September 1, 2006

 

We had a meeting with the Kazangula Health District during the first couple weeks we were back regarding making us an ART clinic.  That’s a clinic able to distribute the free medications for HIV patients.  It would mean that a group of 3 or 4 from the Health District would come to Sons of Thunder twice a month to distribute medications….a physician, pharmacist, and one of the coordinators for HIV care.  They would continue to come out until Sal and I and the staff are trained.  We now have over 65 patients on ARV therapy and more diagnosed every week. Upon our return, we hired an HIV tester/counselor to start in September, not knowing how valuable he would be in this process.  He will be our Infectious Disease Coordinator and will take care of all our HIV and Tuberculosis patients; testing, counseling, scheduling, coordination of care and medications, documentation and statistics, home visits and other family need assessments such as food and powdered milk.  Home visits will be with Julius, a well known man on the farm, pastor of one of the planted churches and graduate of the Bible School.  He came to us when we got back and told us that in his prayer time with God, he felt he was supposed to do more than pastor a church…he was supposed to help the lost and dying and he asked us if we had a need for him to help in the medical ministry somehow. When he was talking, I immediately thought of a Chaplain…and when I mentioned that word, Julius said “Yes, that’s it!”    Over the last year, Julius has been the only pastor that has asked us to go and see sick people from his church in their huts.  Julius often visits his people at their homes.  Well, all that being said….the meeting with Kazangula was positive and it looks like they are seriously considering it.  We are presently checking in Lusaka for lab equipment to perform CD4 counts and sputum testing for TB.  With adequate lab equipment and a Zambian trained HIV counselor, it would be hard for the Health District to say no. 

Yesterday, we had a meeting with Livingstone General Hospital regarding unfair charging.  As a result of the meeting, we are no longer permitted to go to Fast Track with our HIV patients….we must go to the low cost Outpatient Department with the ART clinic.  When we expressed our concerns for staff not showing up and our large group of patients being sent home unseen, they told us things had changed and our clients would get priority on Thursdays.  It was not a very good meeting, but since I know that God turns everything to good for the benefit of those who love Him, I know that He has a purpose and a plan.  Yesterday, I couldn’t see through the tears of discouragement and frustration, but today I see K 3,00,000 (about $850) now available to pay an HIV counselor and a chaplain and maybe some lab equipment with a monthly supply of reagents.  The HIV coordinator from the Kazangula District came to the meeting with me and was able to see the difficulties first hand.  Perhaps that was incentive for him to speed up the process of our becoming an ART clinic.

God does provide when you walk on those stepping stones as He lights them.

Most of the time you step on that next stone not sure of the whole picture…because there is only one lighted stone in a sea of darkness.  But every time we take a step….we find that He is already there.

 

    August 25, 2006

 

            I don’t know if I told you, but I am unable to resize and e-mail pictures directly.  I have been able to put them on the blog site when I go to town, so check it every now and then if you want to see pictures that go along with these updates at www.xanga.com/srm6476.  There are pictures from the previous update posted…a scorpion, 2 snakes and the “Dream Team.”

            So much happens here that it is hard to get it all down or to know what exactly you would find interesting.  I know you medical folk like to hear about the medical cases, but life itself here is also unbelievable at times. 

            Medical cases first I guess.  Sal got to do his first suturing the other night.  Agnes, an older woman was using an axe and cut the back of her leg right above the heel…it was laid open with the Achilles tendon visible.  Thankfully the tendon was not damaged.  After wrapping a dirty rag around it and walking to get to us, it was quite painful and dirty when she got here.  I spent at least half an hour cleaning the wound out using a syringe with peroxide before we even started to put local anesthesia in and begin suturing.  Sal sutured the wound as Christopher, our driver, held the light and was fascinated by the whole procedure.  I was the “get me” person….you know “Get me this and get me that!!!” After a sterile dressing, antibiotics and a tetanus shot were in order.  A night’s stay at the clinic and a couple dressing changes in between and then her sutures were removed yesterday.  Wound is closed with no sign of infection….Praise God!!

 

 

 

 

 

           

 

 

 

 

 

 

 

 

 

 

 

 

 

Sal got a call to go to the bush because one of our antenatal patients was in labor.  He went out to her village and brought her back to the clinic.  Her labor had started supposedly at midnight and it was now three in the afternoon.  Her water broke at 3:30pm, but when she was unable to push the baby out by 5:30pm, we decided to take her to the hospital….after a half hour of paperwork and berating us about why we brought her, they suddenly changed shifts. During that half hour the only thing they did for the patient was check for the baby’s heartbeat.  The new shift that came on decided to catheterize her to relieve her bladder.  I watched as one nurse put on a pair of unsterile gloves and then proceeded to ask us if we had any “surgical gloves.”  We gave her a pair of sterile gloves which she proceeded to contaminate as she put them on overtop of the first pair.  Then she took a catheter and proceeded to attempt to put it in the urethra without cleaning first and without any lubricant…catheter end dragging on the bed and in an unsterile pan.  The attempt failed as she was unable to insert it fully because the baby was right there trying to come out.  So they proceeded to start an IV with oxytocin and then a very large nurse came in and with all her weight pushed a forearm into the top of the pregnant woman’s belly downward and….a baby boy popped out pretty forcibly.  I am continually reminded where I am and how important it is for us to assess the need to transfer patients out…where will they get better care.  Transfers to the local hospitals are not always at a higher level of care.  Well, after making sure Judith and the baby were settled, we left only to return the next morning to take them home.  When Judith brought the baby to Under Five clinic, we discovered she had named her son Sal!  That makes three now.  It makes me ponder…how many more?

 

 

So much for medical now, let me talk about day to day life here…. Another snake!  I don’t know, but this must be the season for snakes….otherwise God is getting me ready for something.  The other day Sal spotted a snake up at the Hill outside Howard’s house (one of the teachers).  It was a cobra…long, skinny, grey and fast.  Howard and Sal did manage to kill it finally after trapping it inside the house where it had run. 

After that “hunting episode”, we went into town with Jessie and Jacob.  On the way home, a very large bird like a turkey called a guinea fowl lost its radar and smacked right into the Land Rover.  We continued to drive home with feathers flying behind us.  When we got on property, we stopped and gingerly got out of the vehicle to see.  Sure enough, it had broken its neck and was lodged up on the roof rack.  We stopped at the first hut we came to, which was Abson’s house…he was very excited to have dinner!!!  He said, “You have a good vehicle!”

