Update, October 27, 2007

We left Zimba Friday morning as planned. We drove first to Victoria Falls which is only a few miles from Livingstone and the airport. We spent about an hour there, marveling at how different the falls are at this time of year (end of the dry season) compared to February and July when we've been there previously. The amount of water flowing over the falls is a very small fraction of what it was at either of the other times. Most of the 1.7 mile span of the falls was completely dry. The area directly in front of the falls where the team got thoroughly drenched in February (drowning Larry's digital camera) was almost completely dry -- only a trickle of water flowed over the falls at that point. The only area where significant amounts of water flowed over the falls was at the Zimbabwean end of the falls and that end we hadn't been able to see on the earlier trips because of the mist and spray closer to us. Amazing.

After a quick (?) lunch, we headed to the airport to catch our flight to Jo'burg, South Africa. They were able to check our luggage all the way through to Detroit, a real blessing even if 2/3 of the 30 some bags were empty. The flight into Jo'burg was a bit bumpy for a brief period since they were having actual rain, something we hadn't seen in a while. After a five hour layover, we were off to London's Heathrow -- about a 12 hour flight. We had a much shorter layover there (about 3 hours) that was quickly gobbled up by long delays trying to get through security so we could get to the terminal from which our next flight would depart. We arrived at the check-in desk with only about 3 minutes to spare. The 8-9 hour flight to Detroit was pretty uneventful, thankfully.

People we meet going to and from Africa, disproportionately, seem to be personalities on steroids -- everyone seems to be a bit extreme.

• The first couple of days in Zimba, a young woman (Tatiana) from California stopped by the mission house to use the internet there to help her with some seed research she was working on. She is an energetic, bubbly, courageous 18-19 year old Peace Corps volunteer living in a remote village by herself in a typical Zambian hut trying to show local farmers how to apply a number of alternative low tech farming practices to make their crops more productive.
• On the flight from Jo'burg to London, some of us sat next to an American father and his 8th grade son who were on their way back home from attending the dedication of a new high school in a remote Zambian village. It turned out the boy, out of a passion for trying to help the HIV orphans in Zambia, had raised $140,000 shooting free throws as a fund raiser to build the new school for a friend he'd met a couple years earlier. Another person (adult) helped to raise a similar amount. Both NBC and CBS had sent news film crews to film the dedication and will air segments in a week or two and then just before the NCAA tournament in the spring.
• Larry and Dr. Kari sat next to a physician from a university in London returning from an annual project meeting. It turned out he is an infectious disease specialist (virology) who is heading up a $96 million phase 3 clinical trial of a polymer-based topical application he'd developed to block HIV transmission. Its being tested in 16 communities all over Africa where they are recruiting over 9,000 patients to try it out for several years. Results will be available in about a year and a half. If it works, it sounds like a Nobel type of accomplishment.

Anyway, the point is, you just meet lots of people who are way out of the ordinary.

We arrived in Detroit around 12:30 but it took a couple of hours to collect all our bags, go through Customs, retrieve the vehicles we had left in long-term parking, and load up to drive home. The ride home was interrupted by an urgent stop to get coffee. The 36 hours of traveling with only what sleep you can get in an airplane seat argued for a late afternoon dose of caffeine to make sure we got the rest of the way home safely.

After meeting up with families at the church, all nine of the team members headed to their homes. Some of us arrived home to discover that our TV and internet cables were out because of storms a couple days earlier. The next morning during the church service, electrical power to the church and the surrounding neighborhoods went out for several hours. For some of us, it helped us feel as though we maybe were closer to Zimba than we had thought.

Thursday, October 18, 2007

Today is our last full day in Zimba. Tomorrow we leave around 6 AM to begin the journey home. We plan to leave a couple hours early so we can visit Victoria Falls for about an hour before going to the airport. The Falls are only about 15-20 minutes away from the airport and our flight doesn’t leave until 1:20 PM. Then we start the long flights home.

During chapel service this morning, Mr. Khondowe let other staff know it would be our last day today. He commented on how much he appreciated the assistance the team has been providing, the training and mentoring, and the work on projects. He expressed being surprised and pleased that the team works so hard and is willing to get their hands dirty and do heavy labor. Apparently some other teams he has seen are more comfortable telling other people what to do rather than pitching in and doing the work with the locals.

