Mission Issues

Thinking and re-thinking missionary issues

First World Technology in a Third World Country

I’ve always been interested in technology (computers and anything related to it) and use this to the best of my ability, especially when I’m working in my office. As I’m away from my office fairly often, my cell phone has now become a handy device to check my email (and to do Facebook updates!) But as a missionary in rural Swaziland, where most houses do not even have electricity and not a single house has running water, modern technology has little use.
Last week I was visiting a lady in her primitive house together with one of the caregivers of Shiselweni Home-Based Care. She is in constant pain, has swollen legs and sores forming on her skin. The caregiver had enquired before whether the client was HIV+, but she seemed reluctant to speak about this. When I visited her, the client took out her “clinic record” card – a document each patient receives when going to a clinic for the first time on which diagnosis and medication are indicated and handed it to me. It’s not the first time it’s happened. I don’t know why they do it, but it might be because I’m white and that they think I am a medical doctor. I had a look at the card, but the diagnosis gave me no indication of what was wrong with the woman. Neither did I have any idea what the prescribed medicine was for.
And then I thought of a possibility. The Swaziland cell phone service does not allow me to go onto the internet with my cell phone. But then I realized that the area in which this woman’s house is located, is fairly close to the Swaziland / South Africa border. I changed the network on my cell phone and found that I could connect to the South African service provider through which I could go onto the internet. I Googled the name of the medication and immediately found that this was indeed anti-retroviral medication (ARV). It was the weirdest feeling, sitting in this primitive homestead, with someone who has absolutely no idea what a computer is, let alone the internet or Google and finding answers which will enable us to raise the standard of our care for this individual. One thing we will do, is to ensure that she takes her medication regularly as prescribed and also to ensure that she has enough nutritious food to eat.
I couldn’t help wondering where this could lead to in the future. We’ve already had situations where clients had severe wounds. The caregivers could take photos of the wounds with their cell phones and we then showed the photos to a pharmacist who helped us to decide on the best medication and method of helping each client. For people in Western countries, this may sound fairly primitive. In our situation, where doctors are scarce, public transport is expensive and where people are so sick that it is very difficult to transport them, this technology might, in the words of Neil Armstrong, be a small step for man, but a giant leap – if not for mankind – at least for the people in rural Swaziland.

Monday, June 14, 2010 Posted by | Africa, AIDS, Cross-cultural experiences, Culture, Culture Shock, HIV, HIV & AIDS, Home-based Caring, Hope, Mission, Swaziland, Theology | 17 Comments

Can a non-missional group become missional?

I’ve just finished reading Alan Hirsch’s book: The Forgotten Ways. It’s a great book and highly recommended, but be warned: It’s not easy to read. I do most of my reading when I go to bed and I really struggled to work through this book, But it is worthwhile reading it.
In short, Alan wants the church to rediscover it’s true purpose, what he calls mDNA, or the Missional DNA of the church. At the core of the church of Jesus Christ is the desire to reach out to the world. Churches which are not doing this, are acting contrary to how God has wired the church.
I have obviously done a lot of reading on this topic, therefore I can’t say that I had many “aha!” experiences while reading the book. He does however emphasise many things and says it in a way, which, as I read it, I just wished that I could share this with everybody I know.
On page 235 he says something which I have suspected for some time but which he is convinced is the truth. Gordon Cosby, the leader of Church of the Saviour in Washington, D.C., noted somewhere that in over sixty years of ministry, he has never seen that groups which are formed around a non-missional purpose (prayer, worship, Bible Study, etc) ever ending up becoming missional. It was only those groups which intended from the start to be missional (and usually embraced things like prayer, worship and Bible Study) that ended up doing it.
This corresponds with my own experience. It is impossible to calculate how many people have contacted me over the years with a request to get involved in our work in Swaziland. Usually the conversation goes something like this: “Hi, we are a cell group / Bible Study group / prayer group from xyz congregation and we have heard about your work in Swaziland. We feel that it is important for us to reach out to others and we would like to visit you to find out how we can assist you.”
Being a fairly positive person, I always invite them to come, but at the back of my mind I know that there is a more than 90% chance that nothing will come from the visit. The reason is simple. To be part of a cell group or Bible Study group asks a small investment of your time: 1 – 2 hours per week. And let’s be honest – these meetings are fun. Coffee and cookies are served. There’s a lot of time for interaction. And after worship and prayer you feel revived and ready to tackle the rest of the week.
Involvement in mission asks much more than that. On most Sundays I leave home at 8 in the morning and return home somewhere between 2 and 3 in the afternoon. And that’s just for a church service. Anything happening during the week involves a lot of driving – two hours at the very least – entering places which may make you feel uncomfortable, seeing things that are not nice to see, walking in the scorching sun. After their visit these groups have a lot to say about their experience and always promise to come back again, but more often than not we never hear from them again. They will return to their cell group / Bible Study group / prayer group and will probably never return to Swaziland.
If I have to say why this happens, then it boils down to a lack of vision. A group that is formed without a missional vision, will never be able to become missional. They will merely follow their vision and if it is not a missional vision, they will not become missional.
Is there a solution for the hundreds of thousands of cell and other groups meeting all over the world with the main intention to feed themselves (pun intended)? The only solution I can imagine is that the leader of the group make the decision to change the vision. That should not be to difficult as most of these groups do not have an official “vision”. They just follow the leader. But if the leader could convince them to determine their vision (which can be as simple as to answer the question: Why are we meeting every week?) and then convince them that the true purpose of the church lies in its calling to become a light for the world (or whatever other missional metaphor he or she wishes to use), it is possible that, over time, a group like this could really become missional, using their normal weekly meetings to build themselves up so that they could do more outside the church.
But that’s my optimistic side speaking. If I have to be realistic, I doubt whether any significant number of church groups will ever become missional.

