Part of Tim’s medical ministry is to fly (with the Mission Aviation Fellowship) two weeks out of the month to places in the furthest southeast part of Angola to minister to incredibly remote villlages that lack accessability to quality health care. Part of the ministry is finding the villages with greatest need and building a relationship with the nurses who staff the underfunded health posts. This requires an exponential amount of patience, because in typical Angolan culture there seems to lack a passion for change or advancement. Instead of valueing truth seeking, most people value being people pleasers. Many empty promises are made – with the best of intentions – which leads to lots of uncertainty and often many plans are never seen through.
This week brought lots of uncertainty, which was a perfect time for me to excersise virtues of flexibility and humility.
We left from the Lubango airport in a Cessna – 182 early Sunday morning, being delayed only by an hour because of a difficult police man and documentation. With that past us, we loaded into the plane full of medication boxes and flew to Menongue airport to refuel. There, we met up with some people from the I.E.C.A. church to chat over a refreshing Coca-Cola. We then flew another two hours to Mavinga and then another hour to finally land at the small military camp of Jamba. Guess what? Even though Tim had many conversations with numerous people, the church leaders where still unprepared for our arrival. We sat on the runway swatting some rather agressive flies for about two hours before we saw the dust stirred up from a car.
The military commander drove us to the small village of Luiana where the villagers scrambled to set up lodging for us. After about an hour or two, we found ourselves settled in a sturdy structure with a mattress and a bottle of water. After pitching my pop-up mosquito net tent, I fell asleep to the African night sounds of insects and music.
Monday: Spent at the health post of Luiana. There was an incredible number of people sick with malaria, along with back pain, infections, and gastritis. We even saw a lady with Cutaneous Larva Migrans, a worm that moves around under the skin and causes severe itching. In total, we saw 67 patients, working well past dark. I rather enjoyed the practice of medcine by lantern light.
Tuesday: By 6am we were back in the plane and flying to Rivungo, a village so far southeast that we were only a few kilometers from Zambia. Here, we were welcomed by dozens of children gathered at the landing strip. Unlike Jamba, we were quickly brought into the village and set up for a clinic at the health post. People came in with many chronic complaints and vision trouble. People take advantage of the presence of a physician, unloading numerous complaints, as this often may be the first time they see an actual doctor. Again, I am consistantly amazed at the amount of malaria. This time, however as the sun set I understood completely why that is the case – so many mosquitos! Rivungo is located near a canal that connects the village to Zambia. After clinic Tim and I walked down the street to the local store to buy water. We were constantly swatting mosquitos in the breif five minute walk. I was impressed.
Wednesday: A second day of clinic in Rivungo, as the ambulance that usually takes Tim to the remote villages is broken (as is the case for many of the health post ambulances). Today was slower paced, as patients came when they had down time. I was kept amused by watching the lizards sneak in a sunbath inbetween us getting up to use the ultrasound machine. I continued to learn about the culture through the types of complaints and the way illnesses were described. Many believe they have worms in their belly, so they say they feel a ‘bug’ move around in their abdomen. People rarely get specific about location of pain or how long they have had the discomfort. A few times Tim and I have laughed at eachother as we continue to ask the same questions expecting to get differing results- the definition of insanity, right?! Our running joke has been to whisper ‘insanity’ when we hold a high hope of getting more specific answers… but it never happens.
Thursday: A perfect example of Angolan philosophy. Some promises are actually kept, but on African time. The night before the Administrator of Rivungo promised to find us a functioning car to take us to Chifuoco. At breakfast we learned a car was set up and ready to make the three hour journey to the village. A few hours later the car had not yet materialized. Late morning, just when Tim was about to waive the white flag and stay in Rivungo for the day, a police car appeared infront of our door. We loaded the medicines, stopped at the praça to grab snacks (aka more bread) and turned on the four wheel drive. The driving here in Angola is difficult to accurately describe. Here in the Southeast corner everything is deep sand. You know the sensation you get when purposefully driving a bit wreckless in a snowy parking lot when no other cars are around? You slip and glide, half gaining control of the car. Substitute the cold for 100 degree weather and that is what I experienced as I was wedged in the front seat between the driver and Tim. Only a few times did I see my life flash before my eyes as we wove in and out of trees.
We arrived at the village early afternoon. Due to the timining, the village was near empty because everyone was out at their field harvesting. After sitting for awhile, the head nurse of the health post came up and engaged us in conversation. Once again, this was a great moment for community relationship building. Our originial intent was to spent the full day in clinic, but instead we gained a better understanding of how to send word further in advance so the villagers would know what day to stay home if they had a medical complaint.
We stayed long enough to see a few consults, making the trip worth it. The children loved the suckers (bon bons), we showed women their babies on ultrasound and gave malaria treatment.
The village was a beautiful site, stratigically places on the banks of a river and under some trees for much needed relief from the sun. Every one room home was made of a stick frame and a sand/rock material for walls. All roofs were grass. I was able to experience a latrine and now totally understand why Angolans prefer to use the bush. I shall spare you the details, but you can use your imagination.
The drive home had an added sense of adventure because we popped a tire and the jack was missing some pieces. As I sat watching the police man (our driver) and the two teens (who hitched a ride from the village to go to the ‘city’ -aka Rivungo) change the tire by cell phone flashlight….I chuckled. It reminded me of the start of a terrible joke: a policeman, physician, med student, nurse and villagers stranded in the African outback…
By the endless graces of God, we made it back safe and sound.
Late Thursday night we received word that the people of the village we were supposed to drive to on Friday were not able to pay for the consults, so we decided to stay a third day in Rivungo. Tim explained that as much as he would love to bring medicine to the most in need, there has to be a willingness to pay. He does not gather the money for self gain, but to purchase the medications he so freely gives. In reality, the 500 kwanzas (which is about a days wage, equivalent to $1.50 USD) he asks for covers only about half of the total costs of medicines he uses during his flight medicine weeks. The rest is funded by generous outside donors from the States.
Friday: Day 3 of clinic in Rivungo. Very slow pace day, with a variety of complaints. I was able to debride an few abscesses (way fun!) and reveal to a woman she was pregnant with twins!
Saturday: We snuck in a few medical consults before flying back to Lubango. One woman, who we have been treating her infections all week, came for a sugar check. She had fasted all night so the reading would be accurate. When we checked her sugar level, it was critically low so we threw a few lolly pops and water her way. During this time she had altered mental status changes and began to sing on the top of her lungs. Thankfully, she returned to normal rather quickly, but it made for an exciting morning.
The food I ate this week was simple, yet delicious. Every morning was pão (bread) with some margarine and a cup of tea. Lunch was funge (imagine something similar to a corn version of mashed potatoes) and some meat. Dinner was rice and meat. I was able to experience the taste of goat, which didn’t taste like chicken but was rather tasty.
This week lent itself to time for real, meaningful conversation between Tim and I. We shared about building a deeper relationship with God through faith. We talked about the spiritual dimension of the Angolan culture. Tim shared further insight into his journey and lessons learned through medical mission work.
Each night I fell asleep to the (not so) distant sounds of lively music. One night there was a rally for the group that is opposing the current government power. The other nights looked and sounded like giant dance parties. I was so tempted to strap on my dancing shoes (aka barefeet) and join, but I already had enough stares tallied up for the day.