The Promise

Yesterday found Ross, Adelaide, and I bumping over a muddy footpath in a bajaj deep into one of the dozens of neighborhoods (which are more like villages) just outside of Mtwara town.  We were actually lost; the woman we were going to see, N—-, had spoken with the driver of the bajaj over our cell phone, but apparently, the directions had been unclear, which was understandable as there are no road signs or even proper roads for that matter, just dirt ruts winding up and down hills covered in palms and banana trees.  We circled a certain school that N—– had mentioned over the phone, until we came across one of her relatives, which she sent to show us the way.  She and her small daughter squeezed into the bajaj to show us the way.  When we got to a landslide in the path that must have been caused by the recent rains, and the bajaj could go no further, we hopped out and climbed the small hill to one of the mud houses with a thatched roof.

N—– was waiting for us under the eves of her house, next to the doorway, on a bamboo mat.  She called Ross to sit on a small wooden stool, which she had apparently put out for him, and called me to sit by her side on the bamboo mat.  After the traditional long introductions, she stretched out her hands to take seven-week old Addie.  The skin on Addie’s arms was white and luminous, N—–’s hands dark and reflective, wrapped around Addie’s torso as she held her face-to-face, “What a big baby!” N—– exclaimed.  “What are you feeding her?”  I probably blushed and replied,

“Mothers milk.  Totally mothers milk.”
“She will be riding a bike here by next week,” N—– said, “All by herself!”

I smiled.  Then the conversation turned to N—–’s legs.  She had them stretched out in front of her; both legs were swollen, but one leg was obviously swollen more than the other.  “It has gone down a lot.  At the New Year, it was this big!” She motioned to show how swollen the leg had been.  The skin on the more swollen, left leg was peeling off all over.  The skin on the less swollen leg was scarred and pitted.  N—– explained her worries over the fact that she had not been able to go to work for a few weeks.

Ross met her when he was buying maize flour at the store she worked at.  She had been so warm and friendly that he wanted to introduce me to her.  Indeed, N—– was as warm as he had promised.  She delighted in Adelaide and kindly cooed and doted over her with me.  When she asked the baby’s name, I told her, “Adi.”

“Hadi?”  She repeated.

“No, A-di.”  I replied.  This had been a problem since we had returned with the baby.  We thought when naming her that “Adi” would be easy for Swahili speakers to say, but apparently, it still sounded foreign, and people had a difficult time repeating and recalling it.  “People have trouble saying that name,” I said, “Maybe because it is an English name.  Is there a word that sounds like Adi in Kiswahili?”  By that time a neighbor woman had joined us on the mat, and N—– and she looked at each other for a second, contemplating.

“Ahadi!”  Said the neighbor.
“Yes, Ahadi.”  Confirmed N—–.  They almost skipped over the first “A” sound in the word, and the breathy “H” glided so seamlessly into the next “A” that “Ahadi” did sound somewhat like her English name, “Addie.”  I glanced at Ross, questioning, because I did not know the meaning of the new word.

“It means promise.”  He said.

Promise—I thought.  N—– repeated the word,

“Ahadi.”

Goosebumps raised on my arms.  I thought back to the conversations that Ross and I shared over the past few years, as our reason for being in Tanzania came into focus.  The conversations would often settle upon the theme that we wanted to invite our brothers, the descendants of Ishmael, into the banquet of blessings that flows from God’s covenant promise with Abraham to bless all nations.  And I remembered the day that we named our blog, “Sharing God’s Blessing as Children of Abraham” because of this.  Yes, our Ahadi represents a promise.  A special promise God made to Abraham to bless the nations.  A promise we have made to stay.

When we got ready to leave, N—– said, “I will see Ahadi off.”  As it clearly hurt N—– to put weight on her legs, I was somewhat distressed to see this, but N—– cradled Ahadi so carefully, took each step with such intent, and boldly raised her head that I dared not protest.  It was a gift that I could not refuse.

As we jostled away down the footpath, thoughts troubled me about N—–’s leg.  Although I have limited tropical-medicine training, the swelling looked like it could likely be a symptom of beginning stage Filariasis—a disease where hundreds of tiny threadworms camp out in the lymphatic system of the groin and sometimes arms.

