Thursday, August 21, 2008

Rehmeyer Ministry Vision Statement for Swaziland - Short Term Relief / Long Term Change

Short Term Ministry Vision

We will be working in communities that have no access to HIV testing/treatment. The goal is to educate the caregivers as to the importance of testing and early treatment for HIV/AIDS for the children under their care. The community that we will be working in to start is Maphiveni, outside the Tambankulu sugar estate. There are about 1500 people in this community. It is a squatter community of ex-sugar cane company workers or families of the workers who have passed away. These people do not have the means to get to clinics or hospitals for testing or treatment. Two or three babies under the age of 5 die in this community each month from HIV related causes. Our goal is to be a facilitator for a project to provide them with education, and access to nearby clinics and the Good Sheppard Hospital to get the care and treatment they so desperately need.

During the past 3 years, working with Children’s Cup, we were able to roll out a program where we provided these services to the children at the care points. We will be trying to replicate this program in areas where it is needed. There are two additional areas of health education we will be focusing on: teaching pregnant women what they must do to prevent mother-to-child transmission of HIV and education regarding water purification and how important it is. Their water source, the Mbuluzi River, is contaminated by run off from nearby farms, industry, human and animal excrement.

The rate of chronic diarrheas in this community is extremely high. In a clinic done for the children in this community recently, 33% of the children were identified as needing to be tested for HIV and almost half were victims of chronic diarrheas. When you add chronic diarrhea on top of already being HIV+, especially in children, you increase the risk of health issues such as dehydration, weakness, and weight loss. These people need to be taught how to treat the water source to make it clean before they drink it.

We will be working with the Home Based Care outreach team at Good Sheppard Hospital to provide HIV testing and treatment services to the Maphiveni community. They provide mobile services in the general area, approximately 30 km radius of the hospital. The area that we will be working in is 48km from the hospital; therefore, they do not have access to these services, unless transport is provided for them. This will be a program that we plan to replicate in other poor squatter communities in the Lobombo region.

The other opportunity that has been presented to Teresa is that of helping to provide guidelines for chemotherapy and breast cancer care in Swaziland. The Swaziland Breast Cancer Network wants Teresa to assist in developing this program for Swaziland. If diagnosed, cancer patients are presently being transported to South Africa for chemotherapy treatment, which is very difficult for them, as well as expensive for the government. Many times they are not able to complete their treatment due to cost constraints.

Long Term Ministry Vision

Ministry Mission

And the Lord said to him (Moses), what is that in your hand? (Exodus 4:2) God has given us everything we need to begin this earthly journey.

Ministry Vision

We see a long term investment into the lives of young people in Swaziland. Training these young men and women up and giving them Godly skills in life and in business. Affording them the opportunity to break the cycle of poverty, and excel.


Beginning in 2005, we made the commitment to work with Children’s Cup to help develop the compassionate care and ministry outreaches to the children in the urban and peri-urban areas of Swaziland. Over the course of the three years, I oversaw the effective doubling of the number of NCP’s that ‘Cup managed and the doubling of the number of children attending. A concern from the beginning was the apparent loss or non-participation of the teenagers at the NCP’s. We have seen teenage boys and girls engaged in stealing, gangs, and prostitution in order to make money. For the NCP’s to have their intended impact on the community, they would need to provide a greater engagement of these older youth. Paradoxically, and of primary concern, is that these youth , as they fall back to their community, with no leadership and a crumbling (or nonexistent) social structure, are the ones to either make or break the fight against the HIV pandemic in southern Africa.

Key Ministry Objectives

The primary challenges in this sub-region are:
  • A culture that stifles innovation and creative thinking
  • Rampant under and unemployment
  • An education system that does not have the infrastructure or capital to educate the children through primary or secondary schools
  • A university system that struggles to find government bursaries for the majority of students that do attend
In answer to this, a program whose goal is to help break the cycle of poverty and HIV is essential.

At the age of 16, many young people in Swaziland are the head-of-household for their homes and providing for younger siblings. As the AIDS epidemic sweeps through this country, this age will become younger and younger. The ministry we have been involved in has been a great short term support to young, undernourished children affected by AIDS through loss of responsible relatives. Over the past two years we have seen these children grow. We have asked ourselves
  • What will happen when they are no longer eligible to be fed or choose not to participate at the NCP’s?”
  • What are we accomplishing – are we establishing lasting Godly principles in these children, that will change their lives or are we just a stop gap to the inevitable decline in health and values when they move on?
As God has spoken to us we have seen that it is Jesus that these children need. Our hearts yearn for a chance to feed these children more than food. They need the unending supply of God’s grace and the sustainable supply of meaning through self worth.

