A Beacon of Light

By Drs. Arthur and Sonja Miskin

It has been four years since Word & Deed became involved in the Nakekela HIV/AIDS Care Centre in South Africa. Looking back, we truly can say that the Lord has been pleased to prosper this essential project. It has served the community well, filling a gaping hole in the step-down care of terminally ill HIV/AIDS patients, particular regarding their spiritual well being. Without the assistance of Word & Deed, we would not have been able to get this far, let alone progress. Some very meaningful advances have been made.

Management consolidation has taken place under clinic manager Babette Grobler’s capable leadership. She has done a marvellous job in streamlining the day-to-day running of the clinic since Joke Parre’s (the project’s pioneer) departure. The multi-faceted nature of organizing this work required a person particularly gifted in this area of ministry, and Babette is a gracious gift of the Lord appointed to this position. Nakekela now functions as a well-run unit, with staff in every department knowing their duties and functions. Babette is also training Dorcas Mathibela, one of our care workers, in office management. With time, we hope that Dorcas will assume many of Babette’s managerial duties at Nakekela.

Nursing care, managed by Emma Masanabo, remains one of Nakekela’s outstanding strengths, a fact that contributes to the burgeoning reputation of the clinic in the local community and beyond. Because the standard of care is so high, there is great demand for the admission of terminally ill patients. Over the past year or two, good relationships and regular interaction have developed between Nakekela and the local clinics, the local hospital, and the various health authorities. Nakekela now functions at full capacity, using all twelve beds. The need, however, far outstrips the supply, and we have been forced to use a waiting list. An ongoing problem remains the late admission of patients who, for a variety of reasons, have delayed seeking appropriate help and are terminally ill when they arrive at the clinic. Although some, by the Lord's amazing grace, are “brought back to life,” others die within a few days. One of the greatest challenges for us at Nakekela, and for those involved in AIDS management in general, is early diagnosis and treatment. Yet patient denial and superstitious beliefs still preclude this essential aspect of patient management.

Emma, right, and one of the patients

Some exciting developments have taken place in supplementary services. Riana Hattingh has joined the team at Nakekela and provides basic physiotherapy and occupational therapy. One positive outcome of this has been arts and crafts days, on which patients are taught basic skills such as drawing and making gift cards. Some of these “works of art” adorn the walls of Nakekela and numerous of these gift cards were sold on our recent tour of North America. Riana also provides essential debriefing counselling sessions for the various staff members at Nakekela. Many of them come from broken homes and traumatic backgrounds and this simple biblically based counselling is immensely helpful. In doing this, Riana is also teaching these same staff members basic biblical counselling skills that can be used with the patients.

A support group has been established on Friday mornings, which former patients in the community are encouraged to attend. Attendance has been good and patients are benefiting greatly from these meetings. Time is set aside for Bible reading, singing, and prayer. There is time for mutual sharing and some volunteers who have attended these meetings have taught basic skills such as arts and crafts.

Due to extra funds from Word & Deed, Sonja now has access to X-ray facilities and specialised sputum tests. These contribute greatly to a quicker diagnosis of tuberculosis, the major cause of death, and so improve patient outcomes. Sonja also has obtained her dispensing license from the South African Health Professions Council, giving her better control over the management and dispensing of medicine.

Emma, (background), Sonja (right), and Dorcas, the trainee manager.

We truly can conclude that this project is prospering under the Lord’s sovereign care and provision. The project serves the community well, has a very good reputation, and serves as a beacon of light where darkness abounds on all sides. It is a well-known fact in the KwaMhlanga area that this is the Lord’s establishment. Whatever healing or improvement takes place, the Lord is openly acknowledged, which the patients come to see and confess. Some lives are saved in the process, but more importantly, some souls are saved too. In so doing, we are in a small way imitating our Lord Jesus’ ministry: “And Jesus went about all the cities and villages, teaching in their synagogues, and preaching the gospel of the kingdom, and healing every sickness and every disease among the people” (Matt.9:35). There is no greater privilege than serving the Lord in this way and we encourage anyone who might be interested in longer term mission, to do as the Lord said to His first disciples, who asked Him, “Rabbi, where dwellest thou?” He simply said, “Come and see” (John 1:38 – 39).

