Trauma Informed Care Introduced at Nundu

by Lwabanya Marx MD

Image courtesy of Unsplash

The following is a news article from Congo:

Our history in South Kivu 

The Democratic Republic of Congo (former Zaire) faces an unprecedented humanitarian crisis. The crisis is described to be one of the world’s deadliest, longest, unfortunately less spoken and happening for decades. It has resulted in massive internal displacement of populations without adequate assistance in many cases. At the same time the DRC is home for refugees from neighboring countries.

This evolving humanitarian disaster is largely silent on the global consciousness, yet the disastrous consequences are felt by all sectors of the population. The eastern part of the country has been the most affected for years by repeated wars and conflicts, resulting in thousands of victims surviving with physical and emotional trauma. The health providers who work in this humanitarian context face many challenges, including poor salary payment contrasting with a massive overload of work while remaining largely untrained in trauma-informed care, unprepared to deal with patients’ emotional stress, and unsupported in any endeavors they personally take on. Adverse effects linked to the instability in the region seriously impact the well-being of both caregivers and patients.

The Nundu Deaconess Hospital (Nundu Hospital), located in South Kivu, has been caring for thousands of Burundian refugees based in the Lusenda Camps since 2015. More recently, in 2020, additional waves of internally displaced people have arrived in the region seeking care, resulting from instability in the middle and high plateaus. Despite desperate needs for equitable healthcare, patients are often dissatisfied with the care they receive due to lack of staff training and support. A small team of international collaborators from the Atlantic Fellows program are seeking to address these issues with the project, “Hope, Healing, Home, Humanity: Strengthening Our Circle of Belonging”

The Program

A program training health care providers on Trauma aware / sensitive / Informed Care (TASIC) was initially developed for the Staff at NDH. However, due to the observed need in the Zone it was extended to all health providers of the heath Zone including 22 health centers and 5 referral health centers and the NDH.

This training is conducted under the project: “Hope, Healing, Home, Humanity: Strengthening Our Circle of Belonging” with the aim to promote inclusive health care that improve people well-being both physical and mental for patient on one side including those in particular contexts (refugees, IDPS, etc) and health providers on the other.

A kick-off meeting at Nundu September 1-6 brought together different stakeholders including local health officials, health providers, Community health workers, Civil society leaders, traditional healers, church leaders, local NGOs, etc these different groups gathered on table and shared their stories, perceptions, root causes of mental health problems in the Nundu community. The inputs from the groups led to the development of learning materials for health providers within five days. The participants recommended this training to be extended to their peers, and shared the commitment to make their work environment a better place for them and their patient.

Addendum regarding Dr. Lwabanya I. Marx

In April, Dr. Marx will be traveling to the United States, where he will be joining 3 other members in the Atlantic Fellows program. They will all be presenting in a major conference at Duke University on April 8-10. He then plans to remain in the United States and will be speaking at the CAHO conference on April 26-27 at the Spring Arbor. During the last half of April, he will be available to speak in churches, at groups, or at one of our Free Methodist Universities. If interested, contact normwetterau@aol.com

FMHF 2023 Retreat Recap: Renewal of the Mind and Trauma Informed Ministry

Image courtesy of Unsplash

Doctors, nurses, chaplains and others gathered for our FMHF fall retreat on Oct 20-22. Our featured speaker, Robyn Florian, shared a wealth of theoretical, biblical and practical wisdom that churches can use to help promote healing of those suffering from past and current physical and emotional trauma.

Robyn graduated last May with a D.M. in Organizational Leadership from Asbury Theological Seminary. This was a culmination of a four-year season of study focused on how to help people hope through intensive, integrated soul care. She is available to do weekend workshops for churches. A full summary of the weekend talks would take many pages.

The quote on her first slide called us to our task:

“The world is in awe of the church [when] the church is in awe of God. When the church lives in awe of God, the kingdom breaks out into the world. When the kingdom breaks out into the world, the world begins to believe in God. When the world begins to believe in God, the church receives them into community.” This quote is from the sermon series Wake Up Call with J.D. Walt; “They Understood the Assignment, Acts 5:12-16”

In her presentation, she mentioned neuroplasticy, which explains why people can change. The gospel is something that can change the shame narrative. This is really what much of her talk is about. Our communities and churches are filled with people who have experienced emotional trauma, and a pastor and church that understands this can really help these people believe in God and come into the church community.

She talked about hope, healing and resilience. She provided some theological and practical ways that church can help. She also discussed the theme: Renewal of the Mind, and Romans 12:2 .

For those who have suffered physical and emotional trauma, it will take more than a sermon or even a weekend retreat to truly heal. It will take an understanding, healing community, which is one of her major themes. How can a church become that? The Free Methodist Healthcare Fellowship encourages pastors and churches to learn more about these areas and become really healing communities. Feel free to contact Robyn or the Free Methodist Health Care Fellowship for further assistance.

Nundu News Thanks Free Methodist Health Fellowship for Dr. Ebuela Mtee Baron's Scholarship

The following article was posted by Nundu News in thanks of the scholarship provided for Dr. Baren:

NUNDU NEWS:  November 20, 2023

BARON SCHOLARSHIP THANKSGIVING

Thank you, Free Methodist Healthcare Fellowship, for providing a scholarship for  Dr. Ebuela Mtee Baron to pursue a residency in OB/GYN.  Dr. Baron joined the staff of  Deaconess Nundu Hospital as a general practitioner in January 2020. Before joining DNH, Dr. Baron completed his internship at “Hopital de Baraka” funded by the MSF-Hollande, for six months. After his training, he served at Fizi Hospital for nine months, and then joined, as the only doctor, a private clinic in Baraka (Polyclinique de Dieu). 