Elephantiasis can be the result of extended disease, where the swelling, which damages the tissues of the limb, is replaced with scar tissue, and the leg becomes huge and unusable.  My mind reflected upon the condition of a man who sometimes begs on the path from the fish market to the post office.  One of his legs is wrinkled, pitted, as large as a stump, and judging from the smell in the general area where he sits, rotting.  Diagnosis for Filariasis requires a skilled microscopist to take blood slides at night (when the worms prefer to travel in the venous system) and examine them under the microscope to look for worms, antibody blood tests, which can only be done with specialized equipment, etc. The treatment involves a strong medicine repeated over months or years, and the medicine along with the dead worms killed by the medicine can cause uncomfortable side effects.  Additionally, Ivermectin, the medicine most useful in community control of the microfilariae, was impossible for me to find in Tanzania, as I looked for it intensely last year and had no success.

As my heart swelled with fondness for N—–, as she had been so open and kind, especially to my child, I simultaneously felt crushed by the weight of energy and resources it would take to even diagnose Filariasis and rule out other possibilities.  We passed many people out in front of their houses; a mother washing clothes with a baby playing in the sand beside her, a man riding a rusted bike in a suit and tie, a group of women in brightly colored kangas, lounging in the shade.  I thought of the mosquitoes carrying microfilaria.  I looked at the windows without net coverings.

Oh, Father, My God–my spirit groaned.

I held my baby and said her name–”Ahadi.”

Time Warp

“Why don’t you have clocks in your house; this is driving me crazy–what time is it?!”  The remark of a recent visitor rebounded in my head as I looked around the post office and glanced at my bare wrist, wistfully wishing for a clock.  Of course, there were no clocks to be found.  I had been standing in front of the post office counter for what seemed like a decade (who knows, exactly how long?), still waiting for change.

At first, like my visitor, I was really bothered by the slow pace of life and the lack of clock-time awareness in Tanzania.  Because I didn’t know what time it was, time seemed to pass so slowly, and I constantly felt like I was living in a time warp.  Those first days and months in Africa often seemed to stretch eternally.  The clock may be missing from our post office not because people don’t care what time it is, but because they often will judge time by event instead of hour.  So, for example, church starts when people gather for church, not at a specific time.  Also, whereas in the states, time is money; here, time is only what it is–time, and there is an abundance of it.  Not everyone is rich, but everyone has time.

For example, late last night, after a long day of caring for a newborn baby with Ross away, I slumped exhausted in the kitchen, preparing myself mentally to begin making dinner from scratch, and my housekeeper, Mariam, surprised me with food.  She was on her way out the door, but she had put a little plate of piping hot ugali and mchuzi out for me to eat.  Food was a welcome sight, as I had been so busy bouncing baby that I had not stopped for lunch.  She sat down next to me in the dining room and said, “Eat.  Ugali makes strong milk.”  A going-out bag was in her hand, and I knew she was on her way to run an errand.

“But, aren’t you on your way out?  Go ahead and go, and I’ll eat by myself.”

“No,” she said, “I have time.  I’ll sit here while you eat.”  In America, I doubt that even if my own mother had an errand to do, she would just sit and watch me eat so that I would have company.

And so, I am beginning to think of the abundance of time in my African life as a special luxury and a gift to give others.  In my African life, I can rock my newborn baby for another few minutes, appreciate those long hours of afternoon that never seem that they will end, and savor the peace I have in Christ while waiting in the post office line.

–Heather

The Visitation

Adelaide in Mariam's big, strong hands.

Ross ran upstairs to our apartment, calling me to bring the baby down to street level to meet some people who wanted to see her.  I quickly wrapped her in a blanket, threw on some long pants to be more African-decent, and descended our main stairway with baby in arms.  As I pushed open the great, metal door of our house, a great cry went up from about the crowd assembled around our front door.  ”Hongera!  Mama mtoto!” they cried.  Many people clapped.

