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Health and the African Continent: A Perspective from Uganda · Centrally Speaking

• 0:01
  SPEAKER_00: Centrally speaking, it is the central strength of the church's family.
• 0:05
  SPEAKER_00: It speaks about issues.
• 0:07
  SPEAKER_00: It would be the interest towards the society.
• 0:09
  SPEAKER_00: In particular, in the justice of the Christian worldview, intersect with the Western sector culture.
• 0:15
  SPEAKER_00: In the spirit of the church's family, we take the perspective of the middle women, which is in agreement with the historic Christian Church.
• 0:24
  SPEAKER_03: I'm Dr.
• 0:25
  SPEAKER_03: Drake Williams, Minister of Mission of Theology of the Church.cscfamily.org.
• 0:33
  SPEAKER_04: Today, essentially speaking, William, we are talking about healthcare and the African continent, perspective from Uganda.
• 0:40
  SPEAKER_04: And we're very pleased to have Tim Eriksson and Fred Wing joining us a little way from Uganda today.
• 0:46
  SPEAKER_04: Let me introduce them both to you.
• 0:48
  SPEAKER_04: Tim serves as the executive director of the Cumber Children's Hospital of Uganda in Mundalay, Uganda.
• 0:55
  SPEAKER_04: This is one of the world's leading hospitals for treating children with hydrocephilis, spin of biphidin, and other neurosurgical conditions.
• 1:03
  SPEAKER_04: Tim's been with CURE since 2006 and has served in a variety of roles.
• 1:08
  SPEAKER_04: He's been in Uganda for the last eight years with his family.
• 1:12
  SPEAKER_04: Tim and his wife Kira are blessed with three energetic young kids.
• 1:17
  SPEAKER_04: He serves as a spiritual director at Cure Uganda.
• 1:20
  SPEAKER_04: He's been a local church pastor for 11 years and mission coordinator for a church planting team for six years before joining Cure.
• 1:28
  SPEAKER_04: He holds degrees in theology, psychology, and counseling.
• 1:32
  SPEAKER_04: And has just recently finished his master's degree in public health from Buginema University in Uganda.
• 1:39
  SPEAKER_04: Brent and Tim, welcome to the show.
• 1:41
  SPEAKER_04: Thank you very much.
• 1:42
  SPEAKER_02: Thank you for having us, Dr.
• 1:44
  SPEAKER_02: Drake.
• 1:45
  SPEAKER_02: Glad to be here.
• 1:45
  SPEAKER_04: Glad to have you both with us and looking forward to speaking with you and health conditions in Africa.
• 1:51
  SPEAKER_04: And let's just start by saying that many in the West think of health conditions in Africa and think of a number of rare diseases that we don't experience here in the West.
• 2:00
  SPEAKER_04: Can you speak about some of the diseases, such as malaria or the Ebola virus, or the Marburg virus, or typhoid, yellow fever, and cholera?
• 2:10
  SPEAKER_02: Sure.
• 2:11
  SPEAKER_02: Thanks for that question.
• 2:12
  SPEAKER_02: And first, I also just wanted to mention that Pastor Fred and I both serve on the senior management team of the hospital.
• 2:20
  SPEAKER_02: We're active in the administrative leadership of all that we're doing.
• 2:24
  SPEAKER_02: Neither of us are doctors.
• 2:26
  SPEAKER_02: We come at this from more of the administrative perspective and how to run healthcare programs and also how to take care of people well, the spiritual side.
• 2:36
  SPEAKER_02: We have a lot of information.
• 2:38
  SPEAKER_02: We certainly are learning, and but from a doctor, you know, we we won't be able to diagnose any ailments you might have today.
• 2:46
  SPEAKER_02: But glad to share from our perspective.
• 2:48
  SPEAKER_02: And both of us have served for the past close to eight years at this hospital and have gained a lot of knowledge through the process.
• 2:57
  SPEAKER_02: So on malaria, just to mention on malaria, we were recently looking at our patient population at Cure Children's Hospital.
• 3:06
  SPEAKER_02: We're the largest provider in the world of surgery for children with hydrocephalus and spina bifida.
• 3:13
  SPEAKER_02: Those two neurological conditions, neurosurgical conditions, we do more of these surgeries than any other hospital in the world.