Meeting with Dr. Baron August 2023

Dr. Baron holds a bachelor’s degree in medicine from “Universite Officielle de Bukavu”, completed in 2016.  He holds a high school diploma in biochemistry, Institut de la Fraternite, Kigoma, Tanzania in 2009, completed while he was a refugee from the conflict in his home country DR Congo. He was born at the Deaconess Nundu Hospital in 1988.  

On his arrival at Nundu from Baraka, he was assigned to the obstetrics-gynecologic service.  While serving as a general practitioner with limited training he attended to many patients who required referral to a specialist.  These patients would have to be transferred to Bukavu, the provincial capital of South Kivu, more than 250 kilometers north of Nundu.  Living away from their home village and traveling to the city was difficult, and sometimes even dangerous.  During their journey their problem would often get worse, and some patients would even die.

Deaconess Nundu Hospital medical staff and church leaders, June visit 2022

Baron is happy for the opportunity to give back to his community.  He is motivated by his desire to help a population which is suffering from very complex medical conditions.  Seeing the need for additional training, he competed successfully with 57 doctors for one of 13 scholarships in a residency program at the University of Burundi in obstetrics-gynecology. However, he found that as a Congolese he was obliged to pay $1500 per year tuition. 

With limited resources available, Dr. Baron began his training in Bujumbura, November 2022, leaving his wife Anne Marie and daughter at Nundu.  In February 2023 he and Anne celebrated two years of marriage as well as the first birthday of their only daughter Emilee. 

Connie Ebuela November 12, 2023

Emilee, Dr. Baron, Anne Marie

The need for scholarship support came to our attention in August of this year while on our mission to the DR Congo. Though Dr. Baron had received support to pay his tuition fees for one year from his brother, he was without sufficient funds to provide the basic needs of his family.  Anne was making a way for herself at Nundu by preparing meals for special events as well as taking on sewing projects.  She also learned that she was pregnant with their second baby, due in November.  The opportunity to support this couple with a scholarship was presented to the Free Methodist Healthcare Fellowship and approved.  Thank you for your support.

The Baron family is now living in Bujumbura, Burundi.  Their second daughter was born November 13 and was given the name Connie Ebuela.  We are blessed to be in relationship with this beautiful family.  Is your heart drawn to Africa?  There are other opportunities to support worthy scholarship recipients as well as to continue support for the additional three years of Baron’s residency.  To give, go to www.congohealth.org. 

Saving the Lives of Mothers and Babies

by Norman Wetterau, MD and Lwabanya Marx, MD

Image courtesy of Unsplash

The American Church is concerned about saving the lives of pregnant mothers, babies, and preventing neonatal deaths by discouraging abortions. In central Africa, many newborns die, and mothers die from childbirth often.

This article is an introduction to the issue of neonatal deaths, with an additional article that will follow later this year. There is much development in this area, including in some of our Free Methodist hospitals and clinics overseas. We welcome comments and additional writers.

Maternal mortality ratio (modeled estimate, per 100,000 live births)

Data Courtesy of: WHO, UNICEF, UNFPA, World Bank Group, and UNDESA/Population Division. Trends in Maternal Mortality 2000 to 2020. Geneva, World Health Organization, 2023

Worldwide, the maternal mortality ratio was 339 per 100,000 births in 2000, however currently the ratio is 223 per 100,000. In many developed countries the rate is under 20. In Canada, it is 11. The rates for 4 countries where we have Free Methodist Hospitals are: Rwanda 259, Haiti 350, Burundi 494 , and Democratic Republic of Congo; 547. These are the incidence of mothers dying from Childbirth. Rates for infant death will be presented later next year.

The Gates Foundation is making this a major project, and they published a report Sept 12, 2023 This report can be downloaded from the internet and presents several initiatives. Their report had seven recommendations:

1. A bundle of interventions that can reduce postpartum hemorrhage, the No. 1 cause of maternal death, by 60% for less than $1 per package

2. Bifidobacteria (B. Infantis), a new probiotic supplement that, when given to an infant alongside breastmilk, combats malnutrition—one of the leading causes of newborn deaths

3. Multiple micronutrient supplements (MMS) that boost survival rates for babies by helping replete nutrient stores in pregnant women and ensuring those vital nutrients are transferred to the baby

4. A new one-time infusion of IV iron for women that replenishes iron reserves during pregnancy, protecting against and treating anemia, a condition that is both a cause and effect of postpartum hemorrhage and affects almost 37% of pregnant women

5. Antenatal corticosteroids (ACS), which are given to women who will give birth prematurely to accelerate fetal lung growth, providing several weeks of maturation in just a few days

6. Azithromycin, which reduces maternal infections during pregnancy and prevents infections from spiraling into sepsis—the cause of 23% of maternal deaths in the United States—and reduces mortality when given to infants in high-mortality settings.

7. An AI-enabled portable ultrasound that empowers nurses and midwives to monitor high-risk pregnancies in low-resource settings to ensure that risks are diagnosed and addressed early

In the Nundu area of Eastern Congo most deliveries are being done by midwives and in some cases by totally untrained midwives. At-risk mothers are supposed to be referred to our hospital where there are physicians. The first problem is lack of trained midwives, but on the positive side, our nursing school there is training midwives and wants to enlarge their student body and building to make midwife training a major goal of the school.

Secondly, Dr. Marx has already instituted a program where midwifes can call by cell phone the hospital to discuss cases and get telephone consultations. For this publication he has sent the report, included below. In our next issue he can share more and we can provide more details on the midwife school.

MATERNAL AND NEWBORN HEALTH IN CONGO

by: Lwabanya Marx MD

The Deaconess Nundu Hospital, a free Methodist Facility is actively involved in the effort to provide quality care to the underprivileged community in the rural area of Nundu, Eastern Congo.  

In the last five years, more effort has been dedicated to improving maternal and newborn health care. This includes and not limited to the following: 

• Setting up a neonatal intensive care unit, with basic equipment to provide quality health care, including two incubator, CPAP, Oxygen, blue light, radiant warmers, Infusion pumps and monitors, etc. 