I was quite surprised and somewhat taken aback, as Ross’ summoning words had me assuming I was coming down to greet three or four people.  Instead, about seventy people: mostly women, most sitting, most old, some standing, some carrying babies on their backs, some in wheelchairs, some blind, many handicapped were crowded around my front door.  When I shook their hands and greeted them in Kiswahili, many showed off smiles with missing teeth, and I noticed that many faces were wrinkled with age and scored with the traditional black patterned lines of Makonde tradition.  The whimsically patterned and brightly colored “kangas” (cloth wraps) worn here in East Africa that were wrapped around waists and draped over heads were especially joyful looking to me at that moment.  All the dazzling colors and smiles dropped upon me so suddenly made me feel like I was in a whirlwind of confetti.

This motley, celebratory crew assembled outside my front door was “the poor”, as they are sometimes called around here.  They straggle into Mtwara town especially on Fridays to beg a few shillings off of town passerby and pick up freebies given out by many business owners and  families on the Muslim holy day, Friday.  Ross and I often give out plastic bags with a little corn flour in them to these poor people who pass by our house on Fridays as a gesture of goodwill to the community.

Among the group that day was a blind woman, eyes sealed closed, who cried out with one of her hands in the air and one on her guiding stick, “Let me see the child, let me see the child!”  I hesitated–how could she “see” the baby?  Then I put my child’s soft, pink foot in her outstretched hand.  ”Ah, a beautiful child.”  The blind woman said.  A great smile wrapped around her face.  I regard her pronouncement one of the dearest complements yet paid to my little daughter.  Mother Theresa believed that one could see the face of Christ in the poor; she got this idea from Christ’s own pronouncement “what so ever you do for the least of these, you do for me.”  If this is true, then Addie’s visit from the poor may have been her most divine encounter yet.   –HJK

First Sunday, now there's three of us!

First bajaj (local transportation) ride.

The team meets Addie for the first time.

Reed points out Addie's toes.

Aletheia greets Addie for the first time and notices that she has toes.

Addie goes to the Mtwara beach.

Ross and his look-alike.

Christmas outfit! First Sunday.

Sharing October

Our favorite street in Mtwara--the one where we live!

Below we have shared what our life and calling was like during the month of October because we want you to feel like you are a part of our work and know about the routine activities of our every day.  We feel so blessed to be servants to the people of our region; they are teaching us much about life, culture, and relationships.  We love our jobs and think that we do some of the most exciting work in the world!

For Ross:         

Ross loves to take friends out to lunch several times weekly. His lunch guests teach him about their culture, language, and religion.

Daily prayer with Heather and Bible reading

Daily translation exercises (worked on Romans in Kiswahili)

Readings from the Quar’an and taking notes

Daily word log review and memorization

Daily porch time, visiting w/ neighbors during day

Evening coffee time w/ old men in market

Spending the day with a friend and his family Oct 4^th

Traveled to Z. village by bike to visit a friend’s family Oct 18^th

Hosted an older gentleman for dinner October 18^th

Took a friend and his family to get his children treated for malaria Oct 5^th

Took several friends to lunch for language practice

Spent time studying with language tutor

Continued to have maize flour available for poor on the street

Attended guy accountability times

Skyped with Lexington church Oct 16^th, lead communion

Emailed supporters

Managed workers working on house

Made rounds to say ‘goodbye’ to friends before month in South Africa

For Heather:

In October, I enjoyed completing "nesting" projects in preparation for the baby.

Hosted a friend for dinner Oct 4^th

Got nursing license from Faith Logistics in Dar, now officially licensed!

Had breakfast conversation with Mariam Oct 6^th

Hosted a young couple for pizza dinner Oct 6^th

Attended girl accountability times

Took care of administrative mission-related work such as blog, work fund, etc.

Studied with language tutor

Looking forward to November (our month in South Africa where we will await the birth of our daughter):

While in South Africa for the month of November, we will continue language study with emphasis in vocabulary memorization and grammar mastery.  Ross will read anthropological research on the Makonde that we have gathered throughout the last few years.  Ross will also write a series of sermons in Kiswahili on the prophets to share with un-reached Muslim audiences in the future.  Also, he will finish reading through the Qur’an and taking notes.

