Practical Theology

It wasn’t easy for Greg to decide how to conclude his Systematic Theology class at JMTI. With a 3 month interruption from COVID-19 and the final month’s classes held outdoors, it had been far from a traditional class. But if nothing else, Greg wanted to see if these future pastors had the theological understanding they needed to become spiritual leaders of their communities. So for his final exam, he asked the group to formulate questions that they might be asked as pastors in the village, and then he asked them to answer the questions first theologically and then in a way that an average church member could understand. Students asked and answered questions ranging from whether it is a sin for women to wear trousers to why so many infants die if life has a purpose.

His students referenced the Bible in their answers as they explained how evil can exist if God is all-powerful, and what it means if someone prays for healing but still remains sick. “Life really has a purpose and one of them is to glorify God…only God knows,” said one student, a conclusion that seems as poignant to our current global situation as it is to difficult situations in Malawi. “God uses people to minister healing unto people,” another student astutely concluded, a reminder of how even the most broken parts of this world give us a chance to reach out to others with grace and love. Greg’s students have a few more years to go before they are ready to graduate and lead congregations, but some of their insights were as helpful to me as they will be to future church members. Greg still has a way to go as he learns how to teach theology meaningfully in such a different culture, and together we are learning how to grow and change and serve in impactful ways.

As we near the completion of our first year at Nkhoma, we praise God that we have an opportunity to take two weeks of vacation to rest, reflect, and strategize for the months and years to come. The country is adjusting to new leadership which is intentionally trying to root out corruption, and Nkhoma Hospital is reaching a stride with COVID-19 preparedness and management. Even more changes are in the future for us. Half of the missionaries who stayed in Malawi at the beginning of this crisis will be finishing their terms or hoping to take brief trips home in the coming month, but with issues of immigration and flight cancelations, it is unclear whether they will be able to leave the country, or to get back in. Either way, some of our closest friends who we have shared dozens of meals and Bible studies with may be away for some months, and we could use your prayers and encouragement especially during this time.

This month, please join us in prayer

- For our fellow missionaries to be able to travel safely and to come back soon

- For the country of Malawi as the COVID-19 death rate increases alongside unemployment, abuse, and teen pregnancies

- For wisdom about priorities and directions as we move into our second year in Nkhoma

Thank you for your prayers and support, Greg and Christina

June Update: And the Government Will be on His Shoulders

Late into the night, we heard shouts, drums, fireworks, honking horns, and even a processional choir walking by praising God. The results of Malawi’s unprecedented presidential rerun were announced hours before, and at least this region of central Malawi couldn’t be happier. The opposition leader and now president-elect, Reverend Dr. Lazarus Chakwera, passed up the incumbent of the last six years, and now holds the nation’s hope for progress and change upon his shoulders. Things were not quiet until well after 1 am, and so life seemed a bit surreal walking into church just six hours later.

Even more surreal, Greg was the guest preacher this morning. He had been on the schedule for months, but this was the first Sunday after the election, and the first English service since the new CCAP pastor had arrived. COVID19 and perhaps revelries the night before had reduced the usual congregation of 400 down to 140. It was also the Sunday where farmers brought the first portion of their harvest into church. 50 kg bags of maize stood outside the doors, and grocery bags laid before the altar began to stir halfway through the service, revealing live chickens inside. Asked to keep to the schedule, Greg started promptly on time, before the choir had arrived or the sound system was hooked up.

He spoke first of Peter’s confession of Christ as the Messiah, and then how the apostle was so focused on military and political leadership that he missed the Kingdom and the mission that Jesus was brining. Greg drew a parallel to the impending political changes, a new leader who was surely considered a Messiah by some in attendance, and encouraged those in attendance to focus on the difference between the hope that we have as Christians and the hope of those in the world. Greg was able to acknowledge the hope of the congregation while pointing hearts back to the Kingdom.

