Episcopal Medical Missions Foundation
Making A Difference
EMMF: Making a Difference
An Important Message from the Executive Director
Lord, when was it that we saw you sick and visited you? . . .‘Truly I tell you, just as you did it to one of the least of these, . . . you did it to me.’ Matthew 25: 39-40. New RSV.
On the occasion of its fifth annual fall conference held recently in Orlando, the Board of Trustees of Episcopal Medical Missions Foundation (EMMF) approved future funding for the healing ministry of health care professionals to the Diocese of Guatemala. EMMF, in partnership with medical brigades from parishes and diocesan initiatives throughout the U.S., currently supports other short-term mission stations, clinics, and hospitals in Belize, Honduras, Jamaica, Haiti, Dominican Republic, Nigeria and Uganda.
It began fifteen years ago with a call for help to build a church in a foreign land, Guatemala. The initiative was seized by the Diocese of the Central Gulf Coast, a companion relationship was formed with the Diocese of Guatemala, and the church was built over three years. Those who went there returned with hearts filled with compassion for the poor people of this Central American country. From the highlands of Solala to the rain forests in Maiscos, living conditions were primitive, poverty was rampant, roads barely navigable, and most of the population illiterate. Public health facilities were nonexistent, the water was not potable, and few had access to healthcare. Episcopalians from Alabama and Florida heard the call of the Holy Spirit to add a medical component to their construction efforts. But the call almost died aborning, when civil unrest swept over the country for two years. With the urging of The Rt. Reverend Armando Guerra, Bishop of Guatemala, a medical team was formed, however, to address one of the most difficult problems facing the Church in Guatemala: health care for the indigenous Mayan population. From this small beginning the medical ministry to Guatemala was grown to the point where now two teams go each year: one team in the winter and the team in the summer.
Malaria is a significant public health problem in Guatemala. The disease is carried by mosquitoes, but these insects mostly inhabit the lowlands and breed there during the summer rainy season. In the summer, therefore, the team avoids the mosquitoes by visiting the central highlands of Guatemala around the cities of Chimaltenango and Quetzaltenango. The winter medical mission team, however, goes to the tropical lowlands of northeast Guatemala around Lake Izabel and the city of Gualan. Each team consists of approximately 50-60 persons: physicians, physician assistants, nurse practitioners and other nurses, pharmacists, Spanish interpreters and other lay persons. Their clinic sites range from a dirt floor house to a church, a town hall, or simply under a tree in a park. They may travel up to two hours one-way to reach 10-12 different locations in the region and treat an average of 600 patients per day.
The mountain gorillas of Southwestern Uganda are, thanks to National Geographic, among the most well known of the endangered species in Africa. Protected for centuries by the Impenetrable Bwindi, a rain forest where they lived in symbiosis with the indigenous Batwa pygmies, the gorilla population began its inexorable decline with the arrival of large numbers of poachers in the 1970’s. Urged on by numerous international conservationists and animal-rights groups, the Ugandan government sought to save the gorillas by declaring the Bwindi off-limits to all human inhabitants, including the Batwas. Driven from there aboriginal home, these hunter-gatherers found themselves without land or shelter and were reduced to begging, dancing, and chasing monkeys from gardens to earn their food and clothing. Wrongly associated with the cause of the decrease in the numbers of gorillas, the Batwas found themselves marginalized in Ugandan society. In their dismay, many of the men in the tribe turned to drinking and gambling to escape the hopelessness of their condition. The other members if the tribe were left to starve or die of disease.
The plight of the Batwas was acknowledged by the Anglican Church of Uganda, where The Most Reverend Livingstone Mpalany-Nkoyoyo, then Archbishop of Uganda, sought to rescue these displaced people. On a visit to Texas, he asked Mrs. Diane Stanton, wife of the Rt. Rev. James Stanton, Bishop of Dallas, to lead the resettlement of the Batwas on two separate parcels of land in the Kinkiizi District: one in Katairiro and the other at Byumba. During her first inspection of the locations in Kinkiize, Mrs. Stanton, an anthropologist in her own right, received reports of an increased death rate among the Batwas that foreshadowed their extinction. She turned to EMMF to provide medical care in this remote region of Uganda. EMMF soon learned that for lack of immunizations, the pygmies were dying of many infectious diseases: tuberculosis, measles, polio, diphtheria, pertussis and tetanus, particularly neonatal tetany. EMMF provided funding for an immunization program to be conducted by local Ugandan physicians. Unfortunately the long distance to the site and the lack of refrigeration to preserve the vaccines, slowed the vaccination of the Batwas. After six months, the frequency of communicable diseases at the settlement had not abated.
