Saturday night, we ate dinner with a small work team up at the guest house.  During dinner, Sal got a call for a woman in labor at Kasiya.  After he left and I spent a short time in additional fellowship, I decided to head back to our apartment.  Armed with my usual small flashlight, I exited the house and proceeded along the path towards the clinic.  The moon was shining pretty bright….I almost didn’t need the flashlight or “torch” as it is called in Zambia.  I started thinking of an earlier conversation I had with one of the ladies on the work team.  She had told me of her fear of snakes and had asked me if I was afraid living here. As I reflected, I honestly could tell her, “No….I really am not fearful of anything.  It’s like one morning I woke up and realized “all fear is gone.” (just like the song J)

Well, about that time I rounded the far corner of the clinic and began to unlock my door when I heard a   “Hsssst.”  I looked down at my feet and to the left not more than a foot and a half away was a coiled up cobra with its head up looking at me!!!!!  I very quickly backed out of its range and circled wide to the front door of the clinic.  I had to do something because Sal was on his way home and I didn’t want him coming up to the door.  I went into the clinic and Collin was working the weekend.  I said, “Collin, there’s a snake.” He asked, “Where?”   I answered,”At my house.”  He immediately came outside with me and together we went to where I had seen the snake.  Collin got a few rocks and after about throwing three, each with careful aim, the snake was sort of paralyzed.  The cobra had hidden himself in the rocks used to decorate around the outside of the clinic, so Collin found a large stick to move the rocks and find the head. After using the stick to lift the snake onto the road and then a few hits to the head, the snake was dead.  I asked Collin if he had ever killed a snake before ….his calm voice answered “Many.”  As Collin and I were further examining the snake, Sal pulled up in the Land Rover. Collin and I told Sal the story and showed him the snake.  He went to the guest house to get the two teenagers on the work team in order to show them a cobra.  They came hurriedly, camera in hand to snap a night shot of the dreaded snake.  After all the excitement, Sal walked the teens back to the guest house and returned to the apartment. 

I realized after we came into the apartment and closed the door just how fortunate I was….that snake really was close enough to have bitten me!  I thanked God more than once for being my Protector!

And now…..I’m thanking you for your prayers!!!!

Technology has arrived in Zambia!!!!!  The Kazunguka District Ministry of Health, thanks to CDC, has given us a desktop computer and printer with a battery back up unit.  Why. you ask? Well it is to incorporate us into the SmartCard program already begun throughout the country.  Every ART patient (patient taking HIV meds) and every antenatal patient (pregnant mother) will be logged into the computer and given a SmartCard.  The card is like a credit card but will have all of their medical information on it so they can travel from place to place.  Great idea you think….well yes it is progress, but most of our patients remember live in grass huts in the African bush.  The card can easily be lost, damaged by fire or eaten by rats….. (you should see their cardboard antenatal cards when they come in and they just have to keep those for nine months! )  Also, most of them can’t afford transport into town let alone travel from place to place.  That’s the whole reason why we provided transport for the first three years and now we go to them with their ART medicines.  Don’t get me wrong…I welcome change here and I think the computerized chart is a great idea and we are already using it….Sal and I.  Teaching the computer program to the staff will be another step forward. The people from CDC out of Lusaka who brought the computer and set it up were excited because they said, “We know you will use it.” Evidently there are some other centers that have had the computer for awhile, but are not using it.  It is intimidating to people who have never been exposed to a computer or had access to a computer…..some Zambians do use computers in town for e-mail purposes, but not actual programs and data entry. I do believe Geoffrey is more computer savvy, but we haven’t been able to discuss with him as of yet. He wasn’t here when the computer and CDC personnel arrived.

Before the excitement had time to wear off that Kazungula District Health Ministry has been really including us in their programs…..they gave us a refrigerator!!!!

They gave us one of the refrigerators donated from Japan specifically designed for the storage of immunizations.  The blue chest style refrigerator also has a small freezer section and runs on electricity, propane and kerosene.  It’s very nice!

            AIDS Alliance, a US organization sponsored a training for three of our HIV patients who are positively living with HIV to be treatment supporters in the community.  Their job will be to work with us in their communities helping to promote ART drug adherence and proper nutrition, along with early recognition of any side effects. They will report back to us any defaulters or problems.  They will also be paid monthly by AIDS Alliance….and a pretty good salary to boot! 

