Danner Update

written by our guests, Dr. Dee and Janet, who are here for about a month providing dental training, dishwashing services and comic relief. (See photo of Dee)

Habari Gani?  ("Hello how are you?" in KiSwahili) or Jambo!

The proper response is: Safi (Safee) which means "clean".

 So we find ourselves in Tanzania! We left our home on a Wednesday Jan. 29 at 9:30 am and arrived at City of Hope on Friday at 7:30pm.  Where did we lose a day? We did spend one night in a guest house in Nairobi, Kenya; however, we arrived there at 1 am and left at 5:30 am. We have heard the guest house is a beautiful place, however it was dark when we arrived and dark when we left!

Entrance to City of Hope

You can imagine on the 10 hour bus ride, I began to wonder why I was doing this. Talk about being tired! We had been told which town the bus stops in to get off and purchase some lunch, however we never knew which town we were in, so we missed lunch! The good news is that I had purchased two bags of Chex snacks at an airport, so we had that and water. This is a tea drinking country, luckily I had brought instant coffee that had cream and sugar already in it.  Wow, did that taste good in the morning!

Someone was to meet us at the end of the bus trip, and we knew the name of the town. Apparently the bus driver was picking up extra passengers and dropping them off where they wanted, so every time the bus stopped, we asked another passenger,is this the right town? I was a little anxious because this was the first time Dee and I had traveled alone. We had one problem after another and could not get our phone to work, so we had no way to contact anyone if something didn't go as planned.

Well everything did go as planned, we met our gracious host at the last bus stop, did the necessary paperwork to cross the border from Kenya into Tanzania and we were on the last leg of the trip to the City of Hope; dead tired. It was dark, the roads were dirt with potholes everywhere. People walking,kids playing, and motorbikes flying past, and our driver also going very fast! I think they could hear us coming and everyone flew out of our path! The most I would have gone was about 10mph on that road! So here we are flying through the country and all of a sudden he turns left and it was like another world. Beautiful flower pots, flowers everywhere and a beautiful painted gate with a roof over it! We passed through the gate and there were 100 children standing there singing to us that they were glad we were there and they were happy to see us! I can't explain to you the feeling of joy, peace and happiness that instantly came over me! It just couldn't have been any better, then all the children came to us wanting to tell us their names and shake hands. It just couldn't have been any better!

Banana Grove 

Walking to the Clinic.

We waited until Monday to start our class on dentistry. We have three women and two men and they all seem to be brillant. They learn very quickly. I have finished teaching them how to do fillings, now we just need patients for them to practice on. As soon as they have had some experience with fillings, Dee will begin teaching extractions.

One student was pregnant. I think it was on Thursday they said she could not come, she had some pain. She had her baby that night and told Dee she would be  back to our class on Monday! Can you imagine? She had her baby and 20 minutes later was on her way home!

The food has been great,except for the rocks in the rice. And if there is going to be one rock, it will always be in my rice!They are so small, you can't see them to pick them out.

If you ever have trouble waking up, take a cold shower in the morning as we are doing. Guarunteed, you will be awake, instantly!  Glad I brought biodegradable soap, so it is not too hard to rinse off.

Downtown Ntgatcha. Also known as "keep left".

Amani Hospital (the City of Hope clinic)

Cow xing

We definitely learn to appreciate all the nice things we have in the U.S.! I did our laundry today, quite a process in buckets and hand wringing. Dish washing seems to take at least one and a half hours with two people doing it. Today church was late because the kids had to go to the river to get water, we were running low. You should see them carry back these big buckets of water on their heads without even holding them!

City of Hope grows a lot of their own food, so the kids are up at 6am every day to work on the farm before going to school. They don't have high school at City of Hope yet, so the older ones have to walk 1 1/2 hours each way to school, that is a long day. Everything is so organized, and the children all seem to be so well behaved, friendly, and happy. I have only seen two adults in charge of them, one for the boys and one for the girls. They give a lot of responsibility to the older children.