Heather will mostly ‘take it easy’ before the birth but also intends to finish her Kiswahili grammar book and support Ross though taking care of mission-related administrative tasks.  Of course, we will also spend time preparing for the birth of our daughter by finding a suitable medical provider and living situation and caring for her after the birth.  We will also spend some time on legal tasks such as procuring the baby’s birth certificate and official US passport after she is born.  Our prayer is to return to Mtwara as soon as possible.

Action Plan for 2011-2012

For our supporters and friends, we have posted an action plan below to let you know what we will be up to in the next year.  See the previous post for a review in pictures and words of last year (our first year) in Tanzania.

Focus on language exposure hours with an emphasis in conversation and interaction until we leave for South Africa at the end of October.

While in South Africa, continue with daily Bible readings in Kiswahili, focus on vocabulary development through memorization, etc., continue grammar study (Heather), focus on reading and mastering all anthropological materials we have collected regarding the Makonde, make phone calls to friends back home to stay engaged in language. Ross will write out some Swahili sermons geared towards this Muslim audience.

 

Proceed with Kimakonde language learning at the first of the year, this will involve village stays, etc.

Begin anthropological research of the Makonde.  The team has assigned us religion and medicine anthropological categories.  We will research in the villages and later report to the team about our findings.  This research will dovetail nicely with Kimakonde language learning.

Participate in an important Tanzania wide retreat in the spring to help CoC become more organized in Tanzania.  This will include a team visit to our African-side supporting church, Langi Church, in Mwanza.

Help the team become more established in our region of Tanzania as a viable church presence that has credibility with locals and officials.  This involves implementing acts of service in the community in our areas of expertise.

By October 1, 2012, we both will be at a level 3 (defined by our language textbook) in Kiswahili and a level 2 in Kimakonde in order to be ready to launch into Phase II, the ministry stage, of the mission. By this time, we would like to be established enough in certain villages as to begin disciple making.

How Do you Measure a Year in Tanzania?

A brief summary of our first year with pictures:

 

We attended Kiswahili school Oct-Jan and graduated with proficiency level status.

The break in Dec included visit with the Langi Church in Mwanza.  During this visit, we stayed in church leader’s homes the village for a few days.  The Langi Church invited our team into the country and continues to be a mentoring presence in the mission.

The break in Dec included a weeklong stay in the home of our teacher, Mwalimu Siagi with his family.

We made connections with many village residents who lived near the language school as well as with workers at the language school.  Ross taught Bible stories, and we left many of our friends with a copy of the Bible and an invitation to continue conversing with us via the phone.

We attended the ECHO Agricultural conference in Arusha for three days in February.

We hosted Ross’ father, Rom Kellis and his brother, Keke Kellis in February.

Ross attended the Men’s Retreat in Kenya in February.

Heather attended a month-long tropical medicine course hosted by a Norwegian University in Tanga in March.  Many of the teachers were Tanzanian scientists and doctors with one-the-ground experience with tropical med.

We moved to Mtwara in April and set up house in a strategically located apartment at the heart of the city.  We continue to establish a home there.

We participated in a three-day long counseling workshop facilitated by MRN (Missions Resource Network) along with the team.

Ross researched the religious situation of the area on behalf of the team.  This involved meeting local religious leaders and exploration, etc.

Heather developed an emergency evacuation plan along with Kristina and Lauren after doing research about healthcare resources in the area.

In May, we hosted Janice Bingham and Lisa Engel for a day or two.

Ross and Andrew did a 6-day survey of Makondeland in June.

 

In June, we spent four days of vacation in South Africa, researching hospital and doctor options for the birth of our baby.

Heather’s Mom stayed with us for the month of July.

We participated in the team bi-annual strategy meetings in March and September.

In September, we got the container and have enjoyed setting up house with the new things that arrived.

Ross finds language practice at his front door.  Often he sits on the side of the street and converses with passersby.  Muslim teachers, pastors of local churches, and public officers all have been known to come by.  Ross also frequents a coffee “hang out” for men in the evenings in the market.

