Word & Deed: Focus on South Africa

A Beacon of Light

2010-10-16T13:40:00.001-05:00

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

2010-01-16T13:59:00.003-05:00

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

2009-06-11T12:19:00.005-05:00

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

2009-05-06T14:22:00.012-05:00

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

2009-02-11T13:39:00.005-05:00

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

2009-02-05T22:38:00.004-05:00

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

2008-11-04T09:41:00.003-05:00

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.

Making a Difference in South Africa

2008-06-27T18:27:00.007-05:00

Darkness as Light - by Randy and Rose Finkbeiner

It was always Rose’s and my dream to volunteer overseas in some capacity of community development work. We shared that dream before we ever said “I do” to each other twenty-six years ago. That leads me back to how I met my wife, which was the first step in an adventure that I wouldn’t trade for the world. That adventure has landed us in the middle of the global AIDS crisis in rural South Africa, volunteering with Mukhanyo Community Development Centre (MCDC).

Randy Finkbeiner with a Nakekela patient.

I think I was probably an average guy who really didn’t know what exactly to do with his life. All I knew was that I wanted to make a difference in this world. I didn’t really have an ambition to make money or to become famous or to break any records in life. I ended up with an education in Cultural Anthropology out of an interest in people but not without dropping out of school several times in the process. Not long after one of those lulls in my education I was at a Christian conference where I heard an impassioned man speak about the need to show the love of Christ to down-and-out people in the heart of San Francisco. A few months later I found myself living in this man’s garage, observing the manifestation of life’s pain in the Tenderloin of San Francisco. I spent nearly two years getting to know prostitutes, drug addicts and those who were the outcasts of society. Little did the world know that a virus was about to announce itself. It made its debut in several major American cities, one being the city of San Francisco. This virus, we now know as HIV, has sent shock waves around the globe. It was during this tumultuous time that I met my wife Rose and within five months we were married.

Rose Finkbeiner with a young friend.

It still amazes me to this day how God takes all of our seemingly unrelated, collective experiences and gathers them together in some profound way to prepare us for some future purpose. I would never have imagined that twenty-six years later I would follow the aftershocks of this virus half way around the world to South Africa.

We have faced no greater pain than to witness the devastating effects that AIDS has brought to African families. We have had a front row seat to this crisis these past four years volunteering with MCDC. My wife and I are involved in assisting families infected and affected by HIV/AIDS (one major MCDC project is the Nakekela HIV/AIDS Hospice which is funded by Word & Deed North America).

Nakekela Hospice

We live in a community that the government claims has an HIV prevalence rate of 34% amongst adults. I read the other day that half of all 15-year-old girls in this country won’t see their 30th birthday. That absolutely shocks me. Not because of the statistic, as raw as that is, but because Rose and I have recently been adopted by a 15-year-old girl who lost both her mother and her grandmother to AIDS. She now refers to us as “mom and dad.”

I met a girl recently who told me she had resigned herself to the fact that she would eventually die of AIDS. When I asked her why she felt this way, she simply replied, “Because someday I want to get married and have children.” A few hours ago I watched a 31-year-old man die. He was the only surviving uncle who was caring for eight orphans.

A new addition to the Nakekela Hospice.

What kind of hope can you offer in a seemingly hopeless environment like this? Rose and I struggle with that question daily. I know that our relationship with Jesus Christ is what transports us from day to day, but sometimes I feel a terrible hopelessness here. So I can’t imagine the suffering for those who do not have Christ in their lives. The only way I have come to reconcile this tension of offering hope in a hopeless place is by my view of the Kingdom of God. I see the Kingdom of God as being revolutionary in its ability to overthrow darkness. I have come to see myself as a member of that Kingdom and wherever I go the Kingdom goes. I recently have found comfort in this portion of scripture from Psalms 139: “If I say, Surely the darkness shall cover me; even the night shall be light about me. Yea, the darkness hides not from thee; but the night shines as the day: the darkness and the light are both alike to thee.”

Our hope is Jesus Christ, the light of the world.

Rose and I thank God daily for the opportunity granted to us at this time in our lives to volunteer with Mukhanyo Community Development Centre (MCDC) here in South Africa. We often see darkness as light.

Randy (50) and Rose (54) Finkbeiner volunteer in South Africa for MCDC. Randy is the Family Development Coordinator and Rose is the Sponsor-a-Family Coordinator and Volunteer Coordinator.