Destiny Primary School, City of Hope 

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Please pray for good health for everyone here, patients to give our students good experience while we are here (we were pleasantly surprised when we screened the orphans that generally their teeth were in great shape.  They have a regimented brushing program and most were brushing very well).  Also pray that all the orphans have a strong relationship with Christ knowing that he will protect them and love them.

I almost forgot to tell you, one of our students is so excited about learning this dentistry he is already talking about possibly going to dental school!

Dental patients

Examining the Children.

Cooking ugali. (ground maize mash)

I hope this letter has found you well and full of His peace.

 Blessings,

Janet and Dee

A Statement of the Problem

by Ty

The problem, as I have seen over and over again in different parts of Africa, is that Westerners typically assume that global health means doing what we do in America, just doing it at a different latitude. They think this way about health care, education, ministry, you name it, but let me talk about health care, which I know a lot more about.  This is a really bad assumption.  To counter it, I would ask these questions:

Are we even happy with the American health care system?  Most doctors and a growing majority of patients are not.  As Walter Cronkite said twenty years ago: It is neither healthy, nor caring, nor a system.  Well then why in the world would we want to unthinkingly export it?  It's not all bad, but I ask this: What part of the American healthcare system SHOULD be exported?  And what part should be quarantined?

Let's apply that to the American church while we're at it: What part of the American Church SHOULD be exported?  And what part should be quarantined?

My working hypothesis is this: We American Christians (and in particular doctors, who are a product of 30 years of our education system) are not really Christian in our basic assumptions.  We are humanistic reductionists with a Christian skin on.  Recently, a biomedical sciences professor, seeking to talk to a practicing Christian doctor about ethical practice, asked me about how Christian doctors typically handle a certain subject.  You know what I had to say?  I said, "Typically?  They do the same thing that everyone else does!"  I was ashamed to have to say it, but it's the truth.

Therefore, over the past 5 years, I have decided to work with students and residents at the Worldview level.  This is of the utmost importance, especially for people in training.  At least, I know that it is what I am called to do.  Better then teaching someone how to treat malaria and TB, or how to do a C section without electricity, or epidemiology, or whatever other technical skill/knowledge you can think of, I think it is more important to give Christian doctors a cohesive biblical worldview and understanding of health.  That's why I work in this little place in TZ.  Students get to work in our little clinic and see all the diseases of poverty, and to try to help people with some very basic resources (so far our clinic doesn't have electricity or running water).  AND during that time, I strive to get them to work out a biblical understanding of health.

To put it in an unkempt syllogism: 

Western Christian doctors are usually humanistic reductionists with a Christian skin on.

African Christians are too often animistic pagans with a Christian skin on.  If you put Africans and Westerners in a seminar together, they see these deficiencies in each other more easily than they see them in themselves.

Neither of these worldviews has a biblical understanding of health.  Meanwhile the Bible teaches people how to flourish (my working definition of health) on every page.  Think of the psalms about a flourishing tree planted next to a stream of living water. Therefore, an appropriate response to the situation is to seek to understand, and then transfuse others with a Biblical understanding of health.

To do that, you need to deal with:  What is Health?  Who is Man?  Who is God?  What are soul and spirit?  What is spiritual health?  What is the gospel?  What has it done to you?  What does it do to cultures/communities?  So we spend hours a day, sitting under an Acacia tree with our Bibles and talking about this stuff.  I think this foundational big picture stuff is the most important thing, and given one month with a student, I think it is the best thing to address.  Real expertise in malaria, TB, and HIV can come later, when a cohesive Christian philosophical framework has been developed in the student, and they therefore have a place and method to house the technical information.  I build the bookshelves.  Others will fill it with detailed books on technical subjects.  We do, by the way, then take our Christian framework and try to apply it to real problems, like HIV, reproductive health, malnutrition, etc.

This absence of a cohesive Christian philosophical framework for health and the practice of medicine is just as big a problem in the US as it is here--maybe more so.  I believe to develop and teach a biblical understanding of health is the antidote to our broken system.  It is the real "health care reform" we so desperately need.

