Saturday morning, a blank page, and some recent highlights and thoughts…

Marco is 24 years old and arrived to Cavango about two months ago in a coma.  He hadn’t felt well for some time but suddenly passed out at home and was brought to our hospital by his concerned family.  He responded to nothing, including pain. He had lost weight during the previous months and was quite thin.  He tested positive for malaria, so we began aggressive treatment for the same.  When he showed no response for several days, we needed to consider other illnesses that he had in addition to the malaria, including meningitis, which can have various causes, divided generally into viral, bacterial and tuberculosis (TB).  We have a lot of people arrive in Cavango in coma (it is a symptom that always communicates severity to loved ones), so it is a common exercise for us to sift through possible causes of each presentation.  We have had three youth survive deadly TB meningitis in the last couple months. 

.

We began treatment for meningitis and within a couple days, Marco began to stir.  A few more days and he was conscious, but quite agitated.  He would scream out all through the day and night, but was not aware enough to communicate to us what he was feeling.  After a few more days, he was able to identify pain in his head and back.  We had found evidence of fractures in his mid-back and could reproduce his pain by tapping on the area, indicating the injury was likely acute.  This confirmed the diagnosis of TB but Marcos was still in severe pain and would cry out with any movement at all.  Marco’s faithful brother never left his side, day or night, for over a month of frequent groaning and screaming because of the pain with any movement.  He fed Marco, helped clean him, helped him change positions, held his hand and was quite selfless and beautiful.

.

As Marco recovered, he noted that he could continue to move his legs but had lost the strength to bear weight. He couldn’t stand or walk.  His brother helped him continue to move his legs but they were almost flaccid.  Over the next month, Marco began to eat better and gain some weight and his episodes of pain decreased in frequency and intensity.  It was nice to not have him screaming out in pain throughout the day and night!  We found out that he was actually a very kind person, much like his brother, who we had grown to know and appreciate.  Marco progressed to sitting in a wheelchair and journeying outside in the same, and he began trying to rehab his legs and gain muscle strength.  We have several people/year arrive in Cavango paralyzed from TB and most recover at least some function after the cause is treated and the inflammation surrounding the spinal cord diminishes.

.

Marco was thrilled to return home this week, ambulating with crutches (photo).  He has a long road of rehab ahead of him but leaves Cavango with understanding that he was healed of a disease that would have killed him but for intervention.  He was one of the few in any culture who expressed gratitude for his turn around and care.  He seemed to believe us when we told him life remains in him for a purpose and he is seeking out what that might be going forward.  We shared with him that in every interaction he can be a seed-planter and play a role in helping another bear their burden.  He understood that one’s whole perspective on life and our interactions with others change when we see others as burden-bearers who need help and he will likely never forget the care he received in Cavango.

.

One of the beautiful advantages of having every TB patient with us for two months is that it gives us the ability to teach them godly, counter-cultural perspectives and encourage their relationship with Jesus in a way we could never do in one or two visits.  They hear our daily interactive talks about walking with Jesus and improving our physical health and they receive many words of encouragement along these lines.  They become part of a small community of others (average of about 40 TB patients) and their families who are suffering from the same illness and are they are able to encourage to one another as only a fellow-sufferer can.  Our facilities are simple, but often better than what they have at home, and our patients are, without exception, pleased with the facilities in Cavango.

.

At a recent staff meeting, I gave a brief message about our vision in Cavango, and that, more than anything else, we seek to communicate and demonstrate care, through our every action/interaction, for those hurting, in a way they may have never experienced.  We can demonstrate tireless care through our every effort (effort is something we all have to give), whether the outcome is pleasant or unpleasant.  Following in the staff meeting was much interaction and enthusiasm about the same, and many shared how they frequently hear comments about how those who arrive here marvel at the care in this place.  This enthusiastic interaction was great to see among our growing Cavango family, who carry out this vision every day.

.

A wonderful team visited us with Dick Pope, a frequent visitor and contributor to our work in Cavango over many years.  The group was from Equipping Farmers International, and they gave a three-day seminar on ways that the people here can improve output from their fields (photos).  Everyone in this region lives off their field and the instruction was enthusiastically received.  Visits by those with kindred spirits who desire to give their lives away for the benefit of others are always so edifying and this group, like so many others, left us grateful.

.

Rosalina was diagnosed with Type I diabetes a few years ago and had to leave her extended family and village to move to Cavango to receive her daily insulin in order to live.  Rosalina and her husband brought their three children.  Her husband took a job at the clinic to help pay for her medical costs, principally the insulin, which costs about $60US/month (the equivalent of thirty days of an average local wage).  Rosalina lost her baby at nine months of pregnancy a year ago.  About nine months ago, Rosalina’s husband, a friend to all of us, was murdered near our hospital.  While grieving her loss, Rosalina was pleased to discover that she was pregnant.  She carried the baby to nine months and went into labor uneventfully.  During the night delivery, the baby’s head delivered but the rest of the baby wouldn’t deliver.  Our nurses called me in and by the time I arrived and completed the delivery (with “shoulder dystocia”), the beautiful little girl had died and we could not resuscitate her.  During the delivery, Rosalina experienced a laceration into her rectum and we flew her to Lubango for operative repair the following day. She returned this week.  It has been quite a year for this lovely young lady…

.

