A blank page near a wood stove’s crackling fire on a very cold, early, winter morning… A look inside follows…

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Our latest attempt to better honor and serve these beautiful and forgotten rural people, by having enough roof-covered beds for those who seek our help, began with a beautiful team of six men from various parts of the US (Scott, Kevin, Frazier, Brian, Dick and André), working with our team of local workers over two weeks (photos), constructing the initial steel structure frame of a building that will have electricity and provide a basic lab, simple X-ray, and beds for our most critical patients.  It will be completed over the next two years and your contributions for basic building materials and a $3/day salary for our workers will serve many for years to come.

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Kevin, one of our visitors who worked quite ill for several days with altitude sickness, was also here several years ago (pre-Covid) to begin our newest inpatient ward in the same way.  On the team’s first day here, we toured the campus and this same inpatient building.  The floor is literally covered in mattresses and sleeps 50-60 patients, though it was designed for 23 beds.  These early winter weeks in Cavango we are “hosting” about 120 inpatients and seeing about 30-40 new visits/day.  We have about 100 mattresses, 50 beds and not even enough floor space, as many patients are too sick to return home but sleep outside by an open fire in temperatures around 40F.  Kevin remarked how beautiful it was for him to see the work he began years ago almost completed and serving so many.  How I wish everyone who contributes to this work could, like Kevin, see the fruit of your contributions, not in bricks and mortar, but in the people served….

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Our simple and hastily constructed “transitional” hospital buildings are almost complete and ready for use. Our local workers have done excellent work!

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We’ve been blessed by the return of Laurel, an NP from the US who is seeing patients daily and doing extremely well in adjusting to the culture and its unique diagnoses and treatments.  She lightens my medical burden greatly and I am grateful!  It may be that soon our days won’t be such a sprint and we will be able to take more time with patients in an unhurried manner!

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Madalena (photo) is five and arrived after suffering with malaria at home for over a week, with a Hemoglobin (Hb) of 2.1 (normal 12). Laurel made the excellent diagnosis and, after a transfusion with her mother’s blood, Madaena’s Hb was normal and she will recover after losing 80% of her blood to this hideous disease!

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We’ve given dozens of transfusions this year, something so easily done in the well-resourced, developed world, but laborious and costly here, and reserved for those who would absolutely not survive without (because of cost). All of the workers in our clinic have donated their blood several times. So many young lives saved by modern technology and knowledge (plastic lines, IVs, blood typing/matching, anticoagulant chemicals for the blood…). In this impoverished culture, living as they did 2000 years ago, they have no idea.

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Florinda is 55y/o and had been to many city clinics and continued to be short of breath without a diagnosis.  Her low oxygen levels and heart failure from long-standing hypertension were diagnosed in five minutes and she is recovering with no difficulty breathing and able to sleep lying down for the first time in months.  Clinics and hospitals here rarely take even simple measurements of vital signs and have little experience diagnosing even simple and common disease processes.

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Three-year-old Eduardo (photos) arrived with fever, cough and difficulty breathing, worsening over two weeks, with oxygen levels in the 60s (normal > 93%) and breathing close to 100x/minute. He needed his chest drained of pus and a simple, improvised chest tube draining into a small plastic bottle, which his father monitored and emptied, as needed, for several days. He then needed both of our oxygen concentrators together for over a week to maintain his blood oxygen at normal levels and recently went home completely recovered from his overwhelming pneumonia.

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The MAF runway project has been approved after a six-year process (and much conflict) and construction on the same will begin soon.

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Seventeen-year-old Lena arrived in a “Zambulance” after three days of hard labor at home for her first pregnancy.  We distributed eight of these “cots-on-wheels” to surrounding villages three years ago and several critical patients arrive on them each year. They were invented in Zambia and produced in LA with hired homeless men and they were brought here in a container via our beautiful friends from AGA.  They are designed to be pulled by a motorbike, but Lena arrived pulled for a half day by several men on foot.  Ultrasound revealed a fetus with a beating heart, whose head was stuck in his mom’s pelvis.  We performed an ancient procedure, called a symphysiotomy, cutting through her symphysis pubis (bone you feel below your bladder) and widening her birth canal by 2-3cm, which she tolerated like a champ.  The baby was born alive and mom is recovering after repair of her urethra by our surgical colleagues in Lubango. 

