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March 4, 2001
Dear Friends, Family, and Mission Associates,
As afternoon lightning and thunder crashes about our corrugated-steel-roofed
bungalow we are again blessed with cool and refreshing rain. About
the time we have reached the limit of our heat tolerance, the
blessed rain and cool relief comes again. So goes our mission
effort and interesting involvement in relationships here.
The Christian Medical Institute of the Kasai (IMCK) is located
in the small village of Tshikaji eight miles from Kananga, the
regional capital of the two Kasai provinces, Occidental and Oriental.
IMCK has three integral parts: The Good Shepherd Hospital, the
Schools for Nursing and Laboratory Technology in Tshikaji, and
the PAX Clinic in Kananga. I work at both the hospital and the
clinic diagnosing and treating patients. I am accompanied by a
very congenial and enjoyable team of young medical students and
residents. The patients
are fascinating and the students are interested and eager to learn.
We have scheduled teaching four evenings a week, three evenings
in our home and one at the hospital. These are in addition to
the regular hospital duties, conferences, and rounds. Sue has
over 15 hours of scheduled English classes for nurses, technicians,
and doctors. She also has been teaching other hospital staff and
high school students in our home.
She has attempted to provide a children’s library service
for 30 to 40 schoolchildren who come to our house for books from
the surrounding villages.
The French language we struggled so hard to learn is only partially
helpful. Tshilubu is of major importance to our understanding
of the cultural riddles. So, we study Tshilubu three days a week
so we can bring some meaningful smiles to the faces of our friends
and patients. It works! Surprise! Surprise! I dreamed the other
night that I was playing a very serious game of "Scrabble"
with only 14 of the required 26 letters of the alphabet.
Of the four other hospitals in the Congo managed by the Congolese
Presbyterian Church, only Bulape and Lubondai have a doctor. The
regional TB, onchocercosis, sleeping sickness, polio, and goiter-prevention
programs are doing well. Malaria is almost universally present.
I’ve seen no bed-nets anywhere yet, but understand they are
expected soon. HIV/AIDS is estimated to be present in 10 percent
(my experience) to 32 percent (estimates of the World Health Organization)
of the Kasai population. I see several new patients with AIDS
every day. There are at least 60,000 infected people in Kananga
City alone who need or will need help with this horror of
horrors. IMCK has the only clinic addressing the diagnosis and
management of the disease. We are trying to collaborate with others
who are doing HIV/AIDS work in the area. There has been extensive
AIDS work here in the past, but it is difficult to find out what
is happening here now. Assisting with HIV/AIDS education of youth
and the general public is one of our major interests. Protection
of the our hospital’s blood supply and its employees from
accidental infection or inadvertently infecting patients is a
second goal.
In Central Congo it has been found that more than 60 percent
of HIV positive pregnant women will infect their newborn babies
unless protective measures are taken. There are three preventative
measures that are effective. First, perform a Cesarean section
at the time of delivery. Second, advise against breast feeding
after birth. The first is too expensive and generally unavailable
except at IMCK. The second is culturally unacceptable and would
lead to serious nutritional problems for most newborns.
The third measure is to convince pregnant women to be tested
for the virus sometime before delivery. If positive, a single
$4 oral dose of Nevirapine at the onset of labor will reduce the
vertical transmission of the virus from mother to infant by 65%.
The IMCK is seeking to get, subsidize, and administer the drug
using available hospital funds in our ECO Public Health account.
Sue and I are struggling with difficulties "inculturating"
here. We find the Kasai a place of many puzzles. The cultural
understanding and signals for what is respectful, acceptable,
and meaningful in relationships is often confounding and trying
for us. Congolese interpretations of charity, honestly, responsibility,
financial accountability, and caring for patients is different
from ours. We need to view them within the context of their culture,
not ours. I have to patiently wrestle with my sense of indignation
and distrust when our different worldviews clash. We are slowly
building meaningful and trusting relationships with our colleagues,
nurses, and administrative friends. The secret to any effective
witness here will depend on strengthening these.
As Anthony Gittens observes in his book, Gifts and Strangers,
mission is delicate in its challenge and complex in its execution.
The underlying imperative to love our sisters and brothers is
as simply stated as ever. However, as we endeavor to love we are
inevitably drawn into new relationships and others’ lives,
histories, and aspirations. The agenda we bring must at some point
encounter the life experience and social context of the others
into whose lives we come. The difficulty and the paradox of Christian
mission is maintaining our loyalty to the saving message of Jesus,
yet at the same time have a deep enough respect for others to
be tentative and open, respectful, hope-filled, and instrumental
of witnessing to the good news, yet never usurping of the place
of the Savior.
I believe our church has started and committed itself to good
things here that need to be seen through. I don’t believe
sending money, equipment, supplies and medicines, "mission
presents" is principally what God expects of us. He would
rather have disciples in "mission presence" here in
this maelstrom of killing, plunder, disregard for human rights,
ignorance, abject poverty, disease, illiteracy, and hunger we
would all just as soon walk away from. The Congolese can’t
walk away. They need and ask for our continuing presence with
them.
In His service,
Bill and Sue Sager
The 2000 Mission Yearbook for Prayer & Study, p. 29
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