Closed Doors and Closed Borders

I munched mindlessly on banana chips and a marshmallow. I should eat dinner. I knew better than to eat this junk food at all. But this was emotional eating. I wanted something sweet and crunchy. The borders closed again today. I mean, land borders closed a year ago and never really re-opened, but anyone could still get in by air. And two weeks ago, they closed he airports to visitors, officially at least, but some people were still trickling in. Two days ago the airport released a memo and today the tourism industry posted a notice, so now it is reinforced. My sister was planning on flying out to see us in a week, a trip we have been planning for over a year. I know that travel plans are difficult everywhere, but this one just hit really close to home. I’m not excited about the potential to be closed off again, no mail, no visitors, no trips out for the foreseeable future. Last time Malawi was isolated for about six months, it was difficult not to feel panicked about embracing that prospect again. I tried to look on the positive side, that I might have more days to relax without having visitors during that time. But it’s still disappointing, feeling distant from family, the death of a dream. But we knew this could happen. Times are hard for everyone.

Maybe they can come another month, another year. I know that I am loved and supported, no matter how far away family might be. But for a time, I want a time to process and grieve the hope that has been, yet again, deferred. To acknowledge that things were so close to working out, preparations so carefully made now put aside. It would have been so encouraging to have family visit, to have my little nieces around the house, to have my sister see our life here. I take naps, I read books, I take long baths and long runs, I drink tea. I try to build myself up with life-giving activities. There’s still a bit of emptiness in my house and my heart and my schedule, but I trust it will fill up soon.

We took a trip back to our Nkhoma house this week. I wanted to bring back plants and fish from our old house. When we left, we thought someone would move in quickly, but now the property has been vacant for months. The fish pond is covered with leaves and plants. Any remaining fish would have suffocated or starved. Mosquito larva have been thriving, however. Surely this pond could supply enough malaria to keep the peds ward in business for months. We drained the pond and try to take a few clippings from the remaining plants, but almost everything died from lack of water, or maybe lack of care. In a way, this place is another visual of hope deferred, gardens planted that came only minimally to fruition. A few rose bushes survive for now, but at this point they haven’t bloomed in years. I’ve been told recently that the soil here isn’t good for the things I was hoping to grow. Maybe I can plan better, be wiser, do more with the garden in our new house.

There were some bright points of the trip – friends visited, laughs over lunchtime, sighs of relief at struggles no longer mine. We bring a friend back for a weekend visit and we go out to Greg’s favorite place for dinner. Just before our food comes, a message arrives. We won the big, 5-year HRSA grant my colleague and I applied for earlier this year. We have the opportunity, even the obligation, to establish a training program for specialized doctors in Preventive Medicine and Maternal Health outcomes in California. I’m excited about this opportunity, and committed up to 8-10 hours a week working from a distance helping to build logistics, quality assurance and mentorship components of the program. I’m excited about this opportunity. This might be one of the biggest awards I’ve earned in my life. A potential beginning of a new way of helping and teaching within an easy context. I’m excited. I jump up and down and chatter away throughout the night, throughout the weekend. There’s still a tickle in the back of my heart, a reminder that I wish I was preparing for my sister right now, that I was about to go on travels and adventures and share life and ministry with my family. But the good news came at a good time, the newly open door right when I needed fresh energy from disappointed hopes and closed-border stagnation. I know times will get busy again soon. I will need to have disciplined balance and intentionality with the different tasks I want to undertake. I need to transition from one type of mentorship to another, from program planning on this continent to program design back home. I think I’m ready to rise to the challenge. Maybe after one more relaxing bath and cup of tea. Or maybe a nap. I will surely need my energy in the days to come.

Seeds of Change in the Dry Season

It’s dry, cold season in Malawi. Most families have harvested, dried, and stored their maize so it can sustain them in the months ahead. But for us, this has been a time of preparing soil, both literally in our efforts to revitalize the bone-dry areas around our home, and figuratively through work in the villages. Since this is a rare month of plentiful food and rest for most of the country, it is the ideal time to bring communities together for trainings and planning for the future.

Not long after the agricultural training in Mngwangwa assisted by Namikango Mission, I returned to Goshen amidst a thousand-women gathering and spoke about how mothers and churches could keep children healthy with preventive medicine and utilization of the healthcare resources available in their communities. We tried to find times of rest for ourselves and our lead-pastor friends in the following week amidst plans for a week-long training in the Mphewa area. This training with TWT focused on Transformational Development and introduced church leaders to ideas of restoring broken relationships and reminding communities of their God-given dignity, existing resources, and ability to bring healing to their families and neighbors.

