By Randy Finkbeiner

Previous issues of the magazine have introduced the Nakekela Clinic, an HIV/AIDS Hospice project run by the Miskins in South Africa as part of the Mukhanyo Community Development Corporation (MCDC). Word & Deed has set a goal of raising $60,000 (US) in 2007 for this worthy project with God’s blessing. In this article, we get a first hand view of the work through the eyes of one of the home-based care workers.

I am between dreams on a cold night in the high veld of South Africa when the ring of my cell phone startles me awake. Reading the name of the caller tells me everything. I hear the sound of a young woman weeping; she says haltingly, between sobs, “My mother - she’s gone.” I try to offer some awkward words of consolation while trying to clear my head of sleep.

I arrive at her home, which is found in the homeland of the Ndebele people, just before dawn. The house is made of mud, and cow dung is the plaster on the walls, applied with the bare hands of her grandmother. The sun is just warming the horizon and, in the darkness of the home, it takes my eyes a few seconds to adjust. Gradually my eyes find the girl’s dead mother lying on a grass mat which graces the hardened dirt floor. A sheet is neatly tucked around the body; a candle burning nearby offers flickering light to the scene.

The grandmother is weeping in the corner next to the body, and my friend is busy clearing the room of all furniture to prepare for the coming week of visiting family members. Together we pray, and I ask Jesus to come and bring some comfort to the family.

For the purpose of this story, I will call the young woman Zanele. Zanele and her mother have both struggled with Tuberculosis (TB) in combination with HIV/ AIDS. They have been receiving antiretroviral drugs (ARVs), a combination of tablets taken to lower the replication of the Human Immunodeficiency Virus, through the US-funded Right to Care program. Zanele’s mother had been a patient at the MCDC AIDS hospice, Nakekela Care Center. While Zanele is responding very well to treatment, her mother was not.

In all the various community projects being done by Mukhanyo Community Development Centre (otherwise known as Masibambisane or MCDC), home- based care is the project in which I have found great passion. I work together with a team of nine local ladies and other overseas missionaries to care for HIV/AIDS patients in their homes. This strategy of caring for people in their homes has proven to be the best method throughout Africa.

Two weeks prior to the death of Zanele’s mother, I had taken her to a government hospital in Johannesburg. The mother was admitted, and we all had hopes that the mystery of Zanele’s mother’s poor response to ARV treatment would be unraveled.

These are the events leading up to the death of Zanele’s mother as I experienced them: I leave home early to collect several patients and take them to the government ARV clinic. Many patients, unable to walk under their own power, need assistance to get to the clinic. Leaving the clinic, I follow a long, boulder-laden path to a pile of garbage to visit a 65-year-old man who is living alone in nothing but a cardboard shack. I check to see that he has food and is taking his ARV and TB tablets correctly. He has food, but no cooking fuel, and so we go together and pick up 5 litres of kerosene. He has improved so much since I found him struggling for life a few months prior, that I ask him to walk home to get some exercise.

Next, I work my way across a rutted-out dusty road to the home of young girl who is denying her HIV status. The girl’s family went to the local clinic out of concern for their sister. I received a call from the nurse at the clinic asking me to convince this girl to come and take an HIV test. After an hour of diplomacy and a little coercion, the girl agrees to get tested. She agrees only after I convince her that I will keep her status confidential. I carry her feather-like frame to my car, and we make our way to the clinic.

Sometime after this and just prior to helping someone collect firewood for an upcoming funeral, I receive a phone call from Nakekela Care Center. They have just received an unexpected call from the hospital in Johannesburg saying that Zanele’s mother had been discharged. They say she is doing much better and is sitting in the hall of the ward waiting for us to come. After a few shuffles of my schedule, Zanele and I are on our way to Johannesburg.

Through open veldt and bush, we make the two-hour journey to the city whose streets are said to be paved the gold left in the tailings of the surrounding mines. Zanele is in high spirits, excited to see her mother after two weeks of separation. After exploring the dreary maze of hospital wards, we eventually find her mother and are shocked to see her condition.

She was removed from her bed that morning and placed in a chair in the hall of the hospital ward. When we arrive, she is having difficulty breathing and cannot speak. Her body is slumped in the chair, and she has no power to pull herself back up. On our return, Zanele is silent as her mother gasps for life in the back seat. I think to myself, what am I going to do if she dies in the car? We arrive well past dark and there is no moon, so the darkness is palpable. We carry Zanele’s mother to the front door, her feet dragging through the red dust.

I hear the bass of pulsing house music coming from a nearby beer hall, and it makes for an abrupt contrast to the issue of life and death before us. Inside, we find the bed down a narrow hall in a small back room. She collapses but shows a small sign of life when she sees her grandchild. We pray together, and I leave the family. I find my way home and, four hours later, get the phone call that awakened me between dreams.

I find the words of the prophet Isaiah a comfort and an inspiration these days, “The people walking in darkness have seen a great light; on those living in the land of the shadow of death a light has dawned” (Isa. 9:9). A light has dawned. Those words inspire me; that Emmanuel has come, our God has brought his Kingdom to