Here in Antsirabe we are staying on the grounds of the Lutheran Hospital. Dr. Harison came here to work because he did not want to work in a wealthy hospital where he would need to wear a suit and tie. After completing his residency on mainland Africa, Dr. Harison returned to this Lutheran Hospital to work. He now is the chief medical officer of the hospital and is in charge. He has been working here for over twenty years. This morning we were able to tour the facility. The main building of the hospital is 114 years old and is still in working order.

However, a hospital in Africa is much less modern than those you will find in the United States. One large difference is that nurses in the hospital are responsible for passing medications to the patients, but the families are responsible for providing food and caring for the patients' hygiene needs. There is a building where the families can stay, but the rooms are primitive with no beds or cots, just a cement floor. There is a building where the hospital workers can stay as well. The Lutheran Hospital here has 200 beds and has medical, surgical, pediatrics and maternity units. These units consist of big open rooms with beds placed in them. There are no curtains separating patients, so you can see all of the other people you are sharing the room with. The call lights are cords that light up a light bulb at the nurses' desk. The IVs hang from metal hooks above the beds, and the IV fluids are spiked with needles and are vented. There are no IV pumps. There are manual blood pressure cuffs attached to the walls. All of the equipment and beds are outdated. There appears to be just a piece of foam placed on metal frames for the patient beds.

We were able to see a woman who had given birth in the middle of the night, and the only pain medication she received was Tylenol. There is another patient in the hospital that Dr. Harison performed surgery on Saturday morning before we headed out to our clinic for a gunshot wound. He is recovering well but also only received Tylenol for pain. The minimal amounts of medication used here are just phenomenal.

A unique part of the Lutheran Hospital is that all of the staff gather in the dispensary (pharmacy) in the morning at 7:00 AM for devotions. A previous LCMS pastor who has worked with Dr. Harison and supported Mercy Medical Teams helped to purchase a sound system for the hospital. The sound system is used to broadcast the morning devotions throughout the hospital. How neat! I cannot think of a health system or hospital in the United States that would even think of doing such a religious act. Also before each surgery the surgical team stops to pray before they begin the operation. How powerful is that?! This morning at devotions they sang "A Mighty Fortress is our God" to welcome us here to Madagascar.

After touring the hospital grounds we had another breakfast of fresh pastries and scrambled eggs and then loaded the vans to head to clinic. We drove about two hours today to reach the village of Vinany. The drive provided gorgeous views of the countryside as we traveled through rolling hills, rice paddies and small villages. The landscape seemed to become a bit more lush today.

As we pulled up in front of the church we were greeted by hundreds of people sitting in front of the church and beneath trees waiting our arrival. They welcomed us and then sang "What a Friend We Have in Jesus". The clinic today was again held in a Malagasy Lutheran Church where the LCMS is present. We set up the clinic in the sanctuary of the church with the same stations: intake, triage, providers and pharmacy. There are pastors working in the church to share the gospel story with those patients who are there.

Our adventure for today was that we forgot to bring about four boxes of medications that were needed for the clinic. The boxes we left behind at the clinic contained blood pressure, pain and other miscellaneous medications. This made it very challenging to fill any prescriptions at all. So, the pharmacy filled what prescriptions they could and then two hours later a taxi driver delivered the missing medications. Those working in the pharmacy spent the rest of the day catching up.

Jo spent the day working in triage again. She enjoys interacting with the patients and working with the interpreters. She is able to speak with many Malagasy people in this role. I again worked in pharmacy. Today was a very busy day with the adventure with the missing medications. The amazing part is that the Malagasy people waited very patiently for over two hours to receive medications without any impatience or complaints. That is just unreal. Today our Mercy Medical Team saw 362 patients and filled 832 patients. We managed to accomplish this feat in about six hours (10:00 AM to 4:30 PM)!

The drive home offered the same great views of the Madagascar landscape, and we were able to see the beautiful sunset. A great way to unwind from the day. Upon arrival at the guest house the kitchen staff had another decadent dinner waiting for us. We had these tilapia enchiladas in cheese sauce as an appetizer. This was followed by pork sausage, vegetables and french fries. Dessert was warm, caramelized pineapple. The food here has been amazing so far!

The evening finished with devotions and packaging up another set of medications to dispense for the clinic tomorrow. Right before bed we were able to see the Southern Cross low on the horizon. A neat constellation to see here in the Southern Hemisphere!

“Hesed” is a Hebrew word that means “kindness”, “mercy”, “loyalty”, “loving-kindness” or “steadfastness.” It’s the way God intends us to live together—a “love your neighbor as yourself”, active, selfless, sacrificial, caring-for-one-another brand of living contradictory to our fallen natures. The “Heseders” are continually looking to work together to share some small measure of God’s extraordinary love. Won’t you join us?