Rev. Arthur Miskin and Dr. Sonja Miskin, oversee the medical department of the Nakekela Care Centre, an AIDS hospice, in rural KwaMhlanga, South Africa.

Nakekela Clinic: The Commitment of Faith

By: Rev. Christo Heiberg

On my trip to Malawi in June of this year I stopped over at Pretoria for a few days. I had the opportunity to make a quick visit to the Nakekela Aids Clinic in KwaNdebele, some 70 km north-east of Pretoria (or Tshwane, as it is now called). I met Arthur and Sonia Miskin at their home at 9:00 a.m. on that beautiful sunny winter’s morning, happy to see them again after a few years. As we drove on the well-kept road to KwaNdebele, we spoke about the relative danger of living in the new South Africa and working in this abjectly poor place. Arthur assured me that by far the greatest risk for them is driving to and from the clinic and college every day, due to the reckless habits of many drivers, often with un-roadworthy vehicles, on that 60 km stretch of road. Fatal accidents occur on a regular basis and one has to keep one’s eyes wide open. (This risk is certainly something to remember as we pray for the Miskins and others venturing out to their daily work elsewhere in the developing world, where driving habits can be quite scary and human lives rather cheap.)


Having arrived at Nakekela for only a three-hour visit, I was immediately struck by the progress evident at the clinic since I visited in April of 2006. What a wonderful witness this clinic is of God’s love and grace in Jesus Christ to a world lost in its sin and misery! As someone has rightly said, there’s only one thing more powerful than dogma, and that is stigma! These AIDS patients would surely attest to that. They are deliberately rejected and forgotten by their society, as if the consequences of a sexually permissive lifestyle is their fault alone. Their plight reminds me of the lepers and other social outcasts in Jesus’ day. What a witness then to see how Christ’s modern-day disciples, male and female, black and white, reach out to these poor folks who have contracted HIV-AIDS.


The clinic itself has been expanded since my last visit in 2006, with extra beds added and more rooms available for administration, pastoral care and socializing. I was impressed with its cleanliness. It was good to hear how all the workers still see their work as the Lord’s calling, although to the human eye it might seem as if their rescue mission amounts to scooping water from the ocean with a bucket. But such is the commitment of faith, of which we read so often in the Bible and two millennia of church history.


The mood among the workers was very positive, although the challenges remain daunting. It was heartwarming to observe the calm, humble, but believing commitment and compassionate attitude of the staff. Let us continue to thank the Lord for the invaluable work that Arthur and Sonia and their team are doing in that poor and forgotten corner of South Africa. Pray that He might keep them safe in His almighty, powerful hand every day.


Rev. Christo Heiberg grew up in South Africa and is the pastor of the Zion United Reformed Church of Sheffield, Ontario.

Encouragement

Pinky is the girl between Emma and me on the picture,she was a patient end of last year for about 2 months.

She came in with severe weakness of both her legs due to HIV nerve damage, unable to walk or even stand alone. She was unable to control her bladder. She was always very depressed and feared she wouldn't walk again. We helped her get onto ARV's which is the medication for HIV.

On Friday we had a follow up clinic for old patients...the plan is to see how they are doing spiritually,socially and medically..(quite a logistical nightmare to pick them all up and get them to Nakekela)It is a time for felllowship and reunion, tea and cake and good lunch together.

Well...Pinky was just one big smile this time so I asked her why she is so smiley....and she says:

"Because I have become a Christian now...when I was a patient you all prayed for me so much and specially Sr Emma, that when I went home I joined the Church and found that the Lord has freed me on the inside as well as healing me on the outside"

She is walking without any aid and has recently been married!Oh how we rejoiced together!

