Merry Christmas from Swaziland

Daran is back in Swaziland after a fund raising trip for several weeks in the States. Many thanks to everyone in Maryland, Pennsylvania, Virginia, Louisiana, North Carolina, Missouri, Illinois, and Arizona who helped make the trip a success. We couldn’t have done it with out your prayers, organizing meetings and invitations. Thanks again for all your help!

As we approach our fourth Christmas here in Swaziland, we also want to express our deep gratitude for the thoughts, prayers and support from everyone back in the States. A peaceful and joyous Christmas to everyone.

We are also celebrating our 20^th wedding anniversary on the 23^rd. As an old friend of ours used to quip “We’ve enjoyed every second of it.” Honestly, as anyone knows, marriage is hard work. We’ve both had a lot of growing up to do over the years. We’ve been blessed with four wonderful children who despite our best efforts, have still turned out to be pretty neat, and committed to Jesus.

We are blessed!

With wishes for a wonderful New Year, God Bless!

Daran, Teresa, Gabrielle, Danielle, Nathanael, & Joelle

Thobile - December 2008

I saw Thobile just a couple of weeks ago. She is looking good, even though she is still very thin. The daily injections that she receives for TB must be extremely uncomfortable, however, she doesn’t complain. When I asked her if they were painful, she said no, amazingly! She will be finished with injections in February. At that time, she can return to school. Her care giver is already asking about school fees and transport fees for her when she is able to start back to school. We continue to help her with transport fees on a monthly basis for going to the TB clinic for her injections. Her mother has stopped taking her ARV’s for herself. She was not keeping up with the doses, that is the reason we got someone else to help with Thobile to make sure she receives all of her meds correctly.

Thobile is growing taller, so all of her trousers are too short. Her care giver has been asking for clothes for her for a while. Nathan and Joelle both went thru their clothes and pulled out the ones that they could no longer wear and we gave 2 big bags of clothes, shoes, and some toys and stuffed animals to her for Christmas. It is a blessing to be able to bless someone else who is in need!

Please pray about helping us this next year with Thobile’s school and transport fees. A donation of $30 a month would help a great deal for us to be able to provide these things for this precious little girl!

Kaiser Daily HIV/AIDS Report

This article spells out some of the current HIV problems in Swaziland. Our response to these problems will help mitigate their impact on children, the most vulnerable segment of the population. CHIPS - a pediatric HIV care management system and Kudvumisa Glass both target vulnerable groups in Swaziland.

Updates

Thobile is still getting daily injections (7 days a week)at the TB clinic and also taking a myriad of other tablets as well, which they give her at the TB clinic, since her mother can't be trusted to give them to her consistently. It costs R20 per day for transport to get her and her mother to the TB clinic. This ends up being at least R600 per month. She is also struggling to have enough food. She is too weak and the care point is too far for her to go there every day for food. So her mother goes to get food for her at the care point. I'm not really sure what they do on week ends when the care point is not open. She is also in need of some clothes. She is no longer going to school, because she is not strong enough. This TB treatment will have to continue for 6 to 9 months at the very least. This is a very difficult life that this young one lives, but she is just happy to be alive! Please continue to keep her in your prayers!

Lomansontfu went to south Africa last week. She had more scans done, and the doctor thinks that he may be able to remove the cyst soon. It seems that it is not as vascular as it was, and he was going to do a biopsy to confirm that it is ok to go ahead with surgery. He is waiting on a prosthesis for her jaw bone,which has been eaten away by the cyst. While they were waiting, she contracted a mild case of the measles, so he decided to wait to do the biopsy when she returns for surgery. She is now at home waiting. After the surgery is done, her jaw will be wired shut for a few weeks. Our daughter, Gabby is about to have some orthodonic surgery where her jaw will be shut with bands for 6 weeks. I would like to take her to see Lomansontfu so she will see and understand what it will be like with her jaw being wired shut, and that she isn't the only one!

Support Raising II

Daran is in the States now for four more weeks. He will be in Philadelphia, Baltimore, Washington, St. Louis, Phoenix, Baton Rouge, Raleigh, Birmingham, and in between. Please contact us if it would be possible for him to meet & share our ministry vision under African Leadership Partners! We know that given the current financial situation in the US that most would say this is the wrong time to be asking for support, but we know the God we serve and that He is able!

