Loving is Caring

Africa Cries Out Report 2023 No. 013

Xiaohong Duan  June 9, 2023

It has been a year since March of last year, when I first learned about the nonprofit charity Africa Cries Out (https://africacriesout.net/). In that time I have read many of the articles Dr. Jun Xu has published, and it is hard to put my feelings into words. I had never set foot on the African continent, and my impression of Africa was poverty, backwardness and disease. This March, full of worry and boundless expectation, I went to Africa with my daughter to witness the heroes Dr. Xu writes about.

The Senegalese sun blazed like fire and scorched our skin. All along the road from the airport to the base we saw devastation: crumbling mud-brick houses, barefoot children playing on dusty roads. I wanted to ask them: aren’t your feet burning? Don’t they hurt? It was the first time my daughter and I had set foot on African soil. I came for my daughter’s sake, but the trip turned out to mean a great deal not only to her but to me as an adult too. All my life I had grown up on a set rhythm: study hard, go to college, find a good job, work hard, find a good partner, buy a house, buy a car, get married, work hard at the marriage, have children, devote myself to raising them, take vacations… This trip to Africa gave me a different way of looking at life. And the other great gift was that it let me know my own child better.

2023 Africa Medical Mission – Day 1

Our team had 91 members, 26 of them doctors, plus 2 acupuncturists; the youngest teenager was 9. Most of us met at the New York airport to take the same flight, checking more than 40 boxes between us, packed with over $700,000 worth of medicines donated by two large American charities, along with toys and shoes from kind-hearted donors. After we had used up every free checked-bag allowance, we still had three big bags of toys and slippers left. Paid check-in cost $200 a bag. My daughter suggested opening the big bags and splitting the contents into team members’ carry-ons, but unfortunately most of the team had already checked in and left the counter. She went down the line of people still waiting to check in, asking each team member whether they had room to carry more. In the end one big bag was left, and a church co-worker offered to pay to check it. I suggested we first ask the airline whether it could give us one more free bag. Just then Dr. Jun Xu called my daughter over, pulled a pile of documents out of his bag – Africa Cries Out’s certificates, the medicine donation certificates and so on – and had her negotiate with the staff for a free bag. In the end we got it. Afterwards I asked my daughter why Dr. Xu had given her the papers and let her negotiate instead of doing it himself. She guessed all sorts of answers. Finally I told her that a teenager wasn’t the best person to negotiate – Dr. Xu was using the opportunity to train and shape young people.

The base in Dakar is at the Assembly of God Church. Africa Cries Out has built dormitories and a vocational school on the church’s land, where a year’s tuition, room and board are free (supporting one student costs about $2,000 a year). This was our first stop, with walls and a gate – very safe. We stayed in the dormitory, four to a room. We could shower, though because of the water pressure the showerhead only dripped. A local female student told me to fill a big bucket first and then scoop the water over myself with a small basin. Even so, I felt lucky just to be able to wash.

When we reached the base, lunch was ready: sandwiches, fruit and drinks – much more than I had expected. After lunch all the teenagers immediately started sorting medicines, splitting big bottles into small portions of 30 or 20 pills. It was a huge amount of work, starting right off the plane with no time to recover from the jet lag – a real test of willpower. My daughter said she packed about five or six thousand tablets that afternoon. We were going to 11 villages on this trip, so the packed medicines then had to be repacked into 11 large sets, ready for the clinics to come.

I helped pack medicines too. I didn’t know many of them, but I knew levothyroxine very well: I have taken it for more than 20 years. People with hypothyroidism depend on it to stay healthy, and they need regular blood tests of TSH to monitor the dose. At the airport I had heard the doctors talking: in Africa there is little basic testing equipment, and everything depends on experience. But how can you dose an endocrine drug by experience? As I counted out the pills, I gave thanks that, whether in China or now living in the US, I have always had the medical care to keep myself healthy – and I used to think a TSH blood test was the most ordinary thing in the world.

The team was divided into three groups. Ours had 6 doctors, 10 teenagers and 3 non-medical parent volunteers like me; there were no college students in our group. Other groups had students about to graduate and apply to medical school, freshmen and sophomores planning to apply, and medical students. At dinner I heard a young person asking the doctors across the table how to prepare for medical school applications. The doctors were very patient with their advice, including telling them about the challenges on the road to medicine and how to deal with disappointment. I don’t want my daughter to study medicine – I think it’s too hard – but for young people who do, I thought it was a great chance to talk with seniors from different medical backgrounds.

