placebo success and to government-employed “nurses” who treat anything and everything with an injection (usually a vitamin), sometimes using the same needle on different people for weeks. A two-month-old baby arrived this week with golfball-sized abscesses all over her body which began with an injection from a dirty needle in a “health post”.  All needed incised and drained of buttery pus, but she will survive.

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It takes longer to earn the trust of medically naïve people in a mission hospital that does not do surgery. Surgery produces a tangible and acute improvement in the condition of a patient and trust in the expertise of the clinician can be more quickly realized.  Over eight years in our nonsurgical hospital, we’ve seen cultural trust in our care grow slowly and steadily, but today dozens arrive daily, many from great distances – hours to several days by foot, motorbike or car.  Word-of-mouth testimonies are the only means of “publicity” and it has simply taken time for the stories of the many positive outcomes to circulate.  Now we are overwhelmed.

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We have so many this week who would be in an ICU in the US, eight kids and adults with severe heart failure of various types, from valvular destruction, to muscular weakness… Several others in various forms of shock, two on oxygen from severe pneumonia… We are in the midst of a run of babies with severe diarrheal illness (one of the most prevalent killers in the developing world), most of them surviving severe dehydration with oral or IV rehydration, and two dying within a day of arrival. We admitted 17 new TB patients in just these two weeks, many of whom needed their chests drained of pus in order to breathe. All are improved and wouldn’t have survived without the procedure. We have over forty acute inpatients this morning and 32 TB inpatients, and we are outside of malaria season! One very bright and educated man went to a “TB Sanatorium” in a major city three years ago with a chronic cough, convinced he had TB and, because a commonly used faulty lab test didn’t confirm the same, he was told he didn’t have TB (no one here makes clinical diagnoses using signs and symptoms). He has suffered inexplicably for these years, unable to breathe and, after we drained from his right chest over a liter of pus, his chronically collapsed lung expanded and he slept all night for the first time in months. We’ll see how his scarred and damaged lungs might improve as we observe his response to the eight months of treatment, which will effectively kill the infectious cause but not heal the scarring.

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We had the privilege of the presence of Laurel Bennett (photo) for these two weeks, a Nurse Practitioner from the US who has moved to Angola and is especially interested in focusing on those with the greatest needs – in the rural areas.  She has been a delight as she navigated new procedures and diagnoses.  She hopes to return and perhaps contribute significantly to our work here. Rosalina, a medical student from Holland, also joined us for a few days to get a taste of medical care in a low-resource, rural setting.

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We have a visiting team this weekend working with the Cavango youth, a beautiful group of both foreign missionaries and Jesus-loving Angolans, who will be here for several days, giving talks, meeting with those hungry to learn about Jesus, playing games and even having an outdoor movie night tonight. They have been received enthusiastically by the young men and women of this village, many of whom seem quite hungry for Jesus, apart from religion. We’ve been contacted by several families from the US, who are seriously considering relocating here to join us. A beautiful couple, Beau and Jackie Shroyer, from Minnesota, with their five kids, are moving to Angola in the next months, will learn Portuguese in Lubango, and then relocate to Cavango next year to focus on loving and serving the people of the region in ways unrelated to medical care, such as youth outreach, agriculture and however else Jesus may lead. We look forward to seeing where their beautiful feet might take them!

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We have had two containers arrive, sent from our cherished colleagues with AGA in the US, full of supplies, clothes, shoes, adult diapers for fistula women, medical supplies, generators, a small Bobcat farm vehicle, and steel for construction of the frame of a new hospital building, but we will be unable to begin construction on this building as a team cannot arrive from the States to erect the beautiful steel frame because of Covid restrictions. In light of this and our increasing patient volume, out of curiosity, last month we cleared the foundation of the former hospital, destroyed during the civil war in the 1970s by one of the invading armies. We cut down mature trees and removed over a foot of dirt and debris and found the foundation beautifully and solidly intact! We’ve decided to construct a new, simple, cement-block, transitional hospital addition on this foundation and the work has begun (pics). We expect the building to be finished in early 2022 and this will allow us to serve our patients with more space and resources. The local men are working diligently and beautifully and the new building will serve us well until we are able to construct the new building in a couple years, Lord willing.

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Problems/challenges often require adjustment and adaptation more than “solutions” and these adaptations will serve our patients well.  We will have an expanded ICU and ED (without beeping machines), as well as more consultation rooms, plumbing, a laboratory and part-time generator-powered electricity.  Our current facility will be renovated to allow a simple kitchen to serve our patients and families, who often arrive without food to support them for a hospital stay of several days or weeks.

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Vision…  We had staff meeting last week and an extended meeting yesterday morning with all of the community leaders and I presented them with the challenge that Jesus presented His followers of the land owner leaving his resources with three leaders and rewarding the productive work of two and castigating the one who didn’t work.  I shared how our Father has left this mission to us and we can be faithful to use it to demonstrate His care for these people… or not.  This work has had many new beginnings – a Leprosarium in the 1950s, a hospital in the 1970s, a new work with our arrival eight years ago, and now an expansion to serve so many more.  I shared how they have been faithful during these years and our Father is granting us further partnership with Him and added responsibility in serving the people of this area.

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I spoke of the difference between a “religious” Christian and a Jesus-follower – a religious person is interested in what Jesus might offer to improve his/her life and a Jesus-follower abandons care for his/her life to serve his King and benefit others. The religious care about rules and performance and Jesus-followers are passionate about serving and helping people, like the One they follow.  As a team in Cavango, we must choose whom we will serve going forward…

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I shared a new management structure that will share responsibility and ownership among our leaders and they embraced it wholeheartedly. Rodé, who is my age and a gifted leader with marked integrity and work ethic, who I appointed as our administrator, will shoulder the brunt of our management changes and, when presented with the greatly increased responsibility and workload for no added pay, said, “Doctor, I am here to serve and I will do whatever Jesus asks of me.”

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I pointed to each person and asked where their family was thirty years ago.  None were in Cavango.  I shared how I didn’t know where Angola was twenty years ago, let alone Cavango.  I made it clear that our Father has called and gathered a special and unique team, over many years, for this work, at this time, to serve the people of this region, for whom He obviously cares… and He has chosen us for this effort.

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My message was received with much enthusiasm and everyone shared how they wanted to be a part.  I look forward to what our Father has in store these coming years in this place forgotten by even its own country and stuck in the poverty and ignorance of antiquity.

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Our Father is joining so many from all over the world to join this work and many of you are playing a significant, unseen role from afar.  No one remembers the role of the elbow in the touch of the hand, yet its action is every bit as key to the outcome.  The role you can play will never grant you earthly fame and will be unknown by all but our Father, but children will survive and mature and know the embrace of a newborn, will see the African sunrise through the morning mist, hold and smell a delicate wildflower after a summer shower, hear stories from their aging parents around the evening fire, gaze in wonder at the Southern Cross, and have opportunity to walk with their Father and know His pleasure…

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Estamos juntos!

4 comments

  1. Praising God for the encouraging news of more hands for the work in Cavango, a creative solution to more hospital space, and progress toward administrative help for you. So much good news!

  2. Thanks, Tim, for the wonderful update. So glad your employees are willing to work with the new management process. It sounds like good things are happening. Continuing in prayer for you.

    Beverly

  3. Thank you for sharing, Dr. Tim and team. I am impressed with your leadership perspective and grateful that you have shared your insights and contextual features of the setting in Cavango.

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