Author: Dr. Michael Johnson

Poverty has been defined by some as a lack of options or alternatives. That is to say, a poor person must decide between less than optimal choices. “Should I send my children to school and lose valuable help on the farm, or keep them here so they can chase away the birds from the newly planted seeds?” These are the kind of decisions faced by most of the rural poor in Kenya. However, for many others, their poverty is worse than that. For them, there are no options.

There are no choices. There is no gambling with the odds. There is no bargaining. There is nothing to use to barter. There are no choices, no options, and no alternatives. There is just patient pessimism.

Patient pessimism means woeful waiting. Woefully waiting for the inevitable. Waiting for the drought to claim what is left of the emaciated cattle and scrawny chickens. As the dead carcasses dry out in the sun, birds devour the portions of the carcass that you are too weak to carve and carry away.

A man thinks to himself, “We will have to take a chance and eat this meat, even though it smells bad after three days and is covered with flies”. One mother thinks; “My two year old baby girl was thirsty, so she drank water from the muddy puddle at the back of the hut where the dogs were playing. I have no options. I will patiently wait for the diarrhea to stop… or steel my heart to her dehydration and death. I will just wait in woe”.

Woefully waiting and watching the hot, dusty wind dry out the few withering, stunted corn stalks. Waiting for death to take another child. At least death will silence the cry. Patient pessimism is the face of poverty. That is what describes the poverty of Kenya and much of Africa. It is not a matter of whether a mother should feed her child grain or oats.

The beans are gone. The cabbage is gone. There is only dust and dry grass. The real question is can she feed her children at all and if so, which one? Should she bother to hope? Hope has proven futile. Hope has cheated her of the reality of life. Hope is not an option. It is too painful to hope. Pessimism does not disappoint as hope does.

Should she choose politics? She has heard that the politicians are coming with food. Food would be available for anyone who is willing to vote for the big man of the area. But what is voting? Is voting an option for her?

Should she choose faith? Faith has failed her. She has prayed and prayed. She knows of the gods of her ancestors. She knows of the faith of the elders. She has even heard about a person some people call the Savior of the world. But, should she choose faith? Is it an option?

Maybe she should stick to what she knows best. That is, patient pessimism. She can depend on this. It has never failed her. It is predictable. It is reliable. She can wait. The thing she no longer fears is coming. She expects death. Woeful waiting is how she meets it. Besides, she has no other options, unless someone like you decides to help. By the way, what are you waiting for? What options are you willing to offer? Are you patiently pessimistic? Can you share what God has given you to relieve this woeful waiting?

As I lay in my $160 per night plush bed with six pillows, soft upholstered chairs, air conditioned room, with perfectly polished furnishings I really wondered to myself, is it that our culture is comfortable and complacent or should it be convicted of conspiracy and complicity?

It was a very well attended denominational meeting, boasting over two and one half million congregants nationwide. Kay and I were attendees for the sole purpose of presenting the projects we have been assigned to do in Kenya, as we hear from the Lord. It was a rather hurried invitation, coming just one week before the date of our presentation. We were overwhelmed with the opportunity to speak before almost 3,000 delegates to the convention, and of course to stay in one of the finer big city hotels. I did my usual thing of plopping on the bed, smelling the fresh linen and making sure to stuff all of the free shampoo and lotion into my overnight bag. After all, someone was paying for it.

I was careful not to get anything on the pay per view television, nor take advantage of the items in the small fridge. Room service was good enough for me, and I was already feeling a bit ethereal and floating from the cough medicine Kay had bought me the night before. However, the sense of comfort and ease were hard to ignore, even as Kay and I reviewed the pictures and graphics, and very graphic details we were to present that evening. We were nervous, so we did not have much of an appetite and ordered just a salad and small sandwich. We took advantage of the free coffee which I had not yet stuck in my bag.

As we made our way down to the convention floor, we were both visibly anxious. It was the first time we had both spoken before such a crowd together and we were not sure how to give each other equal ‘play time’. We decided by playing ‘rock, paper, scissors’. Kay won, so she chose a joint presentation. However, as the Lord would have it, the Power Point presentation went well, giving a detailed analysis of our personal odyssey in missions and the myriad of works and accomplishments we had done in His name.

The crowd gave us a standing ovation. It was touching, heartwarming and encouraging. Then came offering time. It was equally touching, but quite a bit more revealing.

We have come to realize that it is near impossible to consider the hunger, the thirst, and desperation of people who live thousands of miles away, when you can just pick up the phone in your room and order Eggs Benedict and Lox and Bagels. The complacency our churches have towards missions is truly a result of being immersed in a culture that makes creature comfort the right of every citizen. So without realizing it, we all feed right into complicit arrangements with the powers that be to continue to sow seeds of kindness and love and conspire to irrigate with salt water and mix in tares of weeds.