• Short training of general nurses to provide basic neonatal care, 

• Short training of general practitioner doctors and nurses in comprehensive emergency obstetrics and neonatal care. 

Despite the above-mentioned effort maternal and newborn mortality has been oscillating and haven’t yet been close to the SDG -3. 

To address that situation, several new interventions has been initiated at Deaconess Nundu Hospital in collaboration with multiple partner organizations: 

• Mobile Clinic, two mobile nurses are able to organize field trip in the community and reach out mothers and infant facing financial barriers, they perform clinical assessment and provide medications for common conditions like malaria, diarrhea, pneumonia, etc Children found in critical ill condition are immediately transferred to the Deaconess Nundu Hospital for appropriate care where all the care are provided for free because their bill are covered by patients care funds from CAHO. 

• Community Health Workers (CHWs); one supervisor nurse from the Deaconess Nundu Hospital and 10 CHWs are actively involved in supporting served community to prevent common maternal and infant conditions by encouraging antenatal care visit, post-natal visit, sensitizing on hand hygiene, nutrition and contraceptive methods. The Community Health Workers program helped identify several high-risk pregnancies and decisions were made on time. 

• Master Trainer program: as noted in many of our report late referral, poor knowledge of health providers at health centers especially in newborn resuscitation, management of common post-partum emergencies like PPH, etc. The Deaconess Nundu Hospital initiated a program to address knowledge gap at the health centers in the Nundu health District. The model is assess-train- assess- re-train. The program is supported by the Gould Family Foundation and focus on helping baby breath, essential care of small babies, essential care of every baby and helping mothers survive.

 The DRC government has also initiated free-of-charge health care to women delivering and newborn started October 1st, 2023. This program is dedicated to easier the financial burden of maternal and sick newborn. We don’t know yet what will be the next outcome. 

Renewing of the Mind and Trauma Informed Ministry: Free Methodist Heath Fellowship Fall 2023 Retreat

Image Courtsey of Unsplash

Renewing of the Mind and Trauma Informed Ministry

Free Methodist Healthcare Fellowship Retreat

Oct 20-22, 2023 | Essenhause, Middlebury Indiana

Featured Guest Speaker: Robyn Florian

We also hope to have a one hour Zoom conference on this subject with Robyn Florian in early September.

Friday Evening and Saturday Morning: Robyn will present about trauma-informed care and ways the church can participate in this. Trauma-informed care is popular in medical, psychological and other literature, yet its therapeutic principles were employed by Jesus and John Wesley. Many churches already promote trauma-informed care, even if they do not always understand how important their activities are. Robyn will share how trauma and its effects (fear, anxiety, depression) can negatively affect a person, as well as how the brain stores some of these effects as past memories capable of being triggered by present circumstances. In their hopeless, some people turn to substance abuse. Love, connection with people, forgiveness and forgiving others can be part of a healing process. There is evidence that these healing actives actually change brain activity as part of the process of recovery.

After Robyn’s presentations, there will be an open discussion as to how medical professionals—as well as churches, schools and communities—can promote healing by applying what we learn.

Saturday Evening: we will discuss healing of emotional and spiritual trauma overseas. Patrica Porter and other chaplains will talk about the chaplains training program they did at Hope Africa in February and their plans for the future. Dr. Wetterau will also share stories of some of the medical students he trained; stories of trauma, including watching their parents killed in the civil war, and stories of healing and recovery, usually facilitated through Christian friends and the church.

Our featured speaker: Robyn Florian

Robyn graduated last May with a D.Min. in Organizational Leadership from Asbury Theological Seminary and an M.A. in Christian Ministry from Liberty University, the culmination of a four-year season of study focused on how to help people hope through intensive, integrated soul care. She also holds an M.A. in Communication with an emphasis in digital engagement from Regent University (2004) and a B.S. in Education from Greenville College (1988). In 2016, God called Robyn out of a 25-year career in nonprofit communications and into the work of encouraging, equipping and empowering the Church to better tend to people in crisis and emotional brokenness. Her experiences included tenures at Greenville University and Spring Arbor University as well as investments in prison ministry, disaster relief, homeless outreach, and those dealing with medical challenges prior to her current investment in emotional healing and leadership formation.

Americans, Especially American Children, Are Not Living as Long

The Life expectancy of Americans has gone from almost 80 years to 76 years in the past three years. Homicide, suicides and drug overdose deaths are major drivers of this. Life expectancy in Europe is still over 80 year and has not decreased nearly that much with Covid.

Image courtesy of NPR

The graph depicted is from a report done by NPR and shows the life expectancy by year and by country. This report details the decline of life expectancy in the U.S. and the factors that lead into it. To read the article and view the full interactive graph, click here.

Secondly an article in the JAMA Network showed how the deaths of children under 19 have increased. Covid was only a minor cause of this. The article and graphs show that guns were a major cause, both through homicide and suicide. Other methods of suicide contributed as well as drug overdoses, although the majority of drug overdoses are in people over 19. No other country comes near to our drug overdose rate, even when adjusted for population. To read the article by JAMA Network, click here.

Physicians and other American health professionals like to show how advanced our healthcare system is, but due to these other factors, it is not helping people live longer.  This information is becoming more widely known and Americans want to know why we spend more money on health care than any other nation, yet have the lowest life expectancy of a developed nation and our life expectancy is falling.

Churches can make a difference. Those who attend church are less likely to drink excessively, if at all, and less likely to use illegal drugs. Our fall conference will address past life trauma and its effect on health including suicide. Churches can help those with lifelong trauma recover and reduce the incidence of suicide. A belief in a loving God, forgiveness and other loving people can help reduce suicide although Christians still do commit suicide.