South Africa Mission Team Report

2008-01-03T21:29:00.002-05:00

Putting a Smile on the Face of a Child - by Jennifer Byl (with input from other team members)

This summer, from July 31 to August 15, a group of young people from Ontario and two chaperons traveled to South Africa to work and live among the people there. This trip was arranged by Word & Deed and the Miskin mission liaison committee. Here is a report about what we learned, and some of our experiences while we were there. Certainly the experience of traveling to South Africa and being among the people has been a rewarding and spiritually insightful time. We were able to see that Christ's church is truly throughout the world and that the deeds of Christians are an important part of showing the gospel in action.

Orphan Care Centers (operated by Mukhanyo Community Development Center - MCDC)

There are five orphan care centers established in different areas surrounding Pretoria, South Africa. Approximately 60 to 80 orphans come to the care centers each day. These children are usually taken care of by their relatives, but there are cases where children live with 15 others in a shanty with their grandparent(s). This is one reason why the care centers provide food for the children. A single grandparent most likely does not have a source of income, and if he or she does, it will not be enough to provide for all these children.

Much of our time here was spent painting a new church at one of the care centers and erecting pit toilets for the children to use. Working with African workers at the care centers, we learned of their own life stories. One worker lost both of his parents at the young age of ten. Being the oldest of five, he had to leave school and find work and make money so his other siblings could attend school. This man will never be able to find a "good" job since he is illiterate. This is another area where the care centers provide help.

One afternoon we were given the opportunity to prepare a Bible story and some crafts for the children. One of the teachers translated the story of Noah and the flood into the Zulu language as we told it in English. The children all listened very attentively during the story. Afterwards, we did a craft with the children in relation to the story. They were very excited to be able to make something and take it home with them. While working, we also took the time to teach them songs and some simple English phrases. Children of all ages are simply fascinated with cameras. They never failed to flash bright smiles and pose happily for a picture. These children loved any attention we gave them because they receive so little.

It was difficult to communicate with the younger children as they do not yet know English but speak Zulu. It is in school where they learn to speak English; therefore the older children were able to speak to us. However, even though many of the younger children could not understand us and we could not understand them, we could still communicate love and compassion to them and it was readily received.

Nakekela Care Center (an MCDC project supported by Word & Deed)

The Nakekela Care Center is a clinic where people with AIDS are treated. Regular rounds are made in the clinic every day, where Dr. Sonja Miskin and her dedicated staff talk with each patient, discuss their treatments, and offer encouragement. Dr. Sonja Miskin also makes home visits to people who have AIDS.

The severity of the AIDS disease ranges from Stage 1 to Stage 4. One will not find a person with Stage 1 AIDS in the clinic as symptoms are not yet visible. Most of the patients in the clinic have Stage 4 AIDS, and treatment is mostly not effective except for a few cases (mortality is presently around 60 percent). The discovery that a person in the community has AIDS often brings a lot of shame and pain to the sick individual. It is vital that visitors and caregivers are sensitive to strict confidentiality. Such fear, however, presents a problem: by the time someone dares to seek help, the disease has most likely progressed and may have been transmitted to others.

A number of us were privileged to visit the clinic. We had the opportunity to make meals consisting of some meat, vegetables, and pap for the patients. In addition, we cleaned the clinic, visited with the patients, and helped them perform various exercises to loosen their limbs, as many suffer from strokes which are a result of having AIDS.

The effects of this disease are readily seen. AIDS patients are very thin and suffer from strokes, blindness, cancer, and seizures, and have difficulty walking. Many are so weak that they need assistance in even the simplest tasks such as eating their food.

It is difficult to comprehend the reality of what is really going on in many of the homes in South Africa. Those that are treated, and continue taking their treatments, are able to live at home and carry on with their daily lives, yet thousands do not receive the necessary care.

Personal Thoughts and Reflections

We were eager to go on this mission trip for the opportunity to provide help for the people in South Africa and make even a small difference in their lives. The trip itself was a humbling and eye-opening experience. We now have a much greater sense of what life is like for those who have much less than us, and how we should be ashamed for continually looking to materialistic things to make us happy and comfortable. It was especially humbling to see how thankful and content the people are with the little they have.

We are truly grateful for the opportunity to have been able to reach out to those who are less fortunate. It was an unforgettable experience, well worth the time to put a smile on the face of a child who has only known sadness and poverty, and many of us would consider visiting again. Pray for these people, that they might receive physical aid, but also that the Word, being brought with the deed, would be sanctified in their hearts.

