Category: Articles

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.

The Lion Lays Down With The Lamb!

I personally take great comfort in the words of the Bible that the poor we will always have with us. I like it because it makes the problem so enormous that it is impossible for me to fix so I can just walk away and thus fulfill the prophecy. Who am I to contradict Jesus after all?

I also like the part of the lion and the wolf dwelling with the lamb, the leopard lying down with the kid goat, and fatling calf is given to the young lion. My interpretation of that is that because there are weak and hungry people, I can continue to live in a society that grows rich from their positions of lack. The powerful people in our world can continue to live off the powerless. In other words, God provides room service for the meat eaters, and He provides the poor to serve me. I know how to interpret the Bible! Just read for yourself.

Isa 11:6-7 And the wolf shall dwell with the lamb, and the leopard shall lie down with the kid; and the calf and the young lion and the fatling together; and a little child shall lead them.And the cow and the bear shall feed; their young ones shall lie down together; and the lion shall eat straw like the ox.

The leopard shall lie down with the kid goat…, eating it slowly I would imagine.

Well, I must admit I have stretched my interpretation a bit. I don’t really understand how a lion can eat straw like an ox, but I do know that in order to do so, God must tame its heart.

Am I ready to do what it takes to bring the change that God wants to bring? Or am I content with the fact that Jesus said: Mt 26:11 The poor you will always have with you, but you will not always have me.

MICHAEL AND KAY JOHNSON –

Michael and Kay Johnson have been involved with overseas missionary work since 1984. Their work has included a brief trip to Zaire (Congo), where they worked in Tandala Hospital for a period of 7 weeks and again to Kenya in 1987 for a period of 7 weeks. They began full time work overseas in 1989 when they were accepted with World Gospel Mission of Marion, Indiana to work at Tenwek Hospital in Kenya East Africa.

Michael was born and raised in Chicago Illinois. Kay was born and raised in the Ann Arbor community of Michigan. They both knew Christ as Savior when they met and married while Michael attended the U of M medical school and Kay attended Eastern Michigan University.

The Lord called them to Kenya after a few years in private practice in Philadelphia.

The Johnsons now make their home in Kenya to helping provide health care to the over 30,000 street children of Nairobi and to help in the training of Kenyan physicians. They are also involved with several development projects, providing schools, water sources, farming and medical assistance to underdeveloped communities. Through these ministries, many orphaned children are now being placed in Christian families by adoption and foster care.

The Johnsons have four adult children, Elijah 28, Christina 26, Emmanuel 23 and Keturah 20 years of age.

Why not bite death?  It is easier to access and accept on an empty stomach.  It won’t make you vomit nor have diarrhea.  Take a bite of death.  It is cheap and right at hand.

This is the kind of logic it takes to refuse to take Anti-Retroviral Therapy (ARV) drugs.  In fact the drugs have been labeled as such amongst some Kenyans.  According to IRIN/PlusNews ARV’s are considered death drugs.  The article cites that in Isiolo as of September 6, 2007 “ Food shortages in arid, remote northern Kenya are making it impossible for HIV-positive people in the region to adhere to their antiretroviral (ARV) medication regime, relief workers say.”

The life-prolonging ARV drugs have been labeled “death drugs” because of the effect they have on patients who take them without adequate food, according to Ahmed Mohamed Patel, a volunteer with the Kenya Red Cross in Isiolo, in Kenya‘s Eastern Province, which borders Ethiopia in the far north of the country.

“The safety and effectiveness of the drugs depends on the food intake …unfortunately, most of the victims are poor and cannot afford a simple bite of food,” he told IRIN/PlusNews. “The expected relief and intended assistance will never be achieved unless the problem is Health workers said many HIV-positive people were opting to stay off the drugs rather than suffer the side effects of taking them on an empty stomach.

The government has initiated a free food programme empty stomach to assist families of people infected and affected by HIV in Isiolo but so far, only 30 families have been benefiting.

So if you are taking the medicines you don’t really know if your cramping, diarrhea, headache, dizziness, depression and other mood swings are because you are taking too much medicines, not enough medicines, or is it just that you are plain starving to death.

According to Overview of the President’s Emergency Plan for AIDS Relief (PEPFAR) by Myra Sessions The President’s Emergency Plan for AIDS Relief, also called PEPFAR or the Emergency Plan, is a five-year bilateral commitment by the United States Government to support HIV/AIDS prevention, care and treatment programs in developing countries. Authorized to spend $15 billion in five years (fiscal years 2004-2008), PEPFAR is the largest-ever global health initiative dedicated to a single disease.

$15 BILLION IS SPELLED WITH A CAPITAL B!

For the fiscal years 2004 and 2007, the United States PEPFAR program spent $92,474,390-$142,937,153 in Kenya alone.  That is not much bang for the buck if you consider that according to Business Daily of Nairobi which reports that as of June-2007: only 120,000 people living with HIV have access to Antiretroviral Therapy (ART), about a tenth of the total number of the infected population.

Let’s do the math here.  Almost 143 million dollars divided by 120,000 people.  If I add, the five carry the six, minus one…, count my thumbs, take off my socks, and count my big toes I come up with…, $119,000 per person.  That is if the PEPFAR program was actually providing all the care for all of those with HIV/AIDS in Kenya.  This excludes the possibility and probability of some significant contributions of other donors such as Doctors Without Borders, Red Cross, Red Crescent, WHO, UNICEF.  I would imagine that for each one person treated under this program you could treat as many as five or six in the US.

Now the problem here is that undoing or stopping PEPFAR would be unthinkable.  After all, what will the poor mothers and orphaned children of Africa do if the donors decide the program is not working?  Hence, the American taxpayer is in a real dilemma.  We have a program that is spending out of proportion to the benefits it offers, people have to choose between biting death from drugs, or awaiting death from hunger.  If we choose not to share, we are not right.  If we continue to share the way we are doing it, we cause harm.

Is the PEPFAR program truly a relief and remedy for the sick, or remuneration for the wealthy?

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 you are willing to offer?  Are you patiently pessimistic?  Can you share what God has given you to relieve this woeful waiting?

I am always amazed at how quickly the dust settles on the grounds of the stadiums, arenas, conference centers and show grounds of Nairobi.  A visiting evangelist, preacher, healer and crusader sweeps into town, makes a great impression on the spiritually and physically hungry masses, meets some of the important dignitaries and political leaders, and before you know it, the ‘swoosh’ of the sweep is silent.  By this time only the dust at the cash register, and the query of a few thousand confused souls is still unsettled.  The visitors inevitably leave a variety of books, CD’s video tapes, pamphlets, brochures and telephone hot lines for those who still seek answers for a lifetime which they could not get in one week.  There is a lot to be said by prophets about profits.

How is it that the gospel came to be so profitable, to those who preach it today, when it cost the Savior so much?  How do these modern day profiteers make money on what cost Christ His life?

The prophet Isaiah said it well in Isaiah 53:5 “…by His stripes we are healed..”

I would suggest that the King James version could be abridged to say we are well healed, or in these instances ‘well heeled.’

The nations of the world are suffering for the lack of men and women who are willing to show the crucified Christ in His suffering.  It is very difficult if not impossible for the poorest and most desperate to differentiate the eloquent and learned from the sincere and most Christ like. It is hard for them to understand the gospel when these prophets are welcomed not as suffering servants but as well heeled heroes.

The poor want a miracle, not a manicure.  The poor want food, not a photo-op.  The poor want healing that does not come with them as a backdrop for a headline showing the latest prophet to come their way.

The entourage of hundreds of people including body guards, the caravan of fine luxury cars, the expense of staying in the finest luxury hotels and of course, dining (not publicly wining) with the most important people is not the example of the Christ on the cross.

I believe their message is heard loud and clear.  “By His stripes, we are well heeled! It is good to serve God when He will benefit you financially in this life.  After all, this life is  an important thing, so get as much as you can, and after that you get to go to heaven too!”

There was a man crying in my office and it made me feel very uncomfortable.  He was not even on my list of patients to see and I really did not want to be bothered with him.  Nevertheless, he sneaked in quietly after I had thought I had seen my last patient.  Here he was, crying in my office.  I should be used to it by now.  After all, I have actually caused many people to cry.  I have been charged with the ministry of telling a lot of people a lot of bad news.  It has become so common for me to do this, that I can almost do it in my sleep.  Come to think of it, I have done it in my sleep.  I awaken in the middle of the night to the remembrance of the several people to whom I have given heart wrenching reports.

I am sorry Mrs. Owino, your child will lose not just have to lose his arm, but the infection has already spread to his shoulder and at this rate, he won’t see his 7th birthday.  Oh yes I know Mr. Mueni, the cancer probably could have been cured when you saw the doctor 3 years ago, but now it is to late to even try to remove it without killing you.  Yes Mr. and Mrs. Oloshua, the tumor is a part of AIDS and the odds of curing it are low as you don’t have enough nourishment in your body to help you survive the treatment nor enough money to purchase the drugs.  Besides, we don’t even stock those medicines here.

See you later.  I am off to lunch.  And with that, I close my door and wolf down a sandwich, or some chicken and French fries and a cold coke.  It must be cold coke.  What else to soothe this torch like tongue?

Telling bad news makes it hard to relate the Good News quite honestly.  In one breath I tell someone there is little to nothing I can do to prevent, reverse or even treat the illness.  A few seconds later I am supposed to tell them that Jesus loves them and knows all about their illness.  It is hard for me to make sense of it and sometimes I laugh at myself for even trying.  It is easier to laugh than cry.  Compassion hurts.  Better to let go of that feeling of compassion it seems.

Heartless compassion is what I call it.  Removing the heart of flesh and replacing it with a heart of stone is what I refer to as my defense mechanism.  After a while, it gets very difficult to carry the burdens of 1,000 hungry children in 4 orphanages, 10,000 desperately poor and thirsty people in four villages, perform 30 to 40 major surgical procedures per week see 100 people weekly on rounds and in clinic and pay for their care as well as really CARE how they feel or what they feel!  So, I made this man cry.  This time was different though.

This man crying was not crying tears of pain, but tears of joy.  His wife recovered from major surgery I had performed and he was actually in my office to thank me for the good work.  It is rare to have people actually cry tears of joy in my office.  He held my hands and his tears were genuine.  I took comfort in his tears.  He prayed God’s strength on my work and my family and then just as quietly as he entered, he left.  He was now smiling.  It was I who was left crying in my office.  Why not?  After all: Jesus wept. John 11:35

I am not one to express my opinion very loudly, or easily.  Well, maybe that is going a bit far.  However, I do take great pride in humbly balancing my practice of the art and science of medicine.

I can walk into an examination room and without ever talking or listening to the patient, immediately make the diagnosis by placing my stethoscope to the chest and listening to the heart.  Oh yes, I listen to the physical heart, without the senseless, time consuming nonsense of listening to the emotional and spiritual heart.  “Please don’t interrupt me, I am trying to treat you.”  That line always works.  It keeps the patient from getting in the way of my treatment plan.

I have compassion.  It is heartless compassion.  This patient is nothing more than an object, a project, a proposal and a good idea.  As long as I keep it that way, meet my objectives, send out the right letters of appeal, give back the good reports and look good to donors, all things fit.

I believe that the true heart of ‘humanitarian’ or relief and development ministries can only be realized when I begin to listen to the patient.  Otherwise, I will continue to take pride in humbly balancing my art and science of medical practice.

The true heart of relief and development ministries must be Christ centered.  To do anything less is indeed compassionate, yet heartless.

Jesus took time to allow people to express their desire to be healed.  When we ask people what is hurting their hearts, we will have to listen and meet the needs of their hearts, even when it may differ with our personal objectives.

This will mean intentionally forming alliances with well established organizations with both moral and financial integrity.  Ideally, these partner organizations should be operating within the fields of service of our missionaries, and be managed by Christians indigenous to the area.

Heartless compassion is the continuous advancement of an agenda that serves to treat the illness at the expense of killing the patient.  That elevates the project and its managers and supporters, over the needs of the people whom we serve.  We can and must do better if we are to build true sustainability into the works God has commited to us.

In the old days…., long , long, long time ago…, well not so long it seems.  I was a boy however and for many who read this it seems a long time ago.  We used to have cameras back then and they were a bit more of a challenge to operate.  Getting the image on the film required going to a dark place where there was little if any light, opening the back of the camera and then opening the package of film.  The film was on a spool and had a lot of little holes on it and it would hook into some gears that would pull it across to the opposite side of the camera.  Each time it would pull, it would be ready for exposure to the light coming from the lens.  Hence, you would get the image of the object you wanted.

That is if you did not overexpose it.  If somehow you were not in the right place, got too much light your film would be overexposed.  When you took it to the developer, they would try to get something from your film but most often it would be underdeveloped from the extreme light images.

I have often looked back on the old days, long, long, long time ago and wondered how many times I left my own mind and soul overexposed to things that today still taint me?  What parts of my psyche, my emotional make up, my habits, my personality were overexposed to the things that have left me underdeveloped?

Thank God for His grace.  He does allow us to advance to the digital age.  He does give us a second chance, third chance…, in fact He has so much film up in heaven that we will marvel when we turn in our expired rolls of film.

The most important thing God is asking of me is to keep myself from things that would continue to expose me to unwholesome activities and thoughts.

Moses was talking to the sinful children of Israel who had been exposed to the ways of Egypt and the immorality of the day.  His admonition was: Genesis 45:7 And God sent me before you to preserve you a posterity in the earth, and to save your lives by a great deliverance.

Holiness is not an option for those who want to be like God.  It is a must.  Without it we will remain underdeveloped.  We will never experience the true picture of ourselves nor the great things He wants to show us.  Expose yourself to what God wants to show you.  Read His word.

Jesus can perform many functions in life and can be used in many convenient ways.  Here are just a few examples of how you can use Jesus, as demonstrated by many contemporary American Christians.

1. Jesus as a tax exemption.-Just using the name of Jesus can allow you to help add line item deductions to your tax return.  You don’t have to believe on His name, or even pretend to worship at His church.  Just tell the government that along with the school loans, house mortgage and flood damage in your basement (next time remember to turn off that faucet), you gave a lot of money in Jesus’ name and you are guaranteed a better tax return.  This is not true with regard to taxes in other parts of the world.  America!  You gotta love her!
2. Jesus as a ‘Handi-Wipe.’-This one is one of the all time favorites.  When Jesus says He would wash us from our sins, this works out well.  You don’t have to get thoroughly soaked in this faith, just clean enough for the next sinful adventure.  You can appear to be washing away the dirt in a very religious way, but no deep cleaning is necessary.  Go to church, carry a Bible and be nice to people.  This is good as it gives the appearance of righteousness, without all of that holiness stuff.
3. Jesus as a political ally.-Whether you are bleeding heart liberal or cold hearted conservative, Jesus is a great tool to advance your political leanings.  He adds just the tinge of compassion and a touch of conviction to make both sides of any political debate justifiable and believable.  This can make your politics and your faith coincide with your desires to sway people to your point of view, without feeling any remorse or second thought of your true motivations.
4. Jesus as a career builder.-In many circles today just saying you have a religion is a good thing.  The Christian religion still works in many parts of America, as it is seen as a good way to move forward in Christian ministries, from broadcasting, entertainment to writing books.  Just use the name Jesus and royalties are pretty much guaranteed as those who claim to know Him like to sing songs and read books about Him, more than getting to truly know Him.
5. Jesus as a pick up line.-This is another favorite, especially for guys and girls looking for ‘clean and safe’ relationships.  Given the present scare of sexually related diseases, just saying you know Jesus as your Savior, can allow the potential pick-up to take a sigh of relief as you head off to do whatever you put your mind to.
6. Jesus as a fashion statement.-This is never out of season, except when you want to travel incognito.  That is, Jesus can be very useful, especially on Sunday when you are around people who claim to know Him.  You can put Him away in the closet, as you put your Bible on the book shelf, until the next Sunday.  That way, He does not need to be dry cleaned, pressed or even covered in plastic.  Then on Monday through Saturday, you can live your life without the risk of getting any soil on Him at all.
7. Jesus as a money launderer -This is a bit harder than tax exemption.  In fact, you may have to build a church, or even a mega-church for this.  Once you have built this edifice, just convince all who come to worship you, (I mean worship with you) that all of the money they give in this life will guarantee they have a church pew, special hankie and prayer cloth or will benefit some snotty nosed, fly filled face orphaned child, in some nation  on the other side of the world, (far away enough that you never see them).

So, as you see, there are many ways one can use Jesus.  This is just a short list, off the top of my head.  I am sure that with some imagination, we could come up with many more.

Suffice it to say, you don’t have to believe on Jesus to use His name.

There is one very important disclaimer I must make note of here, however.  I remind you that Jesus is rather ‘touchy’ about these techniques and using them will put you on a collision course with Him in this life and the life to come.

Even though you may know all of the right code words, right causes and even some of the right people, if you are just using Jesus, as in the examples above, you will undoubtedly hear Him say; “This people draw near to me with their lips, but their hearts are far from me Matthew15:8”  or “Depart from me, you workers of iniquity, I never knew you Luke 13:27”.

Be careful, and let Jesus use you and not you use Him.  It works out better that way both here and hereafter.