The issue of guns is something else. Our country seems to consider gun ownership as an essential aspect of freedom. We are paying an increasing price in deaths for this belief. Evangelical Christians often oppose any gun control.  Could we support background checks and requirements that guns be locked up? Could assault weapons be stored at firing ranges and checked out for hunting? Do we really need assault weapons in our homes? I know of churches that support gun safety classes. Finally could we add these health crisis to our prayers in church: God give our country wisdom in dealing with the drug epidemic, suicide epidemic, feelings of depression and hopelessness in our teens and our fascination with guns and violence.

As members of the Free Methodist Healthcare Fellowship we can share the sad  information and encourage our church members to be aware of this and pray for the health of our nations young people. . When someone says we have the best health care and are the healthiest in the world, don’t argue but share this information. Being aware of this  is the first step.

Please e-mail your comments to normwetterau@aol.com to be shared in a future issue of our newsletter

Chaplaincy Training at Hope Africa University

Radio interview of chaplains at Hope Africa University in Burundi

We are thankful that three Kibogora Hospital chaplains and five chaplains/pastors from Nundu were able to attend an intensive week-long training conducted by the Chaplains Association of the Free Methodist Church in February.  There were in all 19 chaplains/chaplain candidates from three countries (Rwanda, DR Congo, Burundi), four hospitals (Kibogora, Nundu, Kibuye, and Van Norman), Hope Africa University and the Nundu School of Nursing. The training was hosted by the Van Norman Clinic and HAU in Bujumbura, Burundi and funded by a grant from the Butterfield Foundation.

Attendees received training on many aspects of chaplaincy, including Biblical foundations of chaplaincy, grief and bereavement counseling, trauma-informed care, pastoral crisis counseling, and spiritual assessment and formation.  The faculty traveled to Bujumbura, Burundi from Ireland and the US (Kentucky and California) with a variety of professional interests and experiences. Dr. Tim Porter and Rev. Patricia Porter, Co-Directors of the Free Methodist Chaplains Ministries USA, organized the curriculum and taught some classes including trauma-informed care. Dr. Meneely (PhD, Queens University chaplain from Belfast, Ireland – he is also a hospital chaplain) presented the theological section. Barbara Meneely (Registered Nurse (RN), Diploma of Higher Education Ulster University, Belfast) introduced issues related to hospital protocol and public health. Dr. Tony Headley from Asbury Seminary presented the emotional/mental aspects (Grief & Bereavement, Compassion Fatigue).

What were the outcomes of this chaplaincy training? Right after the classes were finished, the chaplains from the three different countries represented formed a very first chaplains association with all three countries represented!  These same chaplain leaders and Dr.Tim Porter were interviewed on the HAU radio station which was broadcast to all three Central Africa countries. The Butterfield Foundation is planning to start a chaplaincy internship program right away at the Van Norman Clinic as well as some type of chaplaincy certification program at HAU. The participants from Kibogora plan to share what they learned with the other chaplains on staff at Kibogora Hospital and so enhance the chaplaincy services provided. Dr. Marx, Medical Director of Deaconess Nundu Hospital, welcomes the impact this training will have on the spiritual care of patients and their families. Rev. Patricia Porter reports, “I think the chaplains really benefitted from the whole person care concept.  It has been a fruitful mission and I praise the Lord that it all came together!  We praise the Lord for the faithful people of DR Congo, Burundi, and Rwanda and it was a privilege for us to be part of what God is doing in Africa.”

A VIRTUAL INTERVIEW WITH REV. PATRICIA PORTER

Thank you, Rev. Porter participating in the chaplaincy training provided at Hope Africa University. As I reflect on what you have accomplished, I have some questions which come to mind. 

Q: How did you identify the need for training of chaplains at our hospitals in Central Africa? 

A: Tim and I started envisioning international chaplaincy when the bishop from the Philippines inquired about chaplaincy at GC’19, which gave us an idea for a new initiative for FMCA to start international chaplaincy training  in 2021.   Although the mission did not materialize in Asia, a chaplain from Kibogora who had immigrated to the US told us about chaplaincy there.  I contacted Julie Yerger, a former nurse at Kibogora, in March of 2022 and she put me in touch with Dr. Marx at Nundu and Dr. Glenn Snyder from Kibogora.  Both Dr. Marx and Dr. Snyder indicated a need for chaplaincy training at Nundu and Kibogora. 

Q: What brought your group together?    Another way to ask the same question, how did you identify those of like mind? 

A: In August ’22, Dierdre McCool (Executive Vice President of the Butterfield Foundation) and I started discussing her initiative to start spiritual care internship at Van Norman Clinic, with some concerns as to who would train the interns.  Then Dierdre sent me the newsletter written by Bishop Bates regarding the chaplains at Kibuye, so I called Bishop Bates and he had me contact Dr. Meeney who had trained chaplains individually in Burundi and had been there four times already.  We contacted Dr. Meeney and we decided to go as a team with Dierdre coordinating things in Africa and me putting a team together in the US.  It was definitely Holy Spirit-driven as everything clicked into place and the team put together according to God’s will.  Although we had two chaplains who could not go at the last moment, we were able to add recently retired professor from Asbury Seminary, Dr. Headley, to the team as he was willing to go with only a three-week notice! 

Q: As you came together as a faculty, did you find that your different professional interests to be complementary? 

A: It was a very complementary team as four of us were pastors, two were chaplains (university/hospital, military) and we also had medical experience (nurse & PT), and a university and a seminary professor. 

Q: When and how did you identify HAU as being a partner in this training?  How did the Butterfield Foundation join you in this program? 

A: We decided that HAU (in Bujumbura, Burundi) would be a central location for all the hospital chaplains to convene since all four hospitals are in close proximity to one another (3-5 hrs).  Butterfield assisted with meals, lodging, stipend, and travel for all the students, so they did not incur any expenses. 

Q: What did you learn about the different hospitals represented?  What are the plans for the future training?   