 

We have had a language tutor since April.  We continue to meet with her most weekdays.  Heather relies on her more heavily, meeting for an hour each day, while Ross sits with the teacher only a few days a week.

Currently, we are securing a car with church funds and are proceeding with the tax-exemption process.  After the paperwork is cleared with the government, we can pick up the church’s car from the dealership.

Heather is still in the process of securing her Tanzanian nursing license.

Most of every workday for the last year has been language focused.

The Rock at Horeb

I was 29 weeks along when the pregnancy pictures were taken below (now I am 32 weeks).  Lots of thanks to Lauren, our team photographer, who took these pictures.  God has really blessed my pregnancy, and I am so thankful for having been so healthy with no complications this entire time.  The peaceful pregnancy I have had has made it much easier to get adjusted to life here and to continue language learning at a normal rate.  God is so faithful and merciful!  We continue to pray for the health and vitality of our baby, including his or her (most likely HER!) spiritual vitality in the future as he or she grows.  Please keep us in your prayers, too.  We leave Mtwara at the end of October in order to fly to South Africa where we will await the arrival of our little one.

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In other news, I have also posted some pictures taken during a break time of our biannual team strategy meeting.  In this meeting, we presented research to each other over different subjects such as: NGO (non-government organization) presence in the area, religious situation of the area, a proposed emergency evacuation plan, water situation in the villages, tourism and travel, etc.  We made some decisions regarding how to proceed in the next year and did some vision crafting for the next 5 years as well.  The meeting lasted three days, and in the evenings we would swim and eat dinner out.  We also had a campfire made complete with s’mores, around which many of us sat and talked late into the night.  Some of the other pictures included are from Sarah’s birthday which we celebrated last Saturday by chartering a local fisherman’s boat (ahem, yacht) to go snorkeling in the reefs around Mtwara.  Fun was had by all, but I think the most fun was had by the little girls who found a perfect spot to splash in the shallow waters of a sandbar as the Dads looked on.

As one year comes to a close for us, we want to acknowledge all the ways that God has provided for us as we journeyed to Tanzania and as we have made it our home.  On Sunday night we sang the song, “Blessed be the Lord who would not give us up, blessed be the Lord for his unfailing love,” and then the line, “The snare is broken and we have escaped…”  I smiled as I sang this, remembering all the times in the last year when we barely scraped by in some way or another (including some near-death experiences on Tanzanian public transportation), as if barely escaping from a trap because God delivered us.  Also on Sunday, we read Exodus 17:1-7, where the Israelites sinned against God for asking, “Is the Lord among us or not?”  As this first year in Tanzania closes, we want to affirm to all those watching that the same question that the Israelites asked at Horeb is not in our mouths.  Instead, we have witnessed that God has undoubtedly been among us, providing an abundance of water from the rock in the midst of the wilderness.  You may say, “Well, where did you see God, and when, and how can you prove it?”  Maybe there is some answer to these questions in Exodus 17 when God tells Moses, “I, myself will stand there on the rock, and you hit it.”  The way of the surprising God, “I Am,” is to stand unseen over the right rock and lets us strike.  As our thirst is slated and our stomachs slosh full, let us remember that it was not we who caused the water to flow, but Him.

–Heather

New Words

Our life right now continues to be full of words, words, and more words.  I have been reporting to a local Catholic clinic to learn medical Kiswahili words.  To my surprise, upon my first visit, I was greeted warmly by some very caring nurses who seemed like they enjoyed “teaching me” all about their work including how to pack a wound, give Vitamin A, chart on the baby growth charts, etc., all (of course) in Kiswahili.  I also have found a group of girls who sell juice near my house who I have been visiting with for a few hours weekly.  They are all very interested in the subjects of birthing, marriage, my relationship with my husband, pregnancy, etc.  Honestly, I have been a little surprised by the boldness of the questions that they ask me, as this is considered more of a traditional culture.  I guess women are essentially the same the world over and enjoy talking about the same subjects.

