Doctors For Life International Angola outreach, May 2005
November 9, 2005 Cuito Cunevale - "At the sound of your cry..." Angola Medical Outreach:19 Sept -12 October Preparation
After months of preparation (and years of hope) to reach Cuito Cunevale, DFL's team made it home safe after a wonderful time in this poverty stricken area. The desire of reaching these needy communities began to take shape during the outreach to Menongue, the capital of the Cuando Cubango province, in May 2005. A brief meeting was held with the Vice Governor of Cuando Cubango province on the last night before the team started the journey back to South Africa. During this meeting the main message was that they got to know DFL and therefore gave us the green light to work in one of the most war torn areas of Angola. This remains our passion and desire; to assist the poorest of the poor with their physical and spiritual needs!
Logistically the outreach was a challenge. A driving team, 3 drivers with 3 vehicles, were leaving ahead of time to meet a flying team (the medical personnel) in Cuito Cunevale seven days later (the time it takes to drive there from South Africa). "Why don't you hire vehicles there?" you might ask; In fact we did look at this option but we encountered a few minor problems here: Firstly, as far as we know, there are no renting vehicle companies there. Secondly there are hardly any vehicle there and thirdly we were warned not to try and "borrow" any of those that might be available as arrangements would remain uncertain, communication is poor and, well, its Africa...
Getting there
Regardless of all our human efforts to get things perfectly arranged things did not always go according to plan. As we entered Angola on the 4th day, one of the vehicles encountered problems as 2 studs (holding the wheels in tact) broke off from the one back wheel. A third was stripped and we did not know the condition of those that remained. Travelling further with the load towards Menongue and Cuito could result in loosing the wheel altogether and that would leave us stranded in Angola as there are no other places to have a vehicle repaired. The roads are extremely bad as previously reported. Returning to Namibia was our only feasible option to minimise the risk of jeopardising the continuation of the outreach. Rendezvous with the flying team was fixed and we carried 90% of the luggage, food, medicines and camping equipment. Time was of essence too.
We looked for a safe land mine free area, - usually where there are signs of people and cows walking -, unpacked the vehicles and bid one of the drivers, Mr Volkmar Bohmer and translator Amado Markus goodbye as we left with the 2 other vehicles back to the border post 6 hrs away. The plan was for them to put up camp in the bush untill our uncertain date of return. We had no way of communicating with them untill such time.
Driving on some of the roads is a slow and interesting experience which is impossible to explain in words. Almost through out our travels the veld was burning, and our Angola translator numerously expressed his concern about this. Seemingly people set the forests alight without reason, probably killing many thousands of animals, plants and even destroying some of the land mine warnings. We also passed numerous broken down trucks, some of them were huge interlinks. Others would be overturned in the middle of the road due to a huge crater. Others had broken axils, fuel problems, cargo that got shifted and are about to fall over etc. When we stopped to help one of these trucks, we ended up getting stuck ourselves almost overturning our own vehicle.
Arriving back at the border had problems of its own. We only had single entry visas complicating things a little bit. The Angola authorities helped us by allowing us to return to Namibia to have the vehicle fixed. At Namibia's border it was a different story though because we have not officially been "stamped out of Angola". After a couple of tense minutes the official finally decided to keep our passports and write a letter "to whom it may concern" in case we would be caught without our passports. He gave us a 1 day pass to have the vehicle fixed, so without wasting time we shot off to the nearest industrious town, Rundu.
By God's grace we managed to re-enter Angola with a fixed vehicle 2 days later without problems, even though we only had single entry visas. We 2 days behind schedule because of this, but prayer and persistent driving (day and night) finally brought us safe to Cuito Cunevale a few hours before we were suppose to meet the other team. Little did we know, due to poor to no communication, that they had problems of their own. Apart from the capital Menongue, there are no telephone or cell phone communication available in the areas we traveled. Those who can afford it (usually limited to government and international NGO's) communicate via HF radio. We received a confused radio message via the Administrator in Cuito Cunevale (who got it from Menongue, who got it from..) , that the other team had to return to Namibia due to problems but would arrive the next morning early. Although this made no sense at all, we decided to trust God and make use of this opportune moment to rest after days of continues driving. To make a long story short, the Grand Caravan of MAF Angola finally arrived with the medical team the next day around 16h00. This was a time of rejoicing!