A: We had (the participating) chaplains share new initiatives they were doing at their hospitals which were informative and innovative.  One similarity that we observed was that all the hospital chaplains indicated that many patients ask them for monetary support which is not surprising given the economic conditions of these countries.  It was heartwarming to hear how the hospitals are trying to assist patients not only with funds but with food, especially for the young!  Tim and I were both brought on as board members of Butterfield to assist with their spiritual care initiatives and we found that Dierdre and we had the same dreams about international chaplaincy training!   

Our future plans are continued presence in Africa to further train the chaplains in all four hospitals as well as starting chaplaincy internship programs.   Van Norman will begin their internship program this March and Dierdre and I are already discussing possible internships at other hospitals if that is desired by their medical directors.  We would also like to see a chaplaincy certification program at HAU and Kibogora Polytechnic in the future.  We have been in discussions with FM colleges, universities, and seminaries regarding chaplaincy certification in the US as well. 

Q: How can we join you in your mission? 

A: At this point, what I would like to see is continued training in Africa and the formation of a chaplains association with a long-term goal of chaplaincy certification program at universities (in Central Africa).   Another thought I had was that it would be great if we could have the lead chaplains from these hospitals come to the US for three months to do  a unit of CPE at US hospitals.  I will be checking to see if the hospitals require US citizenships or if they only need student visas for CPE internships.  Both Tim and I have been inspired by the African chaplains who instantly became our brothers and sisters; their love for God and love for others in the midst of their own material needs is inspiring and amazing to say the least!   No wonder 500,000 out of 1.5 million FM members overseas are in Burundi, Rwanda and DR Congo!

Blessings,

Patricia

A Call to Support Eric Manirakiza in Pursuing His Doctorate

Image Courtesy of Hope Africa University

Eric Manirakiza is the director of the nursing program at Hope Africa University, and has been for 11 years. He is a graduate of the first undergraduate class of Nursing from Hope Africa University and a graduate from the first Masters-level class. In 2020, he completed a second masters in Nursing from Roberts Wesleyan College, and is now applying for the doctorate in Nursing Leadership at Spring Arbor University. He has also written a paper called Evaluation of Knowledge and Practice regarding Family Planning among Christians Pregnant Women of Gihanga Attending Antenatal Careat Vyizigiro Health Center, Bubanza, Burundi which can be accessed via the button below.

In the fall, Eric started his program at Spring Arbor University to obtain his doctorate, which is incredibly important to Hope Africa University and to Free Methodist Missions. He reached out to our medical fellowship to request assistance for tuition. Eric’s studies will enable him to provide expert leadership from an international perspective at Hope Africa University, and in his small country of Burundi in Central Africa. He is also attempting to pay tuition as well as take care of his three year old daughter and help support his younger brother and an additional orphaned lady on his limited income. Our board decided to help support him by giving him next semester’s tuition through the Thuline fund. The board also decided to have the FM fellowship set up an account to take tax deductible donations for this education, for this second year of his program. We are hoping many of our members will contribute to help support Eric in pursuing his doctorate. Friends of Hope Africa is also helping to raise support, but it is fitting that our fellowship, which includes nurses, also helps. His program is two years, so these donations will help pay for his second year. Supporting Eric will help the head of a very large FM University based nursing program an advanced degree.

If you have any questions about this, e-mail normwetterau@aol.com . Donations can be made online on our website or mailed to our treasurer, David Leffler. Mail checks out to Free Methodist Medical Fellowship and note nursing education in memo. Mail to:

David Lefler

235 Ridgewood Drive

Fort Ashby, WV 26719

Nursing Education in Central Africa: An Important Part of FM International Health Ministry

Image Courtesy of Hope Africa University

One of the gems of our church is our nursing programs in Central Africa, especially at Hope Africa in Burundi. We have nursing schools at Kibagora Hospital in Rwanda, Nundu in Congo, as well as a large University level course at Hope Africa in Congo.

When our church brought modern medicine to central Africa, there were medical missionaries and nurses, and eventually nursing schools followed. Now we have Christian Medical Schools, including our FM one in Burundi, Hope Africa.

Our April issue featured an article about the nursing department at Hope Africa, which can be accessed here. The article detailed the history of the baccalaureate program, and if you’re curious about the students that graduated, you can read about the spirit of our Hope Africa Graduates here, in an article written by Dr. Randy Bond last year.

Eric Manirakiza is the director of the nursing program program at Hope Africa, who, along with graduating from the first undergraduate program at Hope Africa University, has graduated from HSU’s first Master’s class, and has obtained his second Master’s Degree in Nursing from Roberts Wesleyan College. He plans to pursue his doctorate in Nursing Leadership at Spring Arbor University, and to read more about him, his work, and help him obtain his doctorate click here. Eric shared some more information about the Nursing Program at Hope Africa university in an update:

Q:  Around how many students graduate from Hope Africa University each year?

An average of 50 students graduate each year

Q: How many are in the graduate program?

62 students

Q: What careers have these students gone on to?

 Ministry of Public Health with its different departments and program, National

Public Health Institute, Hospitals, Health Centers and Clinics (Public and Private)

around the Country include Van Norman Clinic and Kibuye Hope Hospital, HAU,

Kibogora in Rwanda, Schools, etc…

Q:   How does the nursing program compare to other majors at HAU?

The nursing program is one the most important programs at HAU. It had trained

students from several nationalities: Haiti, Uganda, Tanzania, Cameroon, Rwanda,

Kenya, Burundi, Tchad, DRC. In 2021 and 2022 , we admitted more than 100

students each year.

Addressing Same Sex Attraction from a Christian Perspective: Fall 2022 FMHF Retreat

Image Courtesy of TripAdvisor

Our 2022 fall retreat was a success. Around 30 people gathered to explore the theme: Addressing Same Sex Attraction from a Christian Perspective. In addition to those who attended in person, around 10 people attended virtually. Unfortunately, we were not able to record and make our programs available after the conference but will provide a brief summary here and some references.