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A woman was brought in with her baby in the early morning.  She was covered in burns, shaking uncontrollably, with her baby on her lap.  Her husband stopped the bike and carried their baby into our Emergency “Room”and we unwrapped the toddler to reveal a toddler with the whole front of his body covered in third and second degree burns.  He wasn’t breathing.  They had left home on a motorbike with their severely burned child wrapped in blankets on the lap of a severely burned mother three hours prior, in the middle of a frigid, 40deg night.  The baby died on the way and they didn’t know.  The mother will survive with extensive burns and a long rehab consisting of weeks of painful dressing changes.  The father was carrying into their hut a lit stick of firewood from outside to light a candle and a spark dropped off the stick onto a small container of gasoline (for the motorbike) and it exploded.  The little boy was standing near, thrown across the hut, and the mother was a couple meters behind the boy, and also blown across the room.  Poverty.  Living without heat in winter with nights in the 40s (will soon be in the 30s), open fires for cooking and warmth, gasoline for the motorbike stored in the house because of ever-present theft, candles for light…

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This baby was the sixth dead child I held in as many days. Each was formed/created beautifully, breathed their first miraculously, laughed, played, nursed, cuddled, cried for mom… Each arrived with illnesses advanced and beyond treatment. Our help wasn’t enough. Dead. No second chances… Did they die because of illness, because of the neglect or poor choices of their parents, because I didn’t think of something, because of the government corruption, because the church doesn’t care? The disciples asked of Jesus a similar question about why a man was born blind. Jesus indicated that, even in what we see as hideous and tragic circumstances, His Father has purpose for good, and we won’t always be able to appreciate it…

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Jesus isn’t a religion, way of life, philosophy or belief… He lives – thinking, breathing, feeling, interacting, ruling…  The living Jesus, the same One whose words I read and cherish, is the hope I cling to every day, sometimes in profound sadness and/or anger, as I face the above.  Because of Jesus, and only because of Jesus, I can hope that each of these shortened lives, born into unforgiving poverty, to parents without a clue as to how to care for their kids, brought to a short-staffed and poorly resourced clinic and doctor, will continue living in an unseen dimension spoken about often by the One who died and lived again, and heard my cries this morning…

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What contrasts in Cavango!  I am ever a mix of sadness and joy, frustration and peace, glad and angry…

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Contrast…  The beauty created by our Father is everywhere, yet resides in a world rife with anti-God forces, philosophies, world-views, traditions and systems, which tempt us to live independently of the Lover of our Souls and Creator of such radical and complex beauty.  Ignoring one or both of these realities is common and unhealthy. 

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Contrast… We see countless people arrive deathly ill and return home healed, and we see much death and disability caused by illness. We receive financial support from many living on the other side of the world, yet face daily choices in how to spend our limited resources. So many benefit from my decisions re the same, some do not. Yesterday, we kept a 10y/o boy with intestinal perforation, likely from Typhoid, in Cavango for a day in order to save the cost of an extra flight and he may die before we get him to surgery tomorrow on a flight not requiring extra funding. I held him because I think he will make it, but I’ve been both right and wrong in the same situation before. If we were in the US, he would already be recovering after surgery.

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Contrasts… Most patients pay for their care, some with gratitude, and we also have a stack of hundreds of charts in our pharmacy of people who sneak away during the night, after they are feeling better, without paying.  Finances are always a struggle for the severely impoverished patients and for us, as well, as we try to sustain our simple operation.  Our surgery colleagues in Lubango saved over 100 lives in 2021, yet our costs for the surgery patients we send to them tripled over this past year (weaker dollar, stronger kwanza) and we must ever push to raise more money (always uncomfortable) to help those who will die otherwise and to find other ways to reduce costs. 