Jennifer Byl lives in Burgessville, Ontario, where she attends the Heritage Netherlands Reformed Congregation.

Hands and Feet for Christ

2007-11-29T14:43:00.000-05:00

A Day at Nakekela Care Centre by Dr. Sonja Miskin

It’s an early winter morning as we drive out from Pretoria city to rural Kwamhlanga. There is a mist hanging low and frost on the ground. The sun is up, but gives no heat; it is an unseasonably cold winter. The picture postcards of Africa seldom portray the harshness of the winters. This time of year is dry and dusty, the fields and bushveld have a brownish wheat colour, and although the sky is bright blue, it is of a crisp kind. We consider the truth of God’s Word in describing all of creation as groaning under the curse caused by sin, and this cold weather is a sharp reminder of that.

As we drive, we think about the week lying ahead, in that part of our Lord’s Vineyard where we are called to serve. It will include some heartache but thankfully, also some joy. So, let me describe for you a typical day out at Nakekela Care Centre.
Today we’ll start with a staff meeting, including people in management, the nursing staff, our kitchen team, and the two men doing the garden and general maintenance – 25 people in total. We don’t have a suitable room, so we sit outside in the wide, open-air passage, huddled under jackets, stomping our feet to keep warm. Rev. Arthur Miskin opens with reading from Scripture, which he explains for us, pointing us to the Lord Jesus Christ as the only Name under heaven whereby we must be saved. Reminded of to Whom we belong and Who has called us to our work, we pray, asking for help, wisdom, and strength for the days ahead.
Everyone has an opportunity to share their joys, sorrows and problems, and together we discuss these. We close our meeting by singing together, praying, and sipping cups of steaming rooibos tea.
Sister Emma and I continue with ward rounds to see to our eight in-patients. Today, Lindiwe, Catherine, Pinky and Petros are well enough to sit outside in the sun; they share chit-chat with one another and make jokes with the care workers. It is an encouragement to see them so vastly improved. Soon they will be discharged, and on their anti-retroviral (HIV) treatment will need only monthly follow up. Two of them have had strokes with resulting weakness in their arms and legs, but are able to function fairly well despite the disabilities.
The other four patients are in bed and bundled up under blankets due to the cold. They are so thin and wasted that they have no body fat for insulation. Zanele has AIDS dementia, does not recognize us and is refusing to take treatment. There is not much we can do for her. Mpho is suffering from TB due to poor immunity as a result of AIDS, and it has spread to her bones. She has a lot of pain, so we adjust her medication to make her as pain-free as possible. Lucky is a young man who has lost all function in his legs as a result of AIDS involvement of his nervous system, and has to be turned to prevent bedsores from developing. He needs to wear diapers, too, which affects his dignity. We encourage him by pointing to the other co-patients that have recovered. Venice is a newly admitted patient, with deep, penetrating septic ulcers due to severe neglect. She has been abandoned by her family. We discuss the best approach to wound management considering the high pain level she experiences. We talk to the others in the team about her socio-economic problems and the best way to help her spiritually and emotionally with the rejection she suffers.
After lunch, Pastor Sifiso comes to visit. He does a Bible study with those well enough to sit outside, and then does bedside visitation with the others. He is in no hurry; he reads Scripture to each one, patiently listens to fears and concerns, and prays in a heartfelt way for each patient individually. We notice his compassion for these suffering people, and marvel at how he points them to The Great Physician in their own dialect.
I make plans for the next day to do home visitation with two care workers to follow up on patients lately discharged from Nakekela. They are doing well physically, but need encouragement emotionally and spiritually. We choose the Scripture portions to read and pack our medical supplies in preparation.
Time comes to head home to Pretoria. The road is busy, with many busses and taxis heading in all directions. I use the time to think and pray, thanking the Lord for healing mercies, both physical and spiritual. I reflect on the deep sense of joy in my soul that comes as a result of being exactly where the Lord would have me. Having been saved by Grace, it is a pleasure to do my Lord’s will in this work. Being hands and feet for the Lord Jesus Christ is the least we can do, for He is so worthy!