It was a busy, exhausting time with long hours driving and managing logistics. I joked about building up my arm muscles pumping water and stirring nsima alongside Thokozani as she arranged lunch and refreshments for the gathering. We watched as pastors and women of the church embraced mindset change from needs-focused poverty paradigms to ideas of stewardship and innovation. By the end of the week, we listened to groups from each zone discussed how to implement small development projects using local resources and community buy-in. We know this is just the beginning, the first seeds of change planted as we watch these churches seek ways to bring hope and healing to their communities.

It was a whirlwind time with Greg finishing his teaching and attending graduation festivities at NTCCA. I built up resources to care for children in the clinic, in preparation to take over a practice of well-child visits from a long-termer practitioner leaving next month. During this time we housed our pre-medical student Tony in the guest room, pastors Thoko and Nixon in the guest house, and even fit our friend Isabelle on a mattress in the office. Life was a fury of activity for several weeks. And then our guests went home, and newly enforced border restrictions prevented the visit from my sister we had looked forward to for so long. It was a shock compared to the preceding hectic pace, and an empty disappointment where travel and family time had been.

We still have a few things planned: a village outreach for young women in two weeks, a grant for new part-time work teaching doctors in America, some gardening projects to undertake around the house. But in many ways we don’t know exactly what our schedule or ministry will look like in this new season. We know we want to follow-up with the communities trained and encourage implementation of transformational projects. But we can’t say if this will take the majority of our time, or occupy a small piece of our upcoming schedule.

As the dry season progresses, in terms of our work here this seems to be a time for waiting for seeds to germinate. Please join us in praying for patience during this time and for wisdom to know our roles – what we should do and where we should wait and allow others to do for themselves.

Please also pray for:

- Tony as he flies back home today for a family emergency, that there will be safe travels for him and miraculous healing and peace in his family.

- The churches, pastors, and communities in the Goshen and Mphewa areas as they begin to implement community projects

Thank you for your prayers and support,

Greg and Christina

Health Talk

I’ve never spoken to 1000 people before. I might have thought it would have been more intimidating, that I might have prepared for days or experienced nervous sleepless nights leading up to it. I’m an anxious public speaker. But I trust Thokozani, the woman who brought all these church ladies together. I might not have believed that she would really gather so many people for an annual women’s conference, but because I know her and she knows me, because she asked me to do this and because we have done smaller-scale things in the past, I trust that she can translate my words and guide me through this. So I show up and stand up and I start to talk.

I start with a greeting, Muli bwanji, how are you all? Ndasangalala kukuoanani lelo, I’m so happy to see you all today. I get to know my audience through a raising of hands. Who here has children under 5 years? Over 5 years? How many grandmothers? How many go to churches with programs that care for children? Nearly everyone. That was amazing. Some day I want to learn about those programs and hear about the transformative work. But today they are a sea of faces from churches which I don’t know. So I bring up a Bible verse about children. Children are precious to God and however you care for a child honors God and establishes the Kingdom of Heaven. I affirm their work with and commitment to children.

Then, I I tell a story. I speak in short English sentences and Thokozani stands beside me and Thokozani brings the story to life in Chichewa: Mrs. Phiri had a little girl 2 years old named Chisomo. Chisomo got sick one night with a cough and runny nose. She spent all day and all her money going to the most expensive clinic and getting many tests, but in the end the doctor said nothing was wrong. He prescribed medicine for flu symptoms which took all of Mrs. Phiri’s money. Mrs. Phiri and Chisomo had to walk home because they had no money for transport after spending it all at the clinic. After a few days, Chisomo got better. But then Mrs. Phiri’s neighbor, Mrs. Banda, came for a visit. She said that her daughter had the same sickness the week before, and her daughter was playing with Chisomo last week. But her daughter got better without medicine. Thokozani and I turn to the audience.

“Maybe this isn’t a happy story?” I ask.

“No, it is happy!” the women reply as a group.

“Maybe it is happy because both children are well.” I reply, “but why did Mrs. Phiri spend all her money on medicine when Mrs. Banda’s child got well without medicine?” Silence and puzzled looks. These women don’t know that I have an agenda. I want to talk about utilization of healthcare resources – how Tylenol won’t cure malaria, how most viruses get better on their own, about the dangers of antibiotic resistance. I want these women of the church to become champions of prevention and advocates for going to the clinic early when needed, for helping mothers recognize dangerous illnesses and self-limiting childhood diseases. But I keep that to myself – let them discover for themselves as we go.

The talk seemed simple enough, teaching women the causes and treatments for fevers, but it dug deep quickly. I likened the microscopic bugs to different animals – a cow, a snake, an ant, and said that the fever was like the body starting a fire to chase away all the animals without knowing which was which. I discussed different medications which either controlled symptoms or rooted out the problem, and how to tell if a child had a simple illness that would recover on its own without treatment. Thokozani lets me speak for about 20 minutes, then announced that it was time for questions. She knows exactly how much direct teaching these women can take today and when it is time to get more interactive.