Dr. Rodney Bassett, author of Loving From Where We Stand: A Call to Biblically Faithful Ministry with the LGBTQ+ Community is an ordained elder, has a Ph.D, and had taught psychology and human sexuality at Roberts Wesleyan for many years. He provided an overview of homosexuality through the eye of a Christian psychologist. The question is often asked: is same-sex attraction genetic, or inherited, or is it related to early childhood experience? He presented various studies including twin studies that did not give a single answer. All these and other factors were involved. He also spent considerable time talking about how the younger generation views the issue. For many they see the nonacceptance of those with same-sex attraction and relationships as a justice issue. This issue also came up later when same-sex marriage was discussed. He recommended 2 books to give additional information, including Douglas E. Rosenau’s A Celebration of Sex: A Guide to Enjoying God’s Gift of Sexual Intimacy, which is a general introduction to a Christian view of sexuality (both editions are great), as well as any book by Mark Yarhouse, though the members of your association may be especially intrigued by Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture.

Rev. Bruce Cromwell is the author of Loving From Where We Stand: A Call to Biblically Faithful Ministry with the LGBTQ+ Community as well as an ordained elder, and has a Ph.D. His book is available at Life and Light Press, as well as on their website FreeMethodistbooks.com where one can listen to a podcast about the book and read an excellent summary by Jeff Finley. Although we do not have recordings on our retreat sessions, the book, podcast and summary will provide much information.

In the discussion at the retreat, the group struggled with the issue. Most agreed that God intended sexual activity to be between a man and women in marriage. On the other hand, simply having same sex attraction is not a sin. Also there can be much sin in heterosexual relationships. Everyone should be welcome in a church, even though the church may not approve of all that they do. The church is about forgiveness, yet one does not define forgiveness by saying that all they are doing is fine. The church is to draw all people to Jesus. We do not have to approve of all that everyone does but we are also not to judge them when there are no innocent parties being hurt that need protection. Those who are in same sex relationships are welcome in our churches although maybe not in a leadership role. A chapter in Rev. Bruce Cromwell’s book discusses this in detail. Those who come having been married outside the church are to be recognized as legally married, but the church will not marry them. Here marriage is a legal issue.

It was noted that churches can have three views toward homosexuality. One is to condemn and judge it. Those in same-sex relationships are not welcome at these churches. A second view is affirming what they are doing. But there is a third alternative, and our church is a leader in this: acceptance without affirming. Our church cannot affirm their choices or perform same sex marriages. However, we accept them as children of God and invite them to fellowship and grow as Christians in our churches. Their activity is not the unforgivable sin. Yet at the same time we do not promote same sex activity or marriage as some churches do. Pastor Cromwell noted that as the United Methodist Church struggles with this issue, a number of their churches really like our position. They have problems with those churches that totally affirm same sex activity and celebrate it, yet they do not want to judge and condemn these people. Our churches position allows us to accept the individuals without celebrating their activity. As the United Methodist Church struggles with this issue a number of these churches are very interested in our position since it is one of love but not of celebration of something which is outside Gods perfect will for humans.

Finally, there was a discussion of medical aspects of those with same sex activity. There is a wide spectrum of medical aspects. For those in relationship with just one person there may be few or no medical issues. Issues of having children could be an issue. For those in multiple relationships there are potentially many problems. Drug addiction is common in those with multiple partners but that is equally common in those with multiple heterosexual partners and in younger people in general. Males who have anal sex with multiple partners have a high incidence of HIV. Suicide rates are high, especially among transexual youth. Health care professionals need to be sensitive to the needs of all these individuals. They are all children of God. There was considerable discussion around all these issues.

This retreat was a time of fellowship but also sharing thoughts around these issues We want to take them back to our congregation. Our position: to accept but not celebrate is one that needs to be shared. Also consider ordering the recommended books, especially Rev. Dr. Bruce Cromwells book Loving From Where We Stand: A Call to Biblically Faithful Ministry with the LGBTQ+ Community; for your church library.

FMHF Receives a Bequest from Marcia and Dale Thuline

Recently the Free Methodist Healthcare Fellowship has received a bequest from the estate of Marcia and Dale Thuline. The amount is in excess of one hundred thousand dollars, and this will enable our organization to better serve our members, do new things and help reach out to our churches. Funds could also be used to help our healthcare professionals in what use to be our mission hospitals. Our board will discuss this at our annual meeting in September. We welcome suggestions and will report back at our annual retreat in September.

Marcia (Lerew) and Dale Thuline grew up in the Free Methodist Church and were very active in Bible Quizzing. They were childhood sweethearts. Both went into the medical field, Marcia a nurse, and Dale a doctor.  Once Dale completed his medical residency in Panama, they felt called to the mission field, where they served in both South Africa and Transkei in the 70’s.  After returning to the states he joined the clinic in Arlington, WA, which had a unique program whereby doctors covered for one another while one would rotate for a year or more in a FM mission hospital. Dale continued to serve through missions, with brief trips to Haiti and Africa.  Both he and Marcia lived a life of service.

In addition to mission travel, Dale & Marcia loved to travel and obtained their goal of visiting every National Park in the US and most of the National monuments. Their final foreign travel was to the Galapagos Islands off Ecuador.

Nursing Education at Hope Africa University

Image courtesy of haufriends.org

by Darlene E. McCown

Professional Nursing education at the baccalaureate level began at Hope Africa University (HAU) in 2006 with a  first class of 12 eager students (2 women and 10 men). There were no text books and limited equipment. An African nurse and a U.S. visiting professor served as the faculty.

Over the next 15 years, the baccalaureate program developed with a basic professional curriculum, additional visiting faculty, stable clinical site experiences and expanding professional recognition and East Africa accreditation. The early development of a Nursing skills laboratory with medical equipment, anatomical models, microscopes,  ophthalmoscopes, audio visual materials, etc. revolutionized the education for nurses at Hope Africa University.

