August 2006

Dear Friends,

Praise God from whom all blessings flow! A huge blessing has come my way in the form of a 1998 4-wheel drive Toyota Landcruiser: standard transmission, diesel fuel, dual gas tanks, and an extended back so I can actually use it as a motel when such occasions arise. God provided this blessing through the generous giving of Presbyterian Women in their annual Thank Offering. “Thank you, Presbyterian Women!” Thanks to all of you who prayed for God to help me find a car. God is faithful.

Through the Thank Offering, Presbyterian Women helped Shirley Hill purchase this vehicle to aid in her work as HIV/AIDS and public health consultant in Cameroon.

This car will greatly aid my work as an HIV/AIDS and Public Health Consultant for the Presbyterian Church in Cameroon (PCC). I have been delayed in getting to the field to see what’s going on but now I will be able to step up my program. Dr. Kohlmeyer, the acting medical officer in charge of the PCC hospital in Manyemen has been requesting a visit from me for a couple of months now. We are in the height of the rainy season and the road to Manyemen is impassible except with a large rugged off-road vehicle like the one I now have. Thankfully, I won’t have to wait until the roads dry up before making the trip to see Dr. Kohlmeyer.

One reason for the trip to Manyemen is to discuss the situation of HIV/AIDS and other public health issues like malaria and tuberculosis. In 2005, the hospital diagnosed 341 new cases of HIV, 1042 new cases of malaria, and 269 new cases of TB. Please pray for us as we discuss reasonable actions with limited resources.

In July, I managed a trip to Kumba, which is a three-hour drive over a road that defies description. On normal roads, the trip would only take about 45 minutes. The ride is so rough that it literally jars your insides. I would never recommend it to a pregnant woman (unless she wanted to go into labor!). Although the ride was grueling, the people I met refreshed me physically, emotionally, and spiritually.

I visited the various PCC institutions and facilities like the church center, the seminary, primary and secondary schools, the health and rehabilitation centers, Presbook and Prescraft (two PCC enterprises), the youth center, and the technical center where troubled teens can learn a technical trade, and I met with many people. At each stop, I toured the facility, observed people working, discussed HIV/AIDS, and received their hospitality. The presbyterial secretary and some of the presbytery officers hosted me for several hours as we discussed what is being done by the presbytery and local congregations in the area of HIV/AIDS and the challenges they face implementing their programs.

Implementation is one of the most challenging aspects to carrying out the church’s work in both HIV/AIDS and public health arenas. For example, each presbytery is supposed to have an HIV/AIDS committee that oversees the development of HIV/AIDS committees in its local congregations and to supervise their work. Many congregations are located in remote areas and since most people do not own cars it is very difficult for the presbytery to visit their congregations to train, monitor and assist them with their HIV/AIDS activities.

Another example of the difficulties of implementation within the system occurs in the Prevention of Mother to Child Transmission (PMTCT) of HIV/AIDS program. Last year in Cameroon, there were over 500,000 persons living with HIV/AIDS. Over 60 percent of those are women of childbearing age. The health center in Kumba currently has a program in which they offer free HIV/AIDS counseling and testing for all pregnant women who come to their center. The goal is to determine a mother’s HIV status so she can receive medication that will reduce the risk of passing the virus to her unborn child. Normally, an HIV+ pregnant woman will receive Nevirapine shortly before delivery and her baby receives the drug within 48 hours of delivery. Another preventive measure is to encourage the mother to bottle feed instead of breast feed since the virus is also passed in the mother’s milk.

The problem is that many of the mothers who come to the health center for prenatal care do not return to the hospital for delivery. They deliver at home because they may not have money for public transport to get back to the hospital for delivery. Perhaps there is no public transport available in their village at which case they must walk to the health unit (while in labor). Finally, the roads may be impassable if it’s the rainy season. In such cases, the mother and baby do not receive the needed medications. There are also problems for mothers who choose to bottle feed their infants. Baby formula is expensive and most families cannot afford it. In some situations, strict sanitation and safe water practices must be religiously adhered to in formula preparation in order to keep the baby from getting ill. Even if a mother can afford formula, there is still a great stigma on women who do not breast feed.

You can see some of the many challenges related to implementation that must be considered in every project the church undertakes. This is why your support and prayers are critical. We need God’s wisdom and discernment; and we need the prayers, financial support, and working hands of the saints. I thank God for each and every one of you.

I thank my God whenever I think of you; and every time I pray for you all, I always pray with joy for your partnership in the gospel from the very first day up to the present. (Philippians 1:3-5)

Peace,

Shirley