Mission Issues

Thinking and re-thinking missionary issues

The Medical Situation in Swaziland

Yesterday was pretty hectic. A team from Luke Commission came to visit a school virtually across the road from our church at Dwaleni. We had invited them to come as part of our service to the community, taking care of the sick at their homes.
But I have to be honest that there were times yesterday when I had more questions than answers. After 24 years in Swaziland, I haven’t seen any real improvement in the health system of the country. This was a mobile clinic which we were part of and more than 800 people were attended to. Children were inspected for scabies and other diseases often found in children. Adults’ blood pressure was taken and recorded and those over fifty were also tested for diabetes, a disease which is becoming very common in Africa. All adults were also invited to be tested for HIV. The majority of those who were tested, tested negative. Although this sounds like extremely good news, the reason is most probably that those who are living promiscuously did not consent to be tested. Some of our home-based caregivers then counselled both those who tested negative as well as those who tested positive. Those who tested positive also had blood drawn in order to determine their CD4 count, which will indicate whether they are eligible to receive anti-retroviral medicine from the government. Many of those who had come also had their eyes tested and from tens of thousands pairs of glasses donated, and with the help of a really nifty machine and a huge database, all of those who needed glasses could be helped. On a lighter note, some of those who received glasses looked really strange as many of the frames had been worn in the USA as part of a fashion outfit. But in the end, to be able to see, is what really counts.
Two patients really touched me. One was a young woman with severe chest pains. In fact, she was crying most of the time because of the pain. The doctor told me that she was HIV-positive and they suspected that it might be TB which is causing the pain (one of the main diseases often associated with AIDS.) The sad news was that she had been to the health centre in Nhlangano, one of the main towns in Swaziland and they had given her pain killers and sent her back home. Then she went to Hlatikhulu, where one of Swaziland’s main hospitals are situated and they did the same. And then she came to us, in the hope that we could help her. But the doctor could do nothing for her without first seeing an X-ray. I eventually spoke to the girl’s father and told him to take his daughter to the clinic and insist that they do an X-ray to try and determine what is causing the pain. And then he told me that he could not take her, because he had no bus fare! Eventually I gave them bus fare and hope that they would have gone to the hospital today.
And then a schoolboy turned up. He was probably about thirteen or fourteen. During a football game he had broken his leg above the knee, about four weeks ago. He had gone for surgery and a metal rod was inserted to help with the healing of the bone. He came to us yesterday and his mother told us that almost since the operation he has been suffering from extreme pain. They had gone back to the clinic, but it does not seem as if much was done. The doctor then removed the bandage and we found that the metal rod was sticking at least three inches out of his leg! His body was busy rejecting the rod. His knee was swollen to at least twice its normal size and from the smell it was clear that there was extreme infection in the bone. I cannot even start to imagine the pain the poor boy had to go through.
Fortunately, the doctor could arrange for him to be admitted to a hospital where he is now on intravenous antibiotics. Whether it will be possible to save the leg remains to be seen.
I don’t have an answer to Swaziland (and the same can be said about most African countries’) health situation. I’m just wondering how many lives can be saved if the health system could improve.

Thursday, July 10, 2008 Posted by Arnau van Wyngaard | AIDS, Africa, Cross-cultural experiences, Death, HIV, HIV & AIDS, Health, Mission, Missionary Organisations, Partnership, Poverty, Swaziland | | 2 Comments

Is the AIDS threat REALLY over?