As we were about to close the chapel service and arrange to allow the hospital staff to shake all our hands and say goodbye, the service was interrupted by a serious medical emergency. The doctors and the nurses raced into action. That crisis was followed almost immediately by another as three burn victims arrived needing immediate attention. All of that occurred before the surgeries that were planned and scheduled for the day. Emotionally, this will be a tough day for the medical portion of the team.

Larry “the taller” and Andy went to the school as planned. They met with the deputy head mistress, interviewed her, toured and recorded several classes and interviewed about 6 teachers. They have nearly 1,000 students attending each day and only 24 teachers. Most classes have 50-70 students and just one teacher – no teacher aids. For the most part, there is only the chalk board to work with. In the upper grades, they study English, math, science, civics, home economics, and a couple of other subjects. They have enough textbooks for 3-5 students to share one book. The challenges to covering the material, making it real, making it relevant, keeping the classroom focused and under control are considerable.

In the afternoon, Larry "the taller" met with Daniel the lab tech to examine results of the second set of water test samples. They had drawn additional samples from two other locations around the hospital. The results for both came back negative, confirming the previous tests this visit. That meant we still could not confirm the efficacy of the filter system we brought with us, but it did mean that their water was safe to use -- at least for the time being. Rainy season which will start in a couple of weeks will likely change that.

Later in the afternoon, Larry "the taller" and Andy met with Mr. Khondowe, Dr. Joan, and missionary Janet to review the hospital's list of priorities, the water and sewer plans Glen H. had developed, the results of our testing this trip, and what the team had been able to accomplish. The meeting was very productive. Mr. Khondowe indicated the hospital executive committee was satisfied with the draft plans Glen had developed and wanted to proceed. We noted a few corrections to be made on the layout of existing and planned buildings and agreed on an alternate location for the drain field because of the lay of the land, but the basic plan seemed sensible to the hospital. We also discussed timing, staging, and availability of materials and expertise. Mr. Khondowe seemed very appreciative of the First Wes efforts.

Dianna continued to work with the burn patients in the afternoon while Dr. Kari and the surgical team dealt with another complicated surgery. The surgery went well but things were worse than expected and the patient and her family had to make tough choices. Although the final decisions probably were life saving for the patient, they had consequences that made Dr. Kari feel bad for the patient -- more 'stuff' that made it a tough day for the medical team.

In the evening, a number of people came by to pray for us before we left or to visit briefly one last time. The mission house was full of people and conversation. And when the guests left, we all scurried about trying to get pack for our early morning departure, trying to tie up loose ends, and set aside things we wanted to leave for particular individuals -- a flash drive, gloves, etc.

Wednesday, October 17, 2007

Ray and Bud, with Larry “the shorter” assisting, continued to finish up many of the electrical tasks, including preparing to install the water heater we bought in Lusaka. Andy and Larry “the taller” went to the basic school (grades 1 through 9) to speak with the head master about measuring the buildings of the school for a renovation project another group is hoping to pursue and to video record some of the classrooms, teaching activities, and interviews with teachers. It was determined best to come back in the afternoon to do the measuring and Thursday morning to do the video recording.

From there, Andy returned to the hospital to continue working with some of the staff on building computer skills and spreadsheet tools. Larry “the taller” met with Daniel from the lab to collect the results of the water quality tests put in the incubators the day before. The water sample from the filter came out clean and negative for ecoli which was expected. The water sample from the tap showed low levels of coliforms but was also negative for ecoli – that was not expected since samples had been positive in February. Our best guess is that the continuing use of water through the distribution lines has flushed the contaminated water out of the system while being at the end of the dry season (6 months with no rain) means the ground is very, very dry so there is little moisture in the ground even from leaking sewer lines to contaminate the water lines should there be periods of negative pressure in the water lines.

We decided to draw two additional samples from other taps around the hospital to confirm the negative ecoli finding. For evaluating the effectiveness of the filter, it would really be better to be able to start with water known to be contaminated so we can verify that the water gets cleaned by the filter. In any event, the water appears to be healthier for people right now. The rainy season starts in a couple of weeks and the ground will get thoroughly soaked. The picture will likely change significantly then.

In the afternoon, the two Larrys started the actual perc test, measuring the depth of water poured into each hole every 30 minutes for four hours. Larry “the shorter” got stuck doing most of the recording, standing and sitting out in the field from 1:30 until 5:45. Both were there during the last hour. As soon as the last measurements were taken, they filled in the holes so no one or none of the cows or donkeys grazing in the field would step in the hole and be injured.

