It is a lovely Saturday morning and we begin with this blank screen… we’ll see what jumps from head and heart to screen…. Thank you for joining me! I’m sitting on the outside porch of a cabin overlooking a 45,000 acre desert reserve after driving eleven hours from Cavango after being pushed out the door by Eduardo and Betsy for a ten-day personal retreat of solitude. It is much needed and so nice! Last night I was treated to the grunting and screeching of a large troop of baboons nearby.

“Justice” in the “bush”…  Alfredo (photo) is 65yo and arrived after a four-hour motorbike ride on dirt (!) through the night (because he couldn’t lie down to sleep) with difficulty breathing because of severe pain after he was assaulted the day before by a group of about twenty men and boys from a neighboring village.  They came to execute “justice” for a child’s death, convinced that Alfredo caused the death of a child in their village via a curse.  No evidence, no trial, no police authority…  Only the frenzy of an angry mob which began with the child’s tragic death (from malaria, after suffering at home for several days with his parents seeking no help apart from the shaman), an accusation, more accusations, peer pressure (frenzy), hunger for understanding, “evidence” of Alfredo’s guilt gathered in animated conversations around an evening fire and seeds of suggestion of a “curse” planted by the “all-knowing” shaman. 

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The power given the shaman in this culture is akin to worship.  Whatever he says is truth, far more than anything else.  Same with the sobas (chiefs) who also have unchallenged authority.  Just like the Israelites begging for a king. I am amazed at how the stories of the Old Testament and the Israelites so perfectly reflect the inner battles of conflicted human beings.  Our Father created us to walk in union with Him, and in surrender to Him, yet we seek substitutes, anything but surrender to an unseen, but clearly revealed (for eyes that choose to see), loving Father  – independence vs dependence…

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At their night-time arrival, Alfredo pleaded with the mob that he had nothing to do with the child, illness or death, but there was no restraining the mob.  They held him and beat him severely with clubs, sticks and rocks.  Alfredo walked gingerly into my consultation room, with the aid of a large tree branch for a crutch, he had difficulty moving and speaking and his body was covered in bruises and he had difficulty breathing because of multiple broken ribs.  Quite remarkably, he had no life-threatening injuries.  We have had friends, their wives and their kids beaten severely by mobs similarly. 

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Last month was not one of our busiest and, yet, we gave blood transfusions to 46 patients, each necessary to save a life, mostly children who would have, otherwise, died of malaria.

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“Red herrings”…Estevão (photo) is 23 year-old and arrived almost catatonic, with severe fever and unable to move his head because of a headache and stiff neck.  His family said Estevão’s pain began a week prior, after a collision while playing soccer. Similar to the above ridiculous story of a curse, we are all tempted to create a “cause” for our various infirmities in a way we understand and that fits our worldview.  Estevão may have had a collision playing soccer, but this would not have caused his other, observable, life-threatening signs and symptoms.  Ignoring the story presented by Estevão’s family, we immediately tied together the symptoms and signs (weight loss, fever, delirium, couldn’t speak, deathly ill) and made a diagnosis of TB meningitis and began aggressive treatment.  Within 48 hours, Estevão was fever free and in less pain.  After a couple weeks, he is pain-free and on his way to recovery.

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Faith/trust… Little 8 month-old Adelia (photo) couldn’t stop coughing and was breathing at nearly 100 times/minute.  She had been worsening at home for over a week.  Her oxygen level was critically low (<70%), even with maximum oxygen supplementation using a mask and our most powerful concentrator (10L).  We began aggressive treatment for bronchiolitis and pneumonia and, after a day, she hadn’t improved.  The following morning, I couldn’t believe she had survived the night in such a critical state of respiratory compromise.  Day two and she was still alive and not improved.  Day three saw her improve quite minimally, as she was able to nurse a little.  Adelia’s mother had been forced to bring her to Cavango and she was not happy on arrival, not happy about the poor prognosis we gave her, and not happy about her child’s lack of improvement.  She packed up to leave.  I told her and her mother (somewhat animatedly) that the baby wouldn’t survive the several hour trip home without oxygen and that her only chance for survival was to remain.  I told her we would use every means at our disposal to fight for her survival, but I made no promise about her recovery (I had little hope).  I explained to this (young) mother that she had a choice in whom she would trust and her daughter’s life depended on it.  She decided to stay, mainly at the insistence of her own mother.  Over days, Adelia continued to live and she progressed slowly, but steadyily and, after about a week, she was off of oxygen assistance.  After a few more days, Adelia went home well.  When I explained to Adelia’s family how amazed and pleased I was with her recovery, her mom rolled her eyes and shrugged her shoulders…