• 3:21
  SPEAKER_02: And they're life-threatening.
• 3:23
  SPEAKER_02: These are conditions that need to be treated very urgently.
• 3:27
  SPEAKER_02: This hospital is specialized.
• 3:29
  SPEAKER_02: One of the reasons why we become a center of excellence is because we're focused, very focused on these, on particularly pediatric brain surgery related to malaria and many conditions that people hear about.
• 3:44
  SPEAKER_02: It's very common in this context.
• 3:46
  SPEAKER_02: And in fact, this past year alone, over 1,400 of our patients had malaria.
• 3:53
  SPEAKER_02: So it's it's a very common issue, disease caused by parasites and transmitted through mosquitoes, as you know.
• 4:02
  SPEAKER_02: So I personally have had malaria too many times at this point to count, but thankfully there's great treatment for it.
• 4:10
  SPEAKER_02: And the key is to have treatment early.
• 4:13
  SPEAKER_02: It's a major issue around the world.
• 4:15
  SPEAKER_02: The WHO has been leading significant efforts to tackle this.
• 4:21
  SPEAKER_02: Last update we read, not only do we treat over 1,400 a year, but those are kids who also have the brain conditions that we're treating.
• 4:31
  SPEAKER_02: So it complicates the care that needs to be provided for these children that we're serving.
• 4:37
  SPEAKER_02: But around the world, Africa has 95% of the malaria cases in the world.
• 4:43
  SPEAKER_02: So the vast majority of malaria is on this continent.
• 4:48
  SPEAKER_02: 96% from WHO of the fatalities that have occurred from malaria have also happened on this continent.
• 4:56
  SPEAKER_02: And that's about 600,000 new deaths per year.
• 5:00
  SPEAKER_02: So it's a significant global health issue.
• 5:03
  SPEAKER_02: People that travel here, we often they're taking anti-malarials before they arrive.
• 5:08
  SPEAKER_02: The key is early intervention.
• 5:10
  SPEAKER_02: From our involvement, we also distribute mosquito nets and part of different campaigns to make sure people have mosquito nets so that while they're sleeping, they fend off the mosquitoes.
• 5:22
  SPEAKER_02: That's one of the main ones that people are afraid of, but another one, Ebola, I would say Uganda recently struggled with uh with an outbreak of Ebola in September.
• 5:34
  SPEAKER_02: It's a very deadly post-hemorrhagic fever.
• 5:37
  SPEAKER_02: It's very contagious.
• 5:39
  SPEAKER_02: And the fatality rate of Ebola, which I'm sure you've all heard of, there were a few cases that made it to the States for treatment.
• 5:47
  SPEAKER_02: I don't remember what year that was, but they were coming from West Africa.
• 5:52
  SPEAKER_02: Ebola itself happened, we had an outbreak in the western part of the country in September.
• 5:59
  SPEAKER_02: The fatality rate can be between 25 to 90 percent.
• 6:03
  SPEAKER_02: Malaria, if you get treated early, there's a very high survival rate.
• 6:08
  SPEAKER_02: Ebola is a different level of catastrophe.
• 6:12
  SPEAKER_02: So we had that outbreak.
• 6:13
  SPEAKER_02: The government here is very swift and has a strategy to contain and to isolate and to try best possible to treat Ebola patients.
• 6:25
  SPEAKER_02: I was looking at the statistics and we were declared Ebola 3 in January after about 70 days of having Ebola in the western part of the country.
• 6:35
  SPEAKER_02: It was 55 people had died.
• 6:37
  SPEAKER_02: There were 142 confirmed cases, so about a 40% fatality rate from Ebola.
• 6:44
  SPEAKER_02: Those are some big ones.
• 6:46
  SPEAKER_02: Marburg is another post-hemorrhagic fever, like Ebola.
• 6:51
  SPEAKER_02: That has been in Uganda a few times.
• 6:54
  SPEAKER_02: And thankfully, the Ministry of Health has a very rapid response to this for containment and has done a pretty effective job.
• 7:02
  SPEAKER_02: I hope that answers your question.
• 7:03
  SPEAKER_02: I would be far more afraid of Ebola than I would malaria if that helps.
• 7:10
  SPEAKER_01: Yeah, just to add that uh we we live with malaria every day.