            Speaking of “community”…..I have a list of interested people here at SoT , one or two from each village, given to me by each headman, who I am going to train to be our first community health evangelists or CHEs.  That’s the workshop I went to in Swaziland and I am going to move forward with the program first here at SoT.  We are getting ready to have our first meeting.  I will probably have a couple meetings, but I will begin training after our return from furlough in December or January. Community Health Evangelism is the combining of physical and spiritual health promotion in the community with home visits….each visit incorporates a health lesson with a Bible lesson.  I continue to be reminded of the mission statement of Sons of Thunder….”to feed Africa physically and spiritually through the enabling of the Holy Spirit.”  I really feel this program is just another stepping stone lighting up for us here at SoT Medical. When Sal and I came in 2005….beside the call to “start a clinic on the farm”, we were also called to “Feed a Nation” Our base is the SoT Medical Clinic here at the farm, but we are supposed to reach out into the communities “feeding Zambia physically and spiritually through the enabling of the Holy Spirit.”  With no plan of our own, that’s exactly what I see happening.  As we just do what is put in front of us each day trusting God to light the next stone in the journey…..we are moving out…..we are in five different communities now with SoT making six., covering one whole side of the Kazungula District. Sometimes I just take time to peek over my shoulder and see the tapestry God has already woven, pondering what will be the finished masterpiece!

Life here in Zambia is really different from the US…and sometimes I am reminded of that fact.  After living here for three years now….you kind of get adjusted to the dry season and the rainy season.….you even get used to the bugs and lizards….the occasional bush fire….electricity outages and the like, but every now and then you become keenly aware of just where you are.  One such reminder happened to me on the way home from town.  It was just after dark and I was traveling on the back bush road (because the main tarmac road has enormous pot hole craters and is in almost impassable condition.)  Well as I was driving the Land Rover home, I rounded a corner only to have a very ominous black silhouette staring at me from a small knoll on the side of the road.  I could not make out it’s face or features because of the way the moon was shining, but I can tell you about the large ears and it’s very large stature. It towered over the vehicle just standing very still almost challenging me to try something.  In case you are not sure what it was….it was an elephant….a very large elephant!!!  I have become much more knowledgeable about these creatures than I ever hoped to be.  They are not the cute animals from the zoo or the circus that entertained us….nor are they little “Dumbos.”  They are very dangerous animals inducing a lot of fear among the nationals.  Imagine living in a grass hut and seeing one or more of those animals right outside your door!  Or….imagine waking up in the morning to find your fields destroyed from their carnage the night before.  A couple years ago, a mother with a baby on her back was killed right in Livingstone by a rogue elephant. A couple weeks ago they were right here on the farm proper trying to drink water out of the cistern near the dairy…..for those of you who have been here you know how close that is to the guest house and the clinic and orphanage! 

Well back to my experience the other night…..if you are wondering what I did…..I just kept driving!!!!  Believe me I had no desire to stop and look for a camera! I quickly started praying! I was much better when I reached my apartment and my heart was back in my chest and I thanked God for being my protector!

I remember Dorothy from the “Wizard of OZ” saying “Toto, we’re not in Kansas anymore.”  Believe me, that night I became keenly aware of just where I am..

After the two week class in Choma on Preventing Mother to Child Transmission of HIV, Sal and Geoffrey and I decided to initiate an official “Maternal Child Health Department” here at Sons of Thunder Medical Clinic.  That seems to be what the other rural health centers do and so they see their antenatals all on one day. Another day every week is delegated for Under Fives.  Well, we have already designated the last Monday of the month for Under Five here at Sons and it has been working well for three years now, so no change there seemed needed. We decided to just make Tuesdays “Antenatal day” every week. It only made sense to Geoffrey and Sal that since I handle Under Five….I should also handle Antenatals.  Now remember me?….I have one delivery under my belt….Sal has over 100 and Geoffrey has about 5. So I very quickly told them:  I would be willing to handle group education and ultrasounds, but not exams.  Our thought for this department was to hold group education classes with all the moms prior to their exams and we also decided to start using the ultrasound machine for checking gestation, viability and positioning.   Classes and ultrasounds we hoped would also serve as a way to get men involved with the pregnancy and birth of their babies, which here in Zambia is rare.  And of course, everyone wants to see their baby!!!  Well, God provided two women who came into my path on different occasions and between them both they were able to demonstrate the fundamentals of our donated ultrasound machine.  So, Tuesday the 15^th of July was our first Antenatal day.  Sal told me I had 8 patients scheduled, so armed with teaching models and knowledge, I organized one exam room to accommodate about 12 chairs hoping for some dads to join us.  Well to my surprise, there were 20 moms and 5 dads throughout the day which I had to organize into two classes !!!!  Classes went well…..topics covered were simple anatomy and physiology during pregnancy, preparing for childbirth, nutrition and exercise, anemia, malaria and HIV prevention and/or treatment during pregnancy with discussion of blood tests and prophylaxis. Teaching models were used, questions were answered and everyone seemed interested including the dads!  Next were the ultrasounds…..I was able to check viability by finding the beating heart and positioning just by checking for head down position, but gestational age was another matter.  I found the landmarks and even did the measurements, but my numbers didn’t match up to the charts in the book.  I was able however to point out body parts to the moms and dads and print out take home pictures….they were amazed and very excited to see their babies! And guess what…our numbers for antenatals have increased significantly! J  Just last week, we had one father come to the clinic with his wife in labor….He wanted to be with his wife and see his baby born…..a FIRST here!!!  He sat with his wife all during labor, but when it was time to deliver, he couldn’t be found.  When I asked about it later, mom told me she had told him no…she didn’t want him in there at the time of the birth…..Ugh so close!!!   Oh well, maybe next time.