The Lord Who heals will receive much glory and thanksgiving.

Sonja Miskin

Updates from Sonja Miskin

Dr. Sonja Miskin tells us a little about some of the patients being served by the Nakekela HIV/AIDS Hospice.



This is Phumzile. She lives alone with a young brother: no other living relatives. Due to her vulnerable status she was violently attacked; her eye stabbed out and she contracted HIV as a result. We found her terribly sick and she has been with us about two months now. She was so traumatized that she was unable to smile or even look up for the first two weeks of her stay with us. See now how the Lord's grace and gentleness has changed her!


This is Queenie who was found abandoned in hospital last September by one of our volunteers that did hospital visits. She has been with us since then. She has a totally paralyzed right side due to a tumor in her brain caused by HIV/AIDS. Her prognosis is not good. Her social conditions are dreadful; she has no living relatives and so we are her family and home. She has mental impairment now due to this tumor and so we are not sure how much she understands. We really would appreciate prayer for her...that our Lord would make himself and His saving mercy known despite her handicaps.




This is Pastor Sifiso Hlatswayo who regularly shares God's Word with the patients.


This is Thabile, a young mom of two small children who has improved dramatically under our Lord's care with us. She and her mother praise the Lord for her return to health! She is going home this week.


Please join us in thanking the Lord for his blessings upon the very difficult lives of these precious people.

A Visit to Nakekela

This would be my last day in South Africa visiting the Nakekela Care Center with Dr. Sonja Miskin, who so graciously let me tag along with her. It had rained a lot the day before and now today. People said it had been unusually rainy this season. The sky was gray and heavy with more downpours expected to saturate the red dirt even more. The roads were quieter than usual as we approached KwaNdebele, the area where Nakekela is located. Dr. Sonja commented sympathetically of the misery of the water seeping into the houses with insufficient zinc roofs and dirt floors. How much more miserable for the unfortunate ones that lie on the ground afflicted with the disease that affects every home in these communities.


On this particular day, because of the rain the patients that could be sitting or propped up were congregated in the one room where there is a heater. Their bodies are wasted with the effects of AIDS so it is hard to keep warm even on a temperate day. On sunny days the patients are sitting outside, facing a little garden. The care workers were bustling about cleaning the rooms, washing up and organizing supplies. The care center is immaculate despite the frugality of resources. Dishes are done by hand. Breakfast is simple: two slices of bread with Spam-like meat, slice of cheese and tea with milk.


I was impressed over and over again with the careworkers, Emma, Rose, Anna, Mama Cozi, Jeremiah and many others who selflessly do the most menial tasks: diapers need changing, new patients might have months of dirt to be scrubbed off, floors need to be washed, beds changed, laundry, gardening, cooking. Some workers cannot even read. Some have two jobs. Many are single moms or grandmas, most have young children they are responsible for because of the devastation of the disease. These workers do not have a healthcare plan, they don’t go on strike and they don’t get a paid vacation or pension. They started out as volunteers, but thanks to donors they now have a wage. They live in the community with the deprivations of their patients without the comforts we demand. Yet they work with joy and determination. They consistently share the gospel and counsel their patients.


The commitment of Word and Deed because of the love of Jesus at Nakekela is productive and inspiring. Nakekela is an earthly oasis in a desert where spiritual darkness has afflicted thousands of people with poverty, disease, and abuse. As the work at Nakekela grows, one can see God’s blessing at every turn. One can see that fundamentally, Nakekela depends on the Lord for its needs. The basic need is prayer for spiritual encouragement, strength, wisdom and the daily needs, for lives to be changed for a community to be a light in a very dark world.


The patients at Nakekela are in the last stages of what HIV does to people. Their immunity is as low as it can go. They are susceptible to viruses and diseases such as TB, meningitis and skin infections. Typically, family and friends have abandoned them. Here they are given a clean, soft bed. They are given medical attention. They are given food. Most of all they are given the gospel of Jesus Christ.