My next seminar with a group of 15 students is in July.  In Jan, Feb, and March, we accept students and residents on elective rotations.  Lots of people would rather go to a big mission hospital and do something technical for the month.  But that is not what I think is needed most. 

I don't advertise this way, because it would scare people, but once they are here, a couple of days into the month, I often tell students, "You are here for a good brainwashing.  After the education you've been through, your brain needs to be washed."  They usually like that joke.  And assent to a being washed with the water of the Word.

How to fill a tooth in the dark — Building local capacity

By Ty

Imagine living as a farmer out here in remote Tanzania.  You have no cash in your pocket on a daily basis.  Now imagine that you develop a toothache.  The cost to get to the city (the nearest dentist, who often doesn't use anesthesia, by the way) is about ten dollars.  And it's another ten dollars to get the tooth pulled.  That's about what a goat costs.  And you only have two goats.  It would take you three weeks to earn that much money, if you could find a job, but there aren't any jobs.  So you just live with two months of excruciating pain, pus pouring out of the roof of your mouth, until your tooth finally falls out.  Or worse yet, your cow kicks you in the teeth, breaking off several in the front at the gum line. You save up fifty dollars over six months and you take a trip to the city to find a dentist.  Everyone says there is nothing you can do (unless you are rich, and you travel to the capital and spend $1000 to get your teeth fixed--but they don't even tell you that part because they know you're whole farm isn't even worth $1000).  You just have to live with that for the rest of your life.  Now you can see how valuable skills in dental care would be out here--how much you could help people if you had them, and how much you could help yourself.

That's why we're excited to be hosting a class in appropriate dental treatment for the next month.

In an effort to build capacity within the local community to improve their own health we happily welcome Dr. D and J, an amazing couple who are a dentist and a dental hygienist who have come from the states to teach a course in ART (Atraumatic Restorative Treatment) .  Most simply stated, this is how to do good dentistry in the bush, without electricity or running water, much less fancy technology. These good folks (and dear friends of ours) have gone out of their way to learn and then learn how to teach how to provide much needed dental treatments such as fillings, repair of broken teeth, and even pulling of teeth that can't be saved--all safely and relatively painlessly.

J. and D. teaching ART to the clinical staff.

Dr. D. oversees the students evaluating each other.

The class is attended by all four of our Tanzanian medical clinic staff , a City of Hope staff member, as well as a couple of other guests.

In the interest of helping nearby communities and health professionals, we invited two government clinic employees from neighboring communities.  We offered to give them the training completely for free (rarely do we offer things 100% free).  The invitation was extended by  Dr. B, the general manager of our clinic, who knows both of them personally.

Evaluating all the children at City of Hope (Little T. has 2 cavities...frown.)

Practicing on one another.

Their response was surprising.  They asked, "How much are you going to PAY us to receive the training?!"  They pointed out that when a particular non-profit organization with the word "population" in their name came to this region, they paid local nurses 75,000 Tanzanian shillings per DAY to listen to their training in how to hand out condoms (assuredly a simple activity)!  75,000 shillings is $50--what a typical farm laborer here would make in a month!

Why would anyone pay such a ridiculously high rate to "teach" someone population control...I mean, how to put on condoms?  Perhaps they are motivated by promoting their ideology?! (I will leave my population control rant for another day--the short version is that if you simply send girls to school, and help people improve their land and agriculture, there will be no "population problem".  Sub Saharan Africa is incredibly fertile.  She can feed herself. )

Furthermore, paying over-inflated wages is TERRIBLE for the local economy.  It leads to inflation of actual health care and other costs.  Why would a nurse sit in a village and treat poor people for malaria for five to ten dollars a day when she could sit in the city and make $50 listening to a westerner tell her how to hand out condoms?  Well, she might sit in the village if she could get $40 a day instead of $5. So what does she do?  She either goes to the city, leaving the poor with no help, or she charges the poor higher fees to make up for her lost "opportunity" in the city.  Look, if someone wants to offer seminars on how to pass out condoms, I won't argue.  I believe in a open and free market of ideas. They are welcome to try to offer their condoms as a way to help the poor.  But don't pay people RIDICULOUS sums to sit in your lectures.