The Holy Spirit truly spoke to Dr. Scott Kellermann through the EMMF website where he first learned of the Foundation’s initiative for the Batwas. A specialist in tropical medicine Dr. Kellermann had spent many years as a medical missionary to Nepal, Central America, and South America. He was willing to conduct a site visit in Kinkiize and to report back to the EMMF Board of Trustees in order that a long range plan could be developed to rescue the Batwa’s from certain extinction. His report in November 2000 was among the most comprehensive evaluations of a needed medical ministry ever presented to the Board. His findings were shocking. Forty-one percent of all Batwa children died before their fifth birthday, half before their first. As expected the primary causes of death were protein calorie malnutrition (kwashiorkor), malaria, tuberculosis, measles and other infectious diseases. Simply put only improved health care and immunizations of these children would lower the death rate. Dr. Kellermann also understood that the problems facing the Batwas could not be entrusted to the infrequent public health measures offered to them. He recommended that a full-time public health nurse living among the Batwas would be a significant first step, but deep inside the Holy Spirit was speaking to him to become a full-time medical missionary. Dr. Kellerman then began to make his own plans to go to Africa for three years. First he had to convince his wife Carol, a teacher and spiritual director, but since childhood she had been fascinated by stories about pygmies. Next they sold their home and the medical practice in California. They arrived in Uganda in August 2001. As they passed through the capital city of Kampala, they solved the problem of the lack of electricity to power a refrigerator needed to preserve the vaccines by purchasing a gas-powered one. They quickly set about to complete the immunizations and establish a roving clinic.
The presence of the Kellermanns in Uganda has been a magnet for other health care professionals who are intrigued by the opportunity to make a contribution to the care of the pygmies. One example was a short-term team from Bakersfield, California including two physicians that helped to build a permanent clinic devoted to maternal and child health. Another team of EMMF officers and Board members including a dentist and microbiologist also attended the roving clinics and consulted on ways to expand the medical services. Currently nearly half of the time is devoted to visits from Episcopalians and other organizations interested in the Kellermann’s ministry. So it was with great expectation that the Board invited them to present a review of their first two years in Uganda to the annual fall conference in Orlando.
At the conference the Kellermanns noted that in addition to the new clinic for women and children, a house is under construction to accommodate the Kellermanns and their frequent visitors. Soon ground will be broken for a general clinic with support facilities for minor surgical procedures. The third phase will provide inpatient facilities and an intensive care unit. But the Kellermanns saved the best for the last. What has happened to the death rate among the Batwas and what are the prospects for preventing the extinction of these aboriginal people? The results are unbelievable and a tribute to God’s glory. The death rate for children under 5 years has dropped from 41% to 4% while the infant mortality has decreased from 18% to 5%! Contributing to this amazing result was a full-time public health nurse funded by EMMF. She taught the Batwas basic hygiene and sanitation and the outcome was dramatic. With EMMF funding more nurses can be found to live among the pygmies and teach them about personnel hygiene and nutrition. The Kellermanns are now back in Uganda to complete their third year. There is truth to the rumor that they plan to stay longer and add a school to their ministry.
The keynote speaker at the EMMF annual fall conference was The Right Reverend Dr. Emmanuel O. Chukwuma, Diocesan Bishop of Enugu, Nigeria. A city of over a million people, Enugu is the former provincial capital of the Eastern Region that succeeded from Nigeria prior to the Biafran Civil War. Nigeria remains a divided country with a strong Islamic influence in the North and Christianity in the East. Since the Biafran War the former Eastern Region has been marginalized by a succession of military govenrnments and its infrastructure has deteriorated. The only hospital to survive the war is the Eastern Nigeria Medical Centre. When inspected in 2000 by EMMF representatives, the 100-bed hospital needed extensive renovation and new equipment to bring it up to modern standards. Much of the damage that the hospital suffered during the conflict had not been repaired. Compounding the problems facing the hospital is wide spread poverty and the problem of HIV/AIDS in sub-Saharan Africa. “HIV/AIDS is real,” said Dr. Chukwuma, “and cannot unfortunately, be wished away. Since the first case of AIDS was diagnosed in 1981, there has been a steady and progressive deadly march to involves whole nations of the world at varying rates. Africa as a continent quickly overtook the rest of the world, with the greatest thrust of it in the sub-Sahara Africa. South Africa has taken the lead in this, while Nigeria follows closely behind. In Nigeria, the steady progression is not relenting since the first case was identified in 1986. Since then the national figures of HIV prevalence shows:
· 1991 1.4%
· 1993 1.8%
· 1994 3.8%
· 1996 4.5%
· 1999 5.4%
· 2001 5.8%
In 2001, for which the most recent statistics are available, 3.47 million Nigerian are living with HIV/AIDS.” The figure for 2003 is expected in December. However, as the Chairman for the National Action Committee on AIDS (NACA) recently stated, about 400,000 new cases of HIV infections are recorded in the country every month and no fewer than 850,000 of those already infected die yearly. The epidemic is now clearly an emergency, and it has impacted every sector of the Nigerian society. The Anglican Church in Nigeria is no exception.