That day I met the hero I most wanted to meet – Anna! (See the article “Ms. Anna Pola – a hero who embraces lepers, tortured girls and the forgotten: Dr. Jun Xu’s 2018 West Africa Journal, Part 1“, in Chinese.)

2023 Africa Medical Mission – Day 2

The teenagers got up at 5:30 to make breakfast for the whole team. Before 6 I walked to the dining hall to help them. Muslim music drifted over from not far away; only the streetlights in the base gave off bright light, a faint red glowed on the horizon, and all around it was still dark.

Chairs had already been set out in rows outside the dining hall, and people were already lining up to see a doctor. Inside, the teenagers had started cooking. Getting up this early to make breakfast for others was probably something none of them had ever done. The gas stove didn’t light automatically, the big square block of cheese had to be sliced by hand, and the melons kept rolling around under the knife… Breakfast – scrambled eggs, bread and fruit – was ready on time at 7:00.

Only at breakfast did we learn that the people waiting outside to see a doctor had arrived at 5:00.

Right after breakfast we went to work. The teenagers were split into three groups: two stayed at the base, sorting medicines and assisting doctors, taking turns at each; the third went out to clinics in the villages.

At the base, each doctor worked with a teenage assistant and an interpreter (the locals speak French).

I saw my daughter, working as an assistant, jogging back and forth between the makeshift clinic and the pharmacy. Patients came one after another. She was very busy.

Here half of all children die young. It is hard to imagine how a mother copes with losing child after child. A 6-month-old baby had a stomach virus; the doctor said to make sure the baby didn’t get dehydrated, give some fever medicine, and it would be better in a few days. The mother said another of her children had had the same symptoms and died the week before. Dr. Yang, the pediatrician, was careful to say that without seeing the patient, you couldn’t conclude from a description that the child had died of the same cause – but if it was the same cause, dehydration can kill a child. My daughter saw that mother’s grief with her own eyes. Another mother had spent half her family’s monthly income ($10) to see a local doctor and buy medicine, but after three days there was no improvement – the doctor had prescribed the wrong medicine. My daughter saw that mother’s helplessness and pain too. She came and asked me whether she could give the mother her own $10, and specifically told me not to tell anyone, because your right hand shouldn’t let your left hand know what it is doing (Matthew 6:3: “But when you give to the needy, do not let your left hand know what your right hand is doing”). I was really surprised to hear her say this – my teenage daughter often argues with me about the Bible’s teachings. I hesitated over whether to write this part down. In the end I decided to, because it is a side of her I had not known.

Lunch was simple sandwiches. The doctors and teenagers had no break after eating and went straight back to seeing patients.

Many people worry about infectious diseases in Africa. I watched Dr. Shao holding a little baby and teaching the mother how to burp it – the love in his face was truly moving.

Sorting medicines is simple, tedious work in which you can’t make mistakes – truly a challenge to your willpower, and real training for the young people.

2023 Africa Medical Mission – Day 3

Day 3 was a Sunday with no clinics. In the morning we went to church in Dakar, at noon we had Brazilian barbecue, and in the afternoon we visited the House of Slaves on the island of Gorée.
The church in Dakar is a very unremarkable, simple little yellow house with a roof of cheap aluminum strips, and the rows of chairs are packed very close together.

I couldn’t understand a word of the worship songs, but the singing and the music moved me almost to tears. Suddenly a voice sounded in my mind: “This is my house.” I looked around – this was probably the plainest church I had ever been in. I was deeply shaken, and I couldn’t hold back my tears any longer.

A sister who is also a Christian messaged me saying it would be nice if we could offer a song. I told her, a little embarrassed, that I’m tone-deaf but could go up and hum along with her. While I was humming with her, I felt moved to tell the story of my healing.