Coming home from eating a late lunch near Victoria Falls this past weekend, we were driving along pretty much in town when all of a sudden, Sal yelled “Look at that!”

Turning my head to the left I saw a large herd of elephants!!! There must have been about 12 of them with 2 little babies.  They were in and around these concrete remains of previous construction…half built walls and such.  Sal stopped the vehicle and we continued to watch until one large elephant stared us down and started to move his ears…now I’m not an expert on elephant talk, but that was a warning to me!!!  That’s about the time when we decided to slowly drive away. Unfortunately, we didn’t have our camera with us for any of this Africa flavor!!  Before you say anything, we have decided to keep the camera with us at all times from now on…..promise.

           

 

August 20,2006        .... SEE PICTURES ADDED

            I am sorry that I have not written an update since our departure in April.  The time back in the States was filled with family and friends…..including a whole lot of new friends from all of the churches that we visited.  We would be amiss not to thank all those responsible for our positive and fruitful visits.  So to all of you from Virginia to North Carolina and Ohio to Georgia and Rhode Island to Maryland….we wish to again give you our thanks for taking us in and sharing in the vision of Sons of Thunder Medical Ministries.

            That being said……let me share with you our arrival back in Zambia.  We were picked up at the airport by Tim and Mary and driven right to our door.  As soon as we exited the vehicle, literally a swarm of Zambians ran in our direction.  For the next few minutes we were hugged and greeted with smiles and a very warm welcome.  It was very overwhelming to realize we were actually missed and even more amazing that we really had missed them too.  Even the school kids and the orphanage children seemed genuinely glad to see us.  The orphans started yelling “Sal,” “Sal,” and one little boy went running into the house and said “SAL CAME BACK!!!!”  It was very moving.  I went one way because the school kids were heading for me and Sal went the other because the orphan kids were yelling for him.  It was awesome to get such a warm reception.

            On to the clinic staff…..Do you remember the “Dream Team” from some time ago?  Well, let me introduce you to “God’s Dream Team,” the one that He put together for the Clinic.  This is the team that held the reins of the clinic the three months we were back in the States.  Working together, they were able to keep the Clinic open Mondays and Fridays and spent the rest of the week taking care of HIV patients, along with shopping for mealy meal, powdered milk, medications and other medical supplies as needed.  Despite many obstacles from a lot of different sources, they were able to triumphantly overcome them all.  In each situation that arose, they problem solved, asked no one for help, relied on each other and took care of the problem. They held “department meetings” every week and prayed together every morning.  They took ownership of the clinic and worked as if it were their own. We were and are very proud of them! The pilot was a tremendous success.  As a thank you for a job well done, we all went to dinner at Rite Pub in town.  At the end of dinner, Christopher (the driver) went out to his car and brought in his Bible to read a scripture to Sal.  With tears in his eyes, he said “I am very happy.”  He rededicated his life to Jesus at the HIV meeting/service we had right before we left….came to find out that he would sit in the car during clinic hours Mon and Fri reading his Bible waiting in case he was needed for transport. Not only has he rededicated his life and has been in the Word, but now he wants to go to Bible school here on the farm when it reopens in September!!!  We told him we would be happy to accommodate his work schedule so that he may do that.  Praise God!

It has also been rewarding to see what the staff is spending their money on….Janet has saved enough money to have a house built on her own as a single woman.…a two room mud house with a thatch roof , ready in about thirty days.  She is now saving for a bed!  Anna gives her mother money every month to help with food and she has bought a mattress…she is also having a hut built for herself on her mother’s homestead.  God said “raise the standard” and “give hope” and I see signs of that happening.  Our Pastor once said “each one, reach one”…..one at a time and it will have a compounding effect over time.

                Life in Africa continues to be filled with plagues…this time it is with “stink bugs.”  When we came back to the apartment after three months, there were literally tens of thousands of stink bugs…they are small, crunchy bugs that stink when you kill them.  Thankfully they do not bite but they are very annoying!  It was like living on Fear Factor.  The bugs came out of the ceiling and seams in the walls, they were in the shower and in the bed and in books and in the closets etc….really gross!  Five vacuum canisters emptied so far.  We still have them….but thankfully they are down to about a hundred vacuumed up twice a day.  While cleaning them up one day, I noticed something black come out from under the loveseat…..when I looked down, it was a scorpion!!! I know I told you that we had them before….but they were nothing like this one!!!  This one was as big as my cell phone!  You won’t believe this because I still ponder it, but I was not scared!  I just removed my shoe and killed it!  Just last Saturday, the workers on the farm killed two Puff Adder snakes they found right in the yard of the guest house. There were five other sightings that I heard about….a cobra in Rev Mwikeesa’s television, a mamba out of the trellis of the guest house veranda, two cobras in the bathroom next to the clinic and a cobra in the kitchen of the guest house….all were killed except the one in the kitchen.

 

            Clinic patients have involved a lot of bush runs….the last work team got to see more of the bush than we had seen all of the first nine months we were here.  There have been four deaths since we got back…one, an HIV patient of ours that died in the clinic with all of the family present.  His wife thanked us for more time with her husband and we were able to make sure in that time that he was saved and knew where he was going to spend eternal life. 