Monday, February 2, 2009 Posted by | Church, Comfort Zone, Cross-cultural experiences, Culture Shock, Indigenous church, Mission, Prayer, Short-term outreaches, Support teams, Sustainability, Swaziland, Theology, Vision | 3 Comments

Facing up to the AIDS situation in Swaziland

I started working again this week, after a few weeks of rest. At a conference hosted by HEARD, which I attended last year at the University of KwaZulu-Natal in Durban, I was privileged to meet Prof Robin Root, associate professor at the Baruch College in New York, in the Department of Sociology and Anthropology. She has been working on the topic of the role of faith-based organisations in the fight against AIDS in Swaziland for some years. After we met in Durban, I invited her to come and visit our home-based care project in Swaziland, which she did, and at the moment she is back in Swaziland to continue her research. Not only has she been interviewing the coordinators of the different home-based care groups (twelve at the moment), but she has also been visiting some of the clients who are being supported by our caregivers.
So this was a long introduction to speak about a situation we came across on Thursday. Before we entered the home, the specific caregiver working at the homestead warned us that the client is in a bad shape. Oh boy! Nothing could have prepared us for what we saw. This man was lying on a very thin mattress on the floor with the most grotesque sores on his feet imaginable. (I’ve seen something similar before and a doctor told me that it was most probably Kaposi’s sarcoma, a type of skin cancer caused by the herpes virus.) What does one say to a person in this situation. He cannot walk, because the huge tumours are covering the soles of both his feet. He has been taken to a rural clinic for blood tests to try and determine the cause of the tumours, but the clinic either lost the blood sample or they lost the report (I’m not sure which). He lives in a house without running water and without electricity. As we sat with him, he was using a rag to try and chase the flies away from his feet! Furthermore, he is living in severe pain, but the local clinic was only able to give him the weakest form of pain killers available in Swaziland.
As we left, I said to Robin that we should try and imagine a similar situation in the USA. Had anything like this happened there, the patient would have been hospitalised. He would have received medication. Most probably the tumours would have been surgically removed. Once he returned home, he would have had access to medication which would at least have kept the symptoms under control. Physiotherapy, occupational therapy and whatever else was prescribed by the doctors would have been available to assist this person to lead as normal a life as possible.
But in Swaziland this will not happen. At the moment he has no other future, except to wait for his inevitable death.

Saturday, January 17, 2009 Posted by | Africa, AIDS, Culture Shock, Health, HIV, HIV & AIDS, Home-based Caring, Mission, Poverty, Social issues, Swaziland | 4 Comments