Do a Google search on “Threat of world Aids pandemic among heterosexuals is over, report admits”, and you’ll be surprised to see how many articles refer to a report, written by the World Health Organisation (WHO), in which it is said that, apart from Africa, “there will be no generalised epidemic of Aids in the heterosexual population.” More details can be found here.
My son was speaking to some kind of medical professor from the USA some time ago and she told him, after he had told her what we are doing in Swaziland, that, as far as she is concerned, AIDS is under control in the USA. With the progress made in research and the development of ARVs, I can believe that this may be the truth. AIDS, I always say, is treatable but not curable. With the right medicine and more or less ideal circumstances, most HIV+ people would be able to live long and productive lives.
The fact is that Africa does not provide the ideal circumstances within which to fight a disease such as AIDS. ARVs are expensive. The cheapest tablets that I could find in a pharmacy in Swaziland costs around $50 per month. Where 70% of the population receive less than 45 US cents per day, it is clear that for the most people it is not an option to buy ARVs. Government hospitals supply ARVs, but the choice is limited. The privilege of adapting the treatment with different drugs to find the correct combination for a specific person, does not exist for the majority of the population.
Another problem is that ARV treatment is usually started too late. Last week one of our care supporters told me of someone who’s CD4 count had been determined. It was under 20. Treatment with ARVs in Swaziland should be started when the CD4 count falls below 200. But even that is too late. I spoke to a medical doctor some time ago who specialises in treating people with HIV and he told me that tuberculosis (TB) starts when the CD4 count falls below 350. According to him, if ARVs could be administered when the CD4 count is still above 350, the chances that a patient could live a fairly long life could be hugely increased, as many people who are HIV+ actually die because of TB. But where would Swaziland find the money for these drugs?
Furthermore, ARVs without healthy eating habits also does not give the required results. And this is another problem we have to cope with. Fruit and vegetables are expensive. We have seen, time and again, how people start using ARVs, but because they don’t eat balanced meals they seem to become stronger for a while and then their condition suddenly starts deteriorating and they die.
I can understand why the WHO says that the AIDS pandemic is over in many countries outside Africa. Although, I think in countries like India and Russia we are just starting to see the tip of the iceberg. But if the pandemic could be brought under control in the USA and Europe, then it means that we have to do even more to bring it under control in the rest of the world which is still severely affected by this disease.

Wednesday, June 25, 2008 Posted by Arnau van Wyngaard | AIDS, Africa, Death, HIV, HIV & AIDS, Home-based Caring, Mission, Poverty, Russia, Swaziland | | 2 Comments

The stigma surrounding AIDS

Some of the most often quoted words regarding HIV/AIDS are the words of Gideon Byamugisha, an Anglican priest from Uganda, who himself is HIV positive. He said: “It is now common knowledge that in HIV/AIDS, it is not the condition itself that hurts most (because many other diseases and conditions lead to serious suffering and death), but the stigma and the possibility of rejection and discrimination, misunderstanding and loss of trust that HIV positive people have to deal with.” (You can read much more about what I wrote on this topic on page 17 of the document which you can download here.)
As part of our home-based caring activities, we also try and eradicate the stigma clinging to people with HIV and AIDS. If we don’t succeed in doing this, people will never be willing to face the facts about their condition and they will also not be willing to be tested to determine their HIV status. By openly speaking about HIV and AIDS and also by openly caring for those who are infected, I believe that we are breaking down many barriers which exist between those who are HIV-positive and those who are HIV-negative. For us this is a very important part of our work.
However, the fear of stigmatisation causes another problem, in that we don’t want to acknowledge AIDS for what it is. Something which I hear constantly nowadays is that people are told that AIDS is not a death sentence. I beg to differ. AIDS is a death sentence. With early diagnosis, correct eating habits, a change in life-style and proper medication the actual death can be postponed for many years. But for the moment (and probably for many years to come), to have AIDS means that you are going to die from this disease (unless if you die from some other unnatural cause.) I don’t think it is stigmatisation to tell someone who is HIV-positive that this is very, very bad news. In Africa of course, the news is even worse, because most people do not have money to eat the correct food (lots of vegetables and fruit for example) and to get proper medicine is just out of the question for the majority of the people. I read in the Swazi newspaper a few days ago that 33,000 Swazis have actually been sentenced to death because they cannot obtain the correct medicine for AIDS in Swaziland.
Although I make a strong case in the mentioned document that we do not have the right to look down upon those who are HIV-positive as if they are all sinners, the fear of stigmatisation also prevents us from acknowledging the facts that the majority of people who are HIV-positive did indeed get it from some kind of immoral act. Yes, I know all the arguments about people becoming HIV-positive through no fault of their own - in fact I argue for them in the mentioned document. But I’m referring to the majority of people who are HIV-positive who did contract this disease through a wrong choice. The argument most often heard is about the woman who was caught in adultery and brought before Jesus, and after nobody was willing to cast the first stone, Jesus said: “…neither do I condemn you. Go now and leave your life of sin” (John 8:11). But there is a difference in not acknowledging sin and not condemning a person. We don’t want people to be condemned because of wrong choices they had made (and to be quite honest, how many of us reading this also make wrong decision?) But only by acknowledging the wrong in their behaviour could we cause a change in life-style to take place. This is not stigmatisation. This is acknowledging reality but without condemnation.
I could therefore sit next to someone who has AIDS, explain to that person what causes AIDS, try and determine where  and how that person had become infected and work through all the issues, without stigmatising the patient and at the same time without using such kind words that the truth is never told. In an attempt not to stigmatise someone, I believe that we may be dishonest. And in the eyes of God this is also wrong.