One of the most dramatic patients that I can tell you about was “Nelson”….a 60 year old man who came to the clinic on an oxcart (Zambian ambulance) with extreme difficulty breathing.  His family had brought him from deep in the bush about 6- 7 hours walking.  We put him in bed with his head elevated and started nebulizer treatments…his O2 saturation which is supposed to be in the 90’s was in the 50’s. His ankles were swollen with fluid and his lung sounds were “wet.”  He was literally drowning in his own fluids.  We started an IV to give him Lasix and Aminophylline…and after three neb treatments, his O2 sat was still crappy and he was foaming at the mouth.  I suctioned him as he was losing consciousness.  To make matters worse, there was no vehicle on the farm to use for transport…so we called Tim from up on the hill and asked him to transport us in his lorry to Livingstone General Hospital.  He agreed and came down…Sal started bagging the man to assist with breathing and we got men from the work team to help load him into the back of the lorry on a mattress.  We took two team members with us along with his wife….one team member holding the IV, Sal bagging, me monitoring his O2 sat and level of consciousness and the other team member comforting his wife…everyone praying.  What a sight we were in the back of the uncovered lorry driving on the open road and through town to the hospital.  When we got to the hospital, Tim went to get a stretcher and came out with an army canvas stretcher like you see in the battlefield scenes of old war movies.  When we got inside and asked where we should put him, the only nurse around said “Put him in the emergency room.”  Sounded reasonable, but she then proceeded to unlock a 12x12 room.  From the look of things, it was obvious that this was a room that is seldom used if at all….one stretcher, drawers empty, some old equipment just thrown around on top of counters etc.  Remember Sal is still bagging Nelson…he is not conscious…O2 sat still not acceptable.  When the nurse put us in the room, she left and no one came….turned out the Clinical Officer was at lunch with no way to reach him and this nurse was the only one there covering the Outpatient Department.  We found an old working O2 tank and moved it closer…then we tried to find a mask.  Sal had to “rig up” something that would work to deliver oxygen.  We were able to get his O2 sat up into the 90’s with the oxygen and he would respond to my voice if I was in his ear.  We waited for the Clinical Officer to arrive and gave report and prayed, leaving him there not knowing if they would do anything or if he was just going to die.  We were pleasantly surprised when we discovered he had been admitted to the male ward and even more encouraged when we found they had put him on Lasix, Digoxin and Salbutamol….when we went to visit, his wife ran up to us and hugged us for a long time without letting go. Nelson was discharged about a week and a half later.  When we were taking him home, we stopped at the clinic to get medications for him…(the hospital had only given 5 pills of Digoxin and told him that was all he would need).  While he and his family were in the vehicle, I was stirred to give him a Bible and talk to him about Jesus.  That day we made sure he was saved and knew where he would spend eternal life.  The entire family, wife and grown children were witnessed to professing their relationship with Jesus also.  Nelson went home and Sal made a house call last Friday….he wasn’t looking real good.  It had taken Sal over an hour to get to his house by vehicle.  When Sal returned, he told me “He won’t make it out of there again.”  That was Friday….Nelson died today at home.  Saddened though I am for his wife and family and sometimes frustrated at medical care in Zambia, I can’t help but smile………..you see, I know where Nelson is today. J  

Jha, Anna, Janet and Christopher..God's "Dream Team" for the Clinic

A "REAL" African Scorpion

Two "Puff Adders" killed in the front yard of the Guesthouse

 

Written April 19, 2006

 

 

 

I have two more stories to catch you up on.....

 

 

 

This is the first one.......

 

 

 

On the heels of those last three patients, an elderly man named George arrived. He came in the back of a pick up truck, brought by six family members.  They had been at Katapazi Clinic, (another rural health center some distance away) with their brother and/or uncle  who was having stroke symptoms.  They had kept him for two days at the other clinic and had given him Penicillin injections. (Don't ask...it's probably all they had). Upon exam, George was found to have tremors only on his left side involving just his arm and leg.  There was no facial involvement whatsoever nor any speech impairment. His blood pressure was normal. With the history and exam, Sal admitted him in an attempt to control the twitch.  He went home after two days on Depakote with instructions for strengthening exercises. When they initially arrived at the clinic it was after dark  and I was in Lusaka.  Sal and JoAnne both came out to greet them and while Sal took the patient into the clinic, JoAnne spoke with the family outside.  What I want toshare most with you is what they told her.....They said; "We brought him here to Sons of Thunder Clinic because we heardthat miracles are happening here!"  

 

 

 

People are being drawn to this place and not because it's free. Every government clinic in Zambia is now free!   Oh no, my friends.... there is so much more going on here.  People are being drawn to this place because there is something different here....there is a hopehere.....Jesus is here.

 

 

 

You be glorified God!!!!

 

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Last....but by no means least was Thursday April 13th.........

 

 

 

After months of individual meetings with the Thursday HIV patients, we had a gathering in the church with the entire group.  This Thursday, instead of going into town to the hospital, we met all together to share the Word, praise the Lord, have a time of prayer, eat a meal and provide all necessary direction to be followed during our absence in order that they would continue to receive their medications.

 

The meeting was opened in prayer by Reverend Mwiicheza and I shared the Word out of Romans regarding sin and its consequences.   I started by sharing how until they were given the diagnosis of  HIV, they were unaware that they needed a cure.  They didn’t know what was wrong.  If you didn’t know you had a disease, you wouldn’t know that you needed a cure or a healing.....the same is true of your spiritual state.  Until you become aware that you are dead in your sin, you never know that you need a cure. So we talked about the wages of sin being death but the gift of God being eternal life.  There is no one righteous, not even one.  But Jesus offers a complete cure though His amazing grace.  Once you know you are sick….it’s there for the asking.  They were asked if they died tonight (and many of them had been close to death), where would they go?

 

 

 

After the word, there was a sweet time of praise and prayers of repentance for salvations and rededications.  Thirty Tonga Bibles were distributed to those who did not have a Bible.  It was sweet to see them hover over the Word, talking to each other.  Now after they were given time to make their relationships right with God, they were encouraged to pray for their healings  as Sal and I agreed with them in prayer. 

 

 

 

The informational portion of the meeting came next beginning with introductions to Jha, (the Clinical Officer), Christopher, (the driver), Anna and Janet (the staff) and another Christopher (who helps us out when we are at LivingstoneHospital). They were each given a written personal schedule of medication collection and review dates.

 

The rest of the day was spent in fellowship as they shared a meal of nshema (corn based mealy meal), cabbage, beans and kapinta (small fish about 2 inches in size with the eyes still looking at you!)

 

When it was over, hugs and goodbyes were exchanged before they loaded onto the lorry for Sal to take them home. 

 

 

 

Please keep our patients in prayer during our furlough.....