Working together with Home-Based Caregivers

I’m sitting at our annual synod meeting in Manzini at the moment. I’m the general secretary of the Swaziland Reformed Church and for the past week I’ve been rushing around, getting things ready for this meeting, the reason why I haven’t been able to blog lately. In between I have also been involved with a team from OM (Operation Mobilisation) which had been doing their rural outreach training in Swaziland. Instead of using them for building projects, I use these teams mainly to work with our home-based caregivers. Every morning, after breakfast, they meet the caregivers and start walking with them from homestead to homestead, caring for the patients, often walking down to a stream or river to fetch water and doing whatever is necessary to practically demonstrate the love of Christ to these people.
On Tuesday evening, the day before the group returned to their training base in South Africa, I asked them to come together at our church building at Dwalenito share what they had experienced in the two weeks that they had been in Swaziland. This was a time that I wanted to use to hear from them what had happened, but it was also a time of debriefing for the group, as many of them had really experienced culture shock. One of the young people said: “I had been stretched over my limit while I was there, but it was a good thing. God opened my eyes for the real need of the people in Swaziland.
What really amazed me was to hear how virtually everyone of them said to me that the time had been a challenge to them, having to walk long distances in the day, not having the convenience of a shower, having to fetch their own water, but then hearing every single one thanking us for allowing them to be part of this work. This isn’t what I would consider as a normal reaction. Normally people would be thankful if they had been living in comfortable rooms with comfortable beds and all other things which they would find at home.
But I also realised why they reacted in this way. They had been exposed to some of the worst situations that many of them had seen, things like extreme hunger (at one house they had helped to clean the house and did not find a crumb of food in the house) and also a girl of twelve years who is suffering from a sexually transmitted disease because some family member (probable the father or uncle) had continually raped and abused her. (Through their intervention the matter has now been reported to the police.) But then they also saw how the caregivers gave themselves to help these people. They saw one caregiver who had no food in her own home, going back to her house to fetch a bar of soap, just to be able to share something with someone else. And it was seeing this attitude that made it worthwhile for them to be here. Yes, they were stretched, but they were changed for the good and I believe that not one of them will ever quite be the same again.
Under normal circumstances I have too much other work to be able to visit the clients regularly. But every once in a while I join up with one or two of the caregivers and visit a few homes with them. And every time I do this I am strengthened and enriched merely by observing what these people are doing. But obviously, when I visit a home with them, I cannot leave without praying. These people still believe that there is some special power in a minister’s prayer!
Bill Hybels mentioned that every person should expose him or herself to a place of pain in order to grow spiritually and to have God speak to their hearts. I cannot agree with him more.

Friday, September 5, 2008 Posted by | AIDS, Bill Hybels, Building relations, Church, Comfort Zone, Cross-cultural experiences, Culture Shock, HIV, HIV & AIDS, Home-based Caring, Hope, Mission, Partnership, Poverty, Prayer, Short-term outreaches, Swaziland, Theology | Leave a comment

Returning home after a mission trip

I’ve been following some of the news of the team members who had recently had their short-term outreach to Swaziland from Florida, USA. Most of them are on Facebook. Personally I’m not very fond of Facebook but I must admit that it does give me the opportunity to have closer contact with this team as a whole. But more than anything else I think, I’m intrigued to see how these students adapt to their “normal” lives after their visit to Swaziland.
On their arrival back in the states, they immediately set up a group on Facebook where they could post their photos and video clips and send messages to each other. The first messages were: “I feel so lost without seeing you guys today!!!!” and “I miss you all & Love you all so much!! Hope your summers are swell! Keep in touch, and POST PICTURES! Love you all!” Then the posts concentrated on asking the team members to post their video clips. But now, two weeks later, there is hardly any mention anymore about their trip to Swaziland.
Looking at the individuals’ profiles, it is clear, after two weeks of leaving Swaziland, that life is “back to normal” for most of them, with only one or two still mentioning constantly that they wish they could be back in Swaziland. Oh, and it was interesting to see, just after their return from Swaziland, that all of them had changed their profile photos to one taken in Swaziland. A few have already changed their photos again showing something which they had done during the past few days.
OK, two questions: If I had told the group, just before they left Swaziland that for most of them Swaziland will be a far-off memory in a few weeks time, would they have believed me? Probably not. Is this abnormal? Probably not. I think different people react differently to short-term outreaches. I myself get much more emotionally attached to people than many of my friends. For the past eight years I’ve been going to Samara in Russia for two weeks. For the first week or two after my return, I really struggle to focus on my normal duties. All I can think of is my visit to Russia. I’m not a great tennis fan, but after returning from Russia my wife (she loves tennis) calls me to come and watch each time that Maria Sharapova plays, not because she’s blonde or beautiful or an excellent tennis player, but because she’s Russian! My wife has been to Russia with me, so she understands my withdrawal symptoms after arriving back at home.
How do I handle my return from a short-term missionary outreach? First of all I believe that God had sent me on that trip for a purpose and the purpose is not primarily so that I could enjoy myself. God wanted to teach me something and He wants me to share what I have learnt with other people. And so I try and arrange a time, usually in church on a Sunday, to give a short presentation on what I had experienced. Then I put up reminders (photos or some other gift I may have received) to help me to remember to pray for these people. You can pray for people you do not know. But it becomes much easier and more enjoyable to pray for people whom you do know and whose circumstances, home, family, etc you are familiar with.
But for myself the greatest help is my commitment to the people in Samara. The first year I prayed whether I should go. The second year I prayed that I would be able to go. From then on I prayed that God should show me if He didn’t want me to go! This keeps me focussed on the country and the people I’ve come to know. They know that I’ve made a long-term investment in them and I believe they do appreciate it.
When you arrive in the foreign country, you go through varying degrees of culture shock. When you return home the same thing happens. We have to learn how to handle these emotions and how to apply it in a positive way so that the people that we had visited will benefit from it.