Thursday, March 20, 2008 Posted by Arnau van Wyngaard | Death, HIV & AIDS, Health, Home-based Caring, Hope, Mission, Poverty, Stigma, Swaziland, Theology | | No Comments

Ignorance and denial about AIDS

Yesterday (Saturday) I had to drive up to the capital city (rather town) Mbabane in the northern part of Swaziland for a meeting. Shortly after I left home someone asked for a lift and ended up driving virtually the entire distance with me. He’s a customs official working at one of the border gates between Swaziland and South Africa. After some small talk between us, he suddenly referred to an AIDS conference that had been held in their area a few weeks ago. I asked him if he had attended, but he had not. So I then asked him how much he knew about AIDS and it was clear that he had been informed about the most basic stuff about AIDS saying that abstinence and faithfulness was really the best way to stop the disease from spreading but also complaining that people didn’t want to adhere to this and therefore they were being infected by the virus.
I was obviously quite excited about this man’s positive approach to the disease and thought that I had found someone who was really living responsibly. But my excitement didn’t last long. I asked him how old he was. He’s 37. I then asked him if he was married, and he was not. But he immediately told me that he had a girlfriend and they had three children but they hadn’t come around to getting married yet. Realising that he would probably not be truthful with me I nevertheless asked him if he was faithful to his girlfriend. His answer surprised (and probably shocked) me, when he said something like: “Of course not. It’s very difficult to be faithful.” He then told me that he regularly visited a bar close to his home (the notorious “Why Not Disco Club”) where he would have some drinks after which he would find a girl (evidently prostitutes) standing around and spend the night with her. Although he always has a condom with him he would not use a condom if he went with the same girl the second or third time! (I was really amazed at his honesty.)
I then asked him if he had ever been tested for AIDS to which he replied that he had been tested three years before and he was negative then. Seeing that he was so honest with me, I decided to be honest with him as well and told him that I had bad news for him, because the chances that he was still HIV-negative are virtually non-existent! We had quite a discussion on AIDS and I eventually advised him to go for a test again. But I then asked him what he would do if he was found to be HIV-positive and he replied that he would definitely change his life-style. And when I asked what he would do if he was HIV-negative, he also said that he would change his life-style! In other words, once he had been tested, regardless of the outcome, he would change his life-style. But for the present, before being tested, he will go on with his present life-style, probably believing that he will be one of the lucky ones not to get infected.
At the end of the conversation, just before I dropped him off, I asked him whether his girlfriend was faithful to him, to which he replied that God had given him a wonderful girlfriend who didn’t sleep around with other men! (How sad that she can’t say the same about him!)
I’m still trying to figure this one out. Is it ignorance? Is it denial. Is it callousness? I don’t know, but I’m sure he is not unique. He’s one of thousands of men in Swaziland who believe that he will be the lucky one who will not get the disease. He has heard all that can be said about AIDS. He has all the right answers. But in spite of this, he still believes that he won’t become infected.
We still have a long way to go before people will really acknowledge the seriousness of this terrible disease.

