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Our 1km dirt airstrip (0.62 miles for those in the US) is almost complete.  Three men from Canada – Bob, Randy and Andre – have been pushing the dozer mercilessly for 16hr/day and the landing area is beautiful and ready.  To meet international regulations for wing clearance, leveling the sides will need another month or so, but it is quite a project and the contributions of these men and others have been admirable.  So many will benefit!

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We were visited by the beautiful Shroyer family who plan to move to Cavango in the coming months.  It was great to meet them in person after many Zoom calls.  They enthusiastically joined our efforts in Cavango and met many people and became familiar with the area and the work.  They will be nonmedical servants and such a beautiful addition to our team after diligently studying Portuguese in Lubango for a year.

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Jocelyn announced her weekly bible study would discuss marriage and sex and their house was packed.  The next week there were more.  This week, even more!  The attendees learn about our Father’s heart for healthy (not easy) marital relationships and they are openly sharing their beliefs/perspectives on marriage.  The people of this region are so untouched by knowledge gained elsewhere as there is little education, no books, no Google, etc.  They speak of their unanimous belief that, of course, a very small baby comes from inside the man and grows in the woman.  Her contribution is not genetic (an unknown concept) but her body is a “container” for growth, not unlike a flower pot.  The baby is, of course, essentially and completely, the man’s.  A perfect cultural rationalization for how they view/treat “their” women as objects/slaves…  Both the women and the men are quite amazed that it is inappropriate for a man to hit “his” woman…  There is great interest and interaction (and desire to repent), and fascination for the odd beliefs expressed by the missionaries, such as equality, honor, serving one another…

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In January, we had our lowest monthly volume of new patients in years (500-ish).  No explanation, especially when patients are regularly arriving from areas up to ten hours away on the back of a motorbike. Ebb and flow…

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Last Sunday, we had decreased our critical patients in the ICU and ED to exactly zero.  Our sixteen beds for critical patients, full just three days prior, were empty!  Of our 70-ish inpatients, none were suffering from an immediately, life-threatening illnesses as all, without exception, improved and were moved to normal inpatient beds.  Then on Monday…

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Among many others, we saw arrive two adults with possible intestinal perforation from Typhoid, pneumonia in a 2y/o with a low blood oxygen level, a baby with pertussis also with a low blood oxygen level, a 70y/o man writhing in new onset abdominal pain, a woman severely hemorrhaging after giving birth at home, two babies with severe croup (and low blood oxygen), two kids in malaria comas, a man in severe heart failure with low oxygen, an adult in a malaria coma, and a man with a severe, sight-threatening, intolerably painful ulcer on his cornea, threatening his vision, which may be our first person in Cavango with corneal TB.  This number of serious presentations is not unusual for many hospitals around the world, but for Cavango it’s pretty impressive.  Six of the above died this week in our hospital, the most deaths in a week we’ve had in a while.  All those who died presented to us after waiting too long to arrive and we talked this week in our staff meeting how we are failing the communities around us in our efforts to communicate that they need to seek help more quickly, as a primary means of prevention of any severe illness is early treatment.  It’s a challenge here to convince people that their actions and choices can alter outcomes.  “What will be, will be.”

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Several of these arrivals had visited health posts or shamans and already received “treatments” for their illnesses.  Some of these had wisely left those “caregivers” to arrive at our facility to receive evidence-based diagnosis and treatment.  One person, not among the above, arrived with a note from a health post recommending treatment at our facility.  This virtually never happens, though we are the only place for hundreds of square miles with accurate diagnostic equipment, knowledgeable clinicians and an adequate pharmacy.  We recognized a surgical problem (intestinal obstruction) in this 45y/o man and sent him via MAF to our colleagues in Lubango who saved his life via surgical repair. 

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Can people act with good intentions and harm or kill?  Likely, everyone involved in the pre-Cavango care of these people tried to help, though ignorantly and without appropriate humility (of course, in their eyes, they were doing the “right” thing).  If any of them would have recognized the severity of the problem and/or had the humility to suggest seeking care where there was more expertise, five of these six deaths would likely have been avoided.  I have written before about how sick people here are butchered by people with “good intentions” (not new – see Mk 5.26).  Another woman barely survived this week, arriving with Toxic Shock Syndrome secondary to her vagina packed with “all-natural” plant material by a local “healer”!

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Solomon wrote that every man is right in his own eyes. A profound statement written thousands of years ago and true today in the bush of Africa and in the modern “progressive” universities of the US.  Everywhere, people rationalize their beliefs and behavior and invent or find support for the same.  Jails worldwide are full of “innocent” “victims”.  Objectification of people, so that we can use them for our benefit, is as common today as it was in the middle ages.  We have internet, skyscrapers, planes and weather predictions, but we aren’t very “progressive” when it comes to basic human nature. Objectification of people today includes slavery, trafficking, genocide, pornography and the way rural Angolan men treat their several wives.  Killing in the name of religious and political beliefs fills our history books. 

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Today, people find support for their “right” beliefs from their “tribe” – people who are like them – on Facebook, in bars, churches, universities, factories and neighborhoods and they dismiss, denigrate and separate from those different.  In Africa, the actual language-defined tribes among whom we live are also fractured by conflicts, disagreements and differing beliefs.  Our human insecurity prompts us to demonize those not in our “group”, labeling them as “wrong” and/or “evil” (another example of objectification of people).  Cliques begin in preschool and are evident in nursing homes.  The most common reason missionaries quit is other missionaries.  Churches split.   Marriages divorce.  Civil wars have been a historical norm.  Children don’t honor the parents who nurtured them.  Cains kills Abels… Malicious divisions are common.  Honoring those with differences is rare… and everyone is “right”!