Our wealth and comfort are inextricably linked with the investment of the companies we serve, work for and those with which we invest. The poverty and disease we see, or refuse to see are impacted directly by the price we are willing to pay for chocolate, coffee, tea and even a good banana split (which is one of my favorites). Am I actually conspiring to undo the very work I came to present?

Is it complicity, conspiracy or plain old complacency? You judge for yourself. It is time for me to check out of the hotel now and they would frown on me if I stole the towels.

I cannot weep with you brothers as I have already spent my emotion.

While home in the US for a few weeks, I continued to make appeals to my kinsmen of the African diaspora. The responses I get are amazingly disappointing.

The complaints are myriad. Malpractice is too high, office expenses must be met, no one to cover me. It goes on and on. Your complaints are real and legitimate.

It is difficult for me to get broke up emotionally over these issues which confront you my brothers and sisters, as I have already spent my emotion on the young boys and girls who have no one to help them swallow their AIDS medicines. They have no one to treat them for the chronic osteomyelitis, or the chronic otitis media with the draining pus from their ears.

You see, my list goes on and on too. I cannot weep for you as my emotions are already spent.

I take care of women who cannot find anyone to perform a simple pap smear and come in with aggressively invasive carcinoma of the cervix, infiltrating both bowel and bladder, Tuberculosis and malnutrition.

You see in contrast to the US, where there is one doctor for every 450 people, in Kenya it is one for 100,000 plus people in most of the country. That one doctor in Kenya has very little of the technology available to definitively diagnose and effectively treat most illnesses encountered. It is most often a ‘guessing’ game.

I care for men whose prostate cancer is discovered most often after it has infiltrated beyond any margin for cure and who cannot think of spending money on something like a PSA or they may not eat that day.

I wish I could say something less biting. I wish there was some real light at the end of this tunnel. I just don’t see it.

I see German, Australian, Korean, British, Japanese, and American white doctors, nurses and dentists here. I don’t see daughters and sons of Africa serving Africa.

I watch these dedicated non-African descendant professionals as they care for wards full of people dying with AIDS, vomiting, diarrhea, seizures, coma, which are the typical sort of symptoms on ward rounds where half to often three quarters of a ward of 50-80 people are HIV positive and are dying by the dozens every month.

My emotions is already spent on these non-African doctors have not come to get rich in Africa, nor to see the beautiful wild life. They have come to serve people who don’t look like, talk like, or have any history in common with them.

I cannot weep for you as I witness these same professionals go into the worst slums of the world, with open sewage, homes made of mud and sticks, rodents and insects passing disease and suffering, just so they can make life a little better, and dying a little easier.

While home speaking with my African American professional colleagues, not one of those with whom I spoke wanted to personally involve, or invest in the work of relieving the suffering here in Africa. I get equipment donated, but I have to meet the cost of shipment. I get promises of visits to help, but only if I can find a way to help meet the expense of travel. I get a lot of smiles and warm handshakes and a quick visit to the back door with a pat on the back. I can’t even get a significant gift of money.

That is why I say, I cannot weep with you brothers and sisters as I have already spent my emotion. You take the time to weep for yourselves. Weep for yourselves as there will come a day at the end of your own career that you will really wonder if you should have invested more in relieving the suffering of which I am speaking. Weep for yourselves, because the people of this continent don’t have the time to weep with you. They are too busy burying their own dead.

Life expectancy for nine sub-Saharan African countries is now below 40 years. Infant, maternal and 1st year mortality statistics show no sign of decline and are rising in many countries. When I explain to the Africans whom I meet in Sudan, Congo, Tanzania and Uganda that the African American doctors can’t come because they can’t meet their expenses, they really don’t understand that. They can’t weep with you, and I must admit, neither can I.

Please get involved. Please invest. Please take some time to do more than emote over your brothers and sisters here in Africa. DO SOMETHING ABOUT IT!