 

 

 

Gathering in the Church

 

 

 

Time of Prayer

 

 

 

Sharing a Meal and Fellowship

 

 

 

Wilson...holds a special place in my heart

 

 

 

Sal and Staff

 

(Anna, Christopher, Bertha, Christopher, Janet and Jha)

 

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I want to thank you all for accompanying us on this part of the journey....for staying faithful in interest and prayer....for your words of encouragement....for your support....for your love.  I will probably not be writing much while we are on furlough.  We will be busy with family and friends, catching up and having fun, but you can still reach us by e-mail and I will  be sure to answer.  We will be returning to Zambia in mid-late July.  Until then, be safe, stay in God's Word, and may God Bless.....

 

 

 

In our prayers,

 

Sal and Renee 

 

 

 

PS....Our grandchildren remembered us!!!!!!!

 

 

 

 

 

 

 

 

 

 

Written April 12, 2006

     I know it’s been a little while since I have written an update except for that short story the other day, but things have been just a little busy here lately, not giving me much time for anything.  You see, we are getting prepared to come home for 3 months and we are trying to leave things in place to run while we are gone.  We have been given approval to leave the clinic open 2 days a week on Mondays and Fridays in the hands of a very capable Clinical Officer named Jha. He has been orienting here for the last four weeks, one to two days a week, and both he and the patients are being blessed.  He has handled the patients with the same care and compassion as Sal, making him an ideal candidate to cover during our absence. He is very excited for the opportunity and prospective future this gives him.  As far as the staff is concerned, Rona was given a leave of absence and Bertha is going off to finish school in May.  That leaves Anna and Janet to carry out all the office duties with Anna officially in charge.  The HIV and TB patients will continue their reviews with transport provided by a Zambian driver named Christopher.  He has been training for the last six weeks and is doing a great job.  He has driven patients and staff independently into Livingstone and Zimba this week and has done well.  There will be no Under Five Children’s Clinic until July…all mothers are being referred to Musokotwane Clinic in the interim.  Please keep the clinic in prayer throughout our furlough because this is a pilot study.  Not only are we preparing to leave the clinic operational with Zambians, but also the church.  All Sunday School teachers are in place and all lesson plans from now until August are copied and in the hands of Howard, the superintendent ready for distribution.  The Assistant pastor, Pastor Hanguzu, will take over the running of the church and the budget has been turned over to the Board.  Their responsibility is to count the offering, disperse the monies on paper into different accounts, record all incoming and outgoing funds and provide adequate storage, all on a weekly basis.  So, please keep the Clinic and Church in prayer.

Zimba Eye Clinic came to Sons of Thunder clinic last Monday to do screenings in preparation for the next eye doctor’s visit which is April 24^th.  As a result of patients being seen, 5 received glasses and 15 were scheduled for cataract surgery on the first day.  They told us they would keep a tab and work things out in July for payment. This first time for evaluation and screening went so well that Leonard and Weston, workers from the Eye Clinic, would like to do this on a monthly basis.  They requested to sit down and discuss the possibilities upon our return.

Since we came, a lot of what we have done has been building relationships…with Livingstone Hospital (OPD, Lab,  X-ray, Maternity, Fast Track), Zimba Hospital (OPD, TB, Lab, X-ray, Maternity, Theatre Staff, Ultrasound), Kazangula Health District, Zimba Eye Clinic, District Pharmacist, Doctors in town, Villages, Patients, Fellow Missionaries, Chemist, etc.  How does it all come together God?

Well…..let me tell you about last week’s patients.  The first one was a woman in her 60’s, named Florence who was driven to the clinic in a vehicle.  She was from the other side of Livingstone near Botswana and she came here after being discharged from Livingstone General Hospital with Congestive Heart Failure, with only medications for 2 days.  The vehicle belonged to the village and they had to pay K150,000 for the use of it just to get to us.  Upon exam, she had pitting edema of both feet, ascites (fluid in the abdomen), and rales (basically fluid in the lungs).  So not only was there CHF, but also liver failure and Emphysema! Sal admitted her and put her on Lasix and gave her some nebulizer treatments.  After prayer and education about the disease as well as a nebulizer treatment before bed and sleeping in a sitting position, she was much more comfortable. 

During that same day, a woman walked into the clinic wheezing very badly.  Her name was Priscilla and she was Alexander’s sister-in-law.  Sal gave her a nebulizer treatment, waited a little while and then gave her another one to get her breathing under control.  She was sent home on Salbutamol with Alexander and Agatha that afternoon, breathing easier.  At 2 am, Alexander knocked on our door and said Priscilla, who was still at his hut, was again having difficulty breathing.  Sal gave him an inhaler to give her and told Alexander to come get him if she didn’t improve….but to definitely bring her in the morning.  The next morning, Priscilla came in wheezing badly, respirations at 50 and an O2 saturation of 79%.  She was immediately given a nebulizer treatment, but without effect.  Unable to get control of her breathing, Sal started an IV and hung an Aminophylline drip.  She was definitely a patient that needed admitted but Florence was in the bed and still being monitored. So Priscilla was put in the other exam room on a mattress on the floor.  The drip was hung on a nail in the wall. 

During the course of the day as Sal was seeing patients around these two women, a 15 year old albino girl by the name of Precious was brought in.  She had spent the last two days at Musokotwane Clinic for nausea, vomiting, fever, dehydration, abdominal pain and inability to walk due to muscle weakness.  The two women who brought her in told us…”they failed and told us to go to Livingstone Hospital, but we came here instead.”  Upon exam, she was found to have an enlarged spleen and liver.

For some reason (Holy Spirit?) Sal did a malaria test and it was positive.  So whatever she had going on, she also had an underlying malaria to complicate things. Sal started an IV drip on her for fluid replacement and to give IV medications…..another patient to be admitted!!!!  Now what would we do?….well, we just put her on the exam table with her drip hanging from another nail on the wall. 

          Picture this now….there are two rooms, one bed.  Remember there are family members with each one of these patients and a staff member has to stay the night with them!!!  So, in the first room we have Florence in the bed, her sister on the cement floor and Janet (staff) on an army cot.  In the second room, we had Priscilla and her sister Agatha on a double mattress on the floor, Precious on the exam table and her two family members sleeping on the floor.  We even made pillows out of mealy meal bags!!!  We asked Reverand Mwiikisa (who has become our “elder” or chaplain J) to bring the oil and pray on these people.  He came and we all joined in prayer for healing.

          Florence went home on Lasix and Potassium…no Digoxin or oxygen here. We didn’t even have any more TED hose. The family was told to just keep her comfortable.

