Greetings from Ethiopia!!  My final days are here.  What better way to wind down than a cup of rich, dark, Ethiopian coffee on a blue-sky early morning?  I am sitting in an office which has a large window looking out to the hills.  Close by you note a densely packed collection of houses with different colored metal roofs.  Within the sea of metal, white round discs pop up all over; these are the proverbial satellite dishes common to so many homes in this part of the world.  I am amazed how people will live in very, very marginal dwellings, yet somehow feel they need to expend the cost of a dish and then the monthly fees.

Beyond the houses, a distant hill rises like a high step to the sky.  A patch has been cleared, cut from within the forest, reminding me of the downhill ski runs during the summer months.  Above the view is the dark blue sky as far as you can see.  No clouds break the scene today.

My month has been a good experience.  I have been able to see and better understand the trials and successes of another CURE hospital.  Each of the hospitals has the unique challenges of the host country in which it resides and serves.  I also find that each hospital has a number challenges that are similar to those in other CURE hospitals.  All struggle with funding and staffing issues.  All have more children that need care than the hospital has resources to provide.  All face insurmountable issues that are economic, social, and mythical in nature.  Likewise, all need to remember the work is not our work but God’s, and He will provide.

The medical and social problems I saw this month remind me of my early years in Kenya.  I examined many children suffering the long term effects of polio — frail limbs dragging along, crooked feet, and no motor control.  We can stabilize feet and realign legs, but then there is still the muscle problem.  Long leg braces are expensive for the people who need them, and of course many do not want to wear one.  They want to be normal.  There are something like 100 million people here in Ethiopia.  Immunization programs in the remote areas would be costly and difficult.  I still feel we need to do this for polio and other diseases we can prevent.  They had a “Kick polio out of Kenya” program that was successful.  Prior to leaving, I had not seen a new case in years.  We spend a fortune on AIDS, which of course has value, but we don’t cure people.  Malaria, measles, mumps, and polio injure and kill many each year.  Maybe we need to re-balance our support a little.

Like Kenya, in Ethiopia we find advanced deformities not seen in the western world except as a novelty.  Twisted feet in older children, children with hips out of joint going without treatment for years, burn contractures, nutritional deformities, advanced bony infections, poorly treated or untreated fractures and more fill the outpatient clinics.  People travel long distances for the opportunity for their child to receive life-changing care.  I find it difficult to say “No.”  Sometimes the heart really wants to attempt a procedure, but your mind reminds you the procedure has very closely defined indications and limited goals.  You must remember a poorly conceived plan or operation may leave the family and, most of all, the child worse off than they are currently.  Understanding this fact is the basis of the shift from knowledge to that of wisdom.

Instead, you talk with the family and discuss the limits of medicine.  We talk about the child as a person and the intrinsic value he has.  I try to understand the stresses under which they live, but without the experiences, I can only guess the pain and the trials of their daily journey.

The needs in the developing world are enormous.  When I look at the whole picture, I find it very overwhelming.  Thankfully, I am not responsible for the correction of the whole problem.  Global programs are very difficult to manage and successfully pull off (Read White Man’s Burden by Easterly for his view).  I was given a heart to care for the disabled.  I can only do my part.  Will this make a huge change in the world?  I don’t know — I sincerely doubt any one person will have a huge impact — but it really does not matter.  I have been able to help a few children and families and train others to continue the work.  For those we have helped, life has changed.  Maybe one of children helped will become a person of national influence who has the authority to make major changes within their country.   Maybe others will have a vision to train additional doctors to care for their people.  Maybe others will lead the charge into honorable government with integrity.

That is what faith is about.  I travel day by day.  I do not see the big picture of life.  I am responsible to use my skills and gifts in service for others.  As I journey along I trust there is a plan and a purpose in life.  I follow my guide.  I travel this road in His grip.