Swaziland Breast Cancer Network

I have been extremely busy this past month with the Swaziland Breast Cancer Network. We saw over 600 patients for breast exams in the month of October. We will do over 80 fine needle biopsies on Thursday this week 13th November. We will not know for a couple of weeks how many may be malignant. A pathologist from a South African private lab will come to do the biopsies. We are able to do lumpectomies and mastectomies here in Swaziland. One of the ladies that we got results back on this month is 29 years old and has a very large tumor. She was told that she would need a mastectomy. She is single with no children, I thought we would never see her again after telling her that news. I attempted to call her for about 2 weeks with no success. She is a student and has been busy with classes and also avoiding my phone calls. When I finally reached her I asked her to return to the next clinic so we could discuss her situation. She still didn't come for another week, so I was rather disappointed. Finally she called me back and said she would come to the clinic. That day I saw her sitting in the waiting area outside of the clinic, looking very worried and anxious. We called one of our counselors who is also a breast cancer survivor to come and speak with her. After talking with the counselor, who is also a Christian, and who also had breast cancer the first time at very young age, this young lady had a different outlook on her situation. She was now ready to go forward with the surgery. It was decided that she would be admitted as soon as her classes were finished in about a week. Once she was admitted and it was time to sign the consent for the surgery, we realized that she would not sign consent to have a blood transfusion, because she is Jehovah's Witness. I thought, what will we do with this? The doctors spoke with her about this and tried to convince her to sign for the possible transfusion. Finally, after another week, they decided to go ahead with the surgery, since her labs were OK and the risk was higher to leave her with this large tumor which was already spreading to her lymph nodes.
I received a missed call from her last Tuesday night, and I was unable to return her call until the next morning. When I heard her voice I knew everything was OK. She told me that she had her surgery the day before and she was doing well, and that God was with her because she didn't need the transfusion. I went to visit her the following day and she looked great! She was already doing her physical therapy exercises for her arm and she was still in good spirits. I told her that once she had healed some, we would give her a prosthesis. She said, "What" "What is that." I explained that it is a fake breast that she would wear in her bra. The only problem is that she never wore a bra before. I told her that she would have to get used to them. Praise God that He worked in this situation!
I hope to continue a relationship with her and encourage her along on her journey with breast cancer. Her next step will be to go to South Africa to receive chemotherapy, that is, if there is still money in the government fund to send her. Usually by this time of year, the government starts to run out of money for this fund. My hope is that we can start giving the chemo here in Swaziland soon enough that she can receive it here. We are now looking at our fund raising for this year to see if we have enough to purchase the biological safety cabinet needed to mix the chemotherapy drugs. Please pray for me that God will direct me and use me however He sees fit and that He will give me the wisdom necessary to see this project succeed!

Support Raising!!

We want to thank everyone who has supported us in the past for the work here in Swaziland. Our vision still remains the same: to help the hurting and to show them Jesus; Short Term Relief - Long Term Change. We especially want to thank everyone who has supported us in our transition from 'Cup to African Leadership Partners. The transition in ministry has been smooth; we have been able to begin ministering to children, women and youth through CHIPS pediatric HIV intervention, Swaziland Breast Cancer Network’s breast cancer clinics, and Kudvumisa Glass skills program.

Daran will be coming to the states from November 8th through December 10th to re-raise our support for personal needs as well as ministry projects. We need you to contact us and set up a time that he can meet with you while he is there. He would like to share our ministry goals, vision, and plan with as many small groups as possible, over coffee or tea - nothing fancy or pretentious: Please try to think of those that would be interested in coming and hearing about the ministry God has set before us here in Swaziland. If you are interested in helping us in this way, please email us and let us know. His tentative schedule is attached. It can be modified to accommodate your schedules, but we need to hear from you!

November 7 – 16 Maryland/Pennsylvania

November 17 – 23 Travel & visits between Maryland and Louisiana

November 24 – December 1 Louisiana

December 2 – 5 Travel & visits between LA and MD

December 6 – 10 Maryland

To paraphrase James: "you have not because you do not ask ..." So we are asking: we need your financial support!

The kids are still in school until the end of November. Gabby finishes exams and graduates before having an oral surgery November 27^th.