Precious’ breathing improved after 8 hours on the Aminophylline drip and her numbers steadily improved over the next 24 hours.  She was discharged with a 97% O2 sat and respiratory rate of 22.  Precious was discharged after fluid replacement, antibiotic therapy, and malaria treatment. She has since returned to the clinic and Sal tested her for HIV after finding out that the two women who brought her in were the grandmother and sister…..her parents had both died leaving her an orphan and nobody knew from what.  She was found to be positive and is currently in the process of further testing and getting medications as we are heading home.

 

Looking back over these last nine months, we have watched God perform some awesome miracles and give hope to thousands of people.  What’s even more amazing about the God we serve is that He did it all holding us in the palm of His hand.  He cared for us the entire time we were caring for His people…we’ve been healthy…we’ve never been given more than we could handle…His favor was always with us…His wisdom came when we needed it…He continued to work on our character and spiritual growth while we taught others…He put people in our path as they were needed both personally and professionally, He opened our eyes wider in faith and belief, He removed all fear and gave us rest.  What an awesome God we serve!  It says in His word if we are faithful with the little things, He will give us bigger things…..so Lord, have we been faithful with what you have given us?  Are you going to give us bigger things?  Have we been faithful with these two small rooms? 

 

 

Written April 11, 2006

 

I just want to tell you a quick story…it’s one of many, but one of my favorites: 

 

A Zambian man, Kelly, brought his wife Beauty to the clinic because she was very sick….but to be honest at the time I’m not sure who looked worse….her or Kelly.  They were both very thin like skeletons and drawn-looking.  Beauty had a high fever and large lymph nodes in her neck. It was obvious she had some sort of infection and was very malnourished. She was weak and dirty and understandably had no interest in breastfeeding her baby.  The baby also dirty just cried with hunger.  Kelly was malnourished, unkept but showed concern about his family and his inability to provide for them…he had no clue what was wrong with all of them.  He just knew he was too sick to work or make things better.  She and Kelly were found to be HIV positive and unfortunately so did their 13 month old daughter.  We kept Beauty in the clinic for three days on IVs and IV antibiotics while we drew their blood and took it into Livingstone for testing. After discharging Beauty, we took them both into Livingstone Hospital to get them put on the HIV meds.  We also gave them powdered milk for the baby with a couple bottles along with HEPS and a 25kg bag of mealy meal.  Kelly and Beauty have no family that can help them and he has been too sick to plant and work his fields. There is not enough food to feed his family which we found out also involved a ten year old daughter and a four year old son.  Kelly brought his ten year old daughter into the clinic the following week to be HIV tested and she was found positive also.  He then brought in the four year old son, but to our surprise, the son was negative.  So four out of five in the family have HIV!!!! The 10 year old girl named Gift was covered in skin sores from head to foot so even though her CD4 count was too high to qualify, they placed her on the medications due to her condition. It has been a month now and I wish I would have taken pictures in the beginning and then I would have had before and after shots, but unfortunately it’s hard for me to take pictures when people are so sick and literally dying.  Last Thursday, we took them into Livingstone for their review and the change is just miraculous….Kelly has gained weight and feels healthy.  He was even sporting a little goatee! Beauty is smiling and looking well and Gift’s skin is completely healed….sores are all gone.  They have a hope in their eyes that wasn’t there a month ago. The smile on Gift’s face alone is like looking into the face of Jesus.  It reminds us when He said….when you did it for the least of these, you did it for Me. (paraphrase)

 

March 28, 2006

 

Ten o’clock last Tuesday night, the phone rang.  It was Zimba Hospital.  They had a patient in labor (Orlando) that had stopped contractions even though fully dilated….they said the baby was “stuck.”  The problem was they had no doctor to do a C-section, no Pitocin to assist labor and no diesel for the hospital vehicle to transport the patient to Livingstone Hospital.   So they were calling us to see if we would transport.  We had seen the patient in the clinic for a couple antenatal visits so we agreed to transport her.  It took one hour to get to Zimba Hospital and then another hour and a half to get to Livingstone General.  We left her in the Maternity Ward in the hands of two midwives.  It was around 1am when we left the hospital and 1:30am when we got home.  The next day I went to Livingstone Hospital to take home a discharged patient and I stopped in to check on Orlando.  She was fine and ready for discharge but she was empty-handed….the baby had been born dead.  The women that were with her had already taken the body and buried it in an area near the hospital.  It was very sad and the dad wasn’t even aware of anything yet.  The only reason that baby died was the amount of time it took to get proper attention.  To make matters worse, we found out that 20 liters of diesel had been offered, but as the saga unfolded the Zimba vehicle was being used by a staff member for his personal use at the time and wasn’t available at the hospital for the needed patient transport.  The staff had even waited an hour before calling us.    

 

Remember Tito, the teenage boy with tuberculosis whom we have on TB medications?  Well, when taking patients home from Livingstone Hospital this week, his father came up to our vehicle and told me that Tito was in the hospital. The story was that a tree he was cutting down fell on his leg, fracturing his knee.  That happened on Saturday the 18th and he was scheduled for surgery Wednesday the 22nd….I am not sure why the initial delay.  When I stopped in to see him on Wednesday, I was told he was not going to have the surgery that day because there was no oxygen in the hospital.  They were waiting for a delivery truck to come any day. Sal just stopped in to see him today, almost a week later, and his surgery still has not been done.  It is supposed to happen tomorrow the 29^th….a full 11 days since the injury!  Can you imagine?  He’s been lying in a hospital bed all this time with a bone sticking out of his leg!  I’m really surprised he didn’t get septic, not to mention the pain he’s been in?

 

I really don’t know what to do with stories like these two….the sad thing is these stories are not unusual or rare.  These stories are the norm; they are almost expected.  I know for a fact they are accepted as “just the way things are.”  You will hear people say,  “It’s Africa” shrugging their shoulders almost like “What do you expect?” It reminds me of when they said in the Bible…”Nothing good comes out of Nazareth.”  Ahhh…but we know different, don’t we?  We know who came out of Nazareth. I believe things can be different here as well.  It makes me ponder and ask….. “What are you going to birth out of Africa God?”