I was pretty angry when I heard this.  I'm glad I wasn't face to face with the guys when they said they wanted to be paid to receive a free gift. which we were offering in an attempt to educate them and help their communities.  Because I might not have been gracious about it.  I said we are not going to pay them.  I still hope they come anyway.

Lest I spend too long astride my high horse, I shall get off now.  This morning I read about Peter's denial of Christ.  At the Last Supper, Jesus warned the disciples that they would disown Him and run away.  Peter vehemently denied this possibility.  Basically he said: "Others may do this, but I won't.  I would sooner die."  It was much easier for Peter be to critical of others than himself--to imagine others failing, but not himself.

I find myself asking:

How often do I do that?  How often do I find fault in others, when I am guilty of the same thing myself?

In what way am I guilty of the same thing I am critical of in others (witness my tendency to criticism above)?  How often does God give me a gift, and in return I demand to receive something for the act of accepting it?

How often does God send me a trial--for my own benefit--only to find that I demand some blessing simply for the obedience of tolerating the gift?

Our trials are gifts.  Usually we tolerate them at best.  Usually we want something good to be given along with the thing we can't help seeing as bad.  We want to be paid to tolerate our trials.  Rarely do we receive them warmly.  But why would God allow them if they weren't for our good in the end--even if we can't see that good now?

Our trials are gifts.  If only our hearts could believe it.

A Confession

Written by Ty

I have a confession to make.  I feel a pang of guilt every time someone in America asks me what I do in Africa.  I feel guilty because I fear I am not meeting the expectations I assume they will have when they know that I am a doctor and that I work in Africa.  They expect that I see patients and prescribe treatments eight hours a day.

The truth is that I don’t do much of that.  I do some of that—especially with the more complicated cases that the Tanzanian nurses request my help with.  I do go to the clinic often, but most of my time there is spent teaching—teaching the Bible and teaching medicine.

My calling is to teach.  It is to teach a biblical understanding of health as a philosophical foundation for helping people lead healthy lives.  This is not something I was taught in medical school.  In fact, I was taught essentially nothing in my training about a philosophical foundation for the practice of medicine.  Medicine, as it is understood and taught, is no longer about health.  This is true in the west, and because medical education in Africa has a strong tendency to emulate the west, it is usually true here.  In my experience, many health profession students in America cannot give me a good definition of health, and if they can, then they give me a definition that has little do with what they are being trained to do.  “You mean being healthy doesn’t have much to do with going to the doctor?” I reply in mock surprise.  “Yeah.  More like it means you don’t have to go to the doctor,” they tell me.  Basically, they are right.

But my confession doesn’t end there.  What we have now is a simple outpatient clinic that serves about 100 patients per week.  We need to go to the next level.  The small amount of curative care that we are providing is good, but it cannot be all that we are doing.  I don’t want this hospital to be just another mission hospital—a clone of many that are all over Africa.  I want it to be a place of investing in, teaching, and building biblical health and transformation.  Health is about so much more than pills and surgeries.  And if I spend all my time doing pills and surgeries, then I won’t have time to walk out my calling of re-establishing a biblical understanding of health as a sound and cohesive philosophical foundation for health care.

My confession is that I have been afraid to move the hospital forward because I have been afraid of it not developing into that place of health and transformation.

I’ve been thinking about: what do we need to do to go to the next level?  Will you pray with me about that?  I need discernment from God.  I think we need another person on the team—a doctor or nurse who can focus on doing some of the primary care, as well as work with our team on community health—building capacity within the community to do things that will foster their own health: such as education, agriculture, and clean water.  Will you pray that God will bring us the right person?  Maybe it’s you?