Again, we thank you for your ongoing prayers and support . We ask that you prayerfully consider joining us as we move forward. ALP's contact information is as follows:

African Leadership Partners, Inc.

P.O Box 994044

Redding, Ca 96099-4044

We look forward to hearing from you.

Best regards & God Bless!

Daran, Teresa, Gabrielle, Danielle, Nathanael, & Joelle

Breast Cancer Clinics

We are almost finished with the month of October. It seems like it flew by, while we were busy with breast cancer awareness campaigns, as well as breast cancer treatment campaigns. I am enjoying my work at the Swaziland Breast Cancer Network. I am coordinating our breast cancer clinics that are held two times weekly in two different locations on Tuesday and Thursday mornings. We have two doctors from Cuba who are working with us in these clinics. The challenge is that the Oncologist does not speak much English as all, and my Spanish is extremely poor. We spend a good deal of our time at the clinics trying to understand each other. The other day, he was trying to get me to tell the patient to eat more beef. He didn’t know the English word for cow and I didn’t know what vaca was until he put horns on his head and I said MOO! It was quite amusing!
We are seeing quite a few patients that have breast cancer, and amazingly, some of them are very young, late 20’s, early 30’s. One young 29 year old woman came in with a large lump on one of her breasts. She said that she came last October and was told that it was cancer, but she didn’t have money to go to South Africa for treatment and so she did nothing. She returned this year, 7 months pregnant, unable to walk, lots of swollen lymph nodes, and much pain. I just wanted to cry, she would not let us admit her to the hospital for the first couple of weeks. Now she is very sick and in the hospital with a pulmonary effusion and heart problems. They are trying to let her carry the baby to term and then see if there is anything we can do to help her.
Oncology care in a third world country is very complicated. We don’t have access to a mammogram machine, so we send them for ultrasound of the breast when we find lumps on breast exams. Today, we found out that the only guy that does the ultrasounds was in a horrible car accident over the week end and is now in the hospital. Now we have no way to do ultrasounds. So, we either wait to see if the government will try to find someone else to do them, or try to negotiate with a private radiology clinic to see if they can help us. The best thing to do is to pray for the speedy recovery of the ultrasound tech that is in the hospital!
We have been very successful with our breast cancer awareness campaign this month! We are even going to companies and doing health teaching and breast exams. Our clinics are over flowing with people! We are seeing 60-70 people in a day! We have been flooding the paper with articles on breast cancer, TV, radio, posters, etc. When we finally get all of the ultrasounds done, we then send for FNA (fine needle aspiration) those that the doctor thinks are suspicious on ultrasound. A pathologist comes in from South Africa when we have 20 or more FNA’s to be done. When we get results, if they think they are fibroadenoma’s, a lumpectomy is scheduled and done by the Cuban Oncologist here in Swaziland. If it is diagnosed to be cancer, either, a mastectomy is done here, or the patient is sent for chemo first in South Africa, then a mastectomy is done here.
Our goal is to administer chemotherapy here in Swaziland. We are fund raising to buy a biological safety cabinet to mix the chemo in. Breast Cancer Network will then buy the chemotherapy drugs from a local wholesale pharmaceutical company. We have already started training nurses on chemotherapy administration. This will save the government and the patients a lot of time, headache, and money if we are successful. We want to have a cancer treatment program with high standards and excellent outcomes. We hope to expand our diagnosis and treatment program to cervical cancer this next year. Cervical cancer is the number one cause of cancer deaths in women in Swaziland, with breast cancer at number two. We definitely have our work cut out for us! Please keep us in your prayers as we attempt to help the women in Swaziland!

HIV Training for CHIPS

After having meetings with the health officials in the region where we are doing CHIPS (Children’s HIV Intervention Program in Swaziland), we have started training key people in the rural communities. We selected the teachers at the Christian Family Church primary school in Tambankulu and the teachers and workers at the neighborhood care points in Maphiveni and Lonhlupheko. We had 12 in attendance, and they all seemed excited and interested in what we had to say. The questions and discussions that we had were very good! We talked a lot about the stigma that surrounds HIV, especially in more rural areas. We discussed ways to minimize the stigma, as well as issues with confidentiality.