Sal and I just want to tell you something very important to us……

What we are doing here at Sons of Thunder Medical Ministries would not be possible without you…..all of you.  We are very thankful for your partnership and want you to know what an integral part you play in this ministry. Without your prayers….without your financial support…..without your encouragement…..without your love, we would not be able to effectively do what we feel God is directing us to do.  Please know how important you are to both us and the Zambian people. 

If I could only capture a smile at the time a mom or dad see their unborn baby on ultrasound….

or describe the look of hope in the eyes of a loved one when their mother, husband or child looks and feels better than the day before….

or catch the tears that fall when a young wife or mother is told she is HIV positive…..

or let you hear someone ask Jesus into his or her heart for the first time….

I would…..just so I could send it to you.  Just so I could let you know firsthand that…..

                                    together we are making a difference.

Thank you so very much......with love,

Sal and Renee

PS Sorry there have been no pictures lately....I dropped my camera and it's out of commission.

     Sometimes it’s nice to just pick one person, one story and share it with you.  In this update, I would like to tell you about Ngandu.  Ngandu is a man in his late twenties, married with a very sweet three year old daughter.  They live in Ndola which is in the western province of Zambia, a train ride away.  His family is from Kabuyu and when they heard he was very sick in Ndola, his brothers went to get him and transport him here for medical care.  When we first saw Ngandu he was indeed very sick …as a matter of fact he was dying.  When he was carried in, we saw a man that was very thin, wasted and very weak. He had a high fever, diarrhea and shortness of breath.  After some testing, we discovered he was HIV positive and was dying of AIDS.  With the respiratory symptoms, we suspected TB also.  So IVs, antibiotics and a heart to heart talk not only with his wife and brothers, but also with him was in order.  An honest discussion of his condition and probable impending death led Ngandu to pray and ask Jesus into his heart as his Lord and Savior. Hallelujah!  Sometimes I wonder about those “backed against the wall” prayers, but then I remember the thief on the cross next to Jesus. It’s not for me to judge…after all I can’t see what’s in a man’s heart.  The next few days were days of spiraling downhill….Ngandu stopped responding coherently, became incontinent and had to wear diapers and was only able to tolerate liquids.  We had never had anyone on a clear liquid diet before…so I introduced the family and the clinic cook to Jell-O. It was hard for me watching this man worsen and his attentive wife hold back the tears. TB tests came back negative, but his lungs started to fill with fluid.  As a matter of fact there were no lung sounds audible on the right side.  Medication was added to his regime to try and pull the fluid off the lung. One of the two oxygenators from the medical container had been retrieved from storage and had been in use since his arrival providing oxygen through a nasal cannula.  Frequent positioning and changing bed linens were carried out trying to keep him comfortable.  It reminded me of hospice care. Well, one day I walked in to his room to witness his brother holding a basin while Ngandu was coughing or vomiting (it was hard to tell which) blood….with very large clots coming from both his nose and mouth. I was sure this was going to be the end and I felt what an awful way to watch your loved one die.  Feeling very helpless and small, Sal and I both just looked at each other in the hall outside the room.  I started to walk away when all of a sudden I turned back and heard myself say, “What about Vitamin K.?’  After it was out of my mouth, I realized it had not popped into my mind out of any knowledge or experience I had ever had. I have never given Vitamin K in all my nursing career nor do I remember ever having a patient that had received it.  Sal and I just looked at each other and smiled, knowing in our hearts it had been divinely given.  Sal said, “we have that…..Geoffrey just picked that up from Kazungula last week.” Again we just smiled at each other because God always provides what we need right when we need it. So after reading about the administration and dosage of Vitamin K, we gave it.  The bleeding stopped but his condition continued to plummet.  He was no longer able to swallow pills which meant he wasn’t getting his ARTs (HIV medications).  Family came in waves all to say their last goodbyes.  And so we waited.  Each night we expected a knock at our bedroom window to wake us up and tell us it was over.  But instead each morning proved to be a new day dawning.  His brothers got him in a wheelchair and took him in the shower.  He started eating again…first liquids and then, when we were sure there was no more vomiting, soft foods were added.  He was able to take his oral medicines again.  His IV was no longer needed.  His lungs were sounding clearer….and there were breath sounds in all quadrants.  He no longer needs oxygen.  He has been outside in a wheelchair each day for the past few days. He is continent again and doesn’t need diapers.  He still needs to gain strength….can’t stand on his own yet….but my friends, he is a walking miracle!!  He is a testimony to the power of God.  Sal and I will both tell you, he is alive only because of God!!!  Sal keeps saying “God still has something for Ngandu to do.” 