Thankfully, reports from countries like Uganda, Senegal and Jamaica give one the hope that one day this deadly march will be brought to a halt. In Nigeria, the epidemic proportion of HIV/AIDS prevalence is now obvious and the heterosexual route is recorded as the major mode of transmission of the disease. It is increasingly acknowledged that some traditional and cultural practices aid in the propagaion of HIV. Gender inequality, women’s lack of control over their health and decay in health care infrastructure and services, e.g. The Eastern Nigeria Medical Centre, have been implicated as contributing to the spread of HIV.
Unfortunately the ABC approach being used to halt the march has not been the best. Emphasis on the prevention of HIV infection has not emphasized Abstinence and Being faithful to one uninfected sexual partner. Rather Condom use has been promoted as the only solution. Behavior change has been rightly identified as the best approach to HIV/AIDS prevention, but some argue that the change means learning to always use a condom during sexual contact. This, at its best, can only be a form of harm reduction, which is passive and requires less personal commitment. No wonder the Church or religious leaders from the early days of HIV/AODS prevention have been said to be “naturally antagonistic” to what the HIV/AIDS prevention efforts were trying to achieve. Borrowing a leaf from neighboring countries like Uganda and Senegal, that faced the threat of extinction by HIV/AIDS but are now on the path of recovery, a more committal approach is required. Fidelity to a single uninfected sexual partner, sexual abstinence for the young unmarried persons, is the behavior change required to halt this deadly march of HIV/AIDS. It has worked for other countries; it can work in Nigeria too.
Emphasis is now rightly shifting to faith-based organizations and young people as recognized agents of change. The faith-based organizations and young people are expected to be the best instrument requireds to reverse the trend of the HIV/AIDS menace in the shortest possible time. It is obvious today that HIV/AIDS crisis is a challenge of love and the scripture is a message of love. Practicing scriptural principles related to sex is the best guarantee of rolling back the trend of HIV/AIDS. It is estimated that over 90 percent of HIV infection in Africa have come through heterosexual intercourse. Therefore, teaching and encouraging people to practice the Christian principles related to sex will greatly assist in preventing the spread of HIV
Since one of the highest motivations in life is religion, and since observing sexual abstinence before marriage and faithfulness within marriage will stop 90 percent of HIV infection, then the church community stands out as a key actor in the HIV/AIDS battle. In fact, it would be extremely irresponsible as we now know for the Christian community to ignore their responsibility in the HIV/AIDS crisis. It is also irresponsible and almost unforgivable for government and other agencies involved in HIV/AIDS work to ignore the major contribution that Christian community can make in this struggle. Fortunately the Enugu Diocese of the Nigerian Anglican Communion which Dr. Chukwuma heads recognized this key position and took the initiative at the beginning on issues of reproductive health and rights and HIV/AIDS during (1) the 2002 Diocesan (Anglican) women Conference, (2) a two day sensitization/ training workshop on HIV/AIDS for all clergy from Enugu, Nsukka and Oji Dioceses of Enugu State, (3) a one day pre-trade fair seminar for the business community to build a partnership with private organizations entitled “Is HIV/AIDS a business issue?”, (4) a ten day massive HIV/AIDS awareness campaign during the 14th Enugu International Trade Fair aimed at eliminating ignorance, shame, silence and fear which are the major barriers to effective HIV/AIDS control. The campaign was a collaborative work with Enugu Chambers of Commerce, Save the World Organization, and Youth and New Millennium Foundation.