One major purpose of this training is to teach the teachers and other key people in the community how to identify children that are at high risk of being HIV positive. We talked about how HIV is affecting the children of Swaziland, and how without treatment, only 15% of Swaziland’s HIV positive children will be alive by the age of 10 years old. The importance of getting these children to testing and treatment was emphasized. The signs and symptoms that go along with being HIV positive were discussed in detail. Pictures of several different skin problems were shown to each table of trainees. Malnutrition was also discussed, as well as the importance of good nutrition in children who are HIV positive and on ART’s (antiretroviral therapy).

The higher the viral load of HIV in the body, the lower the CD4 (soldier cells) count is. When the soldier cells are attacked by the virus, the body becomes more susceptible to infections and opportunistic diseases, such as TB. When a person is started on ART’s, the viral load decreases, as the CD4 increases, and they are able to fight off infections.

Jabulani, who we hired to be the HIV counselor and driver for the CHIPS program is now in training for 5 weeks with one of the local HIV counseling and testing companies. We now have our mini-van, and will be ready to start the program when Jabulani finishes training at the end of November. Daran is working on getting the mini-van insured and ready to go. Please keep this program in your prayers, as we go forward to minister to the needs of the HIV positive children in Swaziland.

Times of Swaziland-October 21, 2008

Kudvumisa Trust receives funding

By WANDILE DLAMINI on October 21,2008

Test driving the vehicle: Brenda Jefferson handing over the mini bus keys to Teresa Rehmeyer, it will be used to transport sick children to clinics and hospitals.

MBABANE – Kudvumisa Trust has received the start up funding to begin the Children’s HIV Intervention Program in Swazi-land (CHIPS).

Primary funding for CHIPS is being provided by The Claypotts Trust, administered by Pastor Ken Jefferson of the Mbabane Chapel. Both Kudvumisa Trust and Claypotts Trust are christian charitable organisations.

CHIPS was boosted when Claypotts Trust donated a mini-bus to them, as means of transport for sick children they will be assisting.

The mini-bus will be used to transport children and their caregivers to clinics and hospitals. CHIPS will identify children who will be candidates for testing, then a person in the community will be trained to provide pre-test counselling to the child and caregiver. They will also provide transport and assistance with adherence, inter-community support advocacy, and education.

support

This organisation will also provide in-community, in-home pre-test counselling and ongoing support and education, provide reliable and on-going transport to clinics and hospitals for testing, counselling, treatment, and support, educate the whole community, the children and adults, to increase their health and well-being.

They will look to changing people’s attitudes and behaviours towards testing, treatment, and people who are infected, and promote "Prevention of Mother To Child Transmission (PM-TCT)".

On behalf of the organisation, Director for Kudvumisa Trust/CHIPS Teresa Rehmeyer said the donation would go a long way in assisting many under-privileged children.

Handing over the vehicle on behalf of Claypotts Trust, Pastor Ken Jefferson said they were always willing to assist wherever they could, especially since HIV was a serious problem in the country.

"I hope that many lives will be saved because of this vehicle," said Jefferson.

CHIPS will begin working in the north-eastern Lubombo Region in December. More information on CHIPS can be obtained from Teresa Rehmeyer, her e-mail addres is teresa@kudvumisaglass.com

CHIPS - Fist Steps

We have started the first steps in the CHIPS program. The mini bus was purchased last week. Jabulani, a young man from Tambankulu was hired and began HIV counseling training this week. Teresa and Lori have been meeting with local health officials in the Lubombo Region to develop relationships and working protocols with the administrators, doctors, nurses, hospitals and clinics in the area.
Today, Teresa is going to to conduct a training session for the teachers at Pastor Duarte's primary school in Tambankulu and the teachers from the neighborhood care point and community pre-school in Maphiveni. One of the first goals of the program is to have people in the communities who have interaction with the children to be the first line of referral for children who are candidates for HIV testing. The training today will teach them how to recognize symptoms, illness history, and family medical history that may indicate HIV.
These pictures were taken in Section 19, a squatter settlement in the sugar cane fields of Vuvulane. This will be one of the areas we will be initially working in.
We want to thank and recognize Claypotts Trust for making this outreach possible.