You may be wondering about Ngandu’s wife and daughter.  Yes, they too are both HIV positive.  His wife is still healthy and does not qualify for the medicines yet, but his daughter is now on pediatric ARVs because her CD4 count was low. I don’t know the ending of this story….but a lot of people were witness to the awesome healing power of God.  There can be no denying it…..Jesus is our only source of hope.

I am sorry that I have taken so long to blog…..time just seems to escape and internet connectivity has been sporadic.  There have been a whole lot of things happening as usual.  God continues to propel us forward.  I will share a few areas of advancement…..God keeps directing us forward and it continues to be in the area of HIV. 

The first direction is to “work the other end” as I mentioned in the May update.  Instead of focusing all our attention on treatment, we have felt directed to start incorporating prevention into the mix.  Sal felt very stirred to put together a power point and call it “Choices” and with God’s help, I wrote a drama presentation.  We have presented the program twice now, once for a youth group in Livingstone at a church called Potter’s House and once here on the farm to our Sons of Thunder families.  Both presentations were successful, leaving people talking and thinking.  The presentation in town was strictly in English and also included a DVD on Sexually Transmitted Infections….the one here on the farm was translated into Tonga and we omitted the DVD. We had Owen, our Headmaster and the teachers also come to evaluate the program’s level of effectiveness for say seventh graders in primary schools and secondary level students. After a positive review from them, we are planning to give the presentation to our seventh graders next and then take it out to schools from there.

“Crazy” as I am to find God in many places, J I hopped a plane (really two) to Swaziland a couple weeks ago for a workshop on “Community Health Evangelism” given at a Wesleyan Bible College. Scratching your head? Well, here’s the story.  We received an ultrasound on the container and decided to get it out and start using it on our pregnant ladies as part of their antenatal care.  We just want to check gestational age, viability and position.  God is always faithful to provide just what we need when we need it…..so Dr.Ruby Cheeves, an Obstetrician and co-founder of Global Samaritan came to the farm during her visit here and gave me a quick in-service on the machine.  A week later, we had four visitors from Zimba Hospital….one of which was Marie Schull, an ultrasound tech with 30 years experience.  She gave me a much more detailed in-service in about an hour or two.  Funny thing was she looked like me….petite, around same age, blond hair, same feistiness etc….it made me chuckle inside. J  Well, when she was leaving, her husband asked me if she had told me about the workshop she was going to do.  I said no…and she proceeded to tell me she was flying to Swaziland by herself in two days to facilitate a workshop on “Community Health Evangelism” at Emmanuel Wesleyan Bible College.  I really had no idea what it was all about but I felt God stirring me.  I started to ask questions and she said, “Do you want to go with me?” and I heard myself saying “Yes…I think so.”   She contacted the Bible College and they said they would let me in the course and that I could stay with her in a two bedroom little apartment they called the Round Double. I then went to South African Airlines at the airport and booked the flights through JoBurg to Swaziland to match hers.  I would return 8 days later, a day earlier than she, and return to Zambia where she would be headed back to the US.   Well, the workshop was excellent and was very much in line with the mission of Sons of Thunder to feed Africa physically and spiritually.  I know I was supposed to be there.