• 7:14
  SPEAKER_01: This is something we have like every day.
• 7:18
  SPEAKER_01: But uh the other conditions like Ebola, like Mabak, just to break out, given factors that favor them to break out.
• 7:26
  SPEAKER_01: And once they do, they're really a burden the economy, they have a cost implication on the government, and that's why the governments do everything possible to prevent outbreaks of these very, very deadly diseases.
• 7:42
  SPEAKER_04: And I assume if uh some of these diseases, let's say, get into a village in Uganda, they can be very serious for the entire village, right?
• 7:50
  SPEAKER_04: Not just uh not just for an individual.
• 7:52
  SPEAKER_02: Yeah, so there's usually in the case of the last Ebola in September, they set up a treatment and isolation facility, and then they had a lockdown for that area, so you couldn't come in and out of that region.
• 8:06
  SPEAKER_02: So it is very scary, and as I mentioned, the containment strategy over the years, Uganda has done a really effective job.
• 8:16
  SPEAKER_02: So this outbreak only lasted, I think it was 69 days, and that was a record for quickly containing this condition.
• 8:25
  SPEAKER_02: But with such a high fatality rate, it's even it affected our hospital.
• 8:29
  SPEAKER_02: We were doing much more intensive screening.
• 8:33
  SPEAKER_02: We set up some additional hand washing stations at the gates, we were monitoring temperature, anyone with a fever, anyone with Ebola-like symptoms.
• 8:43
  SPEAKER_02: We had a task force that was having to implement pretty significant measures to prevent that potentially from arriving on a bus.
• 8:52
  SPEAKER_02: Our patients come from all over the country.
• 8:55
  SPEAKER_02: So you can imagine we have an open door policy, people are arriving every day from all over the country.
• 9:01
  SPEAKER_02: And so we had to do some extra measures.
• 9:03
  SPEAKER_02: But thankfully, by January, mid-January, WHO had declared the country Ebolo-free.
• 9:10
  SPEAKER_04: Well, you've given us some orientation to a number of diseases that we're not familiar with experiencing here in the West.
• 9:18
  SPEAKER_04: But how widespread are some of these in Africa, not only in Uganda?
• 9:22
  SPEAKER_02: Typically in tropical areas, and Uganda is very tropical.
• 9:27
  SPEAKER_02: We're on the equator.
• 9:28
  SPEAKER_02: It is spread by mosquitoes.
• 9:30
  SPEAKER_02: There's not so much you can do about there.
• 9:32
  SPEAKER_02: Is some good news that there's a potential vaccine that they're working on.
• 9:36
  SPEAKER_02: There was some information released recently, I believe that was WHO as well, about a potential vaccine.
• 9:44
  SPEAKER_02: But at this point, the main ways to prevent are making sure you try to avoid mosquito bites sleeping under bug nets.
• 9:52
  SPEAKER_02: And you can take malaria prevention, anti-malarials.
• 9:58
  SPEAKER_02: So we would never want to scare people from coming to visit this region, you know, as mentioned.
• 10:06
  SPEAKER_02: We have visitors all the time.
• 10:08
  SPEAKER_02: So we just advise that they take the anti-malarial medication.
• 10:12
  SPEAKER_02: It's not something that people want to stay on for life long term.
• 10:17
  SPEAKER_02: So that's where it's not really a it's not a vaccine.
• 10:21
  SPEAKER_02: So, you know, people, as Fred said, we live with malaria around.
• 10:25
  SPEAKER_02: You get a rapid test if you start to have malaria symptoms, and then you quickly get on malaria medication if you're positive for malaria.
• 10:35
  SPEAKER_01: The reason we have a lot of deaths from malaria is people do not access the medication on time.
• 10:41
  SPEAKER_01: Malaria causes dehydration and children end up being dehydrated.
• 10:47
  SPEAKER_01: And if not, if they've not had a quick intervention, medical intervention, then they will end up dying.
• 10:53
  SPEAKER_01: But also, in some ways, people turn to various models of treatment here, and some of those models are traditional.
• 11:01
  SPEAKER_01: Of course, a lot of time is wasted while people are trying to look for this or that solution, which is not really a solution.
• 11:08
  SPEAKER_01: The delays lead to the deaths of especially children who basically without treatment will die in a few days.
