Land Cruising

I've always thought driving a land cruiser through a river sounded fun. To leave the hospital to go to Harare this past weekend, we had to drive through a river that crosses the road just below the hospital. During the rainy season everyone drives around the river which is an extra 30 minutes longer, but why not save time by driving through a river when you can?



We packed up the land cruiser and headed off to Harare on the left side of the road with me behind the steering wheel on the right. For the first few miles I repeated "left side of the road" out loud to remind myself I wasn't crazy. Driving on the left in the city traffic brought more excitement, but thankfully all went well. I may have grown too comfortable, because on the way home I got a speeding ticket. Twenty dollars later though we were on the road again. We had just reached our last major turnoff on the way home when we recognized a nursing student among a small crowd of people waiting for rides by the roadside. Hitchhiking is a common way to travel here. We pulled over to see if she wanted a ride. She said "yes, but..." looking at the four other people with her and then at our vehicle already full with 3 adults (we had Corrie, a short-term teacher with us) a baby, and a month's worth of food piled in the back. Five minutes later we had crammed in three midwifery students and two nursing students, Lisa and Jude BOTH sitting in his car seat and Corrie laying on top of the food and bags in the back.

We were glad there were no more police checkpoints. If we had left the ladies, they likely would have been dropped off by someone else at the last major road 4 miles before the hospital unless they were lucky enough to get picked up someone else headed to the hospital, which is rare late on a Sunday afternoon, especially since the weekly Sunday afternoon Karanda soccer game was away that week. Needless to say, we were glad we could give them a lift. Everyone but Jude was also sore and "squished" by the time we finally reached the hospital, but thankful that God brought us safely back home.

Chiremba Rick

"Chiremba" (doctor) Rick Moberly finished the fellowship last year, and after volunteering again at Karanda the last month, just left for home last Friday.




We had great times at the hospital, and as you can see here, wandering around "Karanda Town." Rick learned quite a bit of Shona last year, and did a great job of making patients feel at ease.


Just before he went crazy with the balloon animals, he introduced us to the Dokwane Eating House, the (only) local restaurant where you can enjoy sadza, greens, and meat of some kind, usually beef. Sadza is the staple of the diet here- sort of like a mashed potato paste but made from ground corn. If the right person makes it, it can be really good.
Rick is about to start a new practice in New Hampton, Iowa with several other Via Christi graduates. We'll miss you Rick. Fambai Zvakanaka (go well).

Zoster

This patient is recovering from herpes zoster, commonly known as "Shingles" of his left hand, arm, and chest. He has HIV, making him more likely to manifest this disease and to have a more severe case. It is caused by the reactivation of the virus that causes chickenpox, and usually happens at mid-adulthood or later. These kinds of "opportunistic" illnesses are seen everyday in the clinic due to the large number of patients with poorly-controlled HIV who are more susceptible to diseases that cause problems either rarely or not at all in healthy individuals. Great strides have been made toward the prevention, treatment, and de-stigmatization of HIV in Zimbabwe, but there is still a long way to go.

We are enjoying the Shona people and culture of this part of Zimbabwe. Most people I meet each day are quick to give a smile and a greeting in Shona. My favorite word so far is "Zvakanaka," pronounced similar to "Shhh" but with a "Zhhh" sound, and a "Spanish" A (zzzhaw) and it means "Ok," "Alright," or "It's all good." To really say it correctly you need to whistle through your teeth as you say the first syllable. I hope this finds you all Zvakanaka today.

OVC Camp

It is commonly said here that Zimbabwe has lost an entire generation to HIV/AIDS. Educational programs were started as far back as the 1980's according to Dorothy Churindo, director of Karanda's HIV Home-Based Care program, yet very little has changed in terms of the high risk behavior of the local population. Consequently, there is a large number of children here orphaned by parents who died of HIV, and a significant number of these orphans are infected themselves.


This week is "OVC Camp" - or a "spiritual-psycho-social camp for orphans and vulnerable children." Fifty of the area's most vulnerable orphans are attending to learn more about the plague they are growing up in the midst of, and how to deal with the social & psychological effects of the illness on themselves and others. The teaching is done by nurses and chaplains from Karanda along with local public health workers.
What would you do if you were an 8 year-old child infected with HIV? Would you marry? Have children? What kind of job opportunities would you have? Or more appropriate for an orphaned child- how do you respond when the people caring for you abuse and make you work harder than their other children? Or even, "Why did my parents die?"
It doesn't take much reading of Scripture to realize that God has a special love and concern for these children.
I am continually amazed as I see how much life here has been affected by the HIV pandemic. Already a generation has been lost, and educating the public on the reasons for this and how to stop its spread has been a slow and laborious process that still has not been perfected. Excellent medications have been developed, but a change of heart and behavior is still the only guaranteed way to stem the tide of social destruction.
How can a person respond to this devastation? How should we respond to any disaster this great? And these three remain: walking by Faith with our creator and savior, Hope in his mercies that are new every morning, and Love for him and these around us who need food, clothing, shelter, medicine, acceptance, a gentle touch, and knowledge of the one who loves them far more than the parents they never knew.

Arrival

We arrived at Karanda Hospital at about 1:30pm Saturday.


The electricity was off from about 3pm - 8:30pm, but there are two backup battery lights in the ceiling by which we ate supper. The water system here is dependent on electricity to refill, so we have cold water from the hot water tank and no cold water until everything recharges- but that doesn't happen until someone turns the switch back on in the morning, and that time is early but somewhat variable according to the people here.