If you had a zoom lens that could see from you to Tanzania, on Sat night, you would have caught us around a crackling bonfire in the backyard of our friends, JJ and Ester, who live three hours into the bush from Mtwara.  They hosted Andrew, Sarah, Ross and me for two days this weekend.  JJ and Ester are from Holland, and JJ is a medical doctor who is volunteering in a bush hospital.  They have two kids and have been here for two years.  They are also Christians.  We enjoyed fellowship and Christian community together at their house and marveled at how they have survived out in the bush w/o electricity and running water for long periods.

The other morning, Ross was walking downstairs and noticed one of our friends, Z—-, a Muslim woman, intensely reading the Kiswahili Children’s Bible that we leave out for our neighbors to look at.  We found out that she has read the entire thing all the way through.  A few days ago, when she was at the point where Jesus was crucified, she said that she felt “great pain” or “uchungu” (women use this word to describe the pains of child birth), and her eyes were filling with tears.  She has never read the Bible before.  Please pray that we would be able to minister to Z— in her openness to God’s story (even with our limited language ability).  There are others like her (and many Christians) who have never read the Bible or heard stories from the Biblical narrative.  Actually, most people in town can barely read (and these are the town folks, in the country literacy is even less common).  When Ross reads Bible stories with people on our porch, often it is as much literacy teaching as imparting spiritual insight.

–Heather

 

Container Garden

As many of you know, Ross and I live in an apartment in the town center.  We have a small courtyard and have been doing some experimental container gardening.  We have made some shallow beds with concrete block perimeters and are also using recycled and found containers to grow plants in.  Mostly, I am trying to grow veggies and herbs that I miss from home and cannot find here like lettuce, basil, cilantro, green beans, etc.  The basil has done the best–I have enough to feed the whole town, it seems!

Our garden has been a living parable for me this week, as we have been challenged by numerous requests for money from friends and acquaintances due to the Ramadan holidays, I have been reminded of the Apostolic example that

Whoever sows sparingly will also reap sparing, and whoever sows bountifully will also reap bountifully.  Each one must give as he has decided in his heart, not reluctantly or under compulsion, for God loves a cheerful giver.  And God is able to make all grace abound to you, so that having sufficiency in all things at all times, you may abound in every good work. (2 Cor 9:6-8).

Moon Flower--these open in the afternoon and have a wonderful smell

More Moon Flower growing over an old stump

Courtyard view from above

Growing lettuce in an old drawer

Orange cherry tomatoes

Mint

Shallow bed constructed from concrete blocks

–Heather

 

The Widow’s Last Morsel

Image donated by Abbot Dionys, Ndanda Hospital.

“The jar of flour was not spent, neither did the jug of oil become empty, according to the word of the Lord that he spoke by Elijah.” (1 Kings 17:16)

Ndanda Abbey is a Catholic abbey, which is located in the heart of Makonde land and has been here for 105 years.  Onsite is a bustling hospital, called Ndanda Hospital, which provides essential health care services to the entire region.

This hospital, which is run in cooperation with the Benedictine sisters, has 300 patient beds, which are supported by 300 workers and attended by 150 trained staff members.  In 2010, there were 10,429 inpatients treated at the hospital.  There are medical, surgical, gynecological, maternity, pediatric, and tuberculosis wards, a laboratory, and dental clinic.  The laboratory alone tested 19,910 patients for malaria and other blood-borne illnesses last year.  The hospital also has an x-ray machine, a pharmacy, and an active surgical ward.  The outpatient department treated 46,666 patents in 2010.  Alongside the hospital is a nurse training school.  Additionally, the Abbey supports local AIDS education and counseling programs throughout the area in villages with the aid of NGOs.  One of the unique advantages of the Ndanda Hospital is the fact that there is constant access to clean water from local, spring-fed water sources as well as stable hydro-electricity supplied by the same springs.

The Abbey is a great place to rest and break from our work in Mtwara.  A few Sundays ago, as we finished breakfast after church at Ndanda Abbey during a weekend visit, Abbot Dionys, the leader of the Abbey, stopped by the dining room to greet us.  Abbot Dionys has guided the Abbey for about ten years and has lived and worked in the Lindi and Ndanda areas for over forty years.  Kind, generous, and hospitable, the Abbot was outfitted in his Sunday garb of a long white tunic, which was complemented by his equally white head and chin beard.  On Sunday, the fact that he sought us out, and again showed support and interest in our work, was very encouraging.  In fact, the next day, he even let Ross test-drive his car.  The Abbot is the type of person who stops to talk to old village women and sick people sitting along the road that I somehow never even notice until he stops.  When he shakes your hand and says, “God bless you,” you know that God will.