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

My Name is Themba Msiza

2007-06-05T16:05:00.000-05:00

By Themba Msiza as told to Randy Finkbeiner

My name is Themba Msiza. I come from Vezubuhle, South Africa. This HIV is here, I’m telling you, it’s here. I started getting sick in 2004. I didn’t know what was going on with me. By November of 2005 I was bed-ridden. My family took me to the traditional healer and they told me that I was bewitched. At that stage I really believed I was bewitched because I felt there was something moving around in my stomach. It felt like a snake was living inside of me.

My grandfather phoned me on Christmas Day. He asked me why I wasn’t coming to celebrate Christmas with him and said I was speaking very softly that day. He said to me, “What is the matter, grandson?” I said, “I’m sick, grandfather.” He said, “Should I come and fetch you?” And I said, “Please come quickly.” He arrived and picked me up and took me to Vezubuhle. When I arrived in Vezubuhle, he took me again to the traditional healer, the prophets of the Zionist church, and other healers. They made me drink the Zionist tea and I vomited it. I ended up saying that I wasn’t going to go to the traditional healers anymore. My grandfather said to me, “Hey, you need to go to these people to get better.” I said, “How can I keep going to them when every time they give me something to drink or eat I throw it up?”

Then my grandfather decided to take me to a government clinic at KwaMhlanga. I was very weak at that time but had a will to live; I was fighting to stay alive. The sisters at the clinic were very amazed that I could even walk because I had lost so much weight. They said I looked like a walking skeleton. They asked me to get tested for HIV. I asked myself many questions like, “What will people think if I have this thing?” I was taken to the testing room by a very big lady. This lady said to me, “Even though I’m this big, I’m also HIV positive.” I looked at her in amazement because she looked very healthy and beautiful. Then they took my blood and the test came back positive. I accepted my status and at that stage I was very sick and my CD4 count was only 2. I looked like a walking skeleton.

The sisters at KwaMhlanga clinic took me to Nakekela Care Center. When I first came to Nakekela they turned me away because there was no bed. I was very confused at this stage. That evening when I came from Nakekela I started praying to my Lord. After praying I received a call from Nakekela saying they would come in the morning and get me because now there was a space for me. The following day I was admitted to Nakekela. I was sweating a lot and when I would wake up in my bed I found my clothes and the bed was very wet. I was on and off with the sisters. I was saying a lot of crazy things because HIV can also affect the mind. I looked at my own bones and wondered if this was really me. I couldn’t believe what was happening to my body. I was afraid to look at myself. People kept telling me I looked like a living skeleton. I would look at my arm and couldn’t believe it was my own arm.

When I started taking the ARV treatment for HIV I would pray before taking the tablets. I asked God to make these tablets to work in my body. After many months I began to get my strength back and was able to return home. I prayed every time before taking my tablets that God would use this medicine to help me. I now grow my own spinach in my garden. I am speaking at schools and encouraging young people to protect themselves.

I want to encourage you to go and get tested. Because I know my status now, I am a living example that if you get tested you can survive. Look at me and take courage. This disease is here amongst us. Let us go forward with the Word of God so we can get victory over this disease. Without God we are nothing. God is great; let’s pray unto him everyday. I’m asking those who have not yet been tested, do you know yourself what is your status? We know there is no cure for HIV, but if we put our trust in God, we can become a hopeful nation. Let us unite against this disease. Let us together ask God to help us fight this disease in our midst. Thank you for letting me share my story.

Themba Msiza is a former patient at the Nakekela Hospice run by Rev. Arthur and Dr. Sonja Miskin in South Africa. Randy Finkbeiner is an American volunteer at the clinic.

Prayer Requests from Sonja Miskin

2007-03-24T12:18:00.000-05:00

We are doing fine ,by our Lord’s upholding , but very busy. We have had a bad month , with many deaths and many new admissions. We have people at our door every day asking for help as we become better known in the community , and we can only help so few. So a serious and ongoing prayer would be to ask the Lord how we are to proceed towards expanding the work in the face of this obvious need. Also we need capable and skilled hands and willing hearts to physically help bear the burden……mature believers who can counsel from God’s Word. In the near future we will need an on-site project manager skilled in administration , someone prepared to stay for quite an extended period of time.

Please pray for a young man , David , who is trying to turn his life around by God’s grace amidst real difficulties. He is very poor with only an elderly mom , and has gone back to school at age 22 to finish.

Please pray for a young girl , Thembi , who’s mother is with us at Nakekela and her baby brother died last week. She is effectively the head of the household , and it is too much for her. She is church going , but very overwhelmed right now and unable to see God’s hand. She has 4 other siblings to care for.