In 2009 my parents came to the US and we went on a cruise together. The skin on my hands was peeling badly. When I got home I saw a doctor and told him I suspected I was lacking some vitamin. The doctor said it was just dryness – use more hand cream – and wouldn’t order tests. Then I told him I was actually exhausted every day and still suspected a vitamin deficiency. He asked if I snored. I said no, but I would wake up suddenly as if I had choked on saliva and was suffocating. So he sent me for a sleep study, and the conclusion was that I needed a CPAP – a machine like an oxygen mask. When my younger daughter saw me wearing it she asked, “Are you going to die?” Unfortunately I’m claustrophobic and simply couldn’t wear the machine to improve my sleep. I tried hard to get used to it for a long time, but in the end had to give up on that treatment. After that, for a long stretch, I felt every day as exhausted as if I’d stayed up all night, even though I went to bed after 9. Getting up to make the kids breakfast and taking them to school in the morning took sheer willpower. Life felt very dark during that time. Then early last year I made a point of going to a prayer meeting led by a pastor invited from Africa. Afterwards, the friend who interpreted for him asked him to pray for my healing. I don’t remember what he prayed, only that he said everything would be all right. Feeling nothing at all, I said thank you and got ready to go home. I walked to the parking lot, and just as I reached my car I started vomiting – though of course breakfast had long been digested and there was nothing to bring up. Then I felt a ball of air pressing in my chest and I kept burping all the way home; it was still stuck there. I asked my husband to pound hard on my back until I let out a huge burp, and then I felt much better. Then I was busy until evening and had forgotten all about it. As I was getting ready for bed, the prayer meeting suddenly began replaying in my mind. To be honest, although I’m a Christian and have heard many stories of miraculous healing, I didn’t really believe it could happen to me. Just before I fell asleep, the words “the name of Jesus has great power” kept repeating in my head, so I silently said: in Jesus’ name, I declare I have been fully healed. I will have a good sleep. Tomorrow, everything will be new and be changed. When I woke up the next day I felt truly different – full of energy. And so my vitality and strength came back. Without that healing, I don’t think I would have had the strength to take my daughter to Africa. What I never expected was that my story would also give hope to a teammate with the same condition.

The island of Gorée was the largest slave-trading center from the 15th to the 19th century. Male slaves were priced by weight; if they weren’t heavy enough, they were fed until they reached the weight and then sold. Children were judged by their teeth, young women by their breasts. Each slave cell is tiny and held about 15 slaves. There is a door called the Door of No Return, meaning that those sold off the African continent would never have the chance to return to this land. I really wanted to feel what it was like for those locked up here and treated like livestock. Sadly, even after visiting this slave camp in person, to me it still felt like a historical event; I did not feel that pain and despair.

2023 Africa Medical Mission – Day 4

When Moses was to lead his people out of Egypt, one scene in his dealings with Pharaoh is when “the Lord told Moses to put his hand inside his cloak, and when he took it out, the hand was leprous; then He told him to put his hand back inside his cloak, and when he took it out again, the leprosy was gone.” That was where I first learned of leprosy. So I always thought it was a disease from thousands of years ago that didn’t exist in real life. How ignorant I was. Of course, some scholars believe the leprosy of the Bible is not the same disease as leprosy today.

Leprosy may be the oldest plague in the world. Its origins are hard to trace; according to existing records, Egypt, India and China are considered its three main original foci. Today more than 200,000 patients worldwide suffer from the disease.

What makes leprosy more frightening and hateful than other infectious diseases is that it disables and disfigures its victims, leaving them looking “neither human nor ghost”, which instills an insurmountable fear in healthy people. Add to that the lack of understanding that leprosy is a very chronic disease of low infectiousness caused by Mycobacterium leprae. Leprosy patients suffer not only the torment of the disease but also the mental torment of being shunned by the world. Our next stop was a leper village and two villages around it. We would cross Senegal, driving more than 700 kilometers to a hotel near the leper village.

At a gas station we met begging children. These children are controlled by marabouts and beg along the streets; if they don’t bring in enough money, they not only go without food but are also beaten. In 2013 there was a tragedy in which nine children controlled by a marabout were burned to death. Marabouts tell parents they will raise the children and teach them the Quran. Parents agree to hand their children over either for religious reasons or because of poverty. For me, I would never give up my child no matter what. But when I imagined being so poor that I couldn’t feed my children, without doctors or medicine, unable to keep them alive, a wave of sorrow came over me and tears ran down my face. In such circumstances, faced with a choice between giving a child a chance to survive and the strong likelihood of abuse, I truly don’t know what I would choose. We didn’t give the begging children money; we gave them food. The radiant smiles on their faces when they got the food burned my eyes.

When we reached the hotel in the evening, it was as if I had suddenly entered another world. The sharp contrast felt a little unreal: after a whole road of barren poverty, looking at the cool swimming pool in front of me, I felt as though I had jumped through space.

Africa Medical Mission – Day 5

The three groups set off to different villages. Mine went to the leper village, just a 10-minute drive from our hotel. When our bus arrived, the villagers welcomed us beating African drums.

The villagers had put on their best clothes to wait for us. I was helping the teenagers with patient intake. Looking at villagers who had once been ravaged by leprosy, I felt sympathy, but also fear and a wish to avoid them. Suddenly these words popped into my head: “They are my beloved.” I froze, and tears started to flow. In an instant the fear in my heart was gone, and love welled up inside me.