The first question comes from the front right. “When someone is sick in our church,” the woman says, “we pray for them. Sometimes we go to the clinic and the child doesn’t get better. So we bring the child to the pastor instead and ask for prayers.” I feel a pang in my heart as I remember a pastor in church last month announcing that he was going to the funeral of a child who died en route as the family brought her to see him for prayers. Not a mention of a clinic or medical treatment in that story, which left me baffled and regretful. I knew this was a big deal beforehand and asked Greg if I should open today with a Bible verse about bringing people for prayers when they are sick, but he told me to avoid it; it was too loaded to begin my talk with a controversial subject. Well, controversy confronted me anyway, so I take a deep breath. Praise God I know my Bible as well as I know my medicine. I begin to engage. These are church women, at a church conference. I want to show that I am a Christian like them, and that a Christian can pray and still seek medical care.

“Yes, the Bible tells us that if anyone is sick, we should bring them to the elders of the church, and they should pray for healing” I affirmed. “The Bible also says that we should pray continually. And we should, because we are people of God. We should pray before we eat, just like Jesus did. Jesus healed many people who were sick, and Jesus fed many people who were hungry. So we pray when people are sick, and we pray before we eat, we pray when we are hungry, and we believe that God can work miracles. But when you are hungry, do you sit in your house and pray for a miracle, or do you go grow food in your garden so you can eat? When a child is sick and treatments and medicine have been provided for free from the government, do you stay in the village and pray for miraculous healing? Or do you take the child and get that treatment that has been provided? If you stay home and ask God to heal without using the gifts he has already provided, are you not like the people of God asking for food in the desert but refusing to pick up the manna that God has already provided? When Jesus wandered in the desert and was hungry, he was tempted to turn the rocks into bread. But He said, ‘I will not put the Lord my God to the test.’ When you ask for miracles of healing, but you do not use the healing resources that God provides, are you not putting God to the test?” Thoko parallels me word for word. I have walked with her through her own illnesses and through sicknesses of her friends and family. She brings life to my phrases, raising her voice and emphasizing with her intonation the importance of this topic. Women start to nod affirmatively. I begin my conclusion:

“So yes, you should pray - you should pray to keep a child healthy, you should pray for healing when he is sick, and you should pray thanksgiving when he recovers. As women in the church, your role is so powerful. You can pray for these little ones, and you can also tell families when they need to come to the hospital. Some pastors have thermometers so that when they pray, they can also check a temperature and see if a child needs medicine or needs to go to the clinic. Let me tell you how you can tell if a child is critically sick and needs to go to the hospital.“

More questions follow. This talk is a culmination of my 12 years training in microbiology, medicine, and public health. It reflects my decades of studying the Bible and my four short years learning about the culture and people in Malawi.

We talk about antibiotic resistance. We talk about nutrition and treatments for worms. I watch them chuckle awkwardly as I discuss topics that they have heard before, like using mosquito nets or eating more vegetables, we both know that these are easy things to say but difficult to apply, especially when a family can’t see the benefits of these preventive strategies right away. But at least I am able to share these topics with such a wide audience. I discuss how the pastors and this church drained the swamp that was breeding mosquitos and causing malaria every year. Some people think that they can’t do anything about these diseases, I say, that this is just the way life is in Malawi. But look at your leaders, they are changing their community so that there is less disease. Pastors and churches can do this, they can help make their communities well.

One woman stands up and thanks me for coming, she says that everyone appreciates this talk because they know that I am a doctor and they see that I am a Christian. She says that this talk is needed for all of their churches and asks me to come to each of their communities and to give this talk. I think about the 150 churches represented here which span all of Malawi’s central region. I smile and take a deep breath

“I love talking about these things,” I say. “It is my honor to talk to you and I would love to visit each of your churches, to see what you are doing for children, and to help encourage the church to keep the community healthy. But there is only one of me, and there are one thousand of you. You are powerful women of God, and you know your communities better than me, and you know you speak Chichewa much better than me.” Here everyone chuckles a bit. “So it is my prayer that you will all go back to your churches and communities and that you will spread these teachings. Together you can do so much more than I ever could.”

Maybe the woman didn’t like my answer, as it was turning her down in a way. But my words echo everything I believe about transformational development and how the Good News is brought to the poor - healing of the sick, freedom for the captives of poverty – local people taking ownership of their communities and multiplying light and truth. I praise God for this day, for the people who have made it possible and for all the experiences leading up to this opportunity. Maybe this is a mountaintop experience, a pinnacle of my career, which I need to remember in the future when times get difficult. Maybe this is just the beginning of a career catalyzing health and healing in all the churches and communities represented here. I praise God either way. How fortunate I am to participate in the Kingdom in this way.