            As soon as I returned, I found out we were invited to a meeting on Emergency Preparedness for Livingstone….seems we are on the Committee.  I went to the meeting and sat with District Council members, other NGOs etc and at the end of the meeting they went right into another meeting about HIV.  Interesting, huh?.   Sons of Thunder was well known in the meeting…. They kept saying, “Ask Sons.” 

This week, four people from different communities whose names we submitted to Kazungula Health Ministry are in an all expense paid, week-long workshop for “treatment supporters for HIV.”  I haven’t figured out how this all fits together yet, but God is definitely on the move…..and it all centers around HIV.

Thank you all for your continued support.  Without you, none of this would be possible.  Please know that you are making a difference in people’s lives.  I will tell you about a couple stories in my next email.  Please also continue to pray for us…that we keep stepping on the next stone as God lights it up!.

It’s hard enough trying to serve and minister to a different culture, but it really takes awhile before the local traditions and beliefs begin to unfold.  Foreigners are not made privy to traditional practices until the barrier of judgment is removed and there is a development of mutual trust and friendship.  Secret things are hidden from outsiders …things like the beating of the drums, rites of passage, sexual cleansings, funeral beliefs and rituals, polygamy and traditional healing practices of scarification and herbs. There is also witchcraft and the occasional rumors (or not) of body mutilations and sacrifices. The Tonga beliefs and traditions are slowly diminishing thanks to education and Christian beliefs, but they still exist here and there especially in the rural communities we serve.  Giving medical care and Jesus then becomes somewhat interesting and challenging at times.  Let me share with you some of these traditional beliefs and practices:

• Beating of the drums in the distance at night occurs after the village has had a mass circumcision of young men during their rite of passage into manhood
• Sex with a virgin can cure HIV
• After a husband dies, the widow must be sexually cleansed by one of the husband’s relatives, most preferably the brother, in order to prevent the husband’s ghost from returning.
• Herbs are put into little cloth pouches and worn on the body with string in order to promote healing or protection from whatever (charms)
• Cutting of the skin with razor blades in order to put herbs underneath for healing purposes (tattooing or scarification)
• Some widows are made to spend a night sleeping with one arm over their husband’s coffin and then the second night using the other arm.  When the husband is buried, the widow must run back to the house and enter backwards so the husband’s ghost doesn’t see her.  The widow must be covered with mud all over so the husband’s ghost doesn’t recognize her.  The children of the widow must be awakened early in the morning before sunrise to be bathed in cold water three days in a row to be cleansed also after the man’s death
• Polygamy is still alive and well here…sometimes up to 4 or more wives.  One man well known here at the farm had 4 wives and 25 children.
• Women are taught not to cry out during labor and delivery or the baby will die
• An herb is sometimes given to induce labor that has been known to cause uterine rupture and death

Lots of teaching from God’s Word goes along with the medical care given here at Sons of Thunder.  Many of the things which have been disclosed to me after three years of living among the Tonga people include superstitions and beliefs that are really grounded in fear.  We, as Christians, know who operates in fear…don’t we? But God says “perfect love casts out all fear.” So as we show the love of Jesus in our actions and combine them with God’s Word, we hope to see these myths and superstitions dissipate..

        Winter in Zambia is not at all like winter in Pittsburgh or Maryland, but I do have to tell you that after three years I am wearing long pants and sweatshirts! Sleeping without the air conditioner or fan is also something new. Night fellowships with the work teams in the village have even caused me to put on socks and tennis shoes!  I guess your body gets acclimated to the weather wherever you live. Well this time of year, the Zambians wear winter coats and hats and even gloves if they have them.  It is very cold sleeping in grass or mud huts at night….makes you want to huddle by the fire and that is the point of my story.  In the last two weeks I have seen three children with pretty bad burns over the body.  The last little girl, a five year old by the name of Loveness, came driven by her father on a bicycle from Kasiya (25 kilometers).  Somewhere around the school Jeff just happened to meet him with the vehicle and brought them the rest of the way to the clinic. 