(“After Jesus was baptized, He came up immediately out of the water; and behold, the heavens were opened, and he (John) saw the Spirit of God descending as a dove and lighting on Him (Jesus), and behold, a voice from heaven said, ‘This is My beloved Son, in whom I am well-pleased and delighted!'” Matthew 3:16–17.) If I hadn’t experienced it myself, I would think I was writing a fantasy novel.

The teenagers handled several jobs – patient intake, assisting doctors, and the pharmacy – taking turns. I didn’t see a single one of them shrink from these patients.

After the day’s clinic I talked with a few of the doctors. Dr. Chen had seen three leprosy patients in the active stage. I asked if he was afraid. He said there was nothing to fear: he had protection, as a doctor he would never shun any patient, and infection requires close contact with an untreated leprosy patient over many months. The disease is not spread by casual contact with leprosy patients.

Dr. Wang, a woman doctor working with a woman interpreter, met several women whose pain was caused by female genital mutilation. None of the male doctors had mentioned it – presumably the villagers didn’t bring it up when they saw a male doctor. Female genital mutilation was a custom even further beyond anything I had known. (See the article “Ms. Anna Pola – a hero who embraces lepers, tortured girls and the forgotten: Dr. Jun Xu’s 2018 West Africa Journal, Part 1“, in Chinese.)

There was also a young patient with a large tumor covering half his cheek. Without any medical equipment, our doctors could do nothing, and advised him to go to Dakar (the capital) for diagnosis and surgery. I imagine that is a medical bill he could never afford.

We saw more than 200 patients in the leper village. When no more patients were coming, we went back to the hotel early to rest. I luxuriated in a shower with strong water pressure, washed my hair in comfort, and slept in an air-conditioned room. This is true happiness – a happiness I used to have every day without realizing it.

According to the original plan, after the clinic we would hand out food, shoes, toys and other aid to the villagers in the evening. But plans can’t keep up with changes: the aid supplies didn’t arrive on time. Still, as planned, we went back to the leper village once more. This time even more people came. The radiant smiles of the local children made me marvel: they have almost nothing, yet they are still happy.

The young man with the large tumor on his face came too, and everyone prayed for him, hoping he would soon recover.

2023 Africa Medical Mission – Day 6

Day 6 was another long journey back. On the bus I asked some of the teenagers how they felt. One girl said she felt helpless: changing these people’s living conditions would take a systemic effort, and volunteers like us couldn’t make much difference – we couldn’t change their circumstances. She also wondered why, when we had spent two days on the road passing through places that were just as poor, we went so far instead of helping the people nearby – why waste two days? I gave her the answer as I understood it and encouraged her to seek answers to her questions – to ask Dr. Xu, to ask Anna. I think taking part in activities like this can develop young people’s ability to think and question, and a spirit that doesn’t lose heart.

We had two big King Long buses on this trip. The air conditioning on mine broke down on the way back, and we joked on the bus about our good luck in getting a free sauna. My daughter was on the other bus. At a stop she came over in a short-sleeved shirt and shorts and insisted on swapping with me. As a mother, I would rather suffer myself so my child could be more comfortable – but that natural human love isn’t necessarily what’s best for a child. With a slightly aching heart I moved to the other bus. The girl sitting next to her told me my daughter had been very worried about me. I was deeply touched and very proud of her: she could have just called me over and stayed on the air-conditioned bus herself. But God has a good purpose in everything. The people who had been sitting around me were Dr. Han, a leading cardiologist; Professor Zhang, who teaches film history; and Preacher Hsiao. I believe my daughter’s conversations with them gave her a lot to think about. Afterwards they all told me what a loving and thoughtful child she is. On this trip I saw many sparkling qualities in my daughter that I had never seen before. I had brought her to Africa mainly to help her, but it turned out to be me who was helped. As a first-time mother of a teenager, out of fear I had been holding on to her tightly, and she had fiercely rebelled. This mission taught me that I need to let go and let her find her own goals in life. She may fail, she may fall, but that is part of growing up.

2023 Africa Medical Mission – Day 7

This day we saw patients in a village not far from the base. After a bumpy ride along dirt roads we got out and walked, with the supplies loaded onto the local means of transport – a horse cart.