While Larry "the shorter" watched and measured the water in the holes, Larry "the taller," Bud, Ray and Andy returned to the school to measure the buildings. As they finished the first, three representatives from World Hope stopped by to speak with Larry "the taller" about economic development activities in Zimba. Bud, Andy, and Ray completed the measurements of the remaining five classroom buildings while Larry met with the World Hope reps. Larry had had a prior conversation with the head of World Hope exploring ways in which the First Wes team might help stimulate economic development in Zimba, particularly through setting up a micro-finance program. World Hope is not involved in micro-finance in Zambia although they are in several other countries. They indicated that such programs don't seem to work well in rural areas where prospective clients are so widely scattered, making assistance and oversight too challenging.

The reps indicated that World Hope works through the Wesleyan church in a community to explore interest and, if there is, to invited interested parties in the church to attend a meeting to discuss how World Hope works at assisting with Income Generating Activities (IGA) and the kinds of IGAs that seem to have worked well in other communities. Most of these are either agricultural or craft related. People in the community are directly involved in choosing what IGA they think would be viable and which they would want to try. World Hope sends in technical experts to train community members on particular skills needed to increase the likelihood of success. They then also help arrange to provide (as a loan) the start up capital for the IGA. Those working on the project in the community become responsible for working the project and producing a marketable commodity to be sold. Profits get used to repay the start up capital and to provide assistance especially for orphans in the community. World Hope has several IGA projects in Zimba currently and there are five surrounding communities that have also expressed interest. About 20 US churches are currently involved as partners with communities to help generated the start up capital for the IGAs. The partnering pledge is $12k per year for five years. Larry told them we were pleased to find out about their program and that they were already working with the Zimba community. Their approach seemed solid and effective. He indicated that we might be able to complement each other's efforts. He indicated that we would look for ways to come along side their efforts perhaps as a partner but also would try not to work at cross-purposes. At the same time, World Hope could complement our efforts to help the hospital by drilling another well for the hospital under World Hope's well initiative. This seems likely to happen.

The medical staff had a somewhat lighter day than usual so several of the team went to video record interviews with the pastor and a couple of other individuals in the community.

Earlier in our stay we had invited a couple of the clinical staff to have dinner with us. Today we invited several others, including Wedon (anesthesiologist), Mr. Khondowe (administrator), Mr. and Mrs. Siabowa (he is a surgical clinical officer and she is a teacher in the basic school), and Anna (a retired nurse who has helped Dr. Kari with translation this trip and last). The conversation was lively and helpful in getting to know each other better.

Tuesday, October 16, 2007

Bud and Ray, with a bit of help from Andy and Larry “the shorter,” managed to get wiring run from the backup generator to the new operating theater and get outlets installed. Along the way they also got asked to look at a number of pieces of equipment around the hospital that weren’t working or weren’t working properly. They fixed an otoscope, fixed (again) the suction pump for surgery, the oxygen concentrator and a cautery machine, determined why a warming bed for infants hasn’t been working (they had several babies die in the past year because they couldn’t get them warmed up sufficiently) and then figured out how to make it work, and a variety of other problems.

Andy worked again with a couple of the hospital staff teaching them how to use Excel to build spreadsheets for inventory and other forms.

The two Larry’s worked on preparing the holes we dug Friday and Monday for the perc test. This involved filling the holes to a dept h of 12” with water and then maintaining it at 12” for a four hour period. Not hard work by any means, but it required sitting/standing out in the open field under the Zambian sun (95 degrees) for most of the four hours. We split it up in shifts. I worked with Daniel who is in charge of the lab to draw a sample of tap water for testing and then set up the filter system we brought with us. We got the filter working and then gathered a water sample from it as well. We put the samples from both in the incubator to ‘cook’ for the 24 hours required.

The medical team continued seeing patients and doing procedures. Late in the evening, they got called out to do a D & C. Dr. Kari has been working with Dr. Dan (a family practice physician) to become comfortable doing these so he can do them on his own after we leave. This was the third D & C they did together since we arrived and Dr. Dan handled it well and seemed comfortable. This was a major goal for Dr. Kari.