 

Bristo left the clinic Thursday after being scalded and having burns over 38% of his body ten days previous…he was the child we took to Dr Shafik and he spent three nights at his facility.  He had been with us since his discharge from Dr Shafik’s…a total of 7 days.  His dressings were off, pain was gone and healing had been taking place.  Dr Shafik told us that he should have no scarring and the pigment should all return.  Praise God!  Bristo is still not a big fan of mine….he cried every time I enter the room because I am the one who always did his dressing changes.  His mom would even cry and leave the room whenever it was time for his dressings. J  It was good to see his little smiling face as he left for home. Yesterday, Bristo came back for review and Under Five Children’s Clinic….his pigment was already coming in!!!  Thank you God.  He took one look at me and started to squirm, trying to get away from me.  That’s okay….I didn’t take it personal. J

 

I picked up little Libina from Zimba Hospital to take her home last Friday.  I found out her name is Robina instead of Libina…Zambians have a hard time with the “R” sound.  Robina went home without a fever, breathing normally and with a hemoglobin of 6.0.  The left side of her head was shaved where they tried to use a scalp vein for an IV unsuccessfully.  She also was not a big fan of ours….I guess we stuck her one too many times!  Oh well….it was good to see her parents smiling taking her home. God does answer prayer.  Robina’s parents were very thankful for your prayers and told me to tell you so.

 

Oh, as I mentioned, yesterday was Under Five Clinic and guess who showed up for his first check-up…..little Sal!!!!  Yes, it’s true!  Primrose named her baby

“Sal Norish Simutili.”  He’s only two weeks old, very cute and very healthy. I think the picture of mom and baby was in the last update.

 

            This past weekend was the women’s monthly prayer and fasting weekend held this month here at Sons of Thunder Church on the farm…I taught Saturday on “Fasting”, “Getting Oil” and “The Secret Place,” and ended up teaching Sunday School on “The Mary Miracle” and preaching on “Looking Through God’s Glasses.”   We had to restructure the Sunday School Program “Firm Foundations” because we lost two teachers….one with health problems and one because he was asked to pastor one of the outlying church plants.  So Howard, one of the teachers here at the primary school, moved to the adult class and Sal will help out until we leave.  Tim from the Hill has agreed to help out while we are in the States.  He has even agreed to have more Train the Trainer sessions.  One of the Bible College teachers, Pastor Hanguzul (I’m not sure of the spelling) will take over the church until either a new Pastor is put in place or Sal returns. Pastor Hanguzul already has a Baptism and Baby Dedication planned for April to correspond with a Fellowship Sunday….it might even be Easter Sunday, which by the way is when we head for home.

 

This update is filled with tidbits….little noteworthy things I guess.  Either that or my brain is already on its way home…..which just might be the case!!!

Looking forward to seeing you all soon or at least talking to you Stateside with good phone connections!!!!   Thank you all so much for your prayers and encouragement over the last nine months.  I know God has been here with us every minute of every day, but it also says in Proverbs 25:25, “Like cold water to a weary soul is good news from a distant land.”  Believe me, these weary souls have drank and felt the refreshing!!!  

 

                                   Bristo

 

                    Pigment Returning After Burns

 

                   Little "Sal" Norish

March 17, 2006

 

 

 

We are a month away from coming home and just like when you put your resignation in at work…you know how your mind starts leaving before your body does?  Well guess what?  My mind is starting to be there with all of you.  J  It just needs my body to catch up!!!  In all seriousness, we are starting to put things in order for when we leave. There are a lot of questions that we are praying about, seeking answers.  Questions like: 1) Do we close the clinic or utilize a Clinical Officer to work part-time?

 

2) How do we make sure the HIV patients have their reviews and continue to get their medications?  3) Do we hire a driver? 4) Do we keep staff working on a part-time basis?  5)  What do we do about the two eye patients who are to have either a review or surgery on the other cataract when the eye doctors come to Zimba again? Sal and I are both anxious to come home for awhile, but the “manager side” of us doesn’t allow us the privilege of just turning our backs and walking away.  We are too responsible not to want things in place to guarantee continuity of care while we are gone.  Zambians are very used to missionaries walking away and not completing what they have said they are going to do.  When they find someone who keeps his word, they are very surprised and tell you, “You are different.”  Pray that God gives us the answers and sets in place whatever He would have us do.

 

Sal preached again last weekend at Sons of Thunder church on the farm.  Pastor Jerry preached about God loving us when he was here in February.  He told everyone to grab their chin and say “God loves me.”   Sal felt God was asking if anyone loved Him….so Sal preached on the two greatest commandments.  Although a simple message, it left a lot of pondering and self-reflection to be done.  Sunday school lessons with Firm Foundations are underway with four classes of different age groups and a total of eight teachers. Howard, one of the school teachers on the farm has agreed to take charge and manage the schedule.  I will make sure all the lessons are copied and ready for the teachers, but I am turning the course over to Howard by the time I leave for the States.

 

Lately we have had a string of trauma patients at the clinic….First there was David, a 13 year old boy who came to the clinic with one shoulder looking pretty out of alignment.  After examination, Sal thought it was dislocated and sent me to Livingstone Hospital with him and his father to get an x-ray and then possibly treatment.  Well, when I got to Livingstone Hospital, I discovered that both their x-ray machines were broken and they were unable to take x-rays.  They admitted David to a ward and talked to his father about finding a private place to get an x-ray.  The only problem was no one knew if there were any private places to get one.  I decided to drive to the bottom of the hill to a private clinic/hospital owned by a Dr. Shafik.  I found out that he had an x-ray machine…very antiquated, but operational.  He told me he would be happy to see David.  So I went back to the hospital and took David out of the ward and drove him down to Dr. Shafik’s for an x-ray.  The x-ray showed a greenstick fracture of the humerus (break in the upper arm) and no problem with the shoulder.  Dr Shafik splinted the arm to the trunk with gauze wrap and put his hand in a makeshift sling tied around his neck.  He gave us the x-ray to take to the hospital and told us of a Ukranian doctor at Livingstone who was an orthopaedic surgeon.  The next morning, the orthopaedic doctor discharged him concurring with the diagnosis and treatment. We had to pay for the x-ray and treatment at Dr. Shafik’s, but there was no charge at Livingstone Hospital because he was a referral from a clinic!!!