• 11:15
  SPEAKER_01: They have uh malaria.
• 11:17
  SPEAKER_01: That's one of the reasons why we have a lot of deaths.
• 11:20
  SPEAKER_01: Otherwise, if people have access to medication to treatment, then there will be no deaths.
• 11:27
  SPEAKER_04: You just brought up children, Fred, and I'm just wondering about vaccines available for some of the diseases that we've talked about.
• 11:33
  SPEAKER_04: Are there vaccines available for Ebola or Marbur or typhoid or yellow fever, cholera, malaria?
• 11:40
  SPEAKER_04: Are they available for children and are they affordable?
• 11:43
  SPEAKER_01: I think we we have a number of strains of Ebola.
• 11:46
  SPEAKER_01: We had a vaccine that had been developed for Ebola.
• 11:50
  SPEAKER_01: Uh, unfortunately, we had a different strain in this recent outbreak, and the vaccine could not work.
• 11:57
  SPEAKER_01: I don't think the vaccines are available here in Uganda as yet.
• 12:01
  SPEAKER_01: Yes, the good news is it's being developed, and probably a vaccine that cuts across all the strains will be developed and it will sort out the issue.
• 12:12
  SPEAKER_02: And yellow fever, in order to travel to this region, you also have to have the yellow fever vaccination.
• 12:18
  SPEAKER_02: So, yes, that's a requirement to travel here.
• 12:21
  SPEAKER_02: And then malaria is mentioned there.
• 12:23
  SPEAKER_02: I know that they have had some recent news about a malaria vaccine that's being developed or was successful.
• 12:31
  SPEAKER_02: We don't have a lot of information about that, and it's not in this area.
• 12:34
  SPEAKER_01: Another disease that is really a burden in Africa is diarrhea.
• 12:40
  SPEAKER_01: In Uganda, here we administer vaccines for what we call rotavirus, that is to prevent diarrheas in children.
• 12:46
  SPEAKER_01: So that is very available.
• 12:48
  SPEAKER_01: Every child has to be vaccinated against uh rotavirus.
• 12:53
  SPEAKER_04: Am I right to say that vaccines are increasing in Africa?
• 12:56
  SPEAKER_02: Absolutely.
• 12:57
  SPEAKER_02: The Ministry of Health and a lot of these international agencies are partnering together to raise the availability for vaccines.
• 13:06
  SPEAKER_02: We do vaccines here at the hospital through the Ministry of Health, and so a lot of children come here to have their various vaccines done.
• 13:15
  SPEAKER_04: I'm sure some of our listeners are aware of Western agencies and governments that are helping to provide vaccines or helping African health.
• 13:23
  SPEAKER_04: I'm just thinking of the president's emergency plan for AIDS relief that President Bush instituted a number of years ago.
• 13:30
  SPEAKER_04: Some say that it helped secure some 20 million people.
• 13:33
  SPEAKER_04: Then there was the President's Malaria Initiative about the same time that helped to save 7.6 billion people, and then other organizations that our listeners would be familiar with, such as the UNICEF for helping with clean water and vaccinations.
• 13:46
  SPEAKER_04: From your perspective, though, being in Uganda, how important do you feel these types of initiatives and relief efforts from the West are in helping curb some of the diseases?
• 13:57
  SPEAKER_02: A big thing of what Cure does as well is health system strengthening.
• 14:02
  SPEAKER_02: And the challenge of a lot of the health systems here is lack of financial resources, very small amounts per person funding allocated for health care issues.
• 14:14
  SPEAKER_02: And so it does take a village, as they say, as is said, it's a partnership effort where we're living, a low resource setting, a low-income nation needs assistance, especially some of these higher cost health interventions.
• 14:30
  SPEAKER_02: So I think the long term, even what Cure is doing by training surgeons, training nursing team, training anesthesiologists, it's about developing capacity.
• 14:41
  SPEAKER_02: And I think some of these initiatives have made a major impact.
• 14:45
  SPEAKER_02: The malaria initiative is huge here.
• 14:49
  SPEAKER_02: The AIDS effort, I know many people have, you know, said how grateful they were for President Bush starting that.
• 14:56
  SPEAKER_02: I mean, he's well regarded in this region because of those efforts.