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Faith is such a huge part of our existence.  We are all so incomplete in ability and knowledge, and in such great need of help as we journey into our unknown todays and tomorrows.  In whom we place our faith/trust affects our every step/decision (return to the shaman, return to the health post, travel to the city, wait, go to Cavango, etc?).  Faith is also so involved in how we perceive/interpret what actually happens.  Did Adelia’s mom “believe” that her baby’s’s life was saved by our interventions?  Did she believe that “fate” intervened or that Adelia was “lucky”/”fortunate”?  She certainly communicated no sense of gratitude or appreciation when we suggested that a loving Father’s purpose was evident in her outcome.

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Fatalism and determinism are where most people in the world place their “faith” today with both, conveniently, absolving one of personal responsibility for outcomes.  Of course, fatalism and determinism are completely non-relational and leave no place for gratitude.  We live in a rural culture that hasn’t changed in 2000 years, is virtually void of gratitude, and is fascinating (and sad) to behold.

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In an effort to speak the truth to those who return home well, we tell people multiple times daily, as Jesus did, “Well done,” and/or “Your faith has made you well.”  “The choices you made regarding where and, in whom, to place your faith/trust, largely determined your outcome.”

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We easily forget that faith, hope, love and gratitude all require an object, all are relational and all are chosen, learned and cultivated (or not). All are unseen, immaterial, and were created to be a unique part of the human experience by a Creator who embodies and values each. Jesus indicated that, in Him, we find the fulfillment of all of these qualities.  These qualities forever existed in the relationships between the Father, Son and Spirit and it is these qualities which characterize us as made “in His image”.  I haven’t seen anything more radically transform a hopeless, faithless, purposeless and unloved human being than grasping our Father’s favor (love) and living in gratitude for the same.

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We have all been there, to various degrees, as recognizing and embracing goodness, light and beauty in a world in which we are all wounded is simply not easy.  All childhoods wound, all marriages wound, all families wound, all churches wound, all workplaces wound, all relationships wound, along with those people who we encounter who are directly malicious and wounding.

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It seems to me that the harshness and wounds of this life can cause people to choose, on one end of a spectrum, to become insensitive, cynical and “hard” to the pursuit of goodness, beauty and care for (imperfect) others or, at the other end, more sensitive to dig deeper, believing that meaning and purpose are concealed beyond what is readily apparent  We are all on the spectrum somewhere between these two extremes and Jesus indicated that He would give those who seek Him “eyes to see” and “ears to hear” that which is otherwise inapparent.  His call to us is to replace prioritizing our understanding with pursuit of an interactive trust in Him and His character/wisdom…

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When living in a culture largely absent of faith in an interactive, caring God, observations can be fascinating and disturbing.

Some have accused me of making “harsh” observations (like the above) and that one in my position should be more empathetic and accepting, and not speak so directly.   These same people often utter trite cliches, “They don’t know any better”, “Poor things”, “It’s the way they are, you cannot expect them to change”, “They created their own mess”, “I will hope and pray their/your situation improves”, “If I would win the lottery…”, “May God bless them.”  Teddy Roosevelt’s quote about the warrior in the arena comes to mind.

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There was, however, perhaps no one in history more critical of this world and its ways, the human condition, and self-importance, than Jesus.  But Jesus also, uniquely, offered a radical change of perspective – death to our “wisdom”, our pride, our identity, our dreams…  Those of us who have rejected following our own wisdom and personal desires to follow Him carry His same transformational message of hope in another “Way”; that the primary purpose of life is to live in surrender to Him and union with Him, rather than to live in pursuit of the above “ours”, independently of Him.

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In my opinion, the message of one’s words and life depends on one’s confidence that Jesus is real/true, one’s belief in human ability/capability/value and how much we are willing to give of ourselves to see others know Him.  As with Jesus, in order to promote/provoke change, one must recognize and identify error or lack (often seen as critical, though, not necessarily malicious), believe people are capable of “turning”/change, and care enough to invest whatever is necessary to participate in the process of change. To recognize error or lack, one must be “critical” and criticism can be either destructive or constructive (Pharisees vs Jesus).  Analysis and critical thinking are necessary to promote/provoke a change of mind/direction, as is embracing that change is possible. Then, if we truly believe it and care, we will “enter the fray” to see the change occur and, as with Jesus, encourage death to one’s perspectives to relationally turn to Him and become “new”. 