Wednesday, June 11, 2008 Posted by | Building relations, Comfort Zone, Cross-cultural experiences, Culture Shock, Mission, Prayer, Russia, Short-term outreaches, Support teams, Sustainability, Swaziland, Theology | 3 Comments

Once more about planning, trusting and commitment

I have a group of people from a church in South Africa helping us at Dwaleni. The group consists mostly of highschool children (two boys and two girls with three more boys joining today) and then my youngest son and my daughter also joined them on this outreach. They are accompanied by their youth pastor (female), her parents who are helping with the cooking as well as coordinating the work that needs to be done and the chairperson of their church’s missions committee and his wife. One of the things happening this week which I’m really glad about, is that our church is being plastered. The building is over a hundred years old (it used to be a store) and does not give a good impression, as you can see on this photo:.
But all of this is just the background for some conversations I had yesterday. With the exception of one of the children, none of them had previously had any contact with anyone who is HIV-positive. Yesterday I arranged that some of our home-based caregivers take these children with them to visit people at their homes. For all of them this was an eye-opener. Even my own son, who hears about this work every single day in our house and who sees photos and videos of our work, was amazed when he saw what the home-based caregivers are doing, mentioning afterwards to the youth pastor that even he had never realised the extent of the work that the home-based caregivers are doing.
Over lunch the chairperson of the mission’s committee made the remark that he would really like to see something similar start in their own church in South Africa but that it would not happen this year. I then asked him what would prevent them from starting with such a project this year and received the answer I expected: It had not been planned and budgeted for! I’m all for planning. I’m all for calculating the costs. But I’m not convinced that God only works from financial year to financial year. And even if there is nothing on the budget for such a project in the current financial year, what would prevent us from at least getting people together and starting discussions on the issue? This can be done at no cost.
Which probably all comes back to the issue of commitment which I mentioned a few days ago: “Not planned for” and “Not on this year’s budget” are legitimate excuses for not getting involved and not committing to projects. But I think this is an easy way out. What about: “Not planned for and not budgeted for, but let’s pray about this and if this is what God wants us to do, then let’s do it!”

Saturday, March 29, 2008 Posted by | Culture Shock, HIV & AIDS, Home-based Caring, Mission, Partnership, Prayer, Short-term outreaches, Social issues, Support teams, Sustainability, Swaziland, Theology | 2 Comments

What motivates people to help others?

Today we started with the training of our seventh group of home-based caregivers in an area known as Nsalitje. To have a look at a satellite photo of the area on Googlemaps, click on this link.
Today was a typical day in Africa: The sun was VERY hot, with temperatures probably in the 90s (which is in the 30s in Celsius). The day actually started in the Dwaleni area where we are trying to help a community get fresh water. The government helped the community some years ago to install one communal tap which the entire community, consisting probably of a hundred or more people, has to share. But the water is flowing at such a slow rate that the women are spending most of the day at the tap waiting for their containers to fill. A 20 litre container would take about 30 minutes to fill. We hope that we have found a solution, but I’ll write about that when we see the outcome.
We then proceeded to drive through to Nsalitje (praising the Lord all the way for the luxury of air conditioning.) On our arrival at the venue where the training was taking place, I was really shocked. The training was being done in a community hall (known in Swaziland as the Mphakadze.) The entire building is made of corrugated iron and there is no ceiling, so it doesn’t take much imagination to think how it felt inside. 25 people had turned up for the training, all of them eager to become home-based caregivers. As I looked at this group of people, some of whom were clearly HIV+ and one young man whom I’m convinced already has full-blown AIDS, I asked myself the question what the motivation would be for these people to become part of this home-based caring project. Money is definitely NOT a motivation, as we don’t have any money to give them. Not all of them are Christians, so although we would like to think that their faith is the great motivation, this is also not the final answer, although it may definitely be true in some cases.
Ultimately it seems to me that the great motivation would be a desire to really make a difference in people’s lives. But then I’m still puzzled why people who have nothing, most of whom are living far below what we would describe as extreme poverty (less than $2 per day), would be willing to give their time and their energy and often even the little money and food they have to make a difference in other people’s lives. I don’t think I have the answer yet.
What I do know is that this attitude never fails to amaze me.