Sunday, March 16, 2008 Posted by Arnau van Wyngaard | Death, Dialogue, HIV & AIDS, Health, Mission, Swaziland, Theology | | No Comments

Our motive for mission

My “blog-friend” Wes (I think this is the equivalent to a pen-friend of forty years ago), wrote a few interesting remarks on his blog about the topic: Who’s on first? Evangelism or Social Ministry. Click on the link to read it.
This got my mind thinking once again about our motive for evangelism or mission. No matter how objective we try to be, most of us have secondary motives why we want to proclaim the gospel of Christ. The mere fact that so many books have been written about this topic (many of which I have read over the past months) is an indication that many Christians are questioning our own motives. Growing up in South Africa where racism has forever been a problem, the motive for mission has very often been that the black people need to be converted so that they will stop stealing from the white farmers.
On a more humourous note: Time and time again I have heard white people make the remark, after something had been stolen from them, that they had “made a donation” towards mission (meaning that a black person had stolen the article from the white person and that the white person therefore considers the stolen item as a donation made towards mission! Some years ago a white farmer had his truck stolen. He also made the remark afterwards that he had donated his truck towards mission. A week or two later the truck was found and I decided to pay the farmer a visit, telling him that I was there to claim my truck back which he had donated towards mission! Needless to say, I never received the truck ;-)
While this would obviously be an absurd motive for mission, the question remains why we want to convert people to Christianity. I suspect that for many people it’s about power - proving that our religion is better than their religion. I’m addicted to the Peanuts comic strips and remember, while I was still a student one cartoon strip where Rerun says to Linus: “I would have made a good evangelist. You know that kid that sits behind me at school? I convinced him that my religion is better than his religion.” Linus then asks: “How’d you do that?” And Rerun answers: “I hit him with my lunchbox!”
Obviously I also sometimes dream of how wonderful the world would be if we were all committed Christians. But then, at the same time, I realise how much fighting there had been through the years between Christians and then I also realise that this would also not be the final answer.
Why do I want to see people come to saving faith in Jesus Christ? I’m not sure if I can answer this question clearly. Possibly in my circumstances in Swaziland the answer may be easier than in countries in Europe. Looking at the people I see many who are totally enslaved by the world, living in fear of demons and ancestral powers and witchcraft. I want to see them be set free so that they can truly live life in abundance. But to use that argument with people who are seemingly happy, with a good monthly income, living in harmony with their spouse and children (yes, I know many non-Christians who, measured against the standards God sets in His Word, are living a good life) would probably not be very effective as I would have to convince them that my life is far better than their life.
Why would I want to evangelise such a person? Is it because I truly want that person to receive life everlasting? Is it perhaps because it would be a great help if such a person could become a member of my church? How much personal pride is involved?
I’m not quite sure of the final answer. Perhaps you would like to share your thoughts on the motive for mission and evangelism.

Wednesday, March 12, 2008 Posted by Arnau van Wyngaard | Death, Demons, Evangelism, Humour, Mission, Swaziland, Theology | | 4 Comments

