Thoughts about my trip...

It is a long trip, and seems to get longer as I get older. It takes me at least a week to “re-adjust” to the time zone so that I sleep at the right times. Still all of the flights went very well and my luggage arrived at the same time as I did, both going and returning.

• It was really good to see so many of our friends: in Harare, at St. Theresa’s, at Driefontein Mission, in Masvingo, and in Gweru.

• Zimbabwe continues to “look normal” even though there are many bad things happening throughout the country. Fortunately, none of those things are happening in the areas where I was visiting.

• All of the stores have quite a good supply of goods to sell, although at a premium price about 10 to 30% above what we would pay in the U.S. Every place now accepts either US dollars or South African Rand, BUT the money is SO terribly dirty. It is amazing to see dollar bills on which you can barely read the denomination or see the picture. This is especially true of the lower denomination bills.

• I did take care of one of the wards for a few weeks, and even did three C-sections and a couple of other small surgical procedures. It was good to be doing some clinical medicine again.

• All of the people working at St. Theresa’s are doing a tremendously good job. It was so rewarding to see everything running so well. The two young Zimbabwe doctors are doing a great job, as are all of the nurses, administration people, and of course, the Dominican Sisters – in fact, ALL of the staff continue to do exemplary work under very difficult conditions and with very low pay. Even though I did some clinical work, they could have gotten by without me doing that. It does mean that in the future, I can go for just two to three weeks and accomplish all that needs to be done.

• The hospital census is averaging about 50 to 60 people per day. That is such a difference from when we first went back to Zimbabwe in 2001, when the average census was over 120 per day, and some days as high as 145 patients. The difference is due to the very large number of people now on Anti-Retroviral drugs for AIDS. More than 1300 people are returning every one to two months to get their drugs, and are completely well! This means that none of those people are being readmitted every month or so for opportunistic infections. Of all that was accomplished while we were there, this is the most significant. It means that these people can live healthy, productive lives and can continue to take care of their children. Of course, some 70 of these patients ARE children, and we are hopeful that the medicines will prove to be lifesaving for them for many, many years to come, and that at some time in the future, there will be a treatment that will truly cure AIDS.

• I made some home-visits with Sr. Andrea, specifically visiting some people that have been on ARV treatment. Here is a man with quite a story, which he was happy to relate to us: Two years ago, he was totally bed-ridden, and unable to get out of bed at all without help. He was started on ARVs, and for one year, he still needed help. He showed us a wheelbarrow which his family put him in to get him to the pit toilet, or to just let him sit outside on a blanket. After a year, he started to slowly improved, and now he is able to walk with the aid of a stick; is able to work in his garden, and has such a smile! Click on the image to view a video clip of this man; he specifically gave me permission to use it “as I wanted to.”
  

• Another place we visited was where a grandmother was looking after three of her grandchildren. Both of the parents had died of AIDS, and one of these children had recently been started on treatment. Even though people are so very, very poor, they still have such nice smiles, and have such good attitudes. We can indeed learn from these very poor.
  

• I left Zimbabwe with a sense of hope; hope that the leaders of the country will be able to find a way to have true democracy so that they will listen to the needs of the people, and will bring peace and prosperity to these very peaceful village people.

I promised to come back...

I promised to come back to St. Theresa Hospital every year for a month. This year it ended up being only nine months since we left. The trip here was too long, as usual: flight from Tampa to Wash. D.C.; easy connection then to the South African flight to Johannesburg. That is an 18 hour flight, with about 1 to 1½ hours on the ground in Dakar in the middle of the night. I never can sleep much on the airplane, so only had about two hours sleep in the 18 hours. I had reserved a place at a B&B in JoBurg; they were there at the airport to pick me up as soon as I had my bags. The place is only about a 5 minute drive from the airport. I was very happy to get a hot shower and get into bed. Of course, I woke at 3:00 and could not get back to sleep, so just read for a few hours. Then had breakfast and they drove me back to the airport in plenty of time for the flight to Harare. I was met there by three of the Dominican Sisters – they were glad to see me and I was glad to see them. I stayed in Harare Sunday night, and then ran around Harare Monday morning with Sr. Andrea, including meeting with a man about drilling a new borehole for the hospital. I also paid for the rest of the year for the internet satellite connection -- $1,400!