US Presidential Debate

This is an apolitical comment. We sat Monday at the embassy here and watched a re-broadcast of the first Presidential debate. It got a good chuckle when Senator McCain talked about foreign countries getting a "free lunch" from the US, as we all were sitting there eating pizza compliments of the Public Affairs section of the embassy. On a more serious note though, I wanted to comment on something Senator Obama said. He talked about his father coming from Kenya and that at that time, the US was a"beacon of hope" for the world. That everyone dreamed of coming to the US and that that did not exist now. Having worked with impoverished youth here in Swaziland for the past three years, I can say, and I think with out fear of contradiction, that the US is still a beacon of hope for the world. We have heard it over and over again: I want to go to America so I can work, go to school....... While there are plenty of people that hate the US here (and with the steady diet of negative news they get here, it's no wonder), the people which yearn for a better life or an opportunity of a better life still look to the US as a land of opportunity.

CHIPS (Children’s HIV Intervention Program in Swaziland)

This is the new ministry program that we will be beginning. We submitted a proposal for grant money for CHIPS to the Clay Pots Foundation. Pastor Ken Jefferson of Mbabane Chapel administers this fund which is dedicated for HIV initiatives here in Swaziland. He is very supportive of the program we have designed. He has approved our proposal and agreed to fund this program for 3 years (R350000 for year one and R250000 for each of the two subsequent years). This funding covers program costs only: none of it is for our personal expenses here. While in the beginning we will be concentrating on one area in eastern Swaziland, our hope is to expand the program to help kids in the all rural areas of Swaziland to get HIV testing and to access treatment. We are planning to hire and train someone from this area to be an HIV counselor, as well as the driver to take the children and their care giver to the clinic for testing and monthly follow up. The nearest clinic is 17km, and the nearest hospital is 48km. The cost of transport to get to a clinic or hospital for testing or treatment has always been a hurdle (more so in an impoverished community). We know this outreach will provide a major component in ensuring children in the rural areas of Swaziland can take advantage of the life saving health care that is available.
We will be working with Pastor La’Salette Duarte of the Christian Family Church in Swaziland and Lori Schweighardt of Live in Love International. We value their heart, vision, and energy.
I am very excited to start working on this initiative, but at the same time, sad to be leaving the children and teachers I’ve built a relationship with over the past three years.

Thobile Update - September 2008

I saw Thobile this past week Tuesday. She had just returned from her visit to Baylor. When I went out to the van and she saw me, she squealed and ran to get a hug! Her smile was huge, but she looked so thin and is getting around very slowly. She has started getting daily injections for TB again. We had to start TB treatment all over again, since her mom didn’t keep up with her treatment last time and she is still positive for TB.
On Thursday I got a call from one of the doctors at Baylor. I was told that the TB culture that was taken the last time she was in the hospital just came back and was positive for multi-drug resistant (MDR) TB. This is unfortunately not good news. MDR TB is extremely difficult to treat. It requires a very intense treatment regimen with many different drugs, one of which is also a daily injection. I’m not so confident that her mom will be able to keep up with this regimen, since she has not been consistent with the other regimen.
I am not sure if they will want to hospitalize her or just have her come in daily for her injections. The cost for transport to go to the TB clinic daily for Thobile and her mom is R20 ($3.00) per day. We have been paying the transport costs for this and for school. It is getting more and more expensive as fuel costs continue to go up. We would appreciate if someone would come along side us and sponsor Thobile’s ongoing medical costs (which may include hospitalization
I don’t know how good her prognosis is, given the malnutrition and wasting that she is already suffering from. These drugs have many side effects and require good nutrition in order to work. This will be quite a challenge for Thobile and her mom. Please help us pray for a good outcome for this precious little girl!

Last Week at Children's Cup

The new nurse for Children’s Cup has been here for about 4 weeks. We have been working together in the clinics. Her name is Jessie, she is doing well. Sarah, another new missionary is working with her to help with the administrative aspects of the medical program. They are working very well together and will make a great team for the medical program.
This past week, we did a health care worker training for the new teachers. We had about 17 in the class. Jessie and I took turns teaching them basic anatomy/physiology, how to examine a patient, common illness, first aide, and CPR. They were a very bright class and did very well!
Thursday was my last clinic day, and Monday will be my last day with Children’s Cup. I will take Jessie and Sarah to Baylor and introduce them to the medical director and the administrator. I am confident they will do a great job with the medical program!

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.

Background

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

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!