Please pray for Emma and Amos (she is the nursing sister working for us, and her husband is a local pastor) , they have adopted a toddler of a patient who died with us. He probably is also infected and will need much care in the future , this is a big commitment on their part.

Please pray for a refugee family from Rwanda , the lady is very ill and due to her illegal staus in our country , cannot get proper care medically. Her husband and little girl are also HIV infected and will need treatment in the near future. We are trying to help but have limited resources and capabilities at Nakekela. They live in a tiny little one room shanty with very poor prospects for the future.

Please pray for Jo , one of our garden workers who has a big tumor in his neck which will need surgery.

Please pray for our staff , that they all would grow in the grace and knowledge of our Lord Jesus,,, and will totally abandon superstitions fro His sake.

Pray that we would retain our primary focus…i.e. the Gospel of our Lord for perishing sinners as the most wonderful reason to live and serve in the dust of Kwandebele.

Thank you so much

In service of our Lord and Saviour

Sonja

Responding to AIDS in South Africa

2007-02-22T11:52:00.000-05:00

The Problem, the Project, and the Prayers

By Dr. Arthur Miskin

South Africa is by far the most developed country in sub-Saharan Africa. The country definitely enjoys a great measure of economic and political prosperity. Yet, in the midst of much apparent well-being, South Africa is a land of stark contrasts. Extreme wealth exists alongside extreme poverty. While the rich seem to be getting richer, the poor seem unable to shake loose the shackles of their poverty. There is, however, one thing ominously threatening to destroy our relative stability, and that is HIV/AIDS. This destructive disease has reached epidemic proportions, particularly among the poverty stricken classes of our population. HIV/AIDS carries many ramifications into all areas of life.

Consider these sobering statistics:

South Africa has more people living with HIV/ AIDS than any other country in the world, according to the United Nations.
With around 1,800-2,000 new cases per day, South Africa has the world’s fastest growing rate of infection.
Statisticians at the University of Cape Town estimate that there are about 5.4 million people living with HIV/AIDS in South Africa. This figure is set to rise to around 7 million over the next ten years.
HIV/AIDS is no respecter of persons, afflicting people at all social levels and in every economic group. In some South African colleges and universities more than 20 percent of the students have tested HIV/AIDS positive. The armed forces, too, are hard hit. Studies have shown that 89 percent of soldiers who volunteered for testing were found to be positive.

What do these statistics mean for ministry in South Africa? Consider the fact that

as more people within the reproductive age groups die, the number of orphans increase. Should current trends continue, it is estimated that by 2010, there will be around 1.6 million AIDS orphans in South Africa. Already there are many homes within rural areas occupied and run by children who have lost both parents.
the people most severely affected by HIV/AIDS are those who are economically active. It was already estimated in 2005 that at least one in 10 deaths among those 20 to 40 years old would be due to AIDS-related causes. This has a vastly negative impact on human productivity and on life expectancy. It has been estimated that the population growth rate declined from 2 percent in 1999 to 1.9 percent in 2000, and the growth rate was projected to drop to 0 percent in 2011.
AIDS-related deaths will rise from 400,000 per year (at present) to 800,000 to 1 million per year. Some estimates suggest that life expectancy will be reduced to 38 years by 2010.

How should Christians respond?

In the face of such overwhelming realities, what are we, as Christians, to do? We know that human sin lies at the heart of this spreading epidemic. Sexual immorality is rife in South Africa and is indeed the scourge of large parts of Africa itself. But can we squarely lay the blame at the feet of sin alone? I think not. Many other factors play a role, such as crippling poverty, hunger and malnutrition, lack of proper education, and prostitution as a means to survival. Sexual abuse of women is still rampant and child abuse is increasing alarmingly.

As Christians, we also know that the radical cure for this disease is the gospel, “for it is the power of God to salvation for everyone who believes” (Rom. 1:16, NKJV). For this reason, we too must not be ashamed to bring this life-giving remedy to a people perishing in sin and despair. Oftentimes, however, these people are too weak and sickly to even listen. And so a cup of cold water is brought in the name of Christ the Saviour to bring strength and healing sufficient to enable hearing of God’s saving grace in the gospel.