Cuito Cunevale
The local and government officials who partially made this outreach possible, were most helpful and accommodating right from the start. We were welcomed with open arms and sometimes with a large entourage which made you feel a bit like you are either important or seriously in trouble! It started in Menongue where the flying team met the Vice Governor and his assistants who confirmed their appreciation and acknowledgement of the work that would take commence in Cuito Cunevale. In a like wise manner the Administrator, Head of Police and head of Military in Cuito Cunevale took special care of our safety, programme and accommodation. Instead of sleeping in tents, they offered us a house, one of few that remained relatively untouched from strong war activity in this area. Although humbly apologised for the condition of the house, it was in fact wonderful and far above what we expected. The whole group was happy about this shift of venue as we had planned to stay in tents. Looking back I don't think we would have "survived" living in tents under the circumstances and the extreme heat..
At this point I would like to commend the ladies that joined the team. They were truly 'men'' when it came to facing the sanitary and living conditions that were "not quite" New York standards. We fetched water from the Cuito river every other day with which we had to wash, flush, cook and drink. Although the water looked fairly clean we still tried to purify it as much as possible. Maybe the almost R2000 per person vaccine shots we team members had to get prior to this outreach, ( some of them are compulsory and are required to enter or exit Angola) came in handy here too!
There is abundance of water due to this huge river, but the community was large and people staying on the outskirts have to face the extreme heat and distance; Many have to travel very far by foot to reach this source. Bathing, washing clothes and consumption by both human and animal all happens there. The cumbersomeness of this daily necessity and routine effort to the local people, was notable by the fact that our water would vanish during the day while we were holding clinics. When we returned to our house late at night we would find that thieves kindly left a few litres, basically just enough for us to brush our teeth and say goodnight. Again the administrator kindly helped by providing police officers to stand guard, day and night!. Regardless of the continues presence of security we all agreed that one feels more safe in Angola than South Africa. Because of the ease of vehicles, which all of a sudden became a luxury rather than common way of life, water could be fetched relatively quickly. It was good to ponder on what abundance we have in comparison to these people. It makes you appreciate what you have so much more. It also gave us an opportunity to help these people in another way as some would come to ask water from us during our stay there.
In Angola the dress code for the men it is mostly long pants regardless of the weather. Although there is no fine if you don't do this, you would get a surprise when you try and enter a bank in your shorts on a hot summers day.
Cuito Cunevale was a stronghold and strategic point during the civil war. Most of the town was therefore destroyed and military wrecks, bombs and land mines are common in and around this area. Even though a few international organisation like UNSICEFF and HALO Trust started helping in this area, they probably have not scratched the surface. One example was the donation of street lamps, and small water pump house next to the river to supply the town with water at certain spots and a huge generator provide the electricity needed for this. Everything is still virtually brand new but due to the remoteness of the town and the condition of the roads, the town is basically out of diesel, the fuel needed to run the generator. Therefore this white elephant has to remain unused untill an improved infrastructure will come to its rescue. The other problem is that if it breaks, who can fix it? For anybody who would like to help the people of Angola, this would be worth while keeping in mind.
Clinical work
The first two clinics were held in Cuito Cunevale itself. The venue was a huge catholic church which remained remarkably untouched by bullets (as far as I could see). Inside there was not much except for a red cross behind the pulpit and a small picture of the new pope hanging on the side. As usual we started the clinic with a devotion followed by the continues pour of patients from all directions. Dr. Onie quickly taught Mark (a physician assistant from New York) how to clean and extract teeth due to the growing number of patients outside. Time and care was taken to do preventative medicine as well as Dr. Onie gave brief cleaning demonstrations after which hundreds of toothbrushes were handed out. The type of pathology witnessed in Cuito Cunevale indicated the lack of proper health care and medicines. Extreme cracked feet, abscesses, tumors in children, worms, malnutrition, chronic malaria (especially with children), infected wounds, eye infections, amputees from the war and AIDS to name a few. The general condition of the older generation's health also seemed to be poor. Skin diseases and arthritis was common.
Translation remains a challenge with these outreaches, and this trip was no exception. Even though we had a few Portuguese speaking people, the local language is most often the only communication between doctor and patient in these remote areas. Angola used to be a Portuguese colony but received its independence around 1975. There are approximately 11 other native languages spoken in this country. In the areas we worked it was mostly Kangela (Lutshazi) apart from the busman languages. As usual a few people came to our rescue and although I don't remember their names, their unselfish sacrifices will certainly not be forgotten.