Grappling with these two ministerial objectives we feel we can be life changers here in Swaziland. By providing a ministry opportunity from where the NCP initiative ends, we can and will make a difference. This will be through two primary areas of focus:

1. Business Opportunity
The actual skills being taught are not what are important. Many skills based programs in Swaziland concentrate on specific skills with no concept of market saturation and effective wage earning capability. They do teach a specific skill, but they do nothing to prepare the student for effectively implementing the skill in a successful business.

The primary goal of the program will be to teach the participants to effect life changing attitudes about their potential and responsibilities. Secondary will be the specific skills. Even so, the skills that will be taught will be unique and provide opportunities in and of themselves as well as significant crossover into other areas of work.
  • Personal financial responsibility
  • Personal moral responsibility
  • Mastering basic business fundamentals
  • Entrepreneurial skills and training
  • Learning technical skills in glass blowing, etching, beadwork, torch work, slumping, etc.
  • Confidence to seek, and pursue, the dreams and ideas that God gives to each person
2. Camps
During the school year, schools are closed for several weeks between each term. We would use this time and the venue of the vacant schools to provide day camps. Impacting child-headed households will be the primary focus of these camps. Local and international groups will be engaged to assist in the running of life and business skill camps; teaching in areas they have specific expertise.

Skills for household management, health management and self reliance will be the primary focus:
  • Nutrition
  • Budgeting
  • Sustainable household vegetable plots
  • Disease management (HIV and TB being the primary focus)
  • Child rights
  • Homestead micro economic projects

Wednesday, August 06, 2008

Thobile Update - 17 Years Old

Thobile is a little girl who is 17 years old, but only looks ten. We first met her about 2 years ago as we were planning a CarePoint at Madonsa, and decided that we (the Rehmeyers) would sponsor her, since she was too old to be sponsored thru Mission of Mercy. In the past two years, she has been going to Baylor Clinic and taking ARV’s, and has been able to go back to school. She has not been able to walk the long distance to get to school, so we have provided her with money for transport to get back and forth to school each day. This year in March, she was diagnosed with TB, and had to have daily injections for a while. She is still on oral TB meds, she has been hospitalized several times this year for various respiratory problems. After one of her hospitalizations she asked if we could get her a book sack with wheels because the one on her back was too heavy for her to carry.

She has been getting weaker and weaker. She was just discharged from the hospital in Manzini last week, on Thursday and readmitted to the hospital in Mbabane on Monday. They said that the hospital in Manzini said that she was too critical for them so they sent her to Mbabane. One of the nurses told me that when the Manzini hospital weren’t getting anywhere with a case and thought they might loose her, they sent her to Mbabane. I’m not sure if her TB is becoming resistant, or if she has another infection. Her mother seems to be very caring, but I don’t think that she is very responsible in keeping up with her medications.

When we arrived to see her on Monday, we found her lying on a mattress on the floor underneath another bed. There were empty beds in the front of the ward, so I asked why they couldn’t put her there. The answer was that the ward was divided into chronic and non-chronic cases, so she couldn’t go in that part of the ward. I think that they are trying to keep the TB cases separate, which is good, but there is nothing really protecting others from them. The next day she was in a bed, and asking for us to bring her something nice to eat!

I’m not sure what we are facing with this one. One of the Baylor doctors promised to go and see her. As of the second day, she had seen no doctor and nothing had been done except a chest x-ray. She is complaining that her legs are painful and weak and she is unable to walk. Please help us pray that the doctors have wisdom and that she gets the treatment that she needs!

update on Lomansontfu

The beautiful little girl from Maphiveni with the large cyst on her cheek returned from Pretoria. Unfortunately the cyst is still there. She called me on my cell phone from the hospital several times, until I was able to make it to the hospital to get her. When I walked into the room, she smiled, grabbed her little bag and ran to hug me. We were going to have her family come get her the next day, but when the nurses told me how anxious she had been to have me come to get her, I couldn’t bring myself to leave her. We had her family come up and meet us in Manzini at one of the care points. When we drove up to the care point, she slumped down in the seat so the other kids couldn’t see her. She was afraid that they would stare and make fun of her. I quickly took her into the clinic so the kids couldn’t see her.
The doctor from Pretoria found that it is a very vascular cyst, which means that it is full of blood vessels. It can’t be removed until it is clotted off and the hope is that it will shrink. He did try to clot it by going in at her femoral vein in her groin and going up to the veins that feed the cyst. He wants to see her again in the 1st of October. So far, the cyst hasn’t shrunk, but we are praying that this will work. Once it is clotted, she will need surgery to remove it. Depending on how extensive it is, she may need reconstructive surgery as well. Please continue to pray for this situation and for this precious little girl!