The Swaziland Experience

Sawubona,

Hello again from Swaziland! First off, I really want to thank so many of you who have told me that you read and enjoy my emails. I feel blessed to have so many people who care about me and my time in Africa.

For my next email update, I would like to do my best impression of Carrie Muskat’s Mailbag on Cubs.com or David Letterman’s CBS mailbag. So, whether you receive this email directly from me or if it’s passed on from a friend, please feel free to email me questions. Anything is fair game. If I get a lot of questions, I might not be able to answer them all. If I don’t get many questions, then I’ll make some up to try to save face for my failed experiment. So, don’t be bashful, send those questions to me.

I have been visiting homesteads regularly, and this has continued to be such a wonderful experience. I am really realizing the impact of the home-based care groups throughout southern Swaziland, as almost 250 trained home-base care workers are part of our network. I have been so blessed to see their servant hearts as they do all that they can to help their neighbors. Their dedication is amazing.

If you’re interested, please continue to read below for all sorts of stories and follow-ups. Also, please remember to email questions for next update’s Swaziland Mailbag!

Nkhulunkhulu akubusisa,
Tim

+++++++++++ For the curious: +++++++++++

1. I Can Read
2. Thobile Again
3. Fansile Is On ARV’s
4. Rare Sights
5. Some Challenges
6. I Gave the Sermon
7. Lavumisa Church
8. Please Continue to Pray
9. Prayer Requests

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1. I Can Read
A while back, I proudly delivered the information that I’m not an idiot. Now, I’m finding out that I can read, too. Before coming to Swaziland, I don’t think I had finished reading a book in years, but rural Africa can turn almost anyone into a reader. I have enjoyed reading. Right now I’m working on a great baseball book: Three Nights in August.

2. Thobile Again
You’ve probably noticed that Thobile appears in many of my updates. I try to stop by her work to check on her every couple of weeks. I’ve seen many, many sick Swazis now, but you might remember that I met Thobile my very first week here. She was one of the four people in the hospital room when I met my very first sick Swazis, and for this reason she has a special place in my heart. I could write about a different person in each update, but I enjoy letting you get to know Thobile.
This week I visited Thobile at work. I always ask her over and over if she’s feeling okay and if she’s feeling healthy. Just as I was about to leave, I asked one more time. She pointed out that she has started to get small sores on her skin. She showed me several small sores on her arms and feet and told me that there are more. She started to get the sores two months ago, and I know that they’ll likely get worse and worse. This provided the opportunity to talk about ARV’s and if she wants to get a CD4 test to check her eligibility. She and I are both quite certain that she would qualify. She had a CD4 test a couple years ago with results in the mid-200’s (below 200 is the threshold for ARV’s). I have realized that she is very thin, but when I saw a picture of her from two years ago, I was shocked at how much weight she has lost. Without ARV’s I know that she could get very sick very fast, and then who would take care of her grandmother and daughter? I know that ARV’s are important for Thobile to live the best quality of life and to live as long as possible.
Starting on ARV’s is a difficult decision. We talked about three specific fears that Thobile has of starting ARV treatment:
a) Missing work. If Thobile starts on ARV’s, then she’ll have to be late to work on the day of the CD4 test, she’ll have to miss a day of work to start ARV’s, and she’ll have to miss a day of work each month for checkups and ARV refills. She works 8-5 Monday through Saturday, and getting the time off would be very difficult, not to mention the lost day’s wages. She said that her boss would be very upset if she starts to miss a day of work each month. She also rejected the idea of explaining the situation to her boss and asking for cooperation (although I’m going to talk with her about this again and ask if we could talk to her boss together).
b) Side effects. Thobile does not know anyone who is on ARV’s, but she has heard terrible things about side effects on the radio. Admittedly, ARV’s can be very harsh with numerous side effects. Without ARV’s, though, she will suffer in other ways, such as increased skin problems and almost certain earlier death.
c) “Life sentence.” Thobile knows that if she starts on ARV’s that she will have to take them for the rest of her life. This seems like a trap to her.
I’m sure that there are other fears that Thobile and I didn’t discuss (such as stigma and discrimination if people find out), but the main point is that starting ARV treatment is a hard decision to make. This is why denial is sometimes much easier. I am encouraging Thobile toward ARV’s, but she must make he decision herself. I will keep you updated.