She and Dr. Dan had hoped to do the same sort of mentoring with C-sections also but oddly there haven’t been any cases to work on together. Fortunately, Mr. Siabowa (one of the clinical officers) worked with Dr. Kari in February to become proficient at hysterectomies (which may need to be done in an emergency) and has been doing them since then. Once we leave, Dr. Dan and Mr. Siabowa should be able to work together to help Dr. Dan get comfortable with C-sections as well.

Barbara (nurse anesthetist) was able to spend time with Wedon, a clinical officer with special training in anesthesia. Barbara has been very excited to have someone with a shared background to work with and learn more about how things are typically done here and whom she can mentor when appropriate.

Monday, October 15, 2007

We’ve had power outages for several hours at a time most days during the past week and low power or flickering power often. The internet access has been unreliable and nonexistent. That has made it hard to keep the blog updated.

Monday, we returned to our various tasks. Larry “the taller” and Andy worked on digging the second hole for the perc test Glen has asked us to conduct. The two Larrys had dug the first hole Friday. Later in the day, Larry started some of the steps of the tests while Andy provided some computer training on spreadsheets to some of the hospital staff so they can track some of their supply inventory.

Larry “the shorter” and missionary Joan made another supply trip to Livingstone that turned into a nearly all day adventure. Bud and Ray made good progress running wire and conduit from the portable generator to the new operating room and fixing a number of other electrical problems. They’ve been doing real yeomen’s service, but they have been learning how truly blessed we are at home with the easy availability of both the right parts you need and the quantity you need. Within a 5-mile radius of First Wes, you can easily get almost any tool or almost any part you need and then can move on to do the job. Here it is a struggle to find the part (frequently what you want isn’t available) or the quantity you need and you have to go to Livingstone (40 miles) or Lusaka (250 miles) to get it. Lots of solutions to problems have to be creatively invented.

The medical team had a mixed day. Ann and Dianna spent more time organizing supplies but also were able to spend time praying with patients—this was an especially important result for Ann. Dianna discovered that the pharmacy has a storage room for supplies that we knew nothing about. She also found out that there is a person in charge, Delorent, who has a computer to use and has been keeping an active inventory of what they have on hand. He is also the person who orders supplies monthly. Andy was able to work with him later in the day to help him learn how to use a spreadsheet on the computer. Delorent seemed to learn how to manipulate the spreadsheet very quickly and seemed very interested in learning more.

Dianna and Ann also had conversations with Timba in the operating room and Delorent in the pharmacy about not just doing or saying what they think we want just to be nice and gracious. We’ve become increasingly concerned about not trying to impose our views, solutions, and methods on them without even being asked. Ann and Dianna think they made some headway in getting at least these two men to tell us when what we try to do violates or is outside their usual protocol. It is a struggle to be sensitive to the cultural differences, the status differences, and to remember who is the host and who is the guest. We tend to be very task focused and efficiency oriented but we have to be constantly reminded about the importance of relationships and partnering.

Drs. Kari and Dan and nurse anesthetist Barbara spent a portion of the morning trying to save a small boy who came in critically ill the day before, probably with meningitis and probably with other things. In the end the boy died. There was much more grieving than we have seen for other children. There are many children who die.

Sunday, October 14, 2007

The Zimba Pilgrim Wesleyan Church has a new pastor since we were here last and there have been a few changes in the Sunday services as a result. Worship service started at 9 am followed by Sunday School at 10 followed by the church service and preaching at 11. In practice, things don’t start or stop quite according to clock time and the different parts of the Sunday service aren’t as separate and distinct as it might sound. They tend to blend together. But they are all very spirited. The singing is wonderful, the prayers are passionate, the preaching is intense. Nearly all the teaching a preaching is done in English and then translated immediately into the local language, Tonga. Those who do the translation on the fly are really good at both translating the words and relaying the tone and emotional content of the speaker’s words. A portion of the service was devoted to welcoming visitors, including us, and a special welcoming to a new baby.

After the four hours of church service, many of us looked over progress on the construction of their new church. We gathered for a wonderful Sunday dinner and then half the team (Barbara, Andy, Dianna, and Ann) rode with missionary Joan to the Sons of Thunder orphanage down near Livingstone. Kari and Larry had been there in February. There are about 50 children up to the age of 6 who are being cared for by the orphanage. Nearly all the children have been orphaned by the HIV-AIDS epidemic in this area.