The guest house accommodations are actually very nice- nicer and more homey/Americanized than Ghana even, which is nice for a little less culture shock. We are also staying just across the drive from the hospital, much closer than we were in Ghana. The hospital sits on a hillside, with a river at the bottom of the hill, and we literally had to drive through the river to continue on the dirt road up to the hospital. There is another route that is about 10-20 miles longer that they take during the rainy season. Neither the hospital nor the government have been able/willing to come up with the money to build a bridge yet.

Overall Zimbabwe has been interesting- outside the capital (Harare) it seems to be made up of very poor bush people like Ghana in one sense, but there are a lot of "white Zimbabweans" in Harare who had settled here just as many Dutch and English did in South Africa. The history is very interesting- back in 2000 many (actually I believe all) of the white farmers were forced to leave their farms, which were given to black Zimbabweans. (I actually met one of these Dutch farmers in Paraguay in 2000 without realizing the significance at that time. I just remember he was devastated and trying to re-create a dairy farm from nothing). Since then the farm economy in Zimbabwe has crashed. Before that Zimb. was a huge exporter of crops to this part of Africa. There is a lot of interesting history both here and in South Africa, and most of it has happened in the last 30 years. This country has a lot of gold and diamond mineral wealth, and huge agricultural potential. In the capital the weather was gorgeous, and sounds like it is most of the year; palm-ish trees everywhere, and the missionaries have multiple different kinds of fruit trees in their yards. But this country has been hit hard by AIDS (they say it has essentially lost a generation between the ages 20-40) and there are the economic issues that I mentioned above. If the economic situation was different, I think everyone would want to move here.

We left Ghana this spring very concerned for the hospital where we worked, Baptist Medical Centre, because for the first time in its 50 year history it was facing the prospect of have zero physicians on its staff. This is a hospital that treats well over a thousand patients a week. Thanks be to God that the hospital has signed a contract with a Nigerian surgeon who is graduating from a PAACS residency program site. PAACS (Pan-African Academy of Christian Surgeons) is an organization started by American missionary surgeons who want to work themselves out of a job. They are turning mission hospitals into residency training sites for Christian African medical students who are committed to staying in Africa after their training to serve their own people. This may not seem significant, except that between 25%-90% of health personnel trained in African medical schools (rates vary for each county) have left the continent for better paying jobs in Europe and the United States. Africa also accounts for 1/4 of the world’s global disease burden, but has only 3% of its workforce to care for it. The map included shows the global distribution of working physicians. What happened to Sub-Saharan Africa? It’s almost not present.
Who could fault the medical personnel leaving Africa for wanting a better life for themselves and their families? I certainly can’t, as I can run back to America with its first-world amenities anytime I want. What is somewhat more troubling, however, is that 25% of the United States’ physician workforce is made up of foreign medical graduates and growing, which means that we are in a sense complicit in draining poor regions such as Africa of the talent they need to maintain and improve their health care systems. We do need more physicians in the United States, but we also need to think about the effect of our actions on the poorer populations of the other nations involved as we contribute to their “brain drain.” How will it change? That’s a difficult question, but we praise God again for organizations like PAACS that are producing real solutions as evidenced by the provision of a surgeon for Baptist Medical Centre as they seek to spread the gospel by word and deed.

West Virginia

As I sit here writing we are enjoying summer in West Virginia, where I am taking a global health course in clinical tropical medicine and traveler’s health. http://www.hsc.wvu.edu/som/tropmed/Tropical-Medicine-Course/.

West Virginia is the only state that lies completely within the Appalachian mountain range, and was formed after it broke away from Virginia during the American Civil War in 1863. Some have asked if we’re studying tropical medicine in West Virginia because it’s like the tropics. It is one of the poorer states in the Union economically, but the real reason is simply that several people experienced in tropical medicine at the WV University medical school created this great course for medical professionals to come and prepare medically for what they’ll see in Africa, Asia, and other tropical parts of the world where the diseases have a lot more to do with worms, flies, and mosquitoes than the heart attacks and strokes that we often see in Kansas. All that aside, now that it’s 90+ degrees and humid, it’s starting to feel a little tropical around here.

I never really adequately finished writing about our time in Ghana, as it passed by so quickly, and as soon as we returned home we found ourselves busy with wrapping up our time in Wichita and preparing to travel again. On our way home from Ghana we took an extended layover in Europe for several days with our friends Drew and Rachel where we saw some great historical sites and generally just relaxed, enjoying some days without responsibility or the need for ceiling fans day and night. The portions of Europe we saw had their own beauty, but they felt almost like we were back in the States already, with their paved sidewalks, green grass, drinkable water, and animals behind fences where one would think they should be.

The last part of May and June were filled with finishing residency responsibilities, saying goodbye to friends, packing for West Virginia, packing for Zimbabwe, packing for Wichita next Spring, packing for our upcoming move to Lakin, KS, etc... I’m so proud of my wife and her amazing flexibility. God blessed me with an amazing life partner who has been willing to jump into adventures that she had no way of seeing when she said yes to marrying me.

In the meantime, we’ll continue on here in West Virginia until mid-August when make a brief stop through Kansas to shift gears and gather up our things before heading off for almost five months at Karanda Mission Hospital (http://www.teamzimmoz.org/kmh.html) in Zimbabwe, located in the southeastern part of Africa just above South Africa.