Taking hands in the fight against AIDS

I’ve had a pretty hectic week. On Wednesday I made a trip up to the north of Swaziland, to the capital, Mbabane, where we have now started the official process of getting our home-based caring group registered as an NGO. From time to time we have people, churches or other groups wanting to donate clothes, medical supplies or food to assist us with the work we are doing and although the customs officials at the border are VERY friendly and lenient, always allowing us to take the products through, we also realise that the correct way in which to do this is to be registered as an NGO and then to get a tax and customs exemption form from the department of customs and excise. Because we have obtained a lot of credibility with the local people as well as their representatives in parliament, we are fortunately also receiving a lot of assistance to speed up the process, which can, in Swaziland, take up to a few years to complete! From Mbabane I drove to the eastern side of the country, drove all the way down the eastern border to the south, then turned west again to see how things were going on with the training of the people at Matsanjeni, focussing on traumatised children before returning home - a round trip of about 330 miles in extreme heat. (Air conditioning isn’t a luxury - it;s a necessity!) Along the way I came across four American girls stuck with their vehicle after they had a flat (or a puncture, as we know it). They are also working in Swaziland for some mission organisation. I stopped to assist them with the tyre. Fortunately, before the hard work started of loosening the studs on the wheel, help arrived from their mission organisation (how did we survive without cell phones?) and I could continue on my way. So, if any of the mothers of these girls are reading this, I’m pleased to report: your daughter is safe! ;-)
As I was making the trip I just kept on marvelling at the beauty of this country. Swaziland is often called “Little Switzerland” and a trip like I had on Wednesday makes it clear where Swaziland got this nickname.
This weekend I’ll be visiting a church in South Africa in a town called Tzaneen, not too far from the Kruger National Park. This is a typical white, Afrikaans-speaking congregation (which is found all over South Africa) who had decided that they want to take hands with another congregation consisting entirely of black members speaking one of the indigenous African languages (I’m not sure what language - but I’ll find out on Saturday when I’ll be meeting up with them - probably Venda or Pedi.) Because the black communities are so large and also because of their culture where communities are much more closely linked with each other, they also experience the AIDS problem and the related deaths much more personally. They have now invited me to meet with the white congregation this evening (Friday) to inform them about the problem of HIV and AIDS and also to explain to them what we are doing as a church to help people. On Saturday I will meet the members from a number of black churches and discuss the situation with them to inform them of our work but also to try and plan with them how they can tackle the problem in their own communities. On Sunday morning I will be preaching in the white congregation and during the evening service we will try and have a question and answer session, aiming to find a way forward that these two groups can take hands to fight against this terrible disease. Neither of these groups can make a real difference on their own. Thye black churches have the man (woman) power and the white churches have the resources. If these groups can take hands, there is enormous potential within them.
I’m really looking forward to this. I believe that we have developed certain principles in Swaziland (with the help of other people who guided us in the right direction) that can be duplicated in other areas outside Swaziland. Obviously each area and each situation is unique, which is why I cannot merely implement our model in another place. But if the principles are applied, then a group of Christians can, within their unique circumstances, really make a huge difference in their communities, becoming - as we have formulated it in our vision - the hands and feet of Christ within the community.
Just an interesting remark: My good friend, Tim Deller from the USA who is helping us in Swaziland, will this evening be going to his first rugby match ever with some friends of mine from South Africa. He’s travelling up to Pretoria for this occasion. Oh boy - he’s really so excited!
Please also read Tim’s latest post which you can access here.  It will really open your eyes for what we experience on a daily base in Swaziland. He even has a few links to Youtube video clips that he posted if you want to experience Swaziland as he sees it.

Friday, March 7, 2008 Posted by Arnau van Wyngaard | Africa, Building relations, Church, Cross-cultural experiences, Culture, Death, Giving, HIV & AIDS, Health, Home-based Caring, Indigenous church, Mission, Partnership, Social issues, Support teams, Sustainability, Swaziland, Theology, Women | | 2 Comments

Counselling traumatised children

In principle I’m a positive and hopeful person. But when I look at the children in Swaziland, there are times when I do find that I feel a bit hopeless. Of the 947,000 people in Swaziland (according to the latest census), 95,000 are orphans. That’s 10% of the entire population! These are children growing up without a mother to take care of them, doing all the normal stuff that mothers do for children. In most cases they also grow up without a father. In Swaziland, as in most of Africa, orphans are defined as children without a mother. If the father had died and the mother is still alive, then the child is not officially an orphan. If both parents are dead they refer to a double orphan.
I was speaking to one of my Swazi friends this afternoon and discussing the situation in the country with him. The question I asked him is what these children growing up without parents will turn out to be when they get into their late teens. Psychologists have long realised the effects that a parent’s death has on a child, especially in their early teens. Now we are confronted not with a few children losing a parent, but thousands of children losing not only one but often both parents, as well as their brothers and sisters, their in-laws, their grandparents, their neighbours, their friends….
Today we started with a course specifically aimed at teaching a number of our caregivers to determine whether children had been traumatised and then to teach them how to counsel these children. Although the Swazi people in general love their children, very few are capable to counsel children who had been traumatised. I’m surprised to see how difficult it is for people who have an advanced education to see that their own children had been traumatised. How much more difficult for people who very often had only had very basic school training? One of the methods used with small children to encourage them to speak about their feelings is by using a box filled with sand and then to supply a huge number of characters, vehicles, houses, animals and other items, all drawn on paper, cut out and glued onto twigs broken from trees. (It is essential that people are not brought under the impression that you need all kinds of special and expensive equipment before you can connect with a child.) The child is then encouraged to use any of the items to build something in the sand. Once they’re through, the caregiver will ask the child to explain what he or she had done. Things which may then come out for example are that there may be many child figures but no adults. A gentle conversation may then reveal why there are no adults. Sometimes they will include very flashy cars and in the conversation it may become clear that they believe that money will be the solution to all their problems.
The training is being done by specialised staff from the Petra College for Children’s Ministry in South Africa. If you are interested in more information about them or would like to contact them to find out what they can do to help you with a children’s ministry, click here.