There is nothing like a rainy day
That is filled with cold and wind
That makes me want to stay inside
And spend more time with Him

He seems to always have the time
To sit and talk and share
It is just that I am so busy
I hardly know He is there

And yet when I do need Him
He never says, ‘not now’
He makes the time, and takes the time
I don’t know why or how

I do know that He loves me
It feels so safe and warm
To know that He is above me
And yet I am in His arms

So safe and warm inside
Yet outside cold winds blow
It is time with Him alone, aside
True peace and comfort I know

Hebrews 13:5 ‘…, he hath said, I will never leave thee, nor forsake thee’

He seems to have a defect
He seems to have a fault
I remind Him of my failures
But somehow He can’t recall

I tell Him of my dark thoughts
Of my sordid past of shame
He looks at His book of failures
But He does not see my name

I recall to Him my present
How I ruthlessly misuse
His favor and His grace
How His mercy I abuse

He turns to hosts of heaven
He looks down to the depths of hell
He searches earth beneath
He finds no one who can tell

For He tabulates and measures
He keeps eternal counts and weights
He returns with a final verdict
He tells me of my fate

He says to me dear son
I do not find your sin
It appears the price was paid
You need not think on them again

For I do keep perfect records
I do punish and do damn
But it appears your slate was cleaned
By the one who said I AM

So when anyone reminds you
Of your failings and your falls
Tell them you have a merciful Father
He has forgiven and forgotten all

If it no longer bothers Him
It should no longer bother them
When your past comes back to you
Take your forgetful Father’s view

Heb 8:12 For I will be merciful to their iniquities, And their sins will I remember no more.

The whole family sat there. A man, a woman, a small child, together with their means of transport a donkey! Of course this was not the Jesus of the Bible. This was just a plastic figure made to depict the holy family. I wondered as I drove by, would I welcome the real life family to sit on my lawn. It is even more of a question when it comes to the donkey! Yuck! Who is going to clean up after that flea bitten beast?

Now if this was another Jesus (or Hesus as pronounced in a familiar language), I would have no problem telling him to either get off of the lawn, shovel the snow or rake the leaves. If there was another job for Jose’, the kid’s dad, we could work out something like an oil change on my car, and even his mama, Maria could baby sit and do the dishes.

Before we try to find work for this traveling trio (similar to the hunted, and hiding refugee nomadic Nazarene of 0001 A.D.), we need to look at their traveling papers. If they don’t prove true, ‘hasta luego to the whole bunch!!’ Get off my lawn right now and take that ugly beast with you.

Is there room on your lawn for Jesus this Christmas? How about in your heart? Go ahead let this Messiah in. He does an incredible cleaning job with a cleaning agent found nowhere else, but in Him. Let Him in. You need the work.

1 Jo 1:7: But if we walk in the light, as he is in the light, we have fellowship one with another, and the blood of Jesus Christ his Son cleanseth us from all sin.

One of my most embarrassing dates with my wife was when I had to try to beat the waiter.

I used to work in a restaurant, so I am very familiar with the tendency of some patrons to eat, beat, and hit the street. That is they beat the waiter by getting out of the door and into their car, before he (or she) can give them their bill for the food they have consumed.

On this occasion I actually asked the waiter to cover a part of my meal, as I had run out of money and Kay was broke too. That was embarrassing, to say the least. Nevertheless, the bill was paid in full. I paid my part and the waiter paid his part. I told him to give himself a generous tip. I avoided that fine establishment for years.

Even though the bill was paid in full, I always felt guilty and ashamed. I guess it is the same with me as I consider my relationship with God. I avoid study of the Bible or even going to church at times. I am afraid of the debt I owe. I recognize my strong desire and my failure to resist temptation. I still sin.

However, I need to look at the fact that the debt I owe to God has already been paid and I can return to that fine establishment anytime I want. In fact, the sooner I return the better. My delay in communing with God and those who are called by His name only makes it more difficult to do so.

This debt was paid in full. No, I did not pay even a part of it as the waiter did on my date with Kay. Jesus paid it all! Don’t let your heart condemn you for this debt. Christ has paid it. Accept it as paid in full. Go visit that fine establishment again.

1 John 3:5 You know that He appeared in order to take away sins; and in Him there is no sin.

1 John 3:21 Beloved, if our heart does not condemn us, we have confidence before God.

There are three things which Africa does not need.

1. More foreign aid from governments to governments
2. More planners who know the answers to the problems
3. More projects which give away things to poor people

I have worked in Kenya for 17 years and have spent periods of days to months in other African nations of Sudan, Democratic Republic of Congo, Tanzania, Uganda, and Egypt. I have seen many projects undertaken on behalf of and for the people and have come to understand the motivation of those who fund and ‘run’ these projects.

As a Christian I am well aware of the proverb of either giving a man a fish or teaching him to fish. The first proposition of course feeds this man for a day, and the second allows him to eat for a life time.

I rewrite this proverb to say, if you give a man a fish he will:

1. Ask for tartar sauce (make this product high end)
2. Expect seconds with fries (ask for more stuff because we know fries are essential)
3. Invite his family over (they want to eat and could use a job)

The problem with giving things away in development is that it makes it near impossible to stop giving and creates a higher expectation and dependency and codependency as we feel better about ourselves as givers.