When we arrived, the villagers were already slowly taking their seats under a shelter, waiting for us. Senegal’s main faith is Islam (over 90%), and villages are organized by tribe. If the tribal chief doesn’t agree to our coming, even free medical care and free medicine can’t get in. Our team stood under the scorching sun while the pastor thanked the chief for allowing us to come, then waited for the chief to finish speaking, then for someone whose role I didn’t catch to finish speaking. By then the soles of my feet felt hot, and I kept shifting my feet to cool them – and I was wearing sneakers with thick soles. Did the barefoot children running around burn their feet on the hot ground?

Finally our team could go in and start seeing patients. The first patient, of course, was the chief. I had lunch rather late, and not long after eating a sandwich I felt sick and threw up violently, bringing up bile until my throat felt burned by stomach acid. The sandwich had probably gone bad. Although I felt unwell, inside I felt how fortunate I am. Our lunch sandwiches had been kept in a cooler with no ice, and in heat like that it’s hard to keep food fresh. I thought of how, when I travel with a cooler at home, I can put in as much ice as I like, and even if it melts, I can just pick up a bag of ice at any gas station and pour it in – no problem at all.

Lots of little children stood outside. My daughter blew up gloves like balloons and gave them to them, and that alone kept the children happy for ages. Sometimes I think that when material things are too plentiful, it actually becomes hard for people to feel happy.

When the day’s clinic ended, there were still patients lined up outside. I couldn’t meet their pleading eyes and could only silently lower my gaze. We had used up all the medicine we brought and had to end the clinic.

I asked the team leader whether the teenagers could have a ride on the horse cart. There was only one, and my daughter had a chance to try it, but she said to me, “No thanks, Mom – it’s too much of a burden for the horse.”

A big local problem is that rubbish isn’t collected. There are plastic bags everywhere. Without modern products coming in, the waste of a traditional way of life would all be biodegradable; but they have modern products imported from outside without the modern way of life that goes with them.

2023 Africa Medical Mission – Day 8

The two buses were heading in different directions. Everyone was seated and ready to go when the order came to switch buses – we had boarded the wrong ones. I no longer asked why. By my logic, wouldn’t it be easier to just switch the routes? After these days I had realized that here I could no longer think with my common sense; my logic often didn’t work.

After a long, bumpy ride we reached a hotel. The driver no longer knew how to get to the village we were going to, so while we waited for someone to come and guide us, we took the chance to use the hotel bathroom. By now I was used to walking into a hotel as if into a different world, and had adjusted to the stark gap between poverty and wealth.

This time we went to a school run here by a Chinese church, with a courtyard and an iron gate. After 250 numbers had been handed out, I helped the teenagers give the local children fluoride treatments. Almost every child had a mouthful of cavities; they had no toothbrushes or toothpaste at all.

The villagers clean their teeth with a twig: when you chew the end, it splays out like a brush. Even these twigs probably have to be bought; not everyone has one. We gave the toothbrushes we brought to a local staff member, and the children chased after her, scrambling for them. One girl was watching a missionary from the Netherlands teach her friend how to brush. She stared at me and gently patted my arm. The person handing out toothbrushes had just two left, with a crowd of children still chasing her. I knew it wasn’t quite fair, but under that girl’s pleading gaze I went over and got a toothbrush for her anyway. Next year I’ll bring children’s toothbrushes and toothpaste for these kids.

The Chinese church had prepared local food for us – it was truly delicious.

There was constant banging on the iron gate. We still had medicine, so in the end some more villagers were let in. One mother who came in had probably been told earlier that the numbers had run out. Even once inside, while queuing for an extra number, she still wasn’t sure her child would get to see a doctor. She kept pointing at her child and looking at me with pleading eyes, saying things in a language I couldn’t understand. However much I assured her that her child would see a doctor, she couldn’t understand me at all; only when she got a number did she finally breathe a sigh of relief. Day 8 also ended with our medicine running out – and so ended the whole medical mission.

After the mission was over, the medical team gave health checkups to the staff at the base, many of whom had given up comfortable lives to come to this barren land. Although this trip was a cleansing of the soul for both my daughter and me, and its powerful impact makes us want to keep doing something for these children and villagers, I could never give up my life the way they have and come here.

2023 Africa Medical Mission – Days 9 and 10

With the medical work all finished, on the last day we went to see some animals – though not a real African safari.

Goodbye, Africa. I will definitely be back.

About the author: Xiaohong Duan is a math teacher in California.

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Editor of this issue: Juanjuan Cao

Editorial team: Yuanchun Guo, Hui Liu, Xiaohong Duan, Hao Wu, Juanjuan Cao, Grace Huang, Daniel Xu, Zhifeng Yang

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