Greg has been balancing a lot these past weeks. He has started teaching his Systematic Theology class weekly in our yard since the Josophat Mwale Theological Institute (JMTI) is not yet open for classes. He is looking into an opportunity to represent the Nazarene Theological college through an online journal, and is starting to brush up on computer coding so that he can bring more IT support to the hospital and missionary community. He’s starting to get serious about learning the local language Chichewa, and starting to renovate some side buildings on our property to extend housing options to others.

At the hospital, things are a constant flux between priorities for COVID-19 prevention and physician training. For stories from the hospital or to hear Greg’s latest sermon, go to malawimillers.com. For updates on the COVID-19 situation, go to facebook.com/mateyu11.5/

This month, please pray for:

- A smooth and peaceful transition in the government of Malawi

- Wisdom with how we spend our time and resources

- Safety and protection against COVID19

Stories we hear from home seem unbelievable, and we very much appreciate your communication and hearing about your prayer requests during this time. Thank you to everyone who is continuing to lift us up in prayer and partnership in spite of the chaos that has so marked this year.

– Greg and Christina Miller

Preventive Medicine

Some days I really struggle as a Preventive Medicine doctor. My ultimate goal in global health is helping local people solve local problems with local resources. But sometimes it’s painful participating in that process without taking everything into my own hands. There seemed to be great local buy-in for community education. International donors partnered with our hospital to train various levels of community health workers (Health Surveillance Assistants or HSAs). But when it came time to go into the communities, they wanted twice as much added incentive than budgeted according to hospital policy. We worked with our Environmental Health officer to brainstorm modifications to the program that could still reach people. We developed curriculum to disseminate. We met with stakeholders and contacted hospital management and district health office management. We were told that we could not go into the communities without the HSAs, but that the HSAs would not go with us without twice as many funds. We were told that we couldn’t even work with Malawi-based nonprofits targeting the elderly and disabled in communities if we didn’t have HSAs with us. The nonprofits were willing to go without extra financial incentives, but the HSAs were not. In the end, our local hospital leadership decided that we had done enough in community education by training the major chiefs in our area and equipping the HSAs in our area. We had plans to either return the remaining education project money or to meet in person with the District Health Officer who oversaw the District Environmental Health Officer who oversaw the HSAs. That decision came last week, and made me a bit sad since I was so enthusiastic about our training resources and the need in our communities.

Then came our first COVID-19 case, a pregnant woman who would have died if we hadn’t separated her out in triage and gotten her oxygen right away. She was the sister to a woman who died in childbirth the week before (First case form www.malawimillers.com/post/i-do-what-i-can) and suddenly that earlier unexpected mortality made sense with the potential of a COVID-induced thrombus. After the first known positive case was sorted, it came upon our Environmental Health Officer and the District Health Officer staff to go into her community and test family members for COVID-19. The testing went well but this weekend when the team returned to tell 4 out of 5 tested contacts that they were positive, the community said they had no faith in the government’s COVID response and started picking up rocks to stone the team. Our hospital has been told by the chiefs that they should be sure their ambulance is not seen in that village again or there will be trouble. Now hospital leadership is talking about how much community education is needed. They are planning to return in an unmarked car with a police escort in civilian clothes possibly with a parliament member and a senior chief. I wonder if our original educational program would have made a difference to prevent this situation? Maybe there are parts I don’t understand – like maybe the HSAs didn’t just want money, but they were afraid to spread this message among people who didn’t want to hear? Maybe this is just the way that health works in Africa – people are so busy responding to crises and demands of communities that there is no time to be proactive about prevention?

Of course it’s a lot of factors, many of which I will never understand. I want to take matters into my own hands. I want to push programs that will prevent this kind of disaster. A small ugly part of me wants to point out that people should have just listened to me and gotten with the program initially. So I guess that’s the hardest part of helping local people solve local problems using local resources – it doesn’t get done in my way in the timing I like. But maybe deeper, more systemic changes will happen when what I think is a worst-case scenario actually begins to play itself out. That’s the worst – waiting to see people sink down before they see the depth of their need and are willing to use their own strength to pick themselves up. It goes against my grain as a doctor, a Christian, a missionary. But if we keep pushing our own programs in our own timing with our own resources, how can we expect changes that those who trudged before us were not able to achieve?