Loveness has deep burns over the abdomen and both thighs.  The outer perineal area was also affected causing swelling of the region.  I knew immediately she was going to need a urinary catheter.  I went to the storage room and prayed I would find something small enough and as always God is faithful….we always have what we need when we need it. (I just thought of Enelia with the cast boot…remember the woman who almost lost her foot to the snake bite?  Well that reminds me to tell you….this little girl is her granddaughter.  It turns out that Loveness’ father is Enelia’s son.).    Well anyway, there was an 8FR catheter right on the shelf….smallest one I have ever seen.  Next challenge was going to be to put it in….again God was faithful.  IV, foley catheter and bandages over her abdomen and both thighs….she was admitted for observation of possible complications, IV antibiotics, fluid stabilization both in and out, fever control etc. Dressing changes take over an hour as she sobs tiny little muffled cries. Four days in bed practically flat on her back  was pretty boring….storybooks and a coloring book with crayons were the order of the day….those and an occasional “sweet” were all we had to offer.  Sal has managed to get a smile now and then, but alas I (the “dreaded dressing changer” have yet to get a decent look!!! ) Well, today is the 15^th and she has been here 5 days….the catheter is out and she is using one of the bedside commodes to pee and poop.  She is able to sit without pain and pee on her own which is progress.  Her IV was removed yesterday and she is now on oral antibiotics.  Tylenol is still needed for low grade fever control.  Burns are still quite extensive and if you know anything about burns…you know they always look worse before they look better. Her parents have had to sit during dressing changes bracing themselves for what they will see.  Another small step today….Loveness got to go outside on the back porch in a wheelchair …a couple more smiles for Sal!

This is going to be a long recovery ……please keep her in your prayers.

There is a lot going on with Sons of Thunder Medical these days….I am finding it difficult however to find time to write and keep you all updated.  E-mail service and the network have been out off and on for days at a stretch and by the time I can write, I have so much to say and have to balance my writing between stories of real life patients and informational data of our moving forward in this ministry.  I don’t want to make one update too long to read either…ergo my dilemma.  Next update I will share our direction.

A lot has been happening!!!!  I just returned to the farm from an all expense paid two weeks at the Riverside Lodge in Choma.  Sounds interesting, huh?  Well, it was a workshop that the Kazungula District Health Ministry had decided I should attend.  As a matter of fact, they gave us two slots in the class so Sal and I decided it would be beneficial for Geoffrey to attend also.  So Geoffrey and I went to the class in Choma and Sal stayed back at the clinic holding down the fort so to speak.  The workshop was PMTCT: Preventing Mother to Child Transmission of HIV.  It was a two week course sponsored by Boston University.  Boston University is supplying HIV test kits, RPR test kits (for testing for syphilis) and Antiretroviral medications or ARVs for HIV treatment to Zambia and so they decided to also sponsor some of the training to the health centers. All in all a good class with updated national guidelines. I had to share a room with another female and had all the nshima I can stomach for awhile!

The second exciting thing happened of course while I was in Choma…the Container arrived on the farm!!!!  A call was sent out late at night to all the villages and at 8am the following morning, 30 or more volunteers came in force to unload the 40 foot truck loaded with medical goodies. All the contents were put into a large storage room adjacent to the church.  Sal promised he wouldn’t touch anything until I got home so we could go through it together.  The first things we pulled out were IV poles so we don’t have to move nails from place to place.  Then we moved in the hospital beds…3 in the male ward and 4 in the female ward.  We put two beds on one side of the Maternity Suite for those ladies in labor and the Delivery Bed on the other separated by a curtain. We even plugged in some beds with transformers and demonstrated how the head and feet go up and down…our staff were amazed and took turns lying on the beds. J  I think today we are going to dig out the Ultrasound!!!!  There is still so much to go through….it will take some time and perhaps some reorganization of rooms, but we have been blessed and we thank God for always providing what we need when we need it.

Thirdly, this coming Saturday night, Sal will be presenting at a youth conference in Livingstone on “Choices,” a teaching/preaching session Sal put together on HIV, STDs and sexual immorality.  Sal has felt God say to “also work the other end”….instead of just treating HIV, to do something to prevent it before it is contracted.  I think this teaching is something we will be doing in many different arenas…schools, churches, health facilities etc., but we will wait for God’s direction and timing. I’ll let you know how it turns out.

            Weekly outreach to Kasiya is going strong. People are waiting every Wednesday morning as we pull in with the Land Rover filled with packed supplies and medicines.  We have been averaging over 100 regular patients every week and when we add Under 5 week or Child Health week, we cross over the 200 mark! A relationship is being built as we provide care.  Traditions, myths and misconceptions must be met head on with education and the Truth of God’s Word. I think in my next update or newsletter article I will tell you about some of the traditions and myths that challenge us here while we attempt to meet the physical and spiritual needs of the people. Be on the lookout!