In 2011, under the direction of Dr. Darlene McCown, a 2-year Masters of Nursing degree program was started with 8 students (2 women and 6 men).  Six of the students were graduates of HAU and 2 were from other institutions. A thesis written in English was required.  All the students successfully completed their program. They all serve in Africa in positions of leadership in Nursing.

To date, HAU has produced more than 650 graduates in Nursing. Currently, 196 undergraduate and 47 graduate students are enrolled.

The Nursing program is directed by Eric Manirakiza who is a graduate of the first undergraduate class of Nursing from HAU and a graduate from the first Masters-level class; in 2020, he completed a second masters in Nursing from Roberts Wesleyan College, and is now applying for the doctorate in Nursing Leadership at Spring Arbor University, The Nursing faculty at HAU  consists of Eric who also serves as director, three fulltime nurses, and some part-time faculty for general courses. Visiting faculty assist with teaching as needed.

God has provided for this educational ministry over the years since 2006 and has changed the health of the small nation of Burundi through the work of the Free Methodist church and dedicated faculty at HAU. For more information on Hope Africa go to the Dec 2021 newsletter and read: Hope Africa Graduates.

Life and Light Article Promotes Our Fellowship and Fall Retreat

By Norm Wetterau

Jeff Finley wrote an excellent article on our fellowship and upcoming retreat for Life and Light titled FM Health Fellowship Connect and Inform. Read it HERE.

Send this link to others and ask them to sign up for our newsletters on fmhealth.org. We want to add several hundred more healthcare professions to our mailing list. We have so many doctors, nurses and other healthcare professionals in our churches but they say they have never heard of our group. Now they have but they need to be encouraged to sign up to be on our mailing list. Some may want to come to the retreat or go virtually but for others just connect them to our group. We may want to plan some regional events and need names and e-mail addresses so we can connect.

Being a member might be coming to our annual retreat, or a virtual event, reading our newsletter, writing something for it, or helping your church address the many health issues their pastors and members deal with . We also hope that our group can help our members prevent burnout and grow spiritually. This year’s retreat is on same-sex attraction but we will continue to address many other issues in the future. As the article says, our fellowship connects and informs.

FM Health Fellowship Members Go Overseas

By Norm Wetterau

Jerry and Lillie Ann Rusher

Going to Togo, West Africa for 2 months. We will be serving in L’Hopital de Esperance that is located in Mango, Togo. It is associated with ABWE. To see more about where we will be, you can look at their site ABWE/Hospital of Hope/Togo.

“Samaritans Purse has made the arrangements for our flights. SP paid for Jerry’s airfares also. We will be serving in a predominately Muslim community. When we were in Togo 3 years ago it was farther south in the country. This hospital is an 8 hour drive north of the capital, Lome. We appreciate prayer for us as we face a number of challenges. No doubt Jerry will be busy and will need to adjust to their procedures. The heat and humidity will be discomfiting but nothing compared to what our Lord experienced for us. “

Be Blessed,

Jerry and Lilly Ann Rusher

Alice and Randy Mathewson 

They are in Congo for 4 months where they help in facility development. The solar power unit is not enough for the 

hospital needs and they plan to look into that and help with possible expansion. Also there are numerous other projects they may become involved with, their church, Warm Beach  Free Methodist, donates salary for all the hospital maintenance staff.

Tim Kratzer and his Two Grandchildren

They will be going to Congo in June to visit Deaconess Hospital and also meet with the church leadership as champions for Congo (www.congohealth.org) and  look at the best ways to help out with our limited funds.

The Malaria Vaccine: Covid is Not the Only Issue

The NEJM, March 17, 2022 issue, had an article titled:

A Malaria Vaccine for Africa, an important step in a century-long quest.

(Pedro L Alonso MD and Katherine L O’Brian MD  Global Malaria Program,  WHO

As Free Methodists who have started hospitals in India, Rwanda, Burundi, Congo,

Haiti, South Africa, and Mozambique, this should be important news.  For other Americans, whose vision ends with our shores, it may seem less important.

Frankly many Free Methodist Children around the world die of Malaria and many others are treated in our global medical clinics and hospitals. The article reminds us that

Malaria is still with us with over 240 million cases and 627,000 deaths, mainly 

In children under 5 years of age who live in sub-Saharan Africa, which is where Free Methodists have many of our hospitals and clinics, plus a medical school in Burundi. What the NEJM article does not tell us is that it only costs a few dollars to treat a child for malaria. In Congo a 2 day hospitalization, medicine, IV and blood transfusion only costs fifty dollars, which is more than many families can pay. (Most people earn less than $2 per day)  Children die due to lack of funds, or the inability to travel to get the treatment, yet thousands more do get treatment.

In spite of vector control, nets and medications, malaria deaths have increased in many countries. The article has a map which shows countries where malaria mortality has increased since 2015.  In Congo the increase has been over 25%. If you talk with our Free Methodist doctors and nurses who practice in Congo, they will confirm this and see it every day.

The article discusses both prevention, treatment and a new vaccine which has been tested and given to over 850,000 children in Ghana, Malawi and Kenya. Vaccines are not always easy to develop. There is still no effective vaccine for HIV.  It has taken many years to develop this malaria vaccine and it requires a series of 4 shots. It does no give full protections, but along with other measures, it helps. Yet despite the difficulties of giving a series of vaccine in Africa it did happen in 3 African countries. “The use of routine vaccination channels resulted in vaccine administration in 60% of children who had not been reached by mosquito -net distribution programs, thereby increasing the proportion of children with access to effective malaria-prevention tools to more than 90%, Vaccine implementation resulted in a 9% reduction in all -cause mortality and a 30% reduction in hospital admission of children with severe life-threating malaria”.  NEJM March 17, 2022 1005-1007  Much of  this was funded by the Bill Gates Foundation.