We arrived back “home” (really not my home any more, but still sort of feels like it) at 4:00 PM. The tar roads are fairly bad, but the dirt road is really terrible. There had been heavy rains last Saturday which was not good for the road, but good for some of the crops, and for water in our dam. Then again, there was over 3 inches of rain yesterday, so we have plenty of standing water just now.

Since getting back I have not had any patient contact, but will start that tomorrow. I have been busy with administrative “stuff” – especially trying to get the computers to work properly. There was problem with the internet satellite connection, and I was trying to get that sorted out. First with my laptop, then with the hospital laptop. There is a program which “Forces” the modem to lock onto the satellite, but it was not working. Then I connected the hospital laptop directly to the modem rather than trying to connect through the wireless. No luck with that either. So I was putting that laptop away and forgot I had the cord connected, and pulled the modem off the shelf directly onto MY laptop – and it made the screen go blank, and nothing that I do resolves that issue. Obviously will have to have someone look at it when I get back. I am glad that I brought my old laptop and not the new Apple MacBook.

The hospital computers are always having problems with viruses, and most of the anti-virus programs are outdated, so last night I uninstalled the one on the hospital laptop, and purchased a new one that is good for “more than three computers” and for three years. The satellite connections were working alright, and so I downloaded that – it took about two hours at the slow speeds with the satellite connection that we have. After completing everything I then got a message: “An Unauthorized Change was made to Windows” and the computer stopped functioning. The modem was not working at that time, so I had to wait until this morning to get reconnected and try to find out “on line” what the problem was. It seems like the antivirus program has caused a problem and might need to be uninstalled. I have sent an email off the anti-virus company and see what they think I should do. I hope it is going to work out alright.

While at the hospital earlier this morning, the woman in the statistics office called me in to help with that computer. They have a battery to help with short-term power when the main-line electricity goes off, so that the computer does not just go blank because of loss of power. The battery is obviously at the end of its function, because it ceases to function even IF the main-line electricity is on. I have short-circuited the entire system by connecting the computer directly into the wall plug, which means it will go off whenever the electricity does, but at least they can use it when it is on. I wonder how they would handle the problem IF I was not here?

There also was a man here yesterday to try to sort out the solar lighting problems in the Nursing School and Dormitories. That system is quite new, but one entire section was not working, and it is apparently because the batteries are totally dead. The batteries are supposed to last at least three years, and these have been about18 months. We had big problems with the man who installed them, and he has even threatened St. Theresa with a law suit IF anything derogatory is said about him, so I won’t! Seems like a very odd “Business Plan” to me, and not likely to lead to huge success.

Still, all in all, I have to say that things are really running quite smoothly since I left. I am glad to see that. Dr. Maunga has stepped up and become very responsible and helpful in all respects, and apparently a good mentor for the younger doctor. The hospital is very quiet at this time. Only about 45 to 50 patients, which is such a huge difference from 7 to 8 years ago, when we were averaging between 100 and 120 patients, and occasionally as high as 145 – most with HIV related diseases. I am certain it is because of the good AIDS treatment program that we have running. The people no longer are coming back and coming back, ill with one opportunistic infection after another, until they finally die of AIDS. We have about 1400 patients who are returning every one to two months for the medicines, and are very faithful about coming for their appointments and for taking their pills.

DAY TWO: ELECTRICITY

Part two of our Eight Days of Gratitude: Electricity

USA: Lights, electricity at the touch of a fingertip.

ST. THERESA HOSPITAL: Main-line electricity for “maybe” eight hours per day. Special Thanks for the people in Germany who donated a new generator for the hospital several years ago, allowing electricity “when urgently needed.”