Monday, March 3, 2008 Posted by Arnau van Wyngaard | Africa, Building relations, Church, Culture, Death, HIV & AIDS, Home-based Caring, Hope, Mission, Poverty, Swaziland | | 2 Comments

When you lose hope, you lose life

I once read something that Jessie de la Cruz, a retired farm worker in South America wrote: “With us there’s a saying: La esparanza muere ultima. Hope dies last. You can’t lose hope. If you lose hope, you lose everything.” And I read somewhere else that scientists say that a human can last for forty days without food, a few days without water, eight minutes without oxygen but only a few seconds without hope.
I’ve just read a report written by Harry and Echo van der Wal of the Luke Commission. They are from the USA but are involved for a few months every year in a medical ministry in Swaziland. Through one of the regular readers of this blog we made contact and hopefully we will be meeting in the near future. I strongly advise you to read the report which you can access here. This is such a true description of how we find things ourselves. What he is describing is a situation without hope. You see people whom you know will die shortly and all that remains is to show them love and acceptance in order to restore some dignity. They are working in the northern part of Swaziland, the only difference between their ministry and ours being that they have the medical facilities to do something to help these people while we have virtually nothing in the south of the country. But the circumstances with the people are the same.
Yesterday I escorted a group of Christians from South Africa to Swaziland. We have had a two year relationship with this congregation and they visit us about four times per year. On a previous occasion they brought a doctor along and we had an extremely distressing experience at a certain homestead with a 21 year old girl. You can read about that experience by clicking on this link.
Yesterday the team brought a physiotherapist with them. Their aim is to bring a professional person with them on every visit in order to give the caregivers further training. Part of this training is for the professional person to visit a few of the homesteads where we are working and to demonstrate to a few caregivers at a time how to care for this person. We went to visit a lady who is 74 years old and has been bed-ridden for the past eight years. A few times while we were there she told us that she would like nothing better at this stage than to die.
Her story is that she started developing arthritis about ten years ago. It was becoming more and more painful for her to stand up on her own. In the meantime her husband had died and all her children had also died. Eventually she had nobody with the strength (or the will) to help her up in the mornings to get up and because of the pain she remained in bed. At this stage the muscles in her leg had contracted to such an extent that she will never be able to walk again, even if the pain should disappear. Due to her arms and hands not being used, they have also become completely unusable. And so she is really doomed to remain in bed for the rest of her life. Physiotherapy may loosen the hand and arm muscles to a certain limited extent, but she will never regain their use. And most of this was caused by a lack of education and the lack of anybody with the time, energy and will to help her to get up in the morning.
She is now staying in a small house together with her great-grandchildren. In the morning these children go to school after they had brought her food. Then they lock the house and put the key on a windowsill. Anyone, such as the caregivers wishing to visit her, take the key from the windowsill, unlock the door and enter her house. If a fire should ever break out, she will die. If anybody wishes to harm her, they can enter her home at will. She is unable to do anything to protect herself, because she cannot move from her bed without help.
As I prayed for her yesterday, I just trusted that God would restore her hope. As those people mentioned in the report of the Luke Commission, the reality is that people are fast losing hope. Our task is to bring back hope to these people.

Sunday, February 17, 2008 Posted by Arnau van Wyngaard | Culture Shock, Death, HIV & AIDS, Health, Home-based Caring, Hope, Mission, Poverty, Short-term outreaches, Support teams, Sustainability, Swaziland, Theology | | No Comments