Martina arrived nine months pregnant, with severe back pain for over a week.  Her cervix was closed and an ultrasound revealed an empty uterus with a full-term infant outside the uterus!  This is termed an abdominal pregnancy and is quite rare.  We arranged an urgent transport to CEML via our faithful MAF colleagues and our wonderful surgical colleagues took Martina to surgery and delivered her baby from her abdomen and discovered a large laceration in her uterus.  It was surmised Martina went into labor a week prior and ruptured her uterus and the baby essentially delivered through the laceration into her abdomen.  The baby didn’t survive and Martina survived the surgery but succumbed to overwhelming sepsis in the days following.

.

Augustinha arrived with malaria and severe pelvic pain for several days.  She was quite pale and her hemoglobin level revealed that she had lost ¾ of her blood but had no bleeding anywhere.  On questioning, she said she hadn’t had her last period, but she had never been pregnant so dismissed it.  Her pregnancy test was positive. An ultrasound revealed an empty uterus and a mass outside her uterus surrounded by a large quantity of fluid.  Augustinha had a tubal pregnancy that had ruptured into her abdomen and ¾ of her blood volume was inside of her pelvis!  We transfused multiple units of blood into Augustinha and arranged another transfer via our MAF colleagues to CEML.  Augustinha survived surgery and will be live to conceive again and have the family she desires…

.

I wrote about young Sebastiao (photo) last time.  He did not respond to TB treatment and we determined that he has a type of lymphoma common in this part of the world, called Burkitt lymphoma.  The illness is 100% fatal without treatment and treatment with 5-6 chemotherapy meds is typically quite successful in treating this illness (almost 100%) in the rest of the world.  These meds are not available to us here and I bring two of the meds back with me from the US, enough to treat two cases/year.  Studies, especially from Malawi, reveal that statistically 40% survive the illness with our treatment combination.  After the first round of chemotherapy, Sebastiao’s abdominal tumors and severely swollen lymph nodes all but disappeared, but he developed an awful complication to the treatment, called mucositis.  His mouth and esophagus were lined with ulcers, his face and neck swelled severely and he couldn’t swallow.  This complication lasted about two weeks and Sebastiao lost weight he didn’t have to lose. His mucositis has resolved but the second of four rounds of chemo was delayed as he needed nutrition before beginning again.  We will continue his treatment this week and hope that the delay won’t affect the killing of the cancer…

.

We have so many “Sebastiao’s, “Marco’s,” etc. in Cavango.  We pull for each, pray for each and do everything possible for each with the resources we have. That we have anything to give is because so many of you care and send your resources to us…

The patients and their families in Cavango see the doctor for a few minutes each day and have nothing else to do otherwise…  Most don’t know about relationship with the King of Kings and that they are of eternal value to Him; of such value that Jesus came to a place much like Cavango to reveal Himself to us, to endure all He endured… for them…

.

We work in this simple, rural setting that brings conservatively over 30,000 people (patients, families, visitors) annually to our hospital, most of whom stay multiple days/nights. We continue to invite and plead with anyone/everyone who loves Jesus and loves people – pastors, churches, organizations, health care workers and people of every skill and no skill, local and foreign – to come and meet these beautiful Sebastiao’s, Augustinha’s, Marco’s, Rosalina’s, Martina’s, etc. who are very much like the wounded man on the road to Jericho. The opportunities to interact, encourage, serve and impact for eternity are endless…  and the patients and their families would love the interaction… 

It will require leaving your family and friends, abandoning your “dreams” and “bucket list,” and embracing the unfamiliar but, if you are a Jesus-follower, you have died to concern with your personal happiness and you have chosen to surrender your life to the One who will reign forever.  You would rather follow Him into the dark places (Cavango is one of many) and do anything/everything possible to introduce others to Him… All places of darkness are filled with beautiful, hurting and confused men, women and children, created to walk with their Creator. Who will tell them of the King they can know today and forever?

.

As they were walking along, someone said to Jesus, “I will follow you wherever you go.”  But Jesus replied, “Foxes have dens to live in, and birds have nests, but the Son of Man has no place even to lay his head.” He said to another person, “Come, follow me.”  The man agreed, but he said, “Lord, first let me return home and bury my father.”  But Jesus told him, “Let the spiritually dead bury their own dead! Your duty is to go and preach about the Kingdom of God.”  Another said, “Yes, Lord, I will follow you, but first let me say good-bye to my family.”  But Jesus told him, “Anyone who puts a hand to the plow and then looks back is not fit for the Kingdom of God.” – Luke 9