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We communicate lack to help people recognize contrasts as they choose to live in either light or darkness, to either serve our Father and others or to serve themselves, and to prioritize either the eternal, immaterial and unseen or the temporal, material and seen.  Our lives are to be a demonstration of the contrast.  Jesus’ early followers, and many since, were tortured, exiled, and murdered because their lives and words offended their hearers, by revealing the contrast between their words and lives (illustrating dependence and surrender to a single Authority/Truth) and the self-serving cultural norms, which have always promoted independence from the same Authority.

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I have come to know intimately those in this harsh region of the world over many years of shared days, nights, sweat, fatigue, laughter, sadness and joy.  I know them at their best and worst and they know me similarly.  They are capable, bright, talented… and largely living without the hope and tools needed to realize positive change and they don’t know the value they are to the One who created each with purpose and care.  I am ever conversing with them about both their capability and the reality of their value to a real Creator who I know and adore.

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We have had three cases of peritonitis over the past couple weeks.  All families waited at home (after, of course visiting the shaman) while their child was deathly ill.  All had intestinal perforations, one from appendicitis, one from typhoid fever and one from TB.  All were flown to CEML via MAF and one survived surgery.  All would have survived with more timely treatment.

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The economy in rural Angola could not be much worse.  Inflation is through the roof, especially hurting those without.  Rural Angola is largely a cashless culture and few have the resources to secure transport to Cavango (most commonly by hiring a motorbike “taxi”), and cover the nominal hospital fees, which average about $5US/visit for consultation and medication.

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We do all we can to keep our costs as minimal as possible, yet the costs create a difficult decision for a family to transport their ill family member to Cavango for diagnosis and treatment.  And, yet, the shamans are always consulted and are the wealthiest people in every village, perhaps next to the untrained health post “nurse” who commonly works from home selling “free” medications.  Their costs are more than ours and gobble up resources that, otherwise, might be used for solid, timely care.

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We know that our faith is demonstrated in what we do; not what we feel or say.  In one aspect, I think that we have largely failed in our task in this region.  In all of our years here, despite the thousands of lives saved and messages proclaimed we, too often. remain the last option chosen and the delay is often deadly.  Virtually everyone we see has received granny’s potions, has been to the shaman, has visited the “free” government health post which employs minimally trained workers who (when working at the health post) give each patient the same five “free” (often out of stock) medications for every illness (vitamin, Tylenol, antiparasitic, antimalarial, antibiotic), hoping that this “shotgun” approach might resolve the problem.  Sometimes it does, especially with minor illnesses and the “placebo” effect (30% of people who feel poorly will improve from minor complaints with any treatment).

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The placebo effect drives much of the market in any culture.  Acupuncture, shaman’s potions, “faith healing”, “all-natural” vitamins, herbs, supplements, and oils, massage, skeletal manipulation, technological gadgets, psychotherapy, etc, none of which can be validated by reproducible studies, but all of which are supported by pretty (often exaggerated), anecdotal “testimonies” which empty the wallets of the gullible, desperate and/or unwise.  Unvalidated “cure-alls” (shamanism) is dressed up in the west but, from “health” stores to pharmacies to online, remain a highly profitable enterprise, driven by nothing more than the “placebo” effect (and profit).

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Adam (photo) is 28 years-old and lost his ability to speak over a year ago.  He had been taken by his caring family to all of the above seeking a remedy.  He had not lost his ability to hear and to understand.   We made a provisional diagnosis of a parasitic infection of the brain, called neurocysticercosis, and began treatment.  Within a week he was wandering our campus and speaking freely.  He has been with us several weeks and continues to improve.

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Working with those with minimal education and exposure to modern processing/technology is challenging.  We compiled statistics from our patient log books for 2025 and had four people compile the totals for our visits, illnesses, etc and they arrived at multiple, wildly different numbers for every category.  This made us question the stats from previous years so we recounted them and, again, came up with wildly different numbers for each year.  This has been discouraging, as we are seeking to compile statistics to see trends in order to better learn, serve and prepare.

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Thank you for reading, and for supporting this vital work to a few beautiful, valued (to their Maker), largely forgotten, rural people in Sub-Saharin Africa!

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