In Nigeria, it is traditionally a form of taboo to discuss sex and associated issues in the public. Now, the church is steadily breaking such taboos. The church recognizes the fact stated in Hosea 6:4 tht “my people perish for lack of knowledge”. The clergy now know tht issues concerning HIB/AIDS can form part of sermons. Anglican women are working towards sponsoring a proposal to incorporate HIV/AIDS and reproductive health education into the bible studies outline which is used by all Anglican churches in Nigeria. In matters of reproductive health, it has been realized that ignokrance and misinformation on the effective methods of birth control have been responsible for unsafe sexual practices, especially amongst married people. Good child spacing and informed decisions on the number of children a family can comfortably nurture, need proper education on reproductive heralth hich incorporte birth control methods. For example, some couples in an effort to space the bith of children, avoid sexual contacts with their spouses. This practice could lead to their husbands seeking satisfaction outside the marriage, weith the consequent dangers including HIV infection.
In Nigeria they are unrelenting in their mission for fear of losing their entire congregation to AIDS. The results this far are encouraging, but it is expected to be faster as more members get better trained ad better equipped to function as proper change agents. The major limitation Nigerians face is lack of funding to mobilize the clergy and their young people and to provide laboratory testing and monitoring. The Anglican women is developing a working relationship with the Eastern Nigeria Medical Centre to provide a voluntary counseling and testing center and a home-based care and prevention of mother to child transmission program. They hope to be able to send their coordinator Dr. Chinedum Aranotu to attend the ISID International HIV/AIDS training program in the US in 2004.
Speaking on behalf of the new mission station in Belize, Little Rock psychiatrist Dr. Rik Flanigin, made a PowerPoint presentation to the attendees at the EMMF fall conference about the continuing efforts to bring health care to the largely Mayan population of the lowland villages of Placencia, Big Creek, Independence and Monkey River. In these remote locations the lack of water, electricity, and sanitation pose significant problems. Yet the enthusiasm of the teams of health care professionals that have gone to this region over the past two years attests to the work of the Holy Spirit in Belize. Working with the local public health officials and the elected municipal leaders, the teams have formed a working relationship with them and have been invited back next year to expand their ministry to other villages often severely damaged by the hurricanes that prowl the Gulf of Mexico bringing floods to the coastal areas.
Nurse Hyacinth Bridges, a native of Trinidad, and her cameraman husband Bob, gave a delightful video presentation, a collage of film strips of interesting moments during the initial four years of the medical ministry to the slums of Montego Bay conducted by the team from St. Andrew’s Episcopal Church in San Antonio. Near the Wilford Hall Air Force Hospital, St. Andrew’s was able to draw from the physicians and nurse practitioners at Wilford Hall for its team members until the actions in Afghanistan and Iraq drew them away. There is hope the team will return next year.
ABOUT EPISCOPAL MEDICAL MISSIONS FOUNDATION
EMMF is an all-volunteer charitable organization and funding agency that encourages the development of medical teams to serve the mission stations of the Episcopal Church in foreign countries and the wider Anglican Communion. Currently EMMF supports medical missions to Belize, Guatemala, Honduras, Jamaica, Haiti, Dominican Republic, Nigeria, Uganda, and Russia. Recipients of grants from EMMF are churches or dioceses of the Episcopal Church USA or Anglican entities in foreign lands. EMMF has been incorporated in the State of Texas since 1992, is a 501 (c) (3) charity, and is governed by an independent Board of Trustees that meets twice yearly to award grants and conduct the business of the Foundation. EMMF accepts cash contributions or their equivalents and directs approved donations in kind to the appropriate mission station at the expense of the donor. Unsolicited donations or perishable goods can not be accepted.
The mailing address for EMMF is 501 E. 32nd St, Austin, TX 78705. The phone and fax numbers for EMMF are at the bottom of this page.
PLEASE CONSIDER EPISCOPAL MEDICAL MISSIONS FOUNDATION AS YOU PLAN YOUR CHARITABLE GIVING. ANY AMOUNT CAN MAKE A DIFFERENCE. LET’S MAKE 2004 THE BEST YET FOR YOUR MEDICAL MISSIONARIES.
In His service,
Thomas E. Williams, M.D.
Episcopal Medical Missions Foundation
501 E. 32nd St.
Austin, Texas 78705
Fax: 830-899-2135 Phone: 210-422-4779
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