 

Next…Professor, a graduate of the farm program brought his four year old son to our door because he had been scalded with water receiving burns over 38% of his body including neck, left arm, trunk and left thigh...  It was late at night, but Sal took one look at him and decided he needed to be transferred out.  On the way to Livingstone, he remembered that somebody had told us that Dr. Shafik specializes in burns, so in less than one week, Dr. Shaik was to see another one of our patients.  This time he would be meeting Sal.  Dr. Shafik was present at the clinic/hospital as well as his senior clinical officer…they immediately admitted little Bristo, started an IV and wet saline dressings.  Bristo ended up staying for three nights and then we picked him up and brought him to stay at the clinic for a couple days.  When we paid Dr Shafik for Bristo’s care, he was kind enough to give us a 50% discount!  God is good and gives us favor wherever we go…thank you God!!!

 

Following Bristo, another child was burned after falling into a fire….a daughter of one couple (Alexander and Agatha) in the farm program.  Her burns were not nearly as extensive as Bristo’s and we were able to treat those ourselves. 

 

Another man from the farm program (Britius) brought his three year old daughter Libina to the clinic with malaria.  The malaria however was complicated by asthma and anemia.  After a two day admission to the clinic with IVs, nebulizer treatments, malaria medicine, medicine for the fever and iron supplementation for a hemoglobin of 2.5…little Libina was not improving.  Prayer was requested and extended across the ocean.  Sal took Libina  to Zimba Hospital at 2:30 am Wednesday morning at the request of her family.  Sal worked alongside the Clinical Officer there until 6:30 am to start an IV (jugular vein) so they could give her a blood transfusion and put her on an oxygen concentrator that Sal had to show them how to use...They were deciding whether to put her on Quinine  or not for the malaria.  Sal left the hospital with her still in critical condition.  Forty-eight hours later, Britius came to our door with the report that the malaria was under control, the IV was removed as well as the oxygen and she was doing much better.  He said, "Our prayers are working along with yours....thank God."

 

As for the HIV patients….next Thursday will be the last day for new patients in order that we can get them set up and reviewed prior to our leaving April 16^th. When we had the large group of HIV patients a week ago Thursday, I had no more Bibles to give out…..so I wrote out a paper of healing scriptures and we had church in the waiting room.  The group was too large for the exam room! This Thursday I made sure the scriptures were translated into Tonga and again church was in the waiting room. Sal and I are stirred to get the whole group of HIV patients (over 40) together at the farm on the last Thursday before we leave for home. I’m not quite sure what God has in mind but we are going to be obedient however the Holy Spirit leads.  After our Thursday with the patients in town, we usually go back in by ourselves after dropping everyone off to proceed home.  Not so this week however…..instead we delivered a 2.6kg (5.75 lb.) baby boy to a 15 year old unmarried mom.  Baby and mom doing fine…went home this morning with a certificate, a photo and a new baby blanket!  When I asked the name for the baby, grandma said no name yet and asked me my husband’s name….so who knows?

 

As far as life in Africa….It still continues to rain, well over 50 inches to date.(might almost be 60 by now)  Everyone talks about this being an abnormal amount of rain and how it doesn’t usually continue into March.  Dam 3 broke, I think yesterday….that’s the second one this year and I’m not sure what that means for the dry season.

 

Sal and I found a pizza place in Livingstone called “Funky Monkey” that actually has pepperoni!!!!!  That was quite a find….remember who I’m married to!!! It was pretty good too…like Thin and Crispy Pizza Hut!  We also found some mocha lattes at a little outdoor place called “Crocodile Café” in Victoria Falls….another good find!!!

 

Then there was “Hungry Hippos” with steak sandwiches on Ciambatta bread (I’m not sure of the spelling but you know what I mean…like Panera!!!  Who knows what we might discover next? J

 

 

 

New Baby Boy

 

 

 

Bristo 

March 10, 2006

 

I am starting to write this update from the Intercontinental Hotel in Lusaka on March 5^th.  We decided to take a few days away for a much needed break, as well as pick up my nursing license. Unfortunately, although I passed the test and results were posted, the certificates had not yet been signed by the Registrar….so I will have to return again in a couple of weeks to pick up the official document.  I’m telling you, nothing is simple in Africa and everything takes more than one trip!!! The hotel here is beautiful and I’m sorry but I forgot my camera.  We had a breakfast buffet this morning on the large veranda overlooking the pool with palm trees and beautiful landscape….very nice.  Almost makes you forget where you are.  We came with Tim and Mary, another missionary couple from Hilary’s orphanage up on the Hill and we are having a very nice time.  We even went to a movie at a real movie theatre last night.  It’s funny how many things we take for granted living in the US…..over here we had to drive five hours to see a movie!!!  Elephants we can see however!!!!  As a matter of fact, I don’t know if it’s been newsworthy over in the US, but three people got killed last week by an elephant…..in Livingstone!!!  The elephants are coming up out of Zimbabwe around the lower Zambezi where Victoria Falls is and wrecking havoc on Zambian villages and crops.  The people killed were a mother with a baby on her back and a man who were just walking on the street.  Imagine telling someone how your family member or friend died and instead of saying because of this disease or that one, you say “he was killed by an elephant.”  Well…enough of that.

 

            A getaway was needed.  I know what you must be thinking….“yeah Renee, we read your last update.” J But I want you to know that Sal needed the break probably even more than I did (Scary, huh?) because the numbers in the clinic continue to grow.  There were 963 patients in January and 993 in February, not counting the 300 plus seen at the outreach in Kabuyu.  The totals also do not include the patients to Livingstone and Zimba.  Just last week, 12 people went to Livingstone Hospital on Thursday for the HIV clinic, and if all show up that are scheduled next week, there will be 20!  We need the lorry these days to accommodate all the patients.  I’m not sure what God is doing, but there seems to be a stirring within me to share the Word with the HIV patients.  So upon our return from the hospital, we had a time of sharing, praying and I handed out the rest of the Bibles that I had.  Tonga Bibles are out of print here so I’ll have to wait awhile to replenish the stock.  How can you receive healing if you don’t believe……and how can you believe in something if you don’t know it exists?  You see, I believe that Jesus already purchased our gift of salvation and healing with His broken body and shed blood.  It’s wrapped up with a bow waiting to be opened by those who BELIEVE.  All we have to do is believe….believe that He is the Son of God….believe that He was sent by the Father to die on a cross so that our sins would be forgiven….believe that He rose from the dead to overcome all the power of the enemy…believe that by His stripes we are healed….in essence believe His Word.  Psalm 103:3 says “Praise the Lord O my soul and forget not all His benefits---who forgives all your sins and heals all your diseases.”  Salvation and Healing were both paid for…they are both part of the atonement. It seems easier however for most of us to believe we can be saved than to believe we can be healed.  I guess that’s because one is physical and one is spiritual.  We often believe in things we can’t see or explain faster than in things we can.  We see people suffer…we see people die and sometimes that kind of seeing gets in the way of our believing.  I don’t just want to see with my physical eyes…I want to be able to see with the eyes of my heart like the song says:

