November 29, 2004

Dear Friends and Family,

As we celebrated Thanksgiving with a few Malawian and American friends, we were reflecting on the differences and similarities during the holiday season. Last year in the States, we were cold and the kids were ever hopeful for snow. Here, it is hot and humid and we all hopeful for the coming of the necessary rains. Last year, we were regulating our children’s ingestion of sweets and baked goods—it seemed from October to January they were inundated with them. Here, we are regulating the quantity of mangoes they can eat and looking for imaginative ways to serve them (fresh, frozen, jam, bread, chutney, etc.).

The response to Christmas within the church is similar. People are excited about the celebration of Jesus’ birth and the congregations are dedicating themselves to worshiping Him in joyful and meaningful ways. There are concerns for and plans to share with those who have less, as a way of exhibiting God’s love. Our church decided that on December 26 the children attending Sunday school will conduct the church service. They will run the service, give the prayers, preach, be the choirs, and collect the offering. This year Jodi has been involved in beginning a 2- to 5-year-old Sunday school class so she is working with the other teachers to prepare the kids for that day. It will be quite a service.

As a close to this year we did want to describe some of the work that has been accomplished by the church through money donated to the Livingstonia Community Health Training Extra Commitment Opportunity (ECO) account. All this since June 2004. Thank you!

• David Gordon Memorial Hospital (DGMH) at Livingstonia has launched its “Baby Friendly Initiative.”
• Ekwendeni Hospital conducted a palliative care workshop.
• A survey on the sustainability of the shallow well program was conducted and the maintenance of the shallow wells was supported.
• Funds were added to nursing scholarship money (MBF) to send two nurses to South Africa for upgrading their skills.
• The congregational-based malaria prevention program was supported.
• A used Land Rover was purchased for our work and personal use.

Some of you knew us when we were working at Embangweni and may remember when it was establishing itself as a “Baby Friendly Hospital.” This title can only be used by hospitals evaluated by global criteria established by UNICEF and WHO. A health facility with maternity services can be designated “baby-friendly” when it does not accept free or low-cost breast milk substitutes, feeding bottles, or pacifiers, and has implemented 10 specific steps to support successful breastfeeding. As of March 2002, only 25 facilities in the United States were Baby Friendly yet there were seven in Malawi. The hospital undergoes inspections twice each year and, in fact, one hospital in Malawi had their title revoked. Two of the Synod’s three hospitals are Baby Friendly. Money from the ECO went to support the training of staff and purchase materials for DGMH to become the third.

A palliative care workshop was organized by Dr. Lungu of Ekwendeni Hospital. The hospitals and synod have had home-based care (HBC) programs for more than 10 years but the HBC program is primarily for terminally ill patients who require comfort measures that can be carried out by trained non-health professionals. Palliative care is more medically intensive using nursing staff but still takes place at home and its purpose is to keep people from having to spend their limited resources on travel to the hospital and on hospital stays. Ekwendeni is the only one of the three hospitals in the synod piloting this program, and we will learn much from them.

We used the Land Rover to visit Usisya, one of the sites doing congregational-based malaria prevention (“Networkers”) and where Jim is supervising the construction of a new church. This place can only be reached by land during the dry season. The rest of the year it can be reached only by traveling several hours on a small boat.

The shallow well in Usisya was clogged with sand, and Jim was trying out a locally constructed sand bailer based on a prototype he had seen. The maintenance of the shallow well is as important to people as the initial installation, and that is the part of the program that Jim loves, working with people to determine how best to train and support them to maintain and repair their water source.

We thank you for your email, letters, prayers, and financial support. As we end this year and begin another, we are praying for you, the congregations, the PC(USA), our two “home” countries of the United States and Malawi, as well as for the many conflicts throughout the world.

Jim, Jodi, Michael, Jason, Salome, and Selina

The 2004 Mission Yearbook for Prayer & Study, p. 58