Nakekela Clinic

It was to this end that Nakekela Clinic was established. The word means “we care” and the focus of the care is towards both physical and spiritual well-being. The project was conceived of the burning question: “How do we bring a cup of cold water to those who are too sick and hungry to hear the good news?” It became very apparent that the word ministry had to be accompanied by some form of deed ministry. Quite providentially, a black pastor, working in the KwaNdebele area of South Africa, became aware of an abandoned building in one of the villages. With the help of Melanie Prinsloo and others of the Masibambisane Development Corporation, the building was converted into a step-down-hospice facility. It has six beds which are nearly always occupied.

Nakekela Clinic is headed up by Dutch pharmacist/missionary Joke Parre, one of the pioneers of the work. My wife, Sonja, and I provide medical care as far as possible. We are assisted by a variety of nursing personnel and home-based care workers who offer both in-patient and home-patient care and follow-up.

We might wonder what impact a little six-bed facility might have on a problem as overwhelming as the one before us. We do hope, in God’s time, to expand the work, but we have also come to realise that only God can swing the tide of the epidemic. Whether we have a six-bed or a 20-bed facility right now, we need with all of our might to do whatever our hands find to do (Eccles. 9:10).

We have been amazed at some of the things that God has done before our very eyes. Although many patients, sadly, have died, some who have come in unable to walk eventually walked out. They know full well that it is Jesus who alone can cause the lame to rise and to walk. There is no greater joy than sharing the blessed news of Jesus with people who do not know who He is.

Prayer: Our greatest need

What is our greatest need right now? Confronted with the sheer magnitude of the problem, the devastation, and the poverty, we might want to pour vast amounts of money into a variety of projects. This is the easiest thing to do, but not always the wisest, and is not what we need most. What we and all other mission workers need most are the prayers of God’s people, for “the effective, fervent prayer of a righteous man avails much” (James 5:16, NKJV). Our sovereign God alone can remove this mighty mountain that threatens to crush all before it. Jesus said, “If you have faith as a mustard seed, you will say to this mountain, ‘Move from here to there,’ and it will move; and nothing will be impossible for you” (Matt 17:20, NKJV).

There are many things that you can pray for:

Pray for heartfelt, Spirit-wrought conviction of sin in Africa, together with true repentance and faith, for this alone addresses the heart of the problem.
Pray for specific missionaries, their families, and their work. They are subjected to many fears, discouragements, and hindrances by the devil and his hordes.
Pray for our work at the Nakekela Clinic, which we hope will come under the auspices of Word & Deed. Ask that we will maintain a healthy balance between Word and deed. Because the needs are so vast, it is easy to water down the good news to a social gospel.

I end with the words of Dr. Flip Buys, principal of Mukhanyo Theological College: “Missions is not only done out there, far away from us, in the dry dusty fields of KwaNdebele or Northern Zambia or somewhere else in the world. Missions is also done in your closet where you plead on your knees: ‘Let Thy kingdom come, let Thy will be done.’” Missions is also done in your family devotions where you lay the names and the needs of the missionaries before the feet of our Father at His throne of grace.

Dr. Arthur Miskin works for the Masibambisane Community Development Corporation at the Nakekela Hospice, teaches at Mukhanyo Theological College, and preaches at Rietvalei Reformed Church of South Africa.

The Shadow of Death

2007-02-20T14:09:00.000-05:00

Life through the eyes of a Nakekela home-based care worker

By Randy Finkbeiner

Previous issues of the magazine have introduced the Nakekela Clinic, an HIV/AIDS Hospice project run by the Miskins in South Africa as part of the Mukhanyo Community Development Corporation (MCDC). Word & Deed has set a goal of raising $60,000 (US) in 2007 for this worthy project with God’s blessing. In this article, we get a first hand view of the work through the eyes of one of the home-based care workers.

I am between dreams on a cold night in the high veld of South Africa when the ring of my cell phone startles me awake. Reading the name of the caller tells me everything. I hear the sound of a young woman weeping; she says haltingly, between sobs, “My mother - she’s gone.” I try to offer some awkward words of consolation while trying to clear my head of sleep.

I arrive at her home, which is found in the homeland of the Ndebele people, just before dawn. The house is made of mud, and cow dung is the plaster on the walls, applied with the bare hands of her grandmother. The sun is just warming the horizon and, in the darkness of the home, it takes my eyes a few seconds to adjust. Gradually my eyes find the girl’s dead mother lying on a grass mat which graces the hardened dirt floor. A sheet is neatly tucked around the body; a candle burning nearby offers flickering light to the scene.