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We rationalize and justify harmful behavior by placing inappropriate weight on our “good” intentions.  “If it feels right to me, it is right” is commonly applied consciously or subconsciously and lacks the wisdom and humility to recognize that our intentions/feelings can be misguided and/or harmful.  In clinical medicine, reevaluation is a physician’s best friend to assess real vs anticipated results of a particular remedy. The same is true for any journey, relationship or task where we seek healthy progress…  Reevaluation is necessary to identify whether results match that which was intended.  Our intentions can be means to a healthy end, but also can deceive us (and be all about us) if we refuse to evaluate and analyze progress and outcomes.

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For example, cross-cultural short term medical mission outreaches are all organized and performed with the best of intentions and, depending on actual outcomes, they can help or hurt.   Well-staffed and equipped short-term surgical teams can do much long-term good for many, which is why we are preparing a surgical room in Cavango to accommodate visiting surgeons.  Other teams can arrive to an underserved area with the latest gadgets, medications and other “bells and whistles”, see several hundred people in two weeks and “unintentionally” leave the local people with the impression that any local care, by comparison, has no value.  The medicine runs out, the patient’s chronic condition continues (needing care and counsel as much as treatment) and people die because they don’t want to seek help in the “simple” local hospital choosing, rather, to wait for the next group of flashy foreigners to help them.  The foreigners return home with photos, stories and self-satisfaction… and often don’t return.  Our outreaches must be evaluated as to actual vs “intended” benefit…

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By contrast, other foreigners go, remain, live among the local people and become part of the “normal” landscape.   Outside teams come to partner in the long-term work for a “short term” and creatively assist the work of those living among the local people, bringing resources and skills that benefit the long-term work.  This partnering has tremendous value and many of you are doing exactly that with us in Cavango!  On behalf of the many who benefit – Thank you!

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Crusades are another form of well-intentioned short-term “outreaches” and can be either large or involve just a few people.  They often bring energetic teams of workers, generators, electricity, videos, musical instruments, microphones and other attractive resources.  A lot of “flash” that attendees associate with Jesus.  Then they leave and the genuine local Jesus-lover is left to his/her grass-roofed, leaking, hot, bug-filled house or meeting place… to simply converse with his/her friends (no flash) re a living Jesus who wants to walk with them in their real life… 

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Jesus encouraged us not to performances, crusades and music-filled services, but to relationship-driven, example-setting, masks off, genuine influencing and disciple-making…

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“You will be my witnesses…”  What is it that makes a witness credible?  No one immediately trusts the words of someone unknown to them, and wisely so, yet we think preaching about Jesus should be different?  The letters of Jesus’ apostles were personal and intimate, revealing obvious, established relationships with those in the early churches.

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I made many trips to Haiti over many years, joining the work of a mission hospital in the town of Limbé, near Cap Haitian.  A man I consider one of my heroes lived and worked there for over thirty years.  During my many, two-month stints working alongside him, I would meet Bill Hodges around the breakfast table at his house in the predawn before work and think of questions to get him talking just to soak up a few pearls.  I so admired this leathery, direct and thoughtful man and his life.  His personality and appearance would attract few, but what a selfless servant, as demonstrated in his daily life.  He embodied what Jesus said when He said that “No greater love has man than he give his life for his friends”. 

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Bill spoke with sadness as he told of the many crusades to his area where different groups came from all over the world, spent thousands of dollars, rented venues and put on quite a show around decent messages.  The same people responded at the end of every meeting and the crusade organizers all went home with a great sense of accomplishment for all the people who accepted invitations for prayer and made “life-changing” decisions for Christ…  I’ve personally seen this happen so many times in my years working cross-culturally, on a large and small scale…

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It is often difficulties, challenges and pain which break up the fallow soil of our “always right” heart, making it ready for the planting of our Father’s seeds (His perspectives, emphases). 

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These soil-changing crises, along with “witnesses” (people who have experienced healing treatment or/and a touch from God in Cavango) motivate people to travel to Cavango, at great expense and effort, where they are cared for, prayed for and hear of a living and caring Father/Creator/Rescuer…

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We have all experienced these crises which yield “paradigm shifts” in our thinking and spark new beginnings, new motivations, new cares…. and this is why we cherish every opportunity to “come alongside” those hurting, depending on our Father to scatter seeds throughout our interactions, which might germinate and open eyes to the real beauty of a real Father who really cares for them…

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Below are some of our 2022 statistics re these interactions, all possible because many of you are involved and partner with us in this endeavor…

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Cavango Hospital, 2022:

• 10,000+ consultations (20-50/day)
• 1500+ admissions (3-10/day)
• 100+ in-hospital deaths, so many preventable with decent and timely health care access 
• 30-80 acute inpatients/day (avg)
• 40-60 TB inpatients/day (avg)
• 300+ TB patients treated, almost all cured from presentation with severe disease
• 200+ morning gatherings/messages, with 50-200 people, discussing how to improve our physical and spiritual health (Kingdom and Public Health instruction)
• 20,000+ adults heard of the Kingdom and a clear invitation to relationship with Jesus (outside of church services)
• 120 patients transported by air (via MAF) for life saving surgery

Most common admission diagnoses in 2022:

o Malaria
o TB
o Heart Failure
o Renal Failure
o Pneumonia
o Diarrheal illnesses
o Typhoid
o Liver failure secondary to chronic hepatitis or previous treatment by shamans
o Cancer
o OB complications
o Burns
o Infectious wounds