Teaching, and Learning, Care

Thank you for journeying with us through what we hope was our introductory Angolan experience. Beth and I returned to the U.S. ten weeks ago and are now settled into our new home in Boston. These weeks have offered us some opportunity to reflect on our time in Lubango.

On our very first day in Angola, back in October 2006, we had the honor and pleasure of being welcomed by the American Ambassador Cynthia Efird. She had both a listening ear as well as many words of wisdom for us. Those that made the deepest impression came in the context of discussing the value of health care, current public health challenges in Angola, and how we and our colleagues would be stretched in delivering hospital services.

“Whatever you do,” she told us, “teach care.”

Over the next eight months we found that there were indeed many opportunities to teach care. We found even more opportunities to learn care. This blog entry is dedicated to a few of those who have been our teachers.



Dona Zefa
Dona Zefa finished her studies at a Catholic nursing school just prior to Angola’s civil war, and has essentially worked in the operating room her whole adult life. She is now “retired”. Which means she volunteers 4 days of work a week at CEML, she will not accept any pay, except for a Christmas bonus she received last December. Simply put, the CEML OR would not be functional without her. She quietly keeps things rolling all day long – instruments get cleaned and sterilized, operations gets started, all the staff get their lunch (this usually required some browbeating to get Robert to lunch), and at the end of the day everything is as tidy as when it started. All with a beautiful, gentle spirit.

Dona Zefa getting the work done... with a smile.

Kambali
Kambali only has a fourth grade education and used to clean hospital floors. A number of years ago a couple of doctors recognized he was both a quick and eager learner and a humble partner in the work. He was then trained by Steve Collins to assist him in cataract surgery. Now, Uncle Steve is almost useless without him. And Kambali does a number of eye operations on his own. Because of his lack of credentialing, he is only paid $150 per month (compared with $250 for his nursing colleagues). We’ve never heard him complain. He cares for his aged patients with gentleness, respect, and humility. It’s inspiring.

Kambali and Uncle Steve operating in Huambo, Central Angola.

Amelia
Amelia is the head nurse for CEML’s inpatient ward. Ultimately, all that happens in the ward is her responsibility and she functions in the equivalent capacity of a resident physician in the US. She was Beth’s closest and most valued ally at the hospital. Her task is enormous – managing patient care, ensuring bills are paid, and training the ward nurses, many of whom had never touched a patient prior to their first day of work at CEML. She was always steady, always able to translate our Portuguese to Portuguese, so that patients could understand, or to Umbundu or Nhanheca (the most common local languages). And she always defended the “doctora”.

Beth and Amelia (right) with Marcia, who has recovered from her rectal cancer surgery.

Israel
Israel is one of the Emergency Department nurses. He said of himself once that he is frustrated because he doesn’t know enough to do his job properly. Without a doubt he is one of the brightest nurses in our hospital. For years during the war time he was stationed in a rural health post by himself to manage an enormous range of pathologies with minimal resources and effectively no referral options. Now that he is in the city, he is taking advanced practice nursing courses to better himself while working full time and helping care for his family.

Israel and Beth in the "Banco de Urgénica"

Henriques
Henriques works as the pharmacy nurse/technician at CEML. From the day we arrived he has been a friend to us. There is always a smile on his face we he sees you, laughter in his voice when he greets you, and a hug available if you’re close enough. Henriques was one of our best windows into Angolan culture and the Angolan experience of the last 30 years. We were often invited into their home, to share meals, to be with their children, to share life and understanding. He loves his family dearly, loves his work, and is loyal to his friends. He remains a dear companion.

Henriques and Beth with their children, Dalva and Terry

Beth
Beth (pronounce “Betty”) is a nurse on the ward, and is married to Henriques. Together they have two beautiful children – Dalva and Terry. Beth is singularly professional and competent in her care of sick patients on the ward. She is constantly wishing to learn more, asking questions, seeking answers, and always with a gentle and kind spirit. When she worked the night shift, we rested easy; we knew our patients were in good hands. When she called for help, we came quickly.

Lino
Lino works in the OR and has been a surgical assistant for 20 years. His understanding of surgical technique, appropriate instrumentation, and his ability to anticipate the surgeon's next move are top notch. These alone make him a pleasure to operate with. But what is most wonderful about Lino is his calm demeanor, and his caring for patients pre-, intra-, and post-op. Lino also taught me more about Angolan literature, politics, and religion than just about anybody else. A real breath of fresh air.

Lino, always dapper in and out of the Operating Room.

Pastor Moisés
Pastor Moisés took on the chaplaincy at CEML shortly after the hospital doors opened. Previously, he had been head of IESA (Igreja Evangélica Sinodal de Angola), a national evangelical denomination whose members number in the tens of thousands. Now, as the chaplain of a 40 bed hospital, he quietly makes daily rounds – visiting with patients and their families, offering ministries of presence, prayer, comfort, and spiritual guidance. He is the de facto palliative care consultant. In our mind, the greatest complements paid to him came from the dozen of patients, from various religious backgrounds, who refereed to him as “nosso pastor” – our pastor.

"Nosso Pastor"

Danny
Senhor Danny is the CEO of CEML. An administrator by training, he had never worked in healthcare prior to being recruited to CEML 5 years ago. Since then, he has worked tirelessly to get the hospital working, and, now that is has set sail, to keep it afloat. His passion is to provide holistic care for the people of the city and province. He has a servant’s heart and a wry sense of humor. I don’t think I’ll over forget seeing him drive back to work, without complaint, at 8:30 on a Friday night to shuttle the dayshift nurses home in a beaten-up old Landcruiser, after the hospital driver called in sick. 16 staff members piled in and off they drove to be distributed around town.

"O Chefe" - the Boss

There were many times that our experiences in Angola were hard and sometimes painful. These had a broad range of causes – the stress of conducting life in another language, adjusting to a new a culture where for us the rules were not clear, being subject to obstructionist bureaucracy related to visas, and being witness and companion to so many of our patients who died while under our care. Without a doubt, we still have much to reflect on, grow from, and even heal from. But we wish to express our gratitude to those mentioned above for caring not only for our patients, but also for us. Without their grace and kindness our experience would have been so much less rich. We also wish to thank so many others who have gone unmentioned, but who were vital to us this last year – our physician colleagues; hospital staff; the missionary community; family, friends, and colleagues in the U.S. and elsewhere who have loved us well.

As alluded to above, we hope to be back in Angola, Lord willing, in the years to come. And we hope that many of you will take us up on our offers to come visit, experience, share, and contribute.