• 15:01
  SPEAKER_02: You know, the investment in healthcare is a major way to help improve the lives of millions and millions and millions of people.
• 15:09
  SPEAKER_02: It's urgently needed, and Cure wouldn't be here if it wasn't the case.
• 15:14
  SPEAKER_04: Fred is a native Ugandan.
• 15:16
  SPEAKER_04: Why don't you make a comment on that too?
• 15:18
  SPEAKER_01: Yeah, I agree with Tim.
• 15:20
  SPEAKER_01: A lot of people are very thankful to the Western governments for the support.
• 15:25
  SPEAKER_01: Just pointing out support for RAVs, that is for HIUV.
• 15:31
  SPEAKER_01: Hundreds of thousands, if not millions, are on that, and most of that is given by USAID and other governments like that.
• 15:41
  SPEAKER_01: Even the malaria initiative, I believe anti-malarials and malaria treatment would be very, very expensive if it wasn't partly sponsored by some Western governments.
• 15:53
  SPEAKER_01: I don't know how far it has moved and how people are aware that Western governments are involved in some of these medical interventions, but um it seems like the awareness is growing.
• 16:07
  SPEAKER_01: The West is actually very pivotal in providing medical interventions, especially for some of these diseases that are a great burden on the government and also on the individual people here.
• 16:20
  SPEAKER_01: People are really thankful.
• 16:21
  SPEAKER_04: Let's turn to the work of Cure Children's Hospital of Uganda.
• 16:25
  SPEAKER_04: You're working with life-threatening brain conditions, hydrocephalus, then spinovifida, and brain tumors, and other neural-tube defects.
• 16:32
  SPEAKER_04: Can you tell us more about the hospital and then how widespread these conditions are that you treat?
• 16:37
  SPEAKER_02: The hospital is 21 years old and was started by Cure International, our U.S.
• 16:44
  SPEAKER_02: nonprofit based in now uh Grand Rapids, Michigan.
• 16:48
  SPEAKER_02: And the focus of Cure has been on providing life-saving or life-changing surgical care for children with correctable disabilities, along with these neurosurgical conditions.
• 17:02
  SPEAKER_02: This hospital, as I mentioned earlier, we provide life-saving brain surgery for more children with hydrocephalus and spina bifida than any other hospital in the world.
• 17:14
  SPEAKER_02: So we're operating this year, we're on track to surpass over 1,800 brain surgeries.
• 17:22
  SPEAKER_02: That's somewhere around 150 to 160 every month, about seven to eight, sometimes 10 operations a day.
• 17:31
  SPEAKER_02: It's really quite a unique hospital focused on these conditions.
• 17:37
  SPEAKER_02: It was the first pediatric neurosurgical hospital in East Africa.
• 17:42
  SPEAKER_02: We may be the only.
• 17:43
  SPEAKER_02: We're also taking part in training surgeons around the world.
• 17:48
  SPEAKER_02: So we've trained surgeons.
• 17:50
  SPEAKER_02: We've had over 70 surgeons come here, neurosurgeons, to learn the procedures that we're doing to treat hydrocephalus and spina bifida in particular.
• 18:02
  SPEAKER_02: So part of our effort is to not only treat, but it's to develop capacity and to strengthen health systems around the world.
• 18:11
  SPEAKER_02: That's always been part of our mission.
• 18:13
  SPEAKER_02: And also integrated spiritual ministries.
• 18:16
  SPEAKER_02: So Pastor Fred can share a little bit about that.
• 18:19
  SPEAKER_02: He's our head of spiritual ministry at the hospital.
• 18:22
  SPEAKER_02: It's an important part of what we do as well.
• 18:25
  SPEAKER_01: Integrated spiritual ministries.
• 18:26
  SPEAKER_01: Also, our speciality, something that makes us really unique.
• 18:31
  SPEAKER_01: We believe that math is not just physical, and therefore we integrate physical interventions with spiritual ministries.
• 18:39
  SPEAKER_01: But also, people here have a lot of spiritual needs, needs that need to be addressed alongside their medical needs.
• 18:47
  SPEAKER_01: So we do spiritual ministry, we share the gospel of our Lord Jesus Christ, we pray with people, we provide counseling and encouragement, and overall, God is perspective on disability and disease as well in general.