New Beginnings

Dear Friends

Thank you for all your support over the last three years. God has done wonderful things for us here in Swaziland and has opened so many doors we never knew existed!

We know that God has called us to Swaziland and the people here who are in need. Children’s Cup is doing a wonderful work in this country and we are proud to be associated with this organization. The focus of Children’s Cup is clear and well executed. As our time with Children’s Cup has shown us, there are many needs that are outside of the scope of work we are currently doing.

The vision of Children’s Cup is, and will always remain, our vision. After being in Swaziland for some time, our original calling has grown. A clearer picture of the overall need in Swaziland and our place in God, in fulfilling that need, has been solidifying in us for the past six months or more. We feel that the time has come to respond to this larger vision. Children’s Cups’ vision and the confines of the organization cannot facilitate this divergent direction. Prayerfully and with the consent and support of the Children’s Cup leadership here in Swaziland it has been decided that we shall continue working out our calling beyond their structures and leadership.

The number of children with HIV/AIDS and directly affected by HIV/AIDS continues to rise here in Swaziland. We seek ways to help those children who are still not being reached with diagnoses, treatment and coping strategies.

In parallel, there is a large and growing population of older teenagers and young adults who have had little or no training or encouragement/mentorship for growing up to be productive in their communities. There is no provision for being responsible for themselves, their families or even younger siblings that they may find themselves responsible for. We see a great need for developing progressive training in fields that would promise economic growth and self reliance as well as the moral and ethical foundations found in the Christian world view.

Coming alongside the leadership of Children’s Cup, training and assisting new leadership to take our place in Children’s Cup as well as helping with the transition of new leadership in Children’s Cup is our next goal. After three years of experience and commitment we shall be taking as long as needed to ensure a smooth hand over is done. During this hand over period our financial and other personal detailing will be sought out and communicated to you. We are preparing clear visionary goals and we will be sharing them with you as the Lord continues to direct and lead us.

As the Lord led us here as a family, He is continuing to lead and grow us as a family. Thank you again for all your prayer, support and generosity. We hope that you will be as excited as we are for the awesome work we expect to be doing here in Swaziland. Taking the last three years with Children’s Cup, and our lives, to the next level, we trust that God is refining our faith and growing us in Him.

Growing both in God and for God, in vision, action and impact for Swaziland.

God Bless

Daran, Teresa, Gabrielle, Danielle, Nathanael, & Joelle

Lomansontfu June 26

Good News!!!! Praise the Lord!!!!! At long last, after 3 or 4 weeks, we finally have all of the documents necessary to send Lomansontfu to for her surgery to have the tumor removed. I saw the letter from the senior medical officer today, and it states that she will go to South Africa on Monday the 30 of June. Abraham came up from Maphiveni today and took the sister and the child to get the travel documents. He said that it was just God, because when he got here, he realized that one of the certificates he was bringing was not correct. So he prayed and asked the Lord to make a way where there is no way, and He did!! He said that they took them into an office and corrected the document and they were able to get the travel documents without even waiting in the line! We were rejoicing and praising God right there in the corridor of the children’s ward at the government hospital! Prayer works!

When I visited her earlier in the week, I felt led to just pray and agree with the child, and the sister that this paperwork would be gotten quickly and that the doors would be open to get her to I could hear the other care givers in the room agreeing with me in prayer, and God did hear us, and answer! The tumor is getting bigger every day and causing her more and more pain. One of the care givers in the room told me today that it causes her much pain and she cries at night.

Now we must get her older sister to Mbabane to travel with her on Monday.Please help us pray that this goes smoothly, they travel safely, and that the surgery goes well.God is a good God!!

Lomansontfu - June 22

This is a little girl named Lomansontfu (name means Sunday), which probably means she was born on a Sunday. She is from our Maphiveni CarePoint. She is about 10 years old, and she is an orphan. She lives with her older brother and sisters. She is not treated very nicely by them, because she is just an extra mouth to feed. She has a large tumor growing on the side of her face. The doctors think that it is a myeloblastoma. She needs a major surgery to remove the tumor and probably plastic surgery because the tumor is eating into her jaw bone. This surgery can’t be done here is Swaziland. She has been in the Mbabane Government Hospital for 3 weeks waiting for the Senior Medical Officer to approve her case and provide the money through a government fund to send her to South Africa to have the surgery done. We are also waiting for her family to get her certificate of birth from the chief so they can get travel documents for her trip to South Africa.