Today the Abbot had the Ndanda Hospital on his mind and proceeded to share his worries that the hospital will face a financial crisis for the months of July 2011 to December 2011 and even more so in the year of 2012.  In July, the hospital was short of funds equal to about $141,560 USD.  By the end of 2011, the funding shortage will be $707,650.  This means that at this point, the hospital is no longer able to pay salaries or other expenses.  According to the Abbot Dionys, the reason for this funding shortage is complex.

One part or the reason for the funding crisis is that in 2007, the government pledged to support 54 employees and approve support for 35 more, but the funding for these employees has not yet come to Ndanda.  With increased government commitment to fund the hospital, the Catholic funding was gradually withdrawn.  Now there is a funding crisis, and the Abbot does not know where to turn.

Additionally, in November 2010, Ndanda Hospital was officially announced a Regional Referral Hospital by the government, which means that five district hospitals in the Mtwara and Lindi regions can transfer critical-cases there, especially orthopedic cases, motor vehicle accident cases, and other surgeries.  Two Dutch medical students who sat with us at that Sunday who are working medical rotation at a district hospital in the area testified to this fact.  They remarked that in the few weeks that they had been practicing at a district hospital, they had sent several patients to Ndanda because they did not have sterile gloves or other basic supplies on hand to use to perform even simple safe procedures.  In 2010, there were 2,778 major surgeries performed at Ndanda Hospital.

At a recent staff meeting where hospital employees and Abbey leaders proposed cuts in budget, they found that the most expensive areas of hospital functioning were surgical services.  At this time, patients are charged 30,000 Tanzanian Shillings (or $18.50 USD) per a surgery, the price of a bus ticket for one person from Ndanda to Dar, a price that most people are challenged to pay, but can reasonably pay perhaps out of savings or with the help of relatives.  For many years, this has been the standard price of the surgeries as a gift of charity to the community, although in actuality, the doctor’s fees, supplies, medicines, upkeep and maintenance of the operating room, sterilization of instruments, instruments themselves, etc. all add up to much more than 30,000 Shillings per surgery.  If the price of surgery is increased, I personally fear that many Tanzanians who need life-saving surgeries may go untreated for inability to pay.  In 2010, the income generated from patients was $328,840.

At this point, the Abbot does not know where he will get the funding needed to keep the Ndanda Hospital afloat in the coming months.  He has written the president of Tanzania as well as other government representatives, and the government states that they simply have no money to give from their funds.  We have heard that this may be because the government is currently directing a lot of healthcare spending to establishing clinics in the very rural areas in conjunction with one of Bill Clinton’s humanitarian aid projects.  Recently, the government has also increased salaries of hospital workers by 25% and the cost of medicines continues to rise.  Although these advancements are favorable for hospital workers and village people in far-out, rural areas, it puts a strain Ndanda Hospital’s financial situation.  The Abbot has written individual donors, friends, in Europe, but he admits that he is skeptical that individual donors will be able to make up for the wide gap in funding that looms before him in the next month and for the months to come.

The only option is to dramatically reduce services or dramatically increase the price for services.  For example, an increase in service prices of 100% to patients would keep the hospital afloat for 4 months in 2012, but an increase in service prices by 100% may be unreasonable and have devastating consequences, especially for the poorest of patients.  I personally dread the impact that the loss of surgical services will have on the already under serviced communities of the Mtwara and Lindi regions at large.

May the same Lord who provided abundance to spring from the Widow of Zaraphath’s last morsel to fill Elijah during time of famine, the Lord who sees each suffering patient in the Mtwara region, provide a sustainable funding solution for Ndanda Hospital.

Learn more about Ndanda hospital and Abbey at www.ndanda.org.

Heather volunteering in labor ward of Bombo Hospital in Tanga, Tanzania