            Last, and one of my promised disclosures….one thing we felt God was speaking but we couldn’t share at the time because we had to get permission from the Director of the Kazungula District and meet with the other four health centers to discuss….as of June 6^th and every subsequent Friday thereafter, Sal and I along with Alex and Pastor Winfred will be taking ART clinics out to surrounding villages. No longer will we be sending out the lorry on Thursdays to pick up two loads of HIV patients to bring them to Sons of Thunder.  Instead we will see them in their communities where they can be linked to other support services.  We will go to Kabuyu the first Friday of the month, Katapazi the second Friday of the month, Sinde the third, and Siakasipa the fourth.  This is a pilot that the Director was very pleased with and she, along with the Southern Province (over the District level) will be watching outcomes.  God’s building an intricate network of care involving a widespread area and involving many facets.  Stigma and discrimination will not have the stronghold it has had preventing people from surfacing for help. Only when they come forth physically for help can you even hope to help them spiritually.  We are excited to continue moving forward!!!

Please continue to pray for us here at the clinic…not just Sal and I, but all the staff as we are moving in unchartered waters! J  Thank you again for all your love and support.   

The color yellow has a whole new connotation for me these days.  In the past, whenever I thought of the color yellow, I immediately thought of the sun…or maybe a flower….but not so now.  Believe it or not, whenever I think of the color yellow these days, I think of urine.  Pretty weird, you say?  Well, let me tell you the story…..

Steven is a 36 year old married man with children.  Sorry I don’t know how many, but I can tell you he has an 18-month old daughter. (The little girl was very afraid of Sal and I because we were white-skinned and would hide under her mom’s chetange whenever we would come around. It was very cute!)  Well, Steven was admitted to the clinic one night very sick with a high fever.  He had a dazed look and appeared dehydrated.  He was previously treated for malaria at another center just days before.  An HIV test surprisingly was negative. A malaria test was also negative, but expected to be so since he had already been treated.   IVs and broad spectrum antibiotics and fever control were the order of the day. About the second day here with fevers still up and down and I mean spiking high like 104 degrees, I walked into his room making my rounds, greeting patients and families and praying.  When I entered his room, I noticed his urinal sitting on the floor with what should have been urine in it, but I had to ask. You see what was in his urinal was black!!  Not tea-colored, not dark amber, not blood-tinged, not bloody…..just black!  What Steven had was “Black Water Fever”, a very serious form of malaria. His urinalysis was abnormal with protein and ketones and bilirubin.  Quinine was started immediately and a urinary antibiotic was started a couple days later after receiving the drug for the first time from the district.  (Coincidence??)   Despite the new treatment regimes, things were not looking hopeful, so Sal went in to talk with Steven and his family about the probable outcome as medically seen.  He wanted to give them the option of taking Steven home to die or staying at the clinic with a high probability of the same result.  Oh, in other words asking “where do you want to die?”  Pastor Julius had accompanied Sal in to talk with the family and they all prayed together before Sal left.  Pastor Julius continued to stay with the family to pray and offer support.  Steven and his family discussed it and they decided he would go home.  They would spend another night at the clinic and go home in the morning.  His brother was at his beside all night.  I just happened to go over to the clinic because Sal had been called out in the middle of the night to pick up a woman in labor.  I knew he had arrived because of the squeal of the brakes on the Land Rover and I had gone over to help.  I sat down in the main reception area to wait on him and I saw Steven’s brother bringing out his urinal to take to the bathroom to empty it.  I literally had to chase him into the men’s room because my Tonga was not that great and neither was his English. I had to make sure the urine was Steven’s because it was clear yellow!!!  Testing his urine showed all normal results!!!!  Remember, just a couple hours previous, it was black….no change despite all our efforts…..until we had given up and prayed!!!!  When Sal came in and got the lady settled, I showed him the urine and the test.  He looked at me awe-struck,  with tears in his eyes and said, “It’s a miracle!”  He proceeded to go to Steven and the family and tell them we had all just witnessed a miracle!!  He gave God all the glory!!  The family did take Steven home the next day and will continue the course of medicines, but I know we will see Steven again for his follow-up appointment.  I know the outcome we expected was changed that night!