The grandmother is weeping in the corner next to the body, and my friend is busy clearing the room of all furniture to prepare for the coming week of visiting family members. Together we pray, and I ask Jesus to come and bring some comfort to the family.

For the purpose of this story, I will call the young woman Zanele. Zanele and her mother have both struggled with Tuberculosis (TB) in combination with HIV/ AIDS. They have been receiving antiretroviral drugs (ARVs), a combination of tablets taken to lower the replication of the Human Immunodeficiency Virus, through the US-funded Right to Care program. Zanele’s mother had been a patient at the MCDC AIDS hospice, Nakekela Care Center. While Zanele is responding very well to treatment, her mother was not.

In all the various community projects being done by Mukhanyo Community Development Centre (otherwise known as Masibambisane or MCDC), home- based care is the project in which I have found great passion. I work together with a team of nine local ladies and other overseas missionaries to care for HIV/AIDS patients in their homes. This strategy of caring for people in their homes has proven to be the best method throughout Africa.

Two weeks prior to the death of Zanele’s mother, I had taken her to a government hospital in Johannesburg. The mother was admitted, and we all had hopes that the mystery of Zanele’s mother’s poor response to ARV treatment would be unraveled.

These are the events leading up to the death of Zanele’s mother as I experienced them: I leave home early to collect several patients and take them to the government ARV clinic. Many patients, unable to walk under their own power, need assistance to get to the clinic. Leaving the clinic, I follow a long, boulder-laden path to a pile of garbage to visit a 65-year-old man who is living alone in nothing but a cardboard shack. I check to see that he has food and is taking his ARV and TB tablets correctly. He has food, but no cooking fuel, and so we go together and pick up 5 litres of kerosene. He has improved so much since I found him struggling for life a few months prior, that I ask him to walk home to get some exercise.

Next, I work my way across a rutted-out dusty road to the home of young girl who is denying her HIV status. The girl’s family went to the local clinic out of concern for their sister. I received a call from the nurse at the clinic asking me to convince this girl to come and take an HIV test. After an hour of diplomacy and a little coercion, the girl agrees to get tested. She agrees only after I convince her that I will keep her status confidential. I carry her feather-like frame to my car, and we make our way to the clinic.

Sometime after this and just prior to helping someone collect firewood for an upcoming funeral, I receive a phone call from Nakekela Care Center. They have just received an unexpected call from the hospital in Johannesburg saying that Zanele’s mother had been discharged. They say she is doing much better and is sitting in the hall of the ward waiting for us to come. After a few shuffles of my schedule, Zanele and I are on our way to Johannesburg.

Through open veldt and bush, we make the two-hour journey to the city whose streets are said to be paved the gold left in the tailings of the surrounding mines. Zanele is in high spirits, excited to see her mother after two weeks of separation. After exploring the dreary maze of hospital wards, we eventually find her mother and are shocked to see her condition.

She was removed from her bed that morning and placed in a chair in the hall of the hospital ward. When we arrive, she is having difficulty breathing and cannot speak. Her body is slumped in the chair, and she has no power to pull herself back up. On our return, Zanele is silent as her mother gasps for life in the back seat. I think to myself, what am I going to do if she dies in the car? We arrive well past dark and there is no moon, so the darkness is palpable. We carry Zanele’s mother to the front door, her feet dragging through the red dust.

I hear the bass of pulsing house music coming from a nearby beer hall, and it makes for an abrupt contrast to the issue of life and death before us. Inside, we find the bed down a narrow hall in a small back room. She collapses but shows a small sign of life when she sees her grandchild. We pray together, and I leave the family. I find my way home and, four hours later, get the phone call that awakened me between dreams.

I find the words of the prophet Isaiah a comfort and an inspiration these days, “The people walking in darkness have seen a great light; on those living in the land of the shadow of death a light has dawned” (Isa. 9:9). A light has dawned. Those words inspire me; that Emmanuel has come, our God has brought his Kingdom to Earth. Mukhanyo, a Zulu word meaning light, and Masibambisane, a Zulu word meaning to bear each other’s burdens, both reflect the transforming power of Jesus Christ. I live in the land of the shadow of death, but Mukhanyo (the light) has dawned. Christ is working in us so that we can bear each other’s burdens (Masibambisane).

Randy Finkbeiner is an American volunteer working as a home-based care worker at the Nakekela project in South Africa.