Tuesday, February 19, 2008 Posted by | Africa, Church, Culture Shock, HIV & AIDS, Home-based Caring, Mission, Poverty, Social issues, Swaziland, Theology, Women | 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 | Culture Shock, Death, Health, HIV & AIDS, Home-based Caring, Hope, Mission, Poverty, Short-term outreaches, Support teams, Sustainability, Swaziland, Theology | 2 Comments

(In)Sensitivity of Missions Committees

First of all, welcome to the 200th post on Mission Issues. When I started this blog I really wondered how long I would be able to share stories and experiences from the mission. I’m thankful for every positive response, word of encouragement and for people just reading and learning something from my personal experience, even if they don’t respond. And to top it all, yesterday I received an “Excellent blogger Award” from a missionary in the Ukraine. OK, it’s no big deal, but I still appreciate it when people feel that this blog really means something to them. You can read what Michelle writes about this (and other blogs) here.

Many missionaries will be able to share stories about the insensitivity of the mission committees responsible for sending them into the mission field. (We missionaries always refer to the prayer which mission committees supposedly pray when sending someone out: Lord, you keep them humble and we’ll keep them poor 😉
In defence of the missions committee responsible for our work in Swaziland, I can testify that one will have to search very far to find people more concerned about the work and the people doing the work than them. So, if any of those members are reading this, then I want to thank you for what you are doing for us in Swaziland! You people are really great and we honestly appreciate your love and interest in our work.
One of our former colleagues (now retired) used to work in Malawi for many years. She was trained as a social worker and later married a missionary who had worked in Zambia for many years before they joined us in Swaziland. One of her favourite stories was their constant plea to the South African missions committee responsible for Malawi to build flush toilets in the houses of the missionaries in Malawi. Year after year this plea fell on deaf ears. There was never money available for this “luxury” item. And so the missionaries had to make use of a pit latrine built as far as possible (for obvious reasons) away from the homes. (Do you even know what I’m speaking about????)
All this changed one year when the missions committee sent a delegation to visit the missionaries in Malawi. One of the visitors picked up a bug which kept him on the run between the house and the pit latrine throughout the night. Somewhere in the process of running, he also stumbled across a tree stump and fell into the bushes. a few days after the return of the missions committee members to South Africa, the missionaries in Malawi were instructed to install flush toilets in all their houses. Miraculously, money had become available!
Today we can laugh at these stories. But the question remains why committees or organisations sending out missionaries tend to lose contact with the needs of these people? For most missionaries the situation is difficult enough – getting used to a new culture, being removed from families and friends, living and travelling, very often, in ways which they are totally not accustomed to. It is so important for these missionaries to know that, at the very least, they have the support of those who had sent them out to do the work.
We have dear friends working as missionaries in Thailand. Once every fifth year they are given tickets to return to South Africa for a “sabbatical” to regain their strength and also to meet with their supporters (and their families.) I was shocked, during a previous visit, when people complained that they are wasting money coming back to South Africa to see their families as the money for the plane tickets could rather have been spent in a more useful way! (Does that also make you think of the words of Judas?)
Many of those reading here will in some way be involved with the support of missionaries somewhere in the world. Most of the missionaries I know do this with so much love and dedication and in nearly all the cases I know of they will gladly sacrifice luxuries in order for the work to be done which they were called to do. In general they don’t complain, knowing that they are doing this for the Lord and also knowing that greater missionaries like Paul had to endure much worse things.
At a previous annual meeting of our Swaziland missions committee the chairman did something which I thought was really great. There was a thick report written about the work in Swaziland to which a number of people had contributed. When the time came to discuss this report the chairman closed the file and said to all those present that he would go home and read the report. But there, in that meeting, he did not want to read what people had written. He wanted to hear the stories told from their hearts about how they experienced the work, the good and the bad, to hear where they needed prayers and to hear where they needed other forms of support.
We need more people with this kind of attitude in missions committees.

Friday, February 15, 2008 Posted by | Africa, Culture, Culture Shock, Humour, Meetings, Mission, Partnership, Prayer, Support teams, Swaziland | 5 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 | Africa, Cross-cultural experiences, Culture Shock, Death, Evangelicals, Health, HIV & AIDS, Mission, Poverty, Swaziland, Theology | 3 Comments