Each time I see her, the tumor is bigger and bigger. Sometimes, she drools because she can’t keep her mouth closed. She is having a lot of pain, especially at night, and her gums are beginning to bleed. In spite of all of this, she manages to still have a beautiful smile that lights up her whole face! I pray that we can get the help that is needed for this little girl. Please pray that the funding, the paperwork and the approval will all come quickly so that she can get the medical care that she needs and deserves!

10 Year Old Caregiver - June 15

There are so many children that are raising themselves. It is very common that the mom and dad die, and the younger ones are raised by the older siblings. Then the older sibling has children of their own and they are being taken care of by the younger siblings. In many cases, the older sibling is working and the younger sibling is raising their children. So, you have an 11 year old taking care of a 5 year old, a 3 year old, and a 1 year old. This 11 year old girl brought these little ones in to see me at one of the clinics. They all had scabies from poor hygiene. They also had infected sores from where they had been scratching. I can’t imagine my 10 ½ year old being capable of taking care of 3 little ones 24 hours a day 7 days a week. I’m sure that this little girl doesn’t get to go to school since she is the care giver for these little ones while their real mother works, or does nothing, whatever the case may be. She doesn’t have much choice in the matter, if she wants to eat; she has to take care of them. I’m sure that she needs to be tested for HIV herself, but she really has no caretaker to be responsible for her. I sent our counselor out to talk to this family about testing. I have not heard how it went yet. This is one of the many difficult situations that we deal with here in Swaziland, only God has the answers to them all!

Nothando - June 8

This little girl’s name is Notando. She has TB, but not in her lungs. Her TB is in her lymph node on her neck. She is also HIV positive and eligible for ARV’s based on the fact that she has TB. She was hospitalized for about 2 weeks to begin her TB treatment. Both her mother and father are mentally challenged. She was discharged on TB meds, which she is supposed to take 3 tablets daily. When we tried to find out from the mother about the meds, she said that there were no meds. When I checked with the nurses at the hospital, they said that the dad had been trained about the meds and the meds were given to him. I had the teacher at the CarePoint investigate and we found the meds. It looks like none of the meds had been given since the child was discharged from the hospital, which had been about a week. So I had the teacher (Lindiwe) keep the meds and start giving them to Notando when she came to the CarePoint each day.

Now this little one needs to be started on ARVs also. This will be a big problem, because they have to be given 2 times daily, exactly 12 hours apart every day, without missing a dose. This will be next to impossible with mentally challenged parents. Lindiwe can give one dose a day, but the 2^nd dose will be difficult to ensure.

Notando has a younger brother. The mom brought him to me at the clinic this week. He was very sick, probably pneumonia. I knew that I could give her an antibiotic to give him, but it has to be given 3 times daily. This mom really does love her children and care about them, but she is just not capable of taking proper care of them. There is no way that she can handle this, so I told her to bring him to the government hospital the next morning, hoping that they would admit him to get him well. I sent them home with Tylenol for fever and nothing else. I didn’t feel good about my decision, but really had no other choice.

Please pray for me for wisdom. Sometimes I just don’t have the answers, but I know that I serve a big God that does have all of the answers!

Update for April MoM Medical Team

I heard from one of our teachers that a lady from the Logoba CarePoint who was helped by the Mission of Mercy medical team wanted to say thank you for giving her the money to go to the hospital. This lady is pregnant, and was having problems with her pregnancy. The medical team collected money and gave it to her to go to the hospital to have proper tests and medical treatment. She was able to do that and had some left over for food. She has not had the baby yet, but everything seems to be OK with her pregnancy now. She just wanted to let the team know how much she appreciates their kindness!

Belated Mother's Day Update

Again, when the medical team visited Maphiveni, they saw a baby who was dying from malnutrition. The mother is HIV positive and had no more breast milk, and the baby was starving to death. The team gathered money and sent for formula and bottles for this baby. We were able to work with the mom and baby, teaching her how to mix the formula and feed the baby with formula to save her life. We also counseled the mom about getting on ARV’s herself. Pastor LaSalette and her staff also counseled and prayed with her and she accepted the Lord and is now coming to the church regularly! I saw the baby on Mother’s day. She and mom both look good! Mom says that she is now laughing, and she was not doing that before. The baby is about 11 months old, still can’t sit up, but is making progress. Praise the Lord! What a great Mother’s Day Blessing!