Those who stayed at the mission house were able to participate in a vespers service. The group has been working their way through The Purpose Driven Life, by Rick Warren, a book all of us are quite familiar with. The speaker for vespers had also preached during the morning service. He is an evangelist from the area who has helped plant 58 churches in Zambia and several surrounding countries. He is hoping to be able to plant churches in Botswana, Namibia and Angola over the next few years and the Zimba church has a growing interest under the new pastor in missions as well.

Saturday, October 13, 2007

Saturday was our day scheduled to go south to Chobe National Park in the neighboring country of Botswana. Chobe contains the confluence of two large rivers that produced a marshy island. In the dry season, it is a key large watering hole for many of the large animals in the area.

We arose early to drive south to Livingstone then farther southwest to the Zambia-Botswana border, crossed the Zambezi River by ferry (a 12 passenger motor boat) then boarded an open-air jeep on the other side and rode to a lodge at Chobe where we took a tour by boat and by jeep of the park to see the animals. It was truly impressive (impala, giraffe, kudu, waterbucks, water buffalo, hippos, crocodiles, baboons, wide variety of birds, and elephants – lots of elephants, perhaps 400 elephants).

We returned late in the afternoon, stopped in Livingstone to eat dinner and then on the Zimba to prepare for Sunday.

Friday, October 12, 2007

Today was an interesting and successful day.
Andy and Ray rose early to ride to Lusaka with Langa. They left at 6 and got up to Lusaka around 10. Yesterday, we had emailed the list of electrical supplies to the supplier there who agreed to help us find the materials. They were able to track down nearly all of the items we were missing by noon and, after grabbing a bite to eat, headed back to Zimba, arriving by about 6:40 pm.
Bud worked on a number of remaining electrical projects that weren’t dependent on the supplies that still hadn’t arrived. Yesterday, when the power went out for about 4-6 hours for the second day in a row and Dr. Kari and Dr. Dan were waiting to do a surgery late in the afternoon, Ray, Bud, Andy and Larry “the shorter” delivered the portable generator from the mission house to the hospital and installed it. We got it started and provided power to the operating room so the medical team could proceed with the surgery. The portable generator let them finish the surgery and come back to the mission house before electrical power was restored to the Zimba community. But, Bud noticed not all of the portable generator’s capacity was being utilized. He checked it out further today and discovered the reason (an odd wiring situation in the O.R.), fixed it and significantly increased the ability of the portable generator to supply the electrical needs of the O.R. He also tested a number of electrical lines trying to figure out why there seems to be suboptimal voltage on many of the lines. This seems to be a big part of the explanation why we have trouble charging some of our electronic devices like cameras, PDA’s and computers. Its probably also part of the reason why missionary Joan has poor internet connection since the modem seems to be getting too weak a signal to establish contact. Bud hasn’t figure out the cause or a solution but he has at least determined that the problem seems common around Zimba rather than being unique to the mission house.

Update for Wednesday and Thursday

October 10 and 11, 2007:

The last few days have brought some frustrations for several of us as well as adventures and some triumphs.

We continued to be sad about the death of the matron’s nephew yesterday. Several of us had participated in his care. His mother just left for England 2 weeks ago to get some education and her disabled son was in the care of relatives so it was additionally sad for this reason. We asked Joan what an appropriate response for sympathy would be and she suggested we consider a donation for funeral expenses.

The trip to Livingston for electrical materials for a few of us took most of the day and resulted in a fraction of the material needed. Several of the projects were at significant risk for non-completion this visit due to this. However, we had a big discussion in the evening with missionary Janet, missionary Joan, the team and Drs. Dan and Joan. Janet had fortuitously met an American at the American Embassy party in Lusaka a few weeks ago who had a contractors’ supply business. The team electricians were able to give her a list of needs, she was able to contact him in Lusaka and he was able to find most of the needed items. Joan helped us figure out how to handle additional expenses along with a discussion of our known available resources from the church and home so we could cover the costs. We now have a couple of the team members (Ray and Andy with a driver) going on a trip to Lusaka and back tomorrow for the supplies – God is good!