 It can be done. The article also discussed the pushback on developing and testing such a vaccine.  It will not be a great money maker for the biomedical industry, yet in spite of vector control and medications, deaths continued to increase in many countries.

When we consider the 25% increase in malaria deaths In the Congo from 2015 to 2020, this vaccine, along with many other measures, might help. People can read more details in the article itself, as well as on the WHO website under world malaria, which one can google. But I think there are some special lesions that our churches and members might learn. First, malaria is still with us, and in Congo, deaths in children increased by over 25% from 2015 to 2020. Net distribution and treatment with medicine work, but this is not working for many, including those in Congo.

Vaccination can also help, but this does not give complete protection and is costly.

AS one reads the article it appears that malaria seems neglected in relation to other disease in the United States. It is neglected by the medical industry and our medical schools.

Frankly it is also neglected by our churches. Only two Free Methodist churches contribute to medical care in Congo and the figures for other Free Methodist Medical ministries is also low. Most of our churches do not contribute to our medical facilities in the poor countries where we have facilities and in fact, many have no knowledge of what is happening there, or that we even have hospitals. How many of our members, or for that matter Americans,  even know that over one half million children under 5 die of malaria in sub-Sahara Africa. The Gates Foundation knows and we know. Let others know.

An Invitation to the Free Methodist Health Fellowship Fall 2022 Retreat

September 16-18 2022

The Essenhause in Middlebury, Indiana

In Person and Virtual Attendees Welcome

By: Norman Wetterau

For those who come: the program, fellowship, getting back together, sharing and honoring some who have gone to heaven since we last met. 

For all; a very challenging program: Addressing Same Sex Attraction from a Christian Perspective.

Our board felt that this was a very current issue in our churches, and an issue that has theological, social, psychological, and medical perspectives. We have two speakers, plus a panel of our members who will present medical perspectives and respond to the speakers.

Rodney Bassett: Has a Ph.D. in psychology from Ohio State and taught psychology for 44 years at Roberts Wesleyan College, including courses in Human Sexuality. He has published over 100 articles on a variety of research projects with his students, that shared the common theme of viewing psychology through the lens of Scripture and the Christian Faith.

Rev. Bruce N.G. Cromwell:  A member of the FMCUSA’s Study Commission On Doctrine (SCOD), and Superintendent of the Great Plains and MidAmerica Conferences. He has written a book, ”Loving From Where We Stand”. Here he tackles one of the most pressing issues of the day in this practical guide for Free Methodists. In reviewing the book Dr David Bauer says that “Bruce Cromwell offers a vision of the Church’s response to those who experience same-sex attraction, that is truly biblical, is richly theologically informed, and holds the promise of being pastorally and missionally effective…..  He compellingly insists that we must avoid the false alternative of either loving the homosexual or maintaining the biblical perspective.  This is one of the healthiest and most holistically biblical treatments of this issue that I have encountered.”   During his talks on Friday night and Saturday morning he will present key points from the scripture, suggest positions a church might take and then present what our Free Methodist Leadership has chosen as our position. There are two important parts of our position: whether the activity is right or wrong, and how we treat those who are involved in that activity. He proposes expressing love through a welcoming inclusion with accountability.

Rod Bassett is a psychologist who has taught at a Christian College all of his career. In the Friday night session, he will present an overview of homosexuality through the lens of psychology. Do we know why people become homosexual?  Are there biologic differences between heterosexual and homosexuals? What are some of the possible psychological /biological explanations for why some people become homosexual? As part of this discussion, he anticipates talking about different way to conceptualize same-sex attraction and statistics on frequency.

On Saturday morning’s session he hopes to address changing attitudes he has observed among college students. For many of these students this topic has shifted from a Biblical issue to a social justice issue. He plans to discuss Moral Foundation Theory and to spend time talking about psychologic suggestions for being able to love your neighbor when that neighbor h adopted a lifestyle or views that are contrary to your own

Both speakers, social psychologist Dr Bassett and Theologian Bruce Cromwell will address the theme of loving the sinner but not the sin. Is homosexual activity a sin, and if so, how do we individually and as a church relate to those who practice this. (this is really the theme of Dr Cromwell’s book) Also what aspects of this is a sin: the attraction, any sexual relationship or as in the case of homosexuals, any relationship outside of marriage?  Should we as Christians or a church recognize same sex marriage?

There will be over an hour set aside for questions on any aspect of this topic.  On Saturday afternoon there will be a 2 hour zoom session for just college students and young people. There will be a brief review of what has been covered Friday night and Saturday morning but with a special emphasis on how we view and treat homosexuals. Over half of that 2 hour session will be devoted to questions and discussion. 

Saturday evening the speakers will address the issues of companionship and intimacy. If Christians believe that sexual relationships are only acceptable in a marriage between a man and a woman, then how can single people develop close companionship and intimacy at some level?  Also , churches tend to be made up of married people with children. How can the church promote healthy Christian relationships for those who are not married, which could include people with same sex attraction who choose not to have sexual involvement, as well as single heterosexual people, those divorced or widowed?  On Saturday evening several board members will also address how we as health care professionals should care for those in same sex relationships. Are there special health issues that need to be addressed?

All sessions Friday night and Saturday morning will be available on zoom for those who cannot attend in person.  They will need to register and pay a small fee. In addition, our fellowship wants to reach out to college students.  There will be a special 2 hour zoom meeting Saturday afternoon for students or other young adults who may not be members of our fellowship. We hope that as a result some may join our group. Students can attend all the sessions on zoom, or in person if they wish (some scholarships are available) but many may choose to just attend this special session which will include at least a half hour for questions and answers. There will be no charge for students. Address questions to: normwetterau@aol.com

Mark your calendars and share this information with others.  More information on how to register will be sent out in May and will be available on www.fmhealth.org. By mid May, one can register for both the in person retreat and the online sessions on our website www.fmhealth.org .

Pictured: Essenhaus Inn and Conference Center, Middlebury, Indiana