3. Fansile Is On ARV’s
I’ve also written previously about Fansile. I first met Fansile at her homestead when we had actually come to visit her grandma. After I realized her extreme sickness, Fansile and I walked through all the steps to get her on ARV’s except the final visit to the clinic to start on ARV’s. We lost touch over Christmas, but this past week I visited her homestead with three home-based care members. I was excited to see that she had been to the clinic to start ARV’s. I was also excited that one of the home-based care members who I was with, Make Msimango (Make means “mother” but is used like Mrs.), is on ARV’s and was able to give very good ARV counseling to Fansile. Unfortunately, Fansile had not been taking her ARV’s because she had no watch, clock, or cell phone at her homestead to keep time. She didn’t know what would happen if she took her ARV’s at the incorrect time, so she had stopped. Make Msimango was able to give her advice to simply take the ARV’s as close as possible to 6:00AM and 6:00PM as she can guess, and she stressed that it’s very important that she does not stop taking ARV’s. Make Msimango then told Fansile to come to her homestead and ask any questions that come up regarding ARV’s. This is one example of the lack of intuition that many Swazis have regarding medication, and this is one reason that ARV counseling from the home-based care groups is so important.
I was excited to see the effectiveness of the home-based care. I am glad to know that Fansile is now in good hands of people who will continue to look after her and encourage her to properly take her ARV’s. This is really an example of the effectiveness of the home-based care system.
I was also glad to see continued improvement in Fansile’s skin from the medication that the doctor has given her. I am confident that the ARV’s will continue the improvement. She appears to be so much healthier than she was two months ago. She and her family are very grateful.

4. Rare Sights
There are a few things that I have rarely or never seen here:
a) I’ve never seen an airplane fly over Nhlangano. When the sky is clear, I search all day long, but I have yet to see an airplane. I don’t think that a single commercial route flies over Nhlangano, and no private airports are nearby that I know of.
b) I’ve never seen a Swazi spit, but I bet I’ve seen men urinating at the side of the road hundreds of times.
c) I’ve never seen a window screen in Swaziland. For a country with hot temperatures, no air conditioning, and many bugs, this seems a little surprising.
d) I’ve never seen a Swazi chew gum (except maybe once on the bus to Manzini).
e) I’ve never seen a topless Swazi woman like they show in all the pictures, but I’ve seen plenty of Swazi women nursing — on the street, in church, beside me on public transportation — pretty much anywhere.

5. Some Challenges
Overall, I’m still feeling great, but I do sometimes face discouragement. Perhaps I’m hitting a second round of cultural adjustment. As the newness and automatic excitement for life in Africa wear off, I’m faced with a new set of realities and challenges.
Over the past couple weeks, I’ve really started to miss family and friends back home. I wouldn’t say that I feel lonely, but I certainly have an emptiness that can only be filled by people who are almost 10,000 miles away.
I also am able to see some of the challenges and limitations of short-term missions. In the end, I know that I will have affected several people in deep ways, and I know that I’ll never see life the same again. I also realize the incredible importance of long-term missionaries like Arnau, who has been in Swaziland now for 23 years. The relationships that he has formed and the understanding of Swaziland that he has developed have enabled him to establish a very large and growing ministry for AIDS care throughout southern Swaziland.

6. I Gave the Sermon
With about 20 minutes of notice before the service on January 27th, I was asked to preach because Arnau wasn’t feeling well. Like my conversation with Lwazi a couple months ago, I talked from Galatians 5. I really believe that we all have to make a simple decision whether or not to fight the sinful nature and replace it with the Spirit. Over and over, I am amazed that people think that we know a little better than God what will be good for us.

7. Lavumisa Church
I wrote about a potential church plant in Lavumisa in my early updates. We will have a meeting on February 24th in Lavumisa to figure out if there is a need, and how to proceed if so. As I mentioned before, Arnau would like to make this a different type of church plant. Instead of putting up a tent and hoping people come, we would like to first develop a core group of one or two families and then grow from there. I might end up having a lot of involvement with this church, so please keep it in your prayers.

8. Please Continue to Pray
Please continue to pray for me. I really need your continued prayers. I am so grateful for all the prayer that I have received. I can’t explain it except to say that it means a whole lot. I feel like one of the most prayed for people on earth, and I thank you for this.

9. Prayer Requests- Please continue to keep Lwazi, Thobile, and Fansile in your prayers.
- Continued guidance for the ways that God can use me in ministry
- Lavumisa church: preparation and guidance
- Expansion of the home-based care groups starting soon and continuing throughout the year
- Praise for food shipments for the Dwaleni orphans
- Prayer for Make Khumalo’s daughter Sibongile, who is sick with TB
- Prayer for sustained joy and contentment for me throughout my stay