Coming Face to Face with AIDS

2006-04-06T12:18:00.000-05:00

Disease Devastates Africans

By Bernie Pennings

Most North Americans are well aware of the HIV/AIDS epidemic that is ravaging Africa. In April, Bernie Pennings and Rev. Christo Heiberg of Word & Deed Canada went to South Africa to visit Masibambisane Community Development Corporation (MCDC) and see firsthand how Word and deed work together to alleviate suffering. Rev. Arthur Miskin, a medical doctor sent out as a missionary by the Burgessville, Ontario, Heritage Netherlands Reformed Congregation, and his wife Dr. Sonya Miskin introduced this project to Word & Deed for support consideration.

On this Friday morning, we are attending the weekly MCDC staff meeting at the clinic, listening to the workers share their burdens. It is evident that limited funding is the source of much grief, since it inhibits the amount of care the clinic is able to provide.

After the meeting and a cup of South African tea, we accompany a young man named Hannes on some home visits. This is where we gain a clear picture of the difficult work all the workers face daily.

Our first visit is to Michael, a young man who three weeks earlier was so sick he could barely walk. A former cab driver and his family’s breadwinner, Michael received ARV (antiretroviral) treatments. Hannes calls him a living miracle. More than 99 percent of the people in a similar condition would have died. Yet Michael is up and walking, looking to us like an ordinary young man. The ARV treatments increase the appetite, which accounts for Michael’s weight gain. While increased appetite helps to stabilize the patient, it poses a problem for individuals who have trouble finding enough food or are who are too sick to work. For this reason food packets with fresh vegetables are distributed regularly to these families.

Our second visit is to a family who lost a husband and father of seven children the previous Saturday. In accordance with local customs, the mother is in bed going through the grieving process. The youngest children (three-month-old twins, a girl and boy) lie next to her. While it is clear that the twins also suffer from HIV/AIDS, they appear very alert and well-cared for. One of the twins had recently visited the hospital for a routine check-up of her condition.

Next we visit Mike, who has been sick and unable to work since November. Mike is feeling much better and was given permission to return to work. However, his employer informed Mike that he was no longer needed, despite his having worked for the employer for 27 years. Hannes advises Mike to lodge a complaint with the Department of Labour concerning his employer’s illegal actions. (Later Hannes explains to us that many workers do not understand their rights as employees, and their employers often take advantage of them.)

In further conversation with Mike and his wife, Hannes clearly explains the biblical approach to sexual purity, noting that sinful cultural practices are a major contributor to the spread of HIV/AIDS. Two years ago Mike’s first wife died from AIDS; his current wife still has not been tested for the HIV virus. Hannes urges her to be tested as soon as possible. After closing in prayer, we leave a food parcel with this couple.

On our next visit we meet Elizabeth and her two-year-old son. The boy runs in and out of the house while Marie, the home care worker who is visiting with us, goes in to see Elizabeth. Elizabeth is so weak she can hardly walk. But she is able to come out slowly and sit on a bench where Hannes and Marie speak with her. She was to have been tested in order to start the ARV treatment, but this has not been done because she doesn’t have the necessary identity document. To obtain the document she needs to get a letter from the school she attended (in place of the birth certificate she does not have) and then register with the government agency. Then she will be allowed to start the ARV treatments, which are provided free-of-charge by the government of South Africa.

But in her weakened condition, Elizabeth has done nothing to start the treatments. Elizabeth is not alone. Many others in Malawi are too weak to initiate ARV treatments. Hannes offers to take Elizabeth to the school on Monday to obtain her letter and then accompany her to the government agency to register.

In sharing with her the work of Jesus Christ, we discover that she does not own a Bible. Hannes leaves one with her as we close in prayer.

Our final visit is to an HIV-infected mother of seven children. She had suffered a stroke the previous week. The woman gets up, but is barely able to walk to the kitchen. Her son, who is looking for work, does his best to care for the other children, despite suffering from diabetes. We are able to speak with the children, who display a cheerfulness and optimism that makes us marvel. As we leave, Hannes tells us what seems so obvious—it will likely be only a short time until this family becomes another household with a child as its head.

This was but a brief glimpse at the work that is being done every day by the workers of Masibambisani Community Development Corporation. Their labor is very discouraging as they deal with one sad case after another. Pray that resources may be found to assist this clinic as many people afflicted with HIV/AIDS receive help and hope with Christian love.

Bernie Pennings is the executive director of Word & Deed Canada.