By Dr. Arthur Miskin

South Africa is by far the most developed country in sub-Saharan Africa. The country definitely enjoys a great measure of economic and political prosperity. Yet, in the midst of much apparent well-being, South Africa is a land of stark contrasts. Extreme wealth exists alongside extreme poverty. While the rich seem to be getting richer, the poor seem unable to shake loose the shackles of their poverty. There is, however, one thing ominously threatening to destroy our relative stability, and that is HIV/AIDS. This destructive disease has reached epidemic proportions, particularly among the poverty stricken classes of our population. HIV/AIDS carries many ramifications into all areas of life.

Consider these sobering statistics:

• South Africa has more people living with HIV/ AIDS than any other country in the world, according to the United Nations.
• With around 1,800-2,000 new cases per day, South Africa has the world’s fastest growing rate of infection.
• Statisticians at the University of Cape Town estimate that there are about 5.4 million people living with HIV/AIDS in South Africa. This figure is set to rise to around 7 million over the next ten years.
• HIV/AIDS is no respecter of persons, afflicting people at all social levels and in every economic group. In some South African colleges and universities more than 20 percent of the students have tested HIV/AIDS positive. The armed forces, too, are hard hit. Studies have shown that 89 percent of soldiers who volunteered for testing were found to be positive.

What do these statistics mean for ministry in South Africa? Consider the fact that

• as more people within the reproductive age groups die, the number of orphans increase. Should current trends continue, it is estimated that by 2010, there will be around 1.6 million AIDS orphans in South Africa. Already there are many homes within rural areas occupied and run by children who have lost both parents.
• the people most severely affected by HIV/AIDS are those who are economically active. It was already estimated in 2005 that at least one in 10 deaths among those 20 to 40 years old would be due to AIDS-related causes. This has a vastly negative impact on human productivity and on life expectancy. It has been estimated that the population growth rate declined from 2 percent in 1999 to 1.9 percent in 2000, and the growth rate was projected to drop to 0 percent in 2011.
• AIDS-related deaths will rise from 400,000 per year (at present) to 800,000 to 1 million per year. Some estimates suggest that life expectancy will be reduced to 38 years by 2010.

How should Christians respond?

In the face of such overwhelming realities, what are we, as Christians, to do? We know that human sin lies at the heart of this spreading epidemic. Sexual immorality is rife in South Africa and is indeed the scourge of large parts of Africa itself. But can we squarely lay the blame at the feet of sin alone? I think not. Many other factors play a role, such as crippling poverty, hunger and malnutrition, lack of proper education, and prostitution as a means to survival. Sexual abuse of women is still rampant and child abuse is increasing alarmingly.

As Christians, we also know that the radical cure for this disease is the gospel, “for it is the power of God to salvation for everyone who believes” (Rom. 1:16, NKJV). For this reason, we too must not be ashamed to bring this life-giving remedy to a people perishing in sin and despair. Oftentimes, however, these people are too weak and sickly to even listen. And so a cup of cold water is brought in the name of Christ the Saviour to bring strength and healing sufficient to enable hearing of God’s saving grace in the gospel.

Nakekela Clinic

It was to this end that Nakekela Clinic was established. The word means “we care” and the focus of the care is towards both physical and spiritual well-being. The project was conceived of the burning question: “How do we bring a cup of cold water to those who are too sick and hungry to hear the good news?” It became very apparent that the word ministry had to be accompanied by some form of deed ministry. Quite providentially, a black pastor, working in the KwaNdebele area of South Africa, became aware of an abandoned building in one of the villages. With the help of Melanie Prinsloo and others of the Masibambisane Development Corporation, the building was converted into a step-down-hospice facility. It has six beds which are nearly always occupied.

Nakekela Clinic is headed up by Dutch pharmacist/missionary Joke Parre, one of the pioneers of the work. My wife, Sonja, and I provide medical care as far as possible. We are assisted by a variety of nursing personnel and home-based care workers who offer both in-patient and home-patient care and follow-up.

We might wonder what impact a little six-bed facility might have on a problem as overwhelming as the one before us. We do hope, in God’s time, to expand the work, but we have also come to realise that only God can swing the tide of the epidemic. Whether we have a six-bed or a 20-bed facility right now, we need with all of our might to do whatever our hands find to do (Eccles. 9:10).

We have been amazed at some of the things that God has done before our very eyes. Although many patients, sadly, have died, some who have come in unable to walk eventually walked out. They know full well that it is Jesus who alone can cause the lame to rise and to walk. There is no greater joy than sharing the blessed news of Jesus with people who do not know who He is.

Prayer: Our greatest need

What is our greatest need right now? Confronted with the sheer magnitude of the problem, the devastation, and the poverty, we might want to pour vast amounts of money into a variety of projects. This is the easiest thing to do, but not always the wisest, and is not what we need most. What we and all other mission workers need most are the prayers of God’s people, for “the effective, fervent prayer of a righteous man avails much” (James 5:16, NKJV). Our sovereign God alone can remove this mighty mountain that threatens to crush all before it. Jesus said, “If you have faith as a mustard seed, you will say to this mountain, ‘Move from here to there,’ and it will move; and nothing will be impossible for you” (Matt 17:20, NKJV).

There are many things that you can pray for:

• Pray for heartfelt, Spirit-wrought conviction of sin in Africa, together with true repentance and faith, for this alone addresses the heart of the problem.
• Pray for specific missionaries, their families, and their work. They are subjected to many fears, discouragements, and hindrances by the devil and his hordes.
• Pray for our work at the Nakekela Clinic, which we hope will come under the auspices of Word & Deed. Ask that we will maintain a healthy balance between Word and deed. Because the needs are so vast, it is easy to water down the good news to a social gospel.

I end with the words of Dr. Flip Buys, principal of Mukhanyo Theological College: “Missions is not only done out there, far away from us, in the dry dusty fields of KwaNdebele or Northern Zambia or somewhere else in the world. Missions is also done in your closet where you plead on your knees: ‘Let Thy kingdom come, let Thy will be done.’” Missions is also done in your family devotions where you lay the names and the needs of the missionaries before the feet of our Father at His throne of grace.

Dr. Arthur Miskin works for the Masibambisane Community Development Corporation at the Nakekela Hospice, teaches at Mukhanyo Theological College, and preaches at Rietvalei Reformed Church of South Africa.