SURROUNDING AREA: 95% of the rural homes do not have any electricity. Still, they are thankful for a hospital nearby that does have electricity, and the ability to use a generator for laboratory tests, x-rays, emergency surgery, etc.

Eight Days of Gratitude

As we celebrate Thanksgiving and the start of the Advent Season in the US, it gives me a chance to compare what WE might give thanks for and what the people around St. Theresa Hospital might give thanks for.

This post will be the first of eight reflecting on gratitude.

DAY ONE: WATER

USA: Clean, safe water from the tap “every time.”

ST. THERESA HOSPITAL: Clean, safe water “every time” – “as long as bore-holes function. “ Special Thanks to Shawano, WI Rotary Club for their efforts to help with a new borehole in 2010.

SURROUNDING AREA: Clean water at a pump borehole within one to 1½ mile of our home. Many have to use river water and then there is very high risk of water borne diseases (e.g. cholera) IF the water is not boiled.

Nearly Halloween here in the US. One wonders just how much is spent on Halloween, and how much that might help the “really poor” in the world? Difficult question, but after the past eight years among the poor of Zimbabwe, it is also difficult to not think those sort of questions.

The “Government of National Unity” (GNU) in Zimbabwe is in another crisis. First, “GNU” is an oxymoron if ever there was one. I guess it is a government of sort; it is “national”, but there is certainly NO unity. ZANU-PF seems to think that whatever little they do meets “all the requirements” on their part, and if only the MDC would get the world to stop the sanctions, then everything would be just fine. No mention of the on-going arrests of MDC members, of ridiculous charges against Roy Bennet, of the ZANU-youth terrorizing people, of continuing takeovers of what few white farms are left, of an agriculture policy that still will not feed the nation (let alone export products as was true just ten years ago), of now being “one of the worst” countries in the world as far as governance goes. Anyone wanting to read topical articles about Zimbabwe (MORE than you want to read, but just skim), go to: www.zimbabwesituation.com

But, in spite of all the above, I remain optimistic about St. Theresa Hospital, and the work they are doing. They continue to do all of the work we were involved in, and are moving forward. The AIDS treatment is going very well. There now are 435 clients alive and well 2 years after beginning treatment, and 849 alive and well after one year of treatment. One hundred and twenty two of these are children under the age of 14. ALL of those people would be dead by now if treatment had not been available, and there would be many more orphans. It does show a very bright glimmer of hope for the people. We are hopeful that the program can expand to the point where all of the people who should be on treatment will receive it.

I am busy writing our annual Newsletter. I am hoping to have it ready and sent just before Thanksgiving –means I really have to get busy! I will post a copy of it here when I am ready to mail them. Also, I hope to post an entry which will show just what the finances of the hospital are at this time.

God Bless,

Dick and Loretta

Re-entry continues...

We have now been back in the U.S. for a bit over two months. Four weeks were spent traveling, with the climax being our 50^th Anniversary Celebration in Shawano, Wisconsin on 25 July (even though the “real” anniversary date was 29 August). We had it at that time so that all the grandchildren could attend and not have to miss school.

Here is a picture of all 34 of us!

Many of your sent donations to MDA as a gift to us – perfect!

And “thanks so very much.”

Shortly after the celebration, Loretta developed quite severe back pain, and that necessitated several trips to Urgent Care, travelling back to stay with our son Tim near Tampa, FL, and then an MRI and then Physical Therapy. It is good that we were here in the U.S. to get the appropriate treatment and the P.T. Fortunately, she is now improving, so we are hoping that continued exercises will help to solve the problem.