MoM Clinic Outcomes

George is a 16 year old boy who lives in Maphiveni. When the doctors visited in April, he had just gotten out of the hospital. He had recently been diagnosed with diabetes. He had collapsed the week before at school and been rushed to the hospital, unconscious. He was living with his old grandma (gogo), who has difficulty caring for him. Some of the members of the medical team from the States gave Pastor LaSalette some money to take him back to the hospital to get his blood sugar under control. When we checked it at the clinic, it was still very high, even though he was on insulin.

I went back to Maphiveni and checked on George a couple of weeks after the medical clinics. He is now living in a room at Pastor LaSalette’s church. He is being taken care of by Abraham, who also lives and works there at the church. He is trying to cook healthy meals for George and make sure he checks his blood sugar twice a day and takes his insulin. Pastor bought a blood glucose machine for him to check his blood sugar. George looks and feels so much better these days.

HIV Testing Results

	Positive		Negative
Age	Females	Males	Females	Males
^14	2	2	5	4
15-19	1	0	2	0
20-29	7	1	1	3
30-39	7	0	0	0
40-49	4	0	4	2
50-59	0	0	1	1
^60	1	0	4	1
Total	22	3	17	11

These are additional results from the clinics held in April with Dr. Beyda's MoM medical team.

Pepe Update

PePe finally went home from the hospital on the 8^th of May! Praise the Lord! She no longer has an NG tube for feeding. She is now drinking the nutritional formula by mouth. She has to have four 500ml bottles of the formula daily and then she can have other food. She celebrated her 12^th birthday on the 10^th of May! She is doing well at the home that her and her brother, Banele are in. Banele is also doing well! He is going to school this term! Hopefully, soon, PePe will also be strong enough to go to school!

Clinics with Mission of Mercy

The clinics with the Mission of Mercy medical team went very well. The team consisted of 2 doctors, 3 nurses, a paramedic, and 3 other non-medical people, who ran the pharmacy. We saw over 1500 people in 5 days. Everyone had an opportunity to pray with someone before they left. There were many testimonies of salvation, and spiritual encouragement over the 5 days. Many people also went for HIV testing and counseling.

We saw many difficult situations, and were able to help with most of them. One lady that we saw was 11 months pregnant, and could not be induced, because she didn’t have R250 ($32), for the medication for induction. The team gave her the money to go to the hospital to be induced.

There was an 11 year old girl at one of the clinics that had been raped. Her father brought her to be seen by the doctors. She had been living with her mother up until about a month ago, when she was taken to live with her father. He said that she won’t talk to him about what happened, all she does is cry. When we asked her what happened and when, she said that the last time it happened was about a month ago. She said that she feels safe now that she is living with her father. She wouldn’t tell us who raped her, only that it happened while she was living with her mother. She didn’t want to be examined by a man, but when we told her that the teacher and I would be with her, she finally agreed. Dr. Beyda was so kind to her and explained exactly what he was going to do, and that he was so sorry that this terrible thing happened to her. When we tried to examine her, we could only get her legs a few inches apart. We had to do the best we could not to traumatize her anymore than she already was. On examination, we discovered that she had a discharge and a large wart growing between her labia, which is very painful. Dr. Beyda decided to treat her for all STD’s (sexually transmitted diseases), which included an intramuscular injection, along with several oral antibiotics.

After the exam, we called in one of our missionaries, who was doing spiritual counseling to help us talk to her and pray with her. Jacci was definitely led by the Lord, and talked and prayed with her for a long time. The little girl was crying, I was crying, Jacci was crying and our interpreter (one of our teachers) was crying. The girl accepted Christ into her heart, and when we were finished, she was hugging us. In the beginning, she would stiffened when we tried to hug her. Her facial expression changed and you could see that she was different than she was before.

We saw her a week later, and she looked like a different child. The withdrawn, unhappy countenance was replaced by a smile and she was hugging us willingly. I’m sure that she still has a long way to go both emotionally and physically, but praise the Lord, she is on the right path!

Thanks Sabine for the pictures!