Health care in Africa

An article was recently published in Christianity Today which lamented the poor health coverage which a great many people in the USA are getting. In one case mentioned someone had spent five months in intensive care after which he had to pay $1.2 million. When he referred this to his health insurer, he was told that they had already paid $1.5 million and that he had reached his lifetime cap. This is terrible! The article calls on changes which need to be made to rectify the situation where many people are not getting any health insurance whatsoever and sees this specifically as a challenge for evangelicals.
When I first read the article I did not really know what to think about it. We have a saying in our country that one shouldn’t complain with a white bread under the arm (traditionally white bread was more expensive than brown bread and it was considered that only the privileged could eat white bread.) I re-read the article and then realised that there is no difference between myself and those people about whom the article is written. I have excellent health insurance. If I should need to go to hospital, I only have to make a single (toll-free!) phone call and I can enter the hospital of my choice. Obviously health insurance costs money, but I can afford it (or rather, I cannot afford to be without it.)
But what is the situation in Swaziland? Hospitals are run by the government with an extremely restricted budget. A person who is sick has to go to the nearest clinic (run by a couple of nurses and possibly one midwife) or travel to a hospital which may (or may not) have a few doctors. There the person has to fall in line and await his turn to be seen by the doctor - anything up to four or five hours of waiting. In most cases the patient will leave with a few paracetamol tablets and the instruction to return in a few days time if, whatever had caused the illness, had not cleared up. On his return, the process starts afresh, falling in line, waiting for four or five hours….
On some occasions people will be hospitalised. The smell in the hospital wards are sometimes absolutely appalling. I have been in hospital rooms made for two where four patients share the room: two on beds and two on the floor. If you want to see the inside of one of the (more decent) hospital wards in Swaziland, click here (and yes, that’s me visiting a patient in Hlatikhulu hospital in Swaziland). If a person is too sick to feed himself and he has no family to care for him while in hospital, he will probably eventually die. All the hospitals are totally short-staffed which means that no nurses can be spared to feed someone. People entering hospitals due to having full-blown AIDS may be cared for for a few days, but after having been on an IV drip for a few days, will probably be sent home (to die) in order for a new patient to be able to occupy the bed.
We (including myself) complain about high medical costs and health insurance which doesn’t cover all expenses. But at least we still have a choice. To have no choice is to be stripped off all dignity.

Thursday, February 14, 2008 Posted by Arnau van Wyngaard | Africa, Cross-cultural experiences, Culture Shock, Death, Evangelicals, HIV & AIDS, Health, Mission, Poverty, Swaziland, Theology | | 3 Comments

Swaziland: School gates close on orphans

This was the heading of one of the main stories in the Swaziland Observer today. If you are interested in the full article, you can access it here.
Close to 10% of Swaziland’s total population are orphans! According to UNAIDS the number of orphans is somewhere between 45,000 and 77,000 although many organisations suspect that the number is in fact much higher. UNICEF estimates the figure to be around 95,000 (and according to the latest census Swaziland has a population of around 950,000!)
The fact is that many schools are indeed not allowing orphans to attend anymore if someone is not willing to pay their school fees and buy them a uniform. How do I know this? Because just over a week ago one of our home-based care coordinators brought two children to me who had been turned away from school because the government was not providing the necessary funds for the orphans to attend school. One girl was starting school this year and her sister was supposed to go to grade 2. Both their parents had died (described in Swaziland as “double-orphans” compared to “orphans” who had only lost their mother.)
The hopeless expression on the faces picture of these two children broke my heart. The were absolutely at the mercy of other people who were busy taking decisions about their lives - and obviously the decisions that were being taken were wrong. At that point I did what my father would have described as “fools rush in where angels fear to tread” as I told the coordinator to take the children to school and to enroll them and to promise the headmaster that the fees would be paid.
Two days later I received the message that someone had offered to pay for the one child and three days afterwards someone else offered to pay for her sister! We thank the Lord for this, but then, reading today’s newspaper, I realise that there are probably hundreds of children in the same situation at the moment.
Where this will end I do not know. Just thinking of the thousands of children growing up in homes surrounded by death and without their own mother caring for them frightens me. Where will they end up? Is there any possibility for them to educate themselves? Are they going to be different from their parents or are they going to continue the life-style which will inevitably lead to their own premature death? According to UNICEF the life expectancy of a child born in Swaziland today is 30 years!
What hope is there for a child in Swaziland growing up without a loving family and without education?

Tuesday, February 12, 2008 Posted by Arnau van Wyngaard | Death, Giving, HIV & AIDS, Home-based Caring, Hope, Mission, Poverty, Support teams, Swaziland | | 1 Comment