• 19:03
  SPEAKER_01: And this is usually in contradiction with what people say and think traditionally.
• 19:09
  SPEAKER_01: They say things that God says different.
• 19:13
  SPEAKER_01: People will say, probably, this is witchcraft, and we tell them no, it's not witchcraft.
• 19:19
  SPEAKER_01: Maybe you are not created in God's image, maybe God helps you, and we say different because that's not that is simply not what God says.
• 19:29
  SPEAKER_01: We provide that as a ministry, and we've seen God changing lives and intervening into people's situations through our efforts.
• 19:38
  SPEAKER_02: Yeah, you asked how widespread these conditions are that we treat.
• 19:42
  SPEAKER_02: And one of the big issues is there's a small supply of neurosurgeons who can treat these conditions.
• 19:49
  SPEAKER_02: In the US, last we were updated, it was about one per 80,000 people.
• 19:55
  SPEAKER_02: And in this context, it's about one per five million people, many, many times less access to care.
• 20:03
  SPEAKER_02: So not only the widespread, but the lack of access to care is the big challenge.
• 20:09
  SPEAKER_02: In the case of the two conditions I mentioned, which is water on the brain, that's an excessive buildup of fluid in the brain.
• 20:16
  SPEAKER_02: That's hydrocephalus.
• 20:18
  SPEAKER_02: And then spina bifida, which is it's a cleft or an opening in the spine.
• 20:23
  SPEAKER_02: These conditions are also common in the US.
• 20:26
  SPEAKER_02: Hydrocephalus, one to two births per thousand.
• 20:30
  SPEAKER_02: That's what the NIH publishes for the rate in the US.
• 20:33
  SPEAKER_02: And spina bifida is it's about 0.5 per thousand.
• 20:38
  SPEAKER_02: Here in this context, if you multiply that by very large birth rates, the amount of children being born with these conditions, our estimates would be between five to seven thousand new births a year in Uganda alone.
• 20:53
  SPEAKER_02: So we're doing we're doing about 1,800 surgeries, as I shared, out of say 7,000 new children every year that need these interventions.
• 21:05
  SPEAKER_02: You know, that's maybe a quarter of the real burden of disease.
• 21:08
  SPEAKER_02: The hospital is always full.
• 21:10
  SPEAKER_02: We have pretty much a 100% bed utilization throughout the whole year.
• 21:16
  SPEAKER_02: We just built a new ICU.
• 21:18
  SPEAKER_02: We're building a larger new set of operating theaters and continuing to try to expand.
• 21:25
  SPEAKER_02: We'll convert the old operating theaters into another ward just to keep up with the demand.
• 21:31
  SPEAKER_02: In addition, we're also training surgeons.
• 21:34
  SPEAKER_02: So we're trying to grow capacity so that there'll be more access, not just a cure, but around the country and in the greater region as well.
• 21:44
  SPEAKER_02: So very important to our strategy is training and building capacity for the future.
• 21:50
  SPEAKER_02: So the conditions are not just here, they're equally there.
• 21:54
  SPEAKER_02: The one difference here is that there's also some post infectious hydrocephalus.
• 21:59
  SPEAKER_02: So you You can acquire hydrocephalus after birth, and that's not common in the US.
• 22:05
  SPEAKER_02: So that increases the rate of hydrocephalus in particular here in this area.
• 22:12
  SPEAKER_04: Fred was uh mentioning that cures might be given, at least uh contextually, if by a witch doctor in comparison to what you're doing there in the hospital.
• 22:22
  SPEAKER_04: Am I am I making that comparison right?
• 22:24
  SPEAKER_04: If the hospital wasn't there, would people be looking for, let's say, tribal medicines?
• 22:29
  SPEAKER_01: Actually, some researchers estimate that 70 to 80 uh percent of the people here will look at traditional healers for their first line of medical care or intervention.
• 22:41
  SPEAKER_01: So even with Cure, there are a lot of people who still think it's some kind of witchcraft or failure to appease the spirit, and they will actually take these children to traditional healers.
• 22:52
  SPEAKER_01: With um taking the word out there that this is a medical condition and it's treated surgically, just like actually we people need information about uh most of the other medical conditions that are mistaken to be spiritually caused or instigated, uh would actually uh save a lot of people from death because they will actually look for medical care in time.