I remain quite involved with St. Theresa Hospital. Ms. Hove, the Administrator, sends me monthly reports that include finances, diesel usage, Senior Staff Meetings, and “problems.” The current most pressing problem is that Dr. Murungu is leaving on October 1^st! I had been assured that he would be there for at least another year, but an opportunity came up for him to combine working on a Masters in Public Health along with a job at the AIDS&TB Unit in the Ministry of Health. I fully understand that he HAD to take that position, but it still leaves the hospital in a difficult situation. I am busy trying to find adequate donations to be able to fund the “top-up” required for a new doctor. Salaries in Zimbabwe are terribly low by our standards, but it still requires a lot of small donations to find the $12,000 per year per doctor that might be needed.

I continue to plan on returning for a month in March/ April 2010. Possibly one of our donors will travel with me, to see the results of his family’s donations. I am also trying to find “short-term” doctors to go for one to two months to help. They will be able to stay in our house, and I think, have a tremendous experience. IF anyone is interested, contact me at: zim.stoten@gmail.com More on that later!

“Re-entry” for me remains difficult. It is so difficult to be involved in “everything” concerning running a busy hospital and outpatient and AIDS treatment program, and now be involved in mowing the lawn, cleaning out the car, visiting kids and grandkids, etc. Still, this is where God wants us at this time, so I will gradually become more and more involved with “other projects” here. Tomorrow I am going to the first meeting of “This Man is You” at our Church. It goes from 5:30 to 7:00 AM for twelve consecutive Thursdays, with another session in the Spring. I will keep the Blog updated about this! It should help me to meet more people at the very large church that we now belong to, and find ways to answer God’s call right here.

Dick

Re-entry

Some more random thoughts on returning to the US, after nearly eight years in Zimbabwe...

• “Re-entry” is easy because SO MUCH IS AVAILABLE (gas, electricity, water, groceries, ATM’s,…)


• "Re-entry” is tough because SO MUCH IS AVAILABLE! How do we reconcile the differences?


• What do we do to keep the very poorest of the world in “high priority” in our day to day existence?


• And yet, how do we help the very poorest right here in our own country?

Giving a free handout to all who ask is not right, and yet doing nothing is not right either. “Easy Answers” certainly don’t come to me; I don’t envy those in government who are trying to make rational and good decisions. They certainly need our prayers and support, and our involvement..

It is easier to be involved in a large HIV/AIDS program at St. Theresa Hospital and see the results from month to month than it is to try to be involved in helping the homeless or the out of work in the USA.

And yet, someway we MUST be involved!

Recent Memories

Having just returned home, we wanted to share with you some of our recent memories from Zimbabwe…

Farewell parties.
Kind words.
Lots of hugs.
Many tears.
Sad to leave, but happy to be returning to family and friends.
Remember all the very good friends we have there.
Hope to return for short-term visits.
Worry about the political future of the country (PRAY).
Vow to continue to help raise money for the hospital.
Promise to “remain in touch” by frequent emails.

Article to share

I just wanted to share with everyone this recent article in the Economist about the state of Zimbabwe.

http://www.economist.com/world/mideast-africa/displaystory.cfm?story_id=13788284

For good...

The Stoughton’s are leaving St. Theresa Hospital and Zimbabwe “for good” on July 4th, 2009. It has been a difficult decision for us, as we continue to have lots of work to do here, and will be leaving so many very good friends. Still, we are both getting to the age where serious health problems are starting to arise, and it is necessary that we live in the US where we can get good medical care – whenever it is needed! It is somewhat ironic that we leave on July 4th, as in 1970 we arrived with our five children on July 4th also! Two more children were born here during the 70’s, and then we spent 26 years in Shawano, Wisconsin. So, I guess that we have “completed the circle.”

We plan on living some place in the Orlando – Tampa, Florida area. We have one son in Orlando, one just North of Orlando, and one near Tampa, so after we get back we will spend quite a bit of time deciding where the best place is for us. It definitely will be close to one of the families with small children, so that we are part of their lives in growing up. It is what we have missed most in being here for the past eight years.