Not always, but many times patients are open to the gospel. Some heal, go home and share the healing with their community and neighbors. Most do not heal physically. That brings sadness to everyone, but a bittersweet joy when a patient rejoices to meet his Savior Jesus Christ. It is sobering to think that even this devastating disease can be used for good in reaching people who otherwise would not be open to the gospel.

-- Written by Connie Sikma who visited South Africa with her husband Doug and Son, David in January, 2009. They reside in Grand Rapids, MI.

With Strength God Alone Can Give

By Sonja Miskin


Rural KwaNdebele is a bleak place. Physically, it has nothing but dusty, potholed roads, separating dusty little houses consisting of a few tin sheets nailed together. Economically, there is little happening – the future prospects are bleak. Socially, the problems facing the community are staggering. Politically, these people have by all intents and purposes been forgotten. Medically, the HIV/AIDS epidemic is causing a bleakness hard to describe to the average citizen of North America. Spiritually, religious life is overwhelmed by ancestor worship, and crippled by superstition and indigenous African religions.


A bleak picture indeed. However, this is the field of labor chosen for some of us by our Sovereign Lord. It is my experience that in exactly such staggering bleakness the grace of our Lord is greatly manifest. A visible and tangible example of this sovereign grace is Nakekela HIV/AIDS Care Centre, which is now into its fourth year of operation. This could only be made possible by the wonderful financial support we receive from Word & Deed, through the generous giving of North American people.


This past year started off with us being able to move into our new building extensions, which was well worth the discomfort and wait we had through the second half of 2007. Utilizing funds granted by donors in the Netherlands as well as a local South African financial institution, we could make considerable improvements to our premises. Two new patient rooms were added, which now enables us to potentially house 12 patients, double that of the original six.
However, we have started by increasing to only nine due to staff and furniture restraints. Our kitchen and bathroom facilities were revamped. Some much-needed office space was added, as well as a nice little doctor's office with a small pharmacy attached. We had to sacrifice some of our vegetable garden, as we have limited space, but it is still big enough to supply the kitchen with some nourishing spinach, onions, cabbage, and tomatoes.

We also received the most amazing gift of a big electricity generator from a Dutch church group.
To date we have had more than 280 patients under our care, and of this number about 30% recover sufficiently to be able to return home and even go back to work. They will remain well and can live normal lives as long as they continue to take their HIV medication daily. This recovery rate is a remarkable answer to prayer, especially if you consider the dreadful condition in which these patients were on admission.
We strive to have every one who passes through our hands come into contact with the Gospel of our Lord Jesus Christ. To this end we have recently sent some of our Care Workers on a Biblical Counselling course presented especially for them at Mukhanyo Theological Seminary. We have also employed Pastor Sifiso as our very own in-house minister and he makes bi-weekly visits to both staff and patients.


Despite many discouragements, hardships, conflicts and struggles, the work of our Lord continues and we labor with strength God alone can give. We do not give up as we think these are good works God has long ago planned for us to do. In the end, all the glory belongs to the Lord alone for any achievements in this field of labor.

Dr. Sonja Miskin cares for rural South Africans at the Nakekla HIV/AIDS Care Centre in KwaNdebele, South Africa.

South Africa Projects

South Africa – Nakekela HIV/AIDS Hospice

Budget: $128,000

The Nakekela Hospice is a step-down clinic for AIDS patients. There are 12 beds in the clinic, nurses and doctors, and 10 home-based care workers who look after an average of 400 patients in their homes – bringing them medicine, food and speaking to them about their need of a Savior. We praise God for blessings exceeding expectations. In the first year of operation, 95% of the patients were expected to die but instead 60% were able to return home and continue their long term treatment there. Dr. Arthur Miskin and Dr. Sonja Miskin oversee the medical aspects of the clinic. The purpose of the clinic is to treat AIDS patients and alleviate the horrible symptoms that accompany the disease while bringing the Word of God to the afflicted.