I also rewrite this proverb to say if you teach a man to fish he will:

1. Interfere with your market share
2. Sell the rights and patents to your methods to your competitors
3. Make a product which does not look like anything you want to claim to have inspired.

For projects to work we must have people on the ground who are already doing something positive for themselves. We must not introduce something and come on as the experts and fundraisers. William Easterly (White Man’s Burden) states that there are Planners and Searchers. The Planners stand off, stand at the top of the pyramid, have a lot of money, spend a lot of money and get results which are reflected in the 23 trillion dollars which have been invested in Africa over the past 5 decades. Searchers integrate themselves within the community of people who are already doing things, spend a lot less money and realize the joy of seeing the community rejoice in realizing their own dreams come true.

For projects to work, we must not spend a dime without first finding out firsthand who is doing successful ventures within the country and how we can work with them.

He was barely alive, if you can call it life. The energy acquired by each breath was just enough to take the next one. His head bobbed back and forth as he breathed almost ready to detach from his wasted, skeleton like frame. He was the first in a line of 5 patients that day with whom I would share the cursed word ‘cancer’. The other 40 or 50 waiting outside would not hear that word today.

That word has no real equivalent in Swahili. That is to say, I cannot explain to someone what it means to have some cells in the body grow without regulation or reason. I use phrases like ‘kidonda kibaya’ which literally means ‘a bad sore’. I say that this bad sore has grown from the bottom of your big toe (for example a melanoma) and has spread to your bowels, lungs and even brain (which is not uncommon in this particular kidonda kibaya). That is literally from head to toe.

This is hard reasoning for the literate and learned. Imagine how it sits with a person who recognizes two diseases and two diseases only. For most people it is either malaria and typhoid or typhoid and malaria. I guess there is some variety. They have been treated for these two illnesses for days, weeks, even months and years before they come to see me. The blood in their stool, urine, breast nipple or phlegm has been diagnosed over and over again as one of these familiar illnesses for ‘a long time’. That is the typical part of the history when asked, ‘just how long have you been vomiting blood?’ The answer is ‘kutoka zamani’, meaning, for a long time.

When they arrive at the surgical clinic, it is not unusual for my patients to come with a large envelope full of x-rays ‘kutoka zamani’. Likewise there a bits and pieces of dirty scraps of paper, CT scans, ultrasound pictures, fine needle biopsy reports, letters of introduction with official stamps, seals and fancy letterhead. By the time they have spent their life’s savings (literally sold the farm or better yet barren fields), they have nothing left to pay for the necessary and most often palliative care. They have been hampered by hope. The physicians either string them alone for cash, or literally have no idea what the diagnosis is. However, rather than say ‘sijui’ (I don’t know) or ‘uende pengine utubiwe’, go somewhere else to be treated, the physicians and surgeons choose to offer hope when there is none.

Culturally it is either rude or evil tell people bad news, so it is easy to hide behind cultural sensitivity and hamper with hope. No one gets hurt. The disease is already well advanced. Typhoid and malaria medicines are cheap. They want to be treated. Besides I need the money.

This kind of hope can hamper. It is best to offer hope that helps and heals. That is what I offered the man whose head was bobbing back and forth. I was afraid he would expire in my office, so I hurriedly called in the family for counsel and consolation. I told them the truth. I told them this man their father, husband and grandfather was dying. I told them he needed to get his affairs in order over the next several hours, maybe day or so. I confessed that I had nothing to offer him and it was easy to take the last coins in the pockets of his dirty, threadbare pants to pay for more useless tests. I then told them that there was hope for a better life. That life was soon to come for him.

They confessed they did not know of such hope. I told them about Christ. It was a lot to lay on people in less than fifteen minutes. The others waiting outside the office were wondering why I was taking so long with this one case. They had important issues too. As for this family, I am sure they did not have any idea of what I was saying. Kidonda kibaya was still brewing in their heads. They were still hampered by the hope there was a cure to come. They left my office, angry, confused and thinking ‘daktari huyu ni mjinga’ (that doctor is a fool).

They were very accustomed to being hampered by hope. I pray that they would come to know that one hope can help and heal. That hope is in Christ alone.

I carefully measure the money I share I don’t want my own cupboards to ever go bare I could actually give more But there are so many poor After all Jesus said; they’d always be there

I even measure the mercy I show Being quite kind to those I love and I know But if you cross my path You will sure know my wrath God’s up there, I’m in charge down below!

I dole out my pity with pride Take a picture, and get my good side I am sharing my wealth But I won’t risk my own health Now let’s go shopping on the high side

I dole out the small coins I disperse Way down deep in my pockets and purse I am sure they can live On the tidbits and scraps that I give After all without me, it’d be worse.