We did not witness many AIDS cases but AIDS is certainly there. If you think about it it, makes perfect sense that the virus has not spread so much yet. Even though immorality in some of these communities are openly visible, the people, due to the war that lasted almost 30 years, have been isolated from other countries up till very recently. Many of the areas are still very remote and traffics from other cities and towns are rare. Unfortunately the danger remains as Angola starts to open their doors to the outside 'developed' countries e.g. South Africa, in order to invest, trade and import goods.
It is a common fact that you often find between 60-90% of truck drivers are HIV positive, and this is alarming. When we entered Angola on the different occasions, we would sometimes see trucks lined up for kilometres long. Unfortunately an extremely common product to cross the border of Katuitui is, to our (South African's) shame, Castle Lager. The people of Angola are basically without food but yet the market places are flooded with alcohol to which SAB makes a huge contribution. It is sad, yet a reality, to see that so few people, organisations and churches has dared to enter Angolan by facing the challenging roads and conditions, while AIDS and Alcohol might be flooding in as we speak. Its amazing to see that in a country with such huge needs due to extreme poverty and danger, profit would dare to go far beyond charity.
The very last thing Angola needs is another' African Condom campaign'. It has worked no where in Africa even though politicians and even NGO's persistently thumb suck on this theory. Sound moral values should be promoted, implemented and encourage as the solution, and at the same time it might be a good idea for them to check their borders with rapid HIV tests. Strict control over prostitution could also help if you think of all the transport that will boom. It is ironic that a well developed country like South Africa would have a much higher AIDS problem due to a good infrastructure! Basically AIDS spreads much quicker that way.
In total we saw approximately 1400 patients, handed out many bibles 1000ths of tracks and posters and brought the gospel to many more individuals and families. The clinics were held on seven different occasions at 5 different areas.
Mad men making men mad
Something else we were faced with often was people who were mentally deranged because of the war. Soon after our arrival in Cuito Cunevale we met one such a man. Uncle George Osch, our cook, was enjoying a can of soda (a type of Coca-Cola) after breakfast when a man dressed in rags all of a sudden appeared from no where, going like lightning through our camp site. Stunned by this, we looked on as he slipped past Uncle George, taking his can of soda and then immediately throwing it to the back of his throat. After this performance he al of a sudden turned around and gave a friendly nod as he threw down a 10Kwanza bill (worth about 70c in South Africa) on the sand and then continued walking through the camp. While we were still amused by this, he surprised us again a minute or so later, throwing down another bill which might have been a sign of his appreciation.
Local people plainly refer to men like him as 'mad men' but a closer look at such a person might actually reveal an "individuals need" in stead of just a person who is "a burden to society". Many of these people experienced horror during the war, witnessing things unimaginable.
Another such an example was a man dressed in old torn and dirty military clothing walking up and down the main road of Cuito Cunevale. He had a thick heavy chain rapped around his body while dragging the remainder of it behind him in the dust. Although it is easy to say that he too 'has lost it upstairs' he was in fact probably communicating (in an inelegant manor) his inner need by symbolising how might actually feel like inside: i.e.. he felt like he is 'rapped in chains'. Many "intelligent" professionals with education levels exceeding far above most of these Angolans, probably don't have the faintest idea how to express their own needs and most inner desires. In reality you often find millions of people in the husle and busle of cities that form part of the giants of wealth, who easily mistake beauty for truth. These Angolans don't resort to wearing masks so quickly as you so often find in the Western cultures, but rather express themselves in a true humane manner. No wonder the Wise men came from the east and not the west.
One other evening while we were showing a film after holding a clinic in Masheka, a village approximately 80km away from Cuito Cunevale, an old lady decided to join the huge crowd that has gathered around our screen. She profusely shouted something o the effect of " You killed him. Its your fault. Your are all guilty." in their native language. I tried to lead her away calmly but she protested and made herself comfortable on the side of the crowd while continuing to shout aloud. Every so often somebody in the crowd would reply to her but other than that the people were quite content with the uncomfortable situation. We didn't know what to do either.
There were many others too: The extremely tall man walking on his knees by the bridge with very little clothing on; the guy who ate leaves and persisted to stand next to the preacher while singing loudly during meetings, etc. I don't know exactly but I don't think it is by shifting them aside. Please remember these in prayer.
People of Angola
The people of Angola is really what makes us go back there. We have come to love them over the years and there thankfulness and kindness towards us is addictive. In contrast one feels so sorry for them when you see the extreme conditions they live in combined with their need for healthcare and most importantly the Gospel. In general they strike you as soft, humble and friendly and one can understand their cautiousness to foreign help especially if you keep in mind that they just came out of a 30 year long war.