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We consider fellow missionaries our family, as they journey similarly and often provide us such understanding support, yet some directly criticize the way we do (or don’t do) things in Cavango and criticize what I write in these updates to those who support this work. Contrasts…  The church which owns our missionary property is made of so many beautiful people, yet the leadership is apathetic in how they practically serve the underserved with us and they preach a religion of morality, superstition and obligation “in Jesus’ name” (contrasts).  Multiple village chiefs arrived in unison last month to tell me that we were not doing enough for the people in their villages (socially, apart from our medical work). I loved the fact that they were advocating for their people and told them so, then they were confronted about their accusation of favoritism and I emphasized that we are here to serve all  who come to Cavango and have demonstrated the same for many years. 

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So many beautiful people sacrificially support our work and those we serve and so many who know us remain indifferent.  Material items we purchase or bring from the US help greatly as we serve our patients, yet much is stolen (pipe, instruments, steel, cement, blankets, chairs…). Battles and conflicts with/in the contrasts – not as much with people as with the systems, philosophies, traditions, and beliefs that influence them… 

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One morning in our pre-clinic meeting with patients and their families, I asked “passionately” why so many people still go to Shamans (and pay for “treatments”) instead of to a place with world-renowned and proven remedies.  Why do they wait so long to seek knowledgeable help?  No real answers were forthcoming…  I shared with them the parable of the man remaining on top of his house in a flood, refusing rescue from a boat as he prayed for God to save him…

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Contrasts cause conflict and demand choices.  How will we respond to contrasting beliefs and practices?  Confrontation?  Tolerance?  Love must hate (and confront) that which destroys the beloved!   Not all contrast, however, must provoke confrontation.  We must choose…

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Conflicts are often unpleasant and resolving the conflict well often requires exhausting effort, prayer and thought.

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We could be always nice, practice “tolerance” and “accept everyone as they are”, as we are “guests in their country”. The One we follow, however, didn’t always respond the same way to contrasts/conflict and was not conflict-avoiding in the name of love. At various times, in various circumstances, with various people, He “turned His cheek”, He confronted, He was tolerant, He was indignant, He was unaffected, He was angry, He was kind… Love is a verb and cares for, protects, prioritizes, sacrifices…

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Jesus’ followers are called to enter conflict, as did Jesus, to be light in darkness. Not just to be “light”, but to be light in darkness, to confront the darkness for the sake of those harmed by it. Light in the light serves no purpose!  He sent out His followers, with purpose, to the darkness.  Not to just criticize the darkness for being dark or to find fault, but to be light, motivated by love, care, and concern for those in darkness. 

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We each choose, every day, to seek our own benefit, to enjoy our own life, or to abandon the same (conflict) to prioritize Jesus and HIS ways, perspectives, and emphases, and to go to those in darkness, for their benefit, and to embrace conflict  (and discomfort, hardship, sweat, fatigue…) to bring them light. 

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Surrendering to Jesus’ direction will cause conflict with forces opposed to Him, but those suffering from the effects of those forces will benefit.  Jesus modeled the same.  Most Jesus-followers, historically, who have surrendered to Him, have been, like Him, misunderstood, maligned, and have suffered rejection in many forms.  Darkness resists light. He still seeks those willing to suffer, as He did, for another’s benefit.  Taking up a cross is never  pleasant for the cross-bearer, but provides life for another (Barabbas).  For whom will you suffer and sweat today, for their benefit?

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Contrasts… I’m impressed by how the self-worshipping, ungrateful citizens of the palace are angry about so many issues present within their domain, the most knowledgeable and most prosperous in history.  MY dreams, MY fantasies, MY desires, MY satisfaction, MY fulfillment, MY growth, MY plans, MY success, MY pride and MY rights take priority.  How many books/programs in Christian bookstores and on “Christian” websites are dedicated to self-help/fulfillment and how many communicate how to best help/serve/love/honor others?  So many of those inside the palace choose to ignore the blatantly obvious, contrasting realities of those outside (half of the world’s population today  lives on less than $5/day (!) – an amount unimaginable to the poorest within the palace).  Yet the King is rarely within the palace grounds, He constantly journeys outside, and He continues to invite to join Him a few who might see/count the cost and follow…

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For those of you who sacrificially follow our King in supporting this work and others like it, thank you – for being in the radical minority of those who see and care…

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