 

 

 

“Open the eyes of my heart Lord

 

 Open the eyes of my heart

 

 I want to see you

 

 I want to see you

 

 

 

 To see you high and lifted up

 

 Shining in the light of your glory

 

 Pour out your power and love

 

 As we sing holy, holy, holy.” 

 

 

 

Thank you all for your prayers and words of encouragement.  I don’t know why I was to send out that last update.  It was a weak moment of flesh for me and frankly it was not something anyone would want to bare….but there was a purpose in it.  Someone needed to hear it…someone needed to know we are just ordinary people walking in obedience to God’s call.  It is my desire to take you along with us on this walk with the Lord, but in order to do that I must be honest in my sharing.   I want you to experience everything we are going through right from these very pages….that includes all our breakthroughs, all our victories, all our sufferings, all our prayers, and all our emotions (fear, anger, joy, compassion, sorrow, frustration, helplessness, kindness, expectation, anticipation, etc).

 

 

 

 Do you still want to take this journey with us?

 

             

 

 

March 4, 2006

 

 

This was a personal letter sent on March 1^st to Roberta….a very dear friend of mine for almost 20 years now.  As the letter states I just needed to vent some frustration and feelings of helplessness. At the time, I did not intend for this letter to be a public update, but I am sending it out because I feel like it’s the next stepping stone.  So here goes…..unedited. 

 

 

Hi Bert,

 

 

 

I just got back from Zimba Hospital where we took an HIV patient Netta about 10 days ago....I am so frustrated with the medical care here in Zambia...or lack of it.  And it's not just that........ it's the entire attitude.  I don't know how to change the attitude of the whole country...except one life at a time....but it is so frustrating.  I broke down in tears at the hospital as I was questioning a clinical officer there.  They literally have let a 22 year old woman die because....well I really don't understand why.  Only 2 IVs during her whole stay right in the beginning.....hasn't eaten in the last three days, but no IV, no NG.  They promised me last Wednesday they would start her on HIV meds after I drove to Livingstone Hospital and back with her lab results for them but they did not keep that promise....they didn't start her on them until yesterday and frankly she's too bad now to swallow.  She really needed IVs and IV antibiotics besides.  She is a skeleton....totally out of it ....in heart failure...septic....having seizures.  Mother taking care of her in tears looking to Sal and I for any hope....

 

 

 

If a clinic transfers a patient to a hospital (Zimba or Livingstone), it's supposed to be for higher care right?  Well....often they end up dying because they don't do anything except stick them in a bed and give some minor pills.  (We put a TB pt into Livingstone Hospital last month and she also just laid there for days without any TB drugs because she was too weak to produce a sputum specimen!  So they just let her lay there. ) Family takes care of the patient's hygiene needs and often their nutritional needs.  Of course Sal and I are both feeling guilty for not just taking care of her at the clinic.  Her mother had her on the road when I stopped to pick up eye patients one day for Zimba....she had her bags packed and asked me to take her...so I did.  Now I think she would have been better off with us.  There is no doctor at Zimba...the one Zambian Doctor they hired lasted one week...went to Lusaka and called to say he wasn't coming back.  So they just have Clinical Officers and nurses.....and there is not alot of caring going on.

 

 

 

Well....we couldn't do anything but pray for her...couldn't legally take her out of a hospital and put her in a clinic and frankly there's nothing to do at this point.

 

 

 

I was up at 2AM thinking of her...dreaming of her....praying for her...reading my Bible....trying to understand what the heck I'm here for....because frankly sometimes I just don't know!!!!!!!!!

 

 

 

This is a private update.....of course not one I care to send out.  I don't even know if this makes any sense.  I just needed to vent and needed my best friend to listen.

 

 

 

Sometimes I just want to come home.....see my grandkids and live life.  I feel like I'm on assignment...that this is my tour of duty and some day it will be over.  I can tell you that this will never be home for me....

 

 

 

Thanks for listening...I can't even see to type because tears are streaming down my face....so I gotta go,

 

 

 

Love, Renee

 

 

 

As I sit here reading this, feeling the pain all over again, I can’t help but ponder the attitude I talked about in the beginning of the letter that permeates the medical community  and maybe everyone else here.  I don’t think it’s necessarily an “I don’t care” attitude as much as it is a “What’s the use” attitude.  I think they don’t have the fight anymore… if they ever had it. You know that fight I’m talking about….that “try everything and don’t give up” attitude that we have in America.  The “reason to live” attitude.  Death is the conqueror here.  The sting of death is still prevalent…..still a reality here.  You need the resources to fight, both physically and spiritually and I think there is lacking on both planes.  On the physical plane, medical resources are definitely lacking…..technology and medications alike.  Spiritually however I think they are also lacking.  I am reminded of the Scripture out of 1Corinthians 15:55-57… “Where O Death is your victory?  Where O Death is your sting? The sting of death is sin and the power of sin is the law.  BUT thanks be to God!  He gives us the victory through Jesus Christ.”

 

 

As I was looking this scripture up to copy it down for you, I couldn’t help but notice verse 58.  God answers even when you are unaware.  He says “Therefore, my dear brothers (Sal and Renee), stand firm.  Let nothing move you.  Always give yourselves fully to the work of the Lord, because you know that your labor in the Lord is not in vain.”

 

 

Thank you Lord…..You pick me up so I can face another day! J