Cooler weather came the last few days (yeah!) and a somewhat early rainy season (yeah!) along with lightening and power outages (boo!). The first one occurred about the time a patient started hemorrhaging and needed a D and C. The emergency generator still was not available, the usual OR staff were all gone or sick. We (Dr. Kari, Dr. Dan, Barb, Ann, Dr. Joan) managed to do the case with flashlights, Barb monitoring the patient by taking her pulse and only feeling for her breathing. It was quite an adventure. We decided that they are right about the wasteful use of U.S. health care dollars – who really needs things like lights, power, and silly monitoring equipment! ? (Actually we were able to do this case on God’s grace alone – many women in Zambia die for lack of proper equipment, care, blood, etc.). The next major power outage occurred when we were starting another D and C, this one, not quite the same kind of emergency. As God had it planned, a few other things “got in our way” of starting – waiting for blood to arrive from Livingston, a child’s broken arm, etc. That gave the construction team time to set up the emergency generator and they had it working in the OR (“theatre”) before we started! One of the delightful parts of the power outages is eating dinner the last 2 nights by candlelight! Edy pulled out some gas cookers and STILL managed great meals!

One of the most exciting things that has happened while we have been here is the Drs. Dan and Joan have gotten their medical licenses’ approved and Dr. Dan’s work permit was completed. (We aren’t really sure if Dr. Joan’s work permit is properly complete or not.) But it has been wonderful to get to see Dr. Dan FINALLY get to start BEING a doctor while we are here. He has obviously worked hard to become knowledgeable about all the different diseases we see here. What Dr. Joan and I (Kari) have been doing is “rounding” on patients in the hospital together. This has been such a joy to me! While I “co-sign” her entries, to be official, she has such a wonderful knowledge base that I can actually feel far less anxious and stressed being here knowing that she fills in the huge gaps when I am unable to figure out what is going on with a patient and treat them properly. It’s really fun learning from her! What a wonderful trip this is turning out to be from a medical standpoint! Also, I hope, I have been able to refresh Dr. Joan and Dr. Dan on OB/ GYN management of some patients, so they may feel a little more prepared.

Another joyful part of the trip has been renewing old friendships. Anna, a retired but very compassionate and experienced nurse, has been my translator. She is such a great asset to the patients and me and a truly wonderful person. I have not seen Moono as she is getting married next week and is off! Her “kitchen party” is this week – a sort of shower, where she is given gifts and taught how to be a wife by all the local women with a series of songs and dances. I SO wish I could go but we had other team plans for the weekend. We love seeing Joan Wallace again and Ann, Dianna and she have been caught doing their usual giggling.

Larry, Andy and Janet met with Mr. Khondowe ( the administrator) today to present the draft for the water and sewer systems and discussed how to move forward in general. They were pleased with the meeting and have an increasing understanding of issues and how to proceed. As discussed in the past, the nursing housing is critical to attracting and maintaining staff (which are at less than ½, even by Zambian standards). However, as is, the hospital spends up to 70% of its budget in rent for these employees now, sapping needed money for medications, supplies and other needs. When the housing is complete, not only will there be more staff, but also there will actually be more money available for patient care! So – back to getting that project completed. Janet tells us there is a funder for the first of four phases now started who is ready with the money. We just need to get supplies here now before the rainy season. If they get the roofs on before the rainy season, they can work on the finishing and interior work sheltered from the rain.

Ray and Bud guided the rest of the guys through installation of lighting, switches and outlets in the new OR, the overhead surgery lighting, repairing several other pieces of equipment (e.g., the oxygen tanks and suction pump for surgeries). They kid around quite a bit with each other and Larry “the shorter" and they have a little trouble adjusting to the pace and challenges of getting the parts you need to do the job the way they think it should be done, but they’ve certainly been a blessing to have on this trip and are already planning what to bring on the next trip. Andy has been keeping a watchful eye on our funds and taking copious notes to assist our reporting when we get back and has also been very instrumental in helping develop our working relationship with missionary Janet. We also think Andy has befriended every dog in Zimba and quite a number of the children.

Lots more news and adventures but can’t tell them all now. Please continue to pray for our safety, our work, the people of Zambia, the long-term missionaries and for electrical equipment!

First Full Day in Zambia

Tuesday, October 09, 2007

Today was our first full day in Zimba. It was a good day.

The temperature at home when we left was about 88, in London it was about 60, when we landed in Livingstone, it was in the high 90’s. We awoke this morning to low 70’s but it was 100 by about noon. It is very, very dry. The dryness in the air made the 100 degrees pretty tolerable and the breeze this afternoon made it feel relatively comfortable. This is the end of their dry season. Rainy season (lots of rain) starts around the first of November. But it has been roughly 5 months of temperatures in the 80-100 degree range with no rain. Everything is dried up and parched.