• 23:18
  SPEAKER_01: Like uh it's very important for people to bring children for treatment when they are still little, small, because the longer you wait, the more the condition worsens.
• 23:29
  SPEAKER_01: I think uh it's very important to have a word out there that uh these are medically treated.
• 23:36
  SPEAKER_02: And we do a lot of uh outreach efforts, we do a lot of community sensitization to spread the word, and and we have seen a trend over the 20 years.
• 23:47
  SPEAKER_02: The average age of our patient has declined from over a year to now two, three months of age, which is very positive.
• 23:57
  SPEAKER_02: The sooner that you have medical treatment, the better the outcomes.
• 24:02
  SPEAKER_02: As Fred has shared, we may not be the first option, but they are coming faster.
• 24:08
  SPEAKER_02: You do see sometimes the children, the baby presents with some different burn marks on their head and different signs that cuts and different signs that alternative healers have been sought.
• 24:22
  SPEAKER_02: And so, you know, I think our message is every time we get a chance that that these are medical conditions that need urgent intervention.
• 24:32
  SPEAKER_02: And we, I believe because of the internet as well, that's been a major change, the explosion of the internet and people having phones with direct access to the internet.
• 24:42
  SPEAKER_02: We have a lot of people now researching and looking, how can I get help?
• 24:47
  SPEAKER_02: We're getting emails from around the world, definitely around the continent.
• 24:51
  SPEAKER_02: You know, I've read about your hospital.
• 24:54
  SPEAKER_02: Can I bring my child?
• 24:56
  SPEAKER_02: The positive of the growth of mobile phones and internet has really helped people seek information.
• 25:04
  SPEAKER_02: And we are seeing some cultural shift that people are coming to the hospital and the health center sooner.
• 25:11
  SPEAKER_04: Rather than just relying on tribal attempts to take care of cures.
• 25:15
  SPEAKER_04: You all do have an important emphasis on spiritual and emotional needs.
• 25:20
  SPEAKER_04: How do you feel that spirituality uh can help health, particularly the Christian message that promises forgiveness of sin, uh power for living, and hope for eternity?
• 25:30
  SPEAKER_01: I think one of the of the questions that is answered by by spiritual ministries why do we have all these, why do people get sick and why do we have to struggle with disease?
• 25:43
  SPEAKER_01: Providing a God's perspective answer to that question is very critical, very central, so that people change their perspective so that uh they know that it's not because God doesn't love them, because he hates them.
• 25:57
  SPEAKER_01: You know, only that is soothing, it's healing.
• 26:01
  SPEAKER_01: Yes, when people know that, oh well, we we have sin, and disease comes as a result of sin.
• 26:08
  SPEAKER_01: But God has provided the solution, he has given us uh his son to save us, and one day disease and sin and death will be done away with uh when the Lord Jesus Christ returns and brings us into a perfect kind of kingdom and life.
• 26:25
  SPEAKER_01: You know, just that that hope brings a lot of relief.
• 26:29
  SPEAKER_01: When people here they are usually tense and worried and scared, and you know they've told them God doesn't love you.
• 26:37
  SPEAKER_01: I think you you did something wrong.
• 26:40
  SPEAKER_01: You you have a curse on you.
• 26:42
  SPEAKER_01: That's why you have a sick child, that's why you're sick, and uh of course God cannot uh accept you.
• 26:50
  SPEAKER_01: And all these things cause a lot of worry and definitely increase the feelings of being sick, even for the caretakers, because we do a lot of ministry with caretakers in Kiwa Hospital here.
• 27:03
  SPEAKER_01: They are also sick in many other ways.
• 27:05
  SPEAKER_01: They are sick emotionally because of all the things that they've had from their communities and also from the wherever they seek their first line of medical care, of care.
• 27:17
  SPEAKER_01: Spiritual ministry is it it helps medical ministry in many ways.
• 27:23
  SPEAKER_01: I think people feel much better when the spiritual ministry is integrated with the medical ministry they are seeking for.
• 27:30
  SPEAKER_04: So it's almost like a hand-and-glove approach that uh they they both go together.
• 27:35
  SPEAKER_01: Yes, they both go together seamlessly together.
• 27:38
  SPEAKER_01: We we say it's just to uh two sides of the same coin.