And some items for prayer:

Pray that God would give us discernment and resources in trying to take the clinic "to the next level."  I'm trying to figure out how to find and finance a full time community health worker--someone who regularly visits with leaders in villages and works with them to figure out how the community can improve their own health using their own resources.  Better water and better food are prime examples, and places where better use of already existing natural resources here could make a great impact on health.

Also pray that I am a good dad: that my kids know that I am available to them all the time, and that they are a higher priority than ministry.

ty

Aw Rats!

Here are some recent snapshots of the little everyday things.

A midnight rat raid! True was certain he would be able to get it with a flyswatter--or a boot if really necessary! Doesn't he look eager?

Diana and an impromptu art lesson. She plans to teach some art classes to the kids soon.

Wren's first day of school! She is going half days and sitting in the "nursery" class which is 3-6 year olds. Nancy takes her every day and she is really loving it!

Wren and Deborah enjoying coloring on the porch.

Lately some moments between the children have been very sweet.

Nancy is establishing our herb garden-we planted cilantro, basil, summer savory, dill and some others! I can't wait to make pesto!

True helping trim some trees.

Julie and Nancy during our saturday morning small group time-when we really like to check in with each other and ask the question: "Where are you now?"

Psalter has plenty of willing arms to hold him.

Julie's Welcome

By Julie

1/14/14

As I sit on my lower bunk, blue mosquito net swaying slightly beside

me, listening to the drum beats of an African dance party outside my

window, I am struck by how incredibly thankful I am to be here.

MAF Hangar - Wilson Airport

After our arrival in Nairobi we spent 2 days at a Mission Guest House

just outside of town. It was so beautiful! It was also really helpful to have some time to rest and get adjusted to the time difference. On Monday morning we left the guest house and headed to Wilson airport to take an MAF flight to a town just inside the Kenyan border (Migori). It was so much fun to get to take an MAF flight again (even though it made me a bit queasy)—it brought back a lot of fun memories from growing up with a missionary pilot dad :) particularly because the pilot’s daughter was able to join us for the flight—just for the chance to fly with her dad, which I was able to do a few times growing up.

Departing Wilson Airport for Migori, Kenya

Just before takeoff

The youngest flyer

Touchdown!

Ground transport to the village

A ride from City of Hope was waiting for us in Migori to take us

across the border into Tanzania (about 15 min) and then another 45

minutes to City of Hope. Africa is SO beautiful! I loved seeing all

the trees, and the locals going about their days, many of the women

balancing large bags and baskets so perfectly on their heads, all the

dust being kicked up from the dirt roads. There is a side of me that

comes alive in third world cultures that is easily and often lost in

the US. It has been incredibly special to reconnect with that part of

myself. It makes me so happy to watch Wren and True fit so comfortably

into this culture which they have spent part of their very young

lives; I smile knowing they are growing up as Missionary Kids and how

special this time will always be to them.

As we pulled up to City of Hope I could see all the children

in their uniforms standing together, dancing and clapping as they sang

a special welcome song for us. After their song they all rushed toward

us with huge smiles on their faces, eager to ask us our names, hold

our hands and give us hugs. These children are so sweet and welcoming. They offer their love eagerly, without even knowing who you are. They radiate delight and joy, and it makes me eager to learn how to love and experience joy like that; that comes from deep within.

Everything about life is completely different than it was a week ago,

and I am soaking it all in. This morning I enjoyed waking up before

the sun without an alarm – watching the sun bring everything alive,

listening to the birds chirp and the children sing praise songs—it was

the perfect way to start my first full day in the place I will call

home for the next three months. It was fun (and exhausting) to

experience a bit of African life—washing dishes and cleaning out

drawers using large wash bowls outside in the hot African sun (I

forgot sunscreen on the back of my neck—whoops!). I am eager to see

what God has planned for my time here—both the joys and the struggles, the fun things and the hard things.