The decision means that we are very busy getting ready to leave, and I am especially busy in trying to finish several projects that are “in process.” The main one at this time is the quite large project of erecting a steel structure for three 2,500 gallon plastic water tanks. We then will be able to use dam water for all of the irrigation on the hospital property, and will save on the clean borehole water. This is a picture of the men pulling one of the tanks to the top of the structure. It was quite exciting, as with the second tank, just as it got to this position, they lost control of it and it slid all the way back down the poles. Fortunately, everyone was able to get out of the way, and there was not any damage to any people or to the tank!

I am hoping that this project will be totally completed within the next two to three weeks, so that it will be functioning before we leave.

Plans for the future: I plan on continuing to do fund-raising for St. Theresa Hospital, as there is still great need for support, and maybe even more so when we are not here. One of the other Mission Hospitals just South of us has a large group of people in Switzerland who call themselves “Friends of Matibi Mission Hospital” and do great work in supporting that hospital. I am hopeful I can develop a “Friends of St. Theresa Hospital” group in the U.S. who will also help us in this regard. In addition, I am hoping to recruit doctors for short term work here, and I will be returning every year for one month to help out, to see how things are going, and to see how our donor funds are being used.

Anyone wishing to accompany me on one of my trips please let me know! Our email address remains: zim.stoten@gmail.com

God Bless, Dick and Loretta Stoughton

Easter Season

We have just returned from a short "get-away vacation" in South Africa. It was good for both of us, although the last two days were spent shopping for the hospital, and then returning through the border post at Beit Bridge. It is always such a stress for me, because one has to "bribe" your way through, and then you always worry about being stopped and in trouble because of the bribes. Still, it seems to be "a way of life now" and so one has to accept it. I also worry about carrying a lot of money, which is necessary to be able to have the funds to get the necessary supplies in Zimbabwe. One hears about being robbed while on the road, so I am always very thankful when we finally reach our home at the hospital.

Easter is such a time of HOPE for all of us, and especially all of us in Zimbabwe. The "Unity Government" has now been functional for about two months, and we do see gradual but certain progress. There are also many roadblocks being put up by "those in power," but the hope is that they will gradually lose their power and the people who really want to see progress will prevail. Our staff are fairly well satisfied with salaries of US $100 per month for each and every one of them, and then an additional amount which is dependent on their position. That amount ranges between US $30 for the lowest paid to about $550 for the doctors. It is at least a start, and the Finance Minister has vowed that the country would "live within its' means." They actually do not have much choice, since the Zimbabwe currency has now been declared "void for one year." Since the government cannot print currency, they have to live with what they obtain in taxes in US dollars or South African Rand, OR with what they get in donations. Supplies in stores are gradually increasing, and the prices are slowly decreasing since the first of January. The first time in ten years (or maybe forever) that there has been "negative inflation." I read that inflation for 2008 was 6.5 QuinDecillion NovembDecillion percent -- that is a 65 followed by 107 zeros! It is impossible to describe what that means in everyday living.

Returning to see patients on the Women's Ward is therapeutic for me! It gets me back to "reality." Only 20 women today, but they were all new to me, so it took quite a while. Lots of really sick women; still many with HIV related illnesses. I am hopeful that in the next two years, we will be able to start nearly ALL of the HIV people on Anti-Retroviral Treatment, who meet the criteria for treatment. This should greatly reduce the number of severely ill HIV patients in the hospital. It has already had a huge impact, in that the number of in-patients has decreased from an average of about 120 to 140 patients per day, to under 75 patients per day. One of the patients today had an x-ray which showed a partially collapsed lung and some fluid. She is HIV negative, and I had her in the hospital a bit over a month ago, with what appeared to be TB. However, now she is more ill, and has this very abnormal x-ray. I took her to the small operating room, and put a chest tube into her left chest, and got pus plus lots of air. I think she most likely now has a very chronic condition that is most likely NOT going to get better with the chest tube. I am hoping that some strong antibiotics will make a difference.

Hope, Faith, Prayers is what we all need, so please do keep all of us in Zimbabwe in your prayers.

God Bless.