April 11, 2004

Dear Brothers and Sisters,

This message is written on April 11, “black Saturday,” the day Christians in Catholic and Protestant traditions remember Jesus in his tomb, only tomorrow does the day of His resurrection, Easter, come.

Tuesday April 13 will be the full moon of the Hinayana Buddhist new year. Both speak of death and hope in eternity. Both speak of how our universe knows suffering and death but also an ultimate hope. Our experience has been very much in this realm.

This last week we finally were able to go to two important Presbyterian hospitals, Luebo and Bulape, located in the more remote areas of the Kasai where the military front was during the war. We had been delayed by rains, lack of an available car, as well as lack of funds.

We know that in this region both rebels and government soldiers manhandled and killed villagers. Moreover, until recently trypanosomiasis (sleeping sickness) was endemic. The team of the Bulape hospital made a major effort to control it. In 2003 many hogs died, probably of swine flu, and many people also became ill. Some recovered but many died.

Villages are widely scattered, sometimes 20 to 30 kilometers from each other. The average population density is less than 18 people per square mile, 12 per square kilometer. The villages are small, some just one family with four or five huts. Others have up to 2000 people, but their fields are often at long distances (20 to 50 kilometers) from their homes. Good agricultural land is scarce. Roads are trek paths mostly. People move mostly on foot and trek 100 kilometers or more for essentials. Access to health services is limited by distance and the fear people have of going outside of their own communities.

But in the villages we passed through on Tuesday night and Wednesday night, you could hear the youth whistle sharply to signify alert, and you could hear children and women shrieking in fear because they mistakenly thought the car transported military personnel. I prayed God might give them peace and trust and might forgive us. I vowed never again to pass in the dark, but there was no way we could stop or return.

On Wednesday we went from Luebo to Bulape on a secondary road as the principal road had a bridge under construction. The road was extremely narrow, plants scraping the car from both sides and also growing a meter or higher in the middle. It took us five hours to drive 48 kilometers and we did so without ever seeing the ground, as plants were hiding it. We were falling into pits and climbing or descending blindly, being violently shaken without cease. None of us spoke, determined to persist and praying we might make it.

Then, as we came to our destination, someone said, “that was Calvary.” He spoke for all of us, our spirit and body had undergone the test of accepting suffering for the good of others, going ahead blindly but guided by hope. We seem all to have seen it as a union with Jesus’s experience carrying His cross, being beaten and falling, actor in His own sacrifice. Helpless but not hopeless, not able to predict or control what comes next, but firmly in control of himself, committed to God’s mandate to love the neighbor.

These places are not God forlorn. In fact, our team and the local people tend to pray at the beginning and the end of every activity, lengthy prayers that help to refocus mind, emotion, and spirit, largely improvised on the spot. But these places do seem forlorn by the world except for a few UN people and even fewer NGOs and churches. The PC(USA) and the Roman Catholic Church are the principal actors here, with so far heroic but sparse efforts that have a very limited impact.

In both hospitals we were welcomed by the health workers and the other authorities of the mission stations. Not many people visit here, with the notable exception, recently, of some visitors from Whitewater Presbytery who made it last month to Bulape. In April some PC(USA) people will fly in. The mission stations are more like villages with early twentieth-century buildings, many in need of repair and maintenance. They are not mission compounds, as in some other countries. The events of the last ten years have introduced some half-hearted fences around individual buildings.

Bulape hospital is recognized as the reference hospital of its zone and in a radius of more than 100 kilometers people have no other source of referral care. Bulape also provides outreach and supervision to health centers and health posts in its zone. They manage an amazing performance in the face of enormous difficulties.

Luebo plays the referral role in its zone too but the government has recognized a nearby governmental hospital as zone referral, though they do not have the real capacity to do so. This means that Luebo hangs in only because of church support, since the World Bank PUMRR only recently started doubting that they were supporting the right hospital.

We found both hospitals doing a very credible job in general medicine, surgery, obstetrics, and pediatrics, but both turned almost a blind eye to malnutrition since they could not see how to manage. We discussed this in great length, and together we will try to correct this by creating a field for the hospital with church volunteers and run a nutrition rehabilitation program. More than 50 percent of patients are too poor to pay and cannot afford enough quality food for the kids. Couples still believe in having as many children as possible, but also somehow believe that’s what it means to be a true African, a true Kasai relying on God’s provision. The war made them even more committed to this. Remember the baby boom in the United States was also a postwar phenomenon. Family planning has a long way to go, but we discussed whether starting by spacing and postponing reproduction is a possibility. In Luebo, after a couple of disastrous pregnancies in 14-year-olds, they seem to have at least gotten part of the message across.

We hope CPC will ask PC(USA) to create some Extra Commitment Opportunity accounts or permit use of some existing ECOs to support all these vital initiatives.

We, Dr Mwala and myself, both of CPC Medical Department, need some time to further digest the experience, respond to problems of communication between these places and people and PC(USA), and build bridges.

We have promised to go back within three months and focus on improving care for malnutrition, and start the uphill struggle for reproductive health.

We are slowed down by the fact we have to borrow a vehicle from the church to make these trips, and we hope to find a solution soon, thanks to contributions of the Medical Benevolence Foundation and the International Health Ministries Office of the PC(USA) for a car.

We also hope PC(USA) will give us a working budget soon, as now we, the Medical Department of CPC, have no access to a specific budget and we have to use general church funds and personal funds to keep going. Literally. That might be good spiritual discipline for us, it may even help to loose some superfluous fat and come down to essentials, but it is not very efficient for the work. Still we are happy that our witness to God’s love cannot be harmed by it.

Whatever little sleep we got on the trip, we slept like dead. We will soon recuperate to pick up our bags again to visit six more hospitals and zones—carpetbaggers hoping to be messengers of God’s love and our hope in him.

Much love, may we all help to build peace and justice.

Cecile

Cecile De Sweemer