A friend told me they were praying Ephesians 3:20 for my trip,

and I have adopted that passage as my own prayer for this time as

well: “I pray that out of his glorious riches he may strengthen you

with power through his Spirit in your inner being, so that Christ may

dwell in your hearts through faith. And I pray that you, being rooted

and established in love, may have power, together with all the saints,

to grasp how wide and long and high and deep is the love of Christ,

and to know this love that surpasses knowledge—that you may be filled

to the measure of all the fullness of God. Now to him who is able to

do immeasurably more than all we ask or imagine, according to his

power that is at work within us, to him be glory in the church and in

Christ Jesus throughout all generations, for ever and ever! Amen.”

Ephesians 3:16-21 (NIV).

Getting There

Written by Julie and Diana

Ty, Joi, the three children, Diana and Julie all left Blacksburg on

January 10th with a very full minivan and a trailer behind loaded with

8 large shipping containers, 1 bicycle and 7 suitcases headed for

Dulles International Airport. After the 5 hour drive we stopped at the

National Air and Space Museum (right next to the airport) to stretch

our legs and let the kids run around.

We got to the airport where we met up with Nancy. Nancy is 19 and is

spending the next few months helping out at City of Hope, especially

with the Hopkins kids. (She will introduce herself a bit more soon!)

It was quite a process to get 8 people checked in and 17 pieces of

luggage checked! But we finally made it to our gate and to our first

flight to Paris, which thankfully was an uneventful 8-hour flight!

Then came Paris…

Paris was not as uneventful! For whatever reason, we were not able to

get our boarding passes for the flight from Paris to Nairobi when we

were in DC. One very important lesson: you can’t go anywhere in an

airport without a boarding pass! We were concerned that if we couldn’t

get the boarding passes in time we would miss our flight, which

would’ve caused a multiple-day delay. After getting sent in different

directions by at least 4 different airport attendants, going up

escalators, down hallways, on one tram and a bus, we finally made it

to the international transfer desk  and made it to our gate with just

minutes to spare. (Along with many other people which we found out

were in the same boat!) Joi was deeply disappointed to miss her chance

to eat a bona fide Parisian croissant.

Then once we were on the plane, we had to wait for a passenger coming

from a delayed flight and sat for an hour and a half before taking

off! Diana really enjoyed having a spiritual conversation during the

flight with an African Catholic nun sitting by her. So after another

long flight we landed in Nairobi much later than anticipated.

Thankfully, the immigration line was shorter than Ty and Joi had ever

seen it, and we were able to get through very quickly!

However, we were some of the last people to leave baggage claim

because of how long it took to get our 17 pieces of luggage, one of

which (the baby stroller) never showed up! The drivers who picked us

up performed a miracle getting all of our luggage into a small van and

a car! So, the flight landed at 11pm, and we didn’t leave the airport

until 1:20am! Needless to say, we were all exhausted by the time we

got to the guesthouse and everybody ended up getting almost 10 hours

of sleep!

We spent Sunday resting and re-packing while Ty ran some errands in

the city, and we leave for Tanzania on a charter flight Monday

morning!

“Now to Him who, by (in consequence of) the [action of His] power that

is at work within us, is able to [carry out His purpose and] do

superabundantly, far over and above all that we [dare] ask or think

[infinitely beyond our highest prayers, desires, thoughts, hopes, or

dreams]—To Him be glory in the church and in Christ Jesus throughout

all generations forever and ever. Amen (so be it).” Ephesians 3:20-21

(Amplified)

__________________________________________________

Julie is spending the next three months in Tanzania with the Hopkins

as a mission intern. She is 23 and lives in Radford Virginia, working

as a server at Olive Garden. She is taking the next three months to

work at City of Hope with the Hopkins, seeking the Lord and some

clarity for what the future holds for her. She recently graduated with

a degree in Women’s Ministry and is excited to see what opportunities

she will have to use it.

Diana is Joi’s mom and a 63 year old mother of 3 and grandmother of 7.

She is at City of Hope to help out in whatever way she can. She is

praying that God will soften her heart to other cultures and their

other ways of life, and wants to develop more of a heart of compassion

for third world cultures. She is excited to see how God will transform her heart through this experience.