• 27:42
  SPEAKER_01: So we do ministry together with medical ministry.
• 27:45
  SPEAKER_02: Yeah, and I say, you know, often these these moms have been rejected or sent away from their community because of the curses and the different stigma that comes with having a child with a with a rare condition that's unknown, misunderstood.
• 28:02
  SPEAKER_02: And we often say, you know, God loves you so much that he built this hospital.
• 28:08
  SPEAKER_02: You know, there's no real other explanation than, you know, that that God provided an oasis of healing here to take care of some of the world's most vulnerable children.
• 28:19
  SPEAKER_02: These children, otherwise without intervention, have a very, very over, you know, it's hard to estimate, but over 90% fatality.
• 28:28
  SPEAKER_02: So these are some of the world's most vulnerable children.
• 28:31
  SPEAKER_02: And yet, to show that they are loved, look at this hospital that welcomes them, that does not treat them as ostracized.
• 28:40
  SPEAKER_02: And then they come and they find a community here of many other mothers.
• 28:45
  SPEAKER_02: I mean, right now we have 55 children admitted with these conditions when people think I'm the only one.
• 28:53
  SPEAKER_02: Oh, this only happened to me.
• 28:55
  SPEAKER_02: Why me?
• 28:55
  SPEAKER_02: Why, well, it's actually a disease and it's a sickness and it needs to be treated.
• 29:02
  SPEAKER_02: And look at all these other people.
• 29:03
  SPEAKER_02: So they find instant community here, you know, sharing and supporting one another and having hope, as Pastor said.
• 29:12
  SPEAKER_02: You know, the message of hope is very important.
• 29:15
  SPEAKER_01: I think when our caretakers, especially the mothers, are told that the cause of their children is the sickness, I think that that is so weighs on you.
• 29:26
  SPEAKER_01: Yeah, it weighs so heavily on the mother.
• 29:29
  SPEAKER_01: They keep asking questions they cannot answer.
• 29:32
  SPEAKER_01: I mean, why?
• 29:33
  SPEAKER_01: Why should I be the reason for the suffering of my child?
• 29:36
  SPEAKER_01: When they come here and we tell them you've done nothing wrong and you're not the reason, it's just um a condition.
• 29:43
  SPEAKER_01: You know, you usually tell them, see, there are mothers from Kenya, there are people from South Sudan, there are people from Rwanda, and there are people from Uganda here.
• 29:52
  SPEAKER_01: You are not the cause, and you are not the only one uh in the sea.
• 29:56
  SPEAKER_01: That brings a lot of relief.
• 29:58
  SPEAKER_01: Yes, my child is sick, but I'm not the cause.
• 30:01
  SPEAKER_01: And I can have other children who do not have these conditions.
• 30:05
  SPEAKER_01: My child will be helped.
• 30:07
  SPEAKER_01: I I've finally found people who love the child, they carry them.
• 30:11
  SPEAKER_01: You know, in the communities, no one wants to touch a child with a disability because they think it is contagious.
• 30:19
  SPEAKER_01: They think they can also catch the bad evil spirit and have children with the same conditions.
• 30:25
  SPEAKER_01: So when the children come here and we carry them and we tell them we also have children, you know, it's not contagious.
• 30:33
  SPEAKER_01: There's no spirit behind the disease.
• 30:36
  SPEAKER_01: It's just a medical condition that we shall try and treat and bring healing to your child.
• 30:42
  SPEAKER_01: I mean, it speaks volumes in the lives of these mothers of relief on their heart.
• 30:48
  SPEAKER_04: Tim and Fred, we're so thankful for uh the time that taken with us today and uh so glad that uh you're doing this good work in Africa.
• 30:55
  SPEAKER_04: May God's blessings be with you as you as you serve there.
• 30:58
  SPEAKER_02: Thank you as well, Dr.
• 30:59
  SPEAKER_02: Dre.
• 31:00
  SPEAKER_02: Thank you to the to the Central Swenkfelder Church and all the families that have been involved in in helping support this hospital.
• 31:09
  SPEAKER_02: We're really grateful and and glad to be connected with you all.
• 31:13
  SPEAKER_04: Thank you, as we are too.
• 31:14
  SPEAKER_04: Thank you, gentlemen.