We had a really stimulating chapel service this morning. It is always impressive to me how insightful and unabashedly passionate some of the lay staff here are in their preaching. Some of it is style, much of it is a genuine conviction.

Kari, Ann, Dianna, and Barb spent much of the day in surgery, minor procedures, re-stocking shelves and re-organizing materials in storage so they can be found when needed. I escorted Bud, Ray, Andy and Larry “the shorter” around the hospital grounds to get them oriented, to review draft plans for a new water system and a new sewage system, and to examine the electrical project sites. We planned to spend today giving Bud and Ray a close up look of the projects so they could determine what supplies are needed to move them forward. The plans are to install a portable backup generator sent on the shipping container from First Wes a year ago, to hookup outlets and lights in the operating rooms to make use of it when the power goes out (as it apparently does often during the rainy season), to install receptacles, switches and lights in the new operating theater (about eight rooms), a water heater, and outdoor security lights, fix a shorted outlet in the new addition on the lab where a CD-4 counter is to be installed soon, and try to figure out a way to arrange and water level sensing on/off switch for the pump to the water storage tanks. The shopping list is lengthy. The shopping trip to Livingstone is on the schedule for tomorrow. In the afternoon, we installed many of the receptacles in the new O.R.

We all got back to the mission house more or less on time for another wonderful meal – homemade tacos – Joan has given Edy a complete menu of American dishes (South Carolina style). We’re not suffering at all when it comes to food.

This evening, we reviewed the day. Those for whom this is their first trip to Zambia noted how much they thought the pictures and reports had failed to help them grasp what things are really like here. The poverty is more widespread, the struggle to make a living more persistent and intense, and the friendliness and hospitality more freely given.

A nine year old child died yesterday before we got here. A six year old died today. Tomorrow we move on trying to find a way to help where we can.

Monday, October 8, 2007:

The flight from Detroit to London was pretty uneventful – a real blessing since we were leaving at 10:30 PM. After a late meal on the plane, most of us were able to get a fair amount of sleep over the course of the 8 hour flight. Our layover in London was long enough (11 hours) to dare taking the train in to downtown for a quick sightseeing stroll and some fish and chips. Ann was tickled to visit her ancestral homeland.

After boarding our plane for Johannesburg, we sat on the tarmac for an extra hour just to warm up the plane thoroughly. That flight was overnight as well so, again, most of us got a fair amount of sleep before breakfast and our descent into Jo’burg. The pilot made up most of the hour we lost before take-off by the time we landed, but then we had to sit on the tarmac again waiting for a gate. That shortened our three hour layover to less than two with the whole length of the airport terminal to traverse to check-in for our flight to Livingstone. After rushing to get in line we received word that British Air determined that they needed to switch planes for us. The result was that we got the hour back we lost sitting on the tarmac. This time we got to stand in line waiting to board the next plane. Traveling is an adventure whether you want it to be or not.

We arrived in Livingstone, Zambia, about an hour later than planned. We cruised through passport control uneventfully and could see our missionary host, Joan Wallace waiting for us through the double doors by the customs desk. Customs, however, decided it was important for them to examine every medication we were carrying in our luggage. We’d faxed a complete listing of all the medications we would be bringing a couple of weeks ago along with quantities, lot numbers and expiration dates. The list had been approved by the Zambian government; nevertheless, another branch of government was concerned about one of the medications and they wanted to see it.

There are nine of us in the mission team. We were each allowed to bring 3 suitcases of checked luggage plus a carryon bag. They wanted to search through them all. It took a rather long time. Even though Kari had made lists of which particular medications we each were bringing and they found the one they were concerned about fairly quickly as a result, they still wanted to check all bags. About an hour later, they took Bud, Andy, Kari, and Barb to the office. We all prayed that the outcome would be better than that of the team from Tennessee a month ago (their leader’s passport was held for a couple of days and some of their medications confiscated). In the end, the customs officials explained why they wanted to confiscate a large bottle of benedryl and then let us all go. We were relieved on many counts.

We were finally able to join our host Joan. Kari and I saw her in February/March, but it had been 15 months since she had seen Ann, Dianna, and Barb. Joan, Ann and Dianna had developed a particularly strong bond when we were all here last so they were all excited to see each other again.

We loaded the 35-40 bags of luggage into the two vehicles and squeezed the nine of us plus Dr. Dan and a driver into one of the vehicles and Joan and the head nurse into the other.
The 40 mile drive to Zimba was quicker than usual. The areas where there had been numerous large potholes on our earlier trips have been filled in (mostly) . We arrived at the mission house in time to enjoy a terrific meal fixed by Edy, who does the cooking at the mission guest house.

We spent some of the evening just unpacking, re-gathering the medical supplies, re-gathering the construction materials, figuring out which room was whose. After quick showers and an evening devotional from Oswald Chambers, everyone was happy to turn in early for a good night’s rest.

Coming Aboard!

I am so happy that Bud is going on this trip, it is so hard to share with others what you saw and how it impacted you spiritually and emotionally-there are times when words are difficult. The amount of work that is still to be done at the Zimba Mission Hospital seems enormous, but we are confident that our God is able to use us (especially in our weaknesses) to help provide a place where the people of that region can receive the health care they so desperately need. I anticipate being surprised by what God places before us and how He will stretch us and grow us while we are there. I think that the benefit to us almost outweighs the benefits we provide! The travel is hard for us but not near as difficult for us as it is for the people of Zimba that may walk days with their children on their backs or as one man-his father on his back. I will remind myself and Bud when we are grousing about our cramped seats.

T-47 and counting

Two days from now at this time we should be airborne out of Detroit on our way to London. The next 47 hours will be even more of a flurry of activity than the past week has been. This part of preparing for a mission trip challenging -- trying to remember to bring everything you know you'll need (passport, immunization record, insect repellant, sunscreen, chargers for cameras, etc.). Then there are the supplies we'll take for the hospital, for surgeries, for the construction projects, for other tasks. Then there are the loose ends to tie up at work and home (who'll watch the cat? remember to stop the mail. remember to get some extra cash and snacks for the trip, charge the batteries in the cameras and laptop). Somewhere in there you try to leave space to listen for God to tell you what to bring that isn't on any of the lists but will turn out to be absolutely crucial. It was like that a year ago July when, at the last moment, I felt compelled to pack my hammer, tape measure and leatherman tool. This was clearly not necessary since we had loaded lots of tools and supplies on a 20' shipping container we'd sent four months earlier. But, when we arrived in Zambia, the shipping container still had not. It turned out the hammer, tape measure, and leatherman were about the only tools we had for the project we ended up working on. Without them we would have been really stuck. It was a really good thing I listened. I hope I've been keeping my ears and heart open this time. We'll see. I have felt a need to bring blackboard chalk. Andy and I are supposed to conduct some computer classes. The chalk might come in handy.

Final preparations

Well, the last minute rush to complete our packing and organization is growing to a close. The day AFTER I had gotten our surgical supply order in , we got an email from Zambia of urgently needed supplies. Thankfully some of these were already prepared and we were able to get a few of the other items on their list. The team met for a "packing potluck" this week. Andy helped remind us that we go as Christ's ambassadors and the trip is more about BEING those ambassadors than the actual work we do - something that I especially need to keep in mind. Glen gave much needed advice on working God's plan, not necessarily our pre-planned agenda. We are so thankful for his ongoing support this trip, even though he is not coming with us. We each left the "party" with boxes of supplies for the mission hospital to pack in our luggage. We recently found out that groups for registered missionary travelors (we are) are allowed an extra suitcase on the plane for each member of the team so looks like we we get pretty much everything in!

The weather is supposed to be hot - up to 100 degrees, so I went for more Gator Aide powder tonight to put in the suitcase. Along with items for the mission, we have our clothes sprayed with insect repellent ( skirts for the women whenever possible as pants are considered suggestive), our anti-malaria pills that we start before leaving, our insect repellent to decrease the risk of multiple insect born diseases, specially requested items for the long-term missionaries ....

We ask for ongoing prayers from our many supporters in Michigan, North Carolina, Tennesee and elsewhere around the country. Especially please pray for smooth travel arrangements, pleasant and friendly passing through borders , that we will be a blessing to all we meet on our journeys, for the health of each traveler, for a spirit of support among the team members in dealing with soul - rending situations we will see, for the Wesleyan Church congregation in Zimba in it's mission in the region, that we are able to bring hope as well as practical benefit to those we serve in Zambia, for wisdom in our working with the nationals and long-term missionaries (especially respect and cultural sensitivity), and for ongoing team-work with the many committed people in the States who are striving to work togather in support of Zimba Mission Hospital and the people there.