In 2 of the villages the community presented us with gifts; a goat leg and a live chicken. Obviously we were all very thankful for this, especially since we have not had real meat for a while. The goat leg went down quickly but when it came to the chicken it was a bit more challenging. One of the team members liked the 'little hen' and was hoping it would get away during the night by leaving its cage open. When we looked for it was no where to be found. A day or two later, while the rest of the team were busy with another clinic, the cook and I suddenly spotted a chicken, recognising that it was the one that was given to us. We caught it and after a brief photo session with our "meal" (to remember this memorable gift) the chicken made it into the pot.
On another occasion we could buy fish from one of the fishermen. Shop owners would give us beverages for free while others would give us discount at the market place. As previously mentioned the local leaders also went out of their way to make our stay as pleasant and safe as possible. Considering that many of them could probably hardly afford to help us in the way they did, we appreciate it even more.
The devotions shared with the villages can also be remembered for their beautiful singing. In some of the churches there would be approximately 4 or even more choirs ready to sing to the congregation prior to the service. I managed to record a few which you can download.
Casting more bread..
A man who works for a de-mining company in Angola, was asked why they leave the bombs and canons lying around, as they pose a huge danger to anybody who dares to touch them. His answer was that realise that there is a enormous need for this, but they just don't have enough manpower. Therefore they focus on taking out the" bombs" you cannot see first i.e. the land mines, as they are even more of danger. In life it is many times like this; humans easily watch out for the dangers that are openly and clearly visible but they forget that the ones we don't see are the ones we should really watch out for. These invisible 'mines' are the real enemies and destroyers of society, families and individuals. One example is the AIDS epidemic in Africa. To solve this human pandemic, the attention is so easily shifted to simple materialist device i.e. a condom, while the main problem is the unseen one i.e. immorality, lack of values and good decisions. These are made in the unseen realm, in other words peoples minds and hearts, and these decisions are influenced by what they see and what they hear. If the main problem has to do with choices and morals, then we shouldn't expect a peace of latex to help with decision making but rather encouragement to faithfulness and abstinence un till marriage.
We were overjoyed to witness many people accepting such a behavior change in their own lives and a zeal to tell others to do the same. There is no greater joy than to know that the work you do bares such an eternal fruit, when you see people accepting Christ Jesus.
Another practical lesson we learned was from the millions of flies in Angola. In some of the areas where we traveled we were consistently bugged by flies. During clinics, that were mostly outside, doctors would have to fend them off while trying to examine the patients. Especially when there were open wounds, abscesses or skin diseases.They were especially active at the dental section where kids would sit with wide open mouths while flies would daringly fly in and walk around on their lips. It was almost impossible to chase them away and the team must have caused some human to the local people as our hands would instinctively be waved around our heads like a cows tail. The villagers in the other hand, were relaxed allowing flies to sit, walk and fly where they want. Kids had them in their eyes, faces etc. In the summer it gets extremely hot and dry in these areas and so the insects become desperate for a bit of moist. There is also a smaller type of fly in these areas, and I can believe that this little guy could even be the cause death by frustration.
Apparently it has happened during the war that soldiers, out of frustration, through down their weapons after months of tormentation of these little flies. They seek any kind of moist; in you ears, eyes, mouth, armpits, nose etc, and would literary go inside. Waving them away is a waste of precious time and energy. It is amazing that an insect approximately 3mm long could make a trained soldier just 'give up'. Unfortunately these flies also pose a health risk to the communities as they could spread other diseases as well. During dental procedures they would uninvitedly sit on the patients lips and even wonder around inside of the mouth while procedures were taking place..
In closing
If you plan to assist Angola my advise would be respect their protocol, respect the leaders and don't go there if your are not serious in serving them only. We have come to love the people of Angola very much and we would not like to see them become corrupt because of your selfish ambitions. If you would like to assist us wit our next outreach to Angola, please contact a2a@dfl.org.za
'Doctors for Life International' represents more than 1400 medical doctors and specialists, three-quarters of who practice in South Africa. Since 1991 DFL has been actively promoting health care that is safe and efficient for all South Africans. DFL was founded as a South African organization in 1991 and has spread across the globe. DFL is involved in several community projects including orphan care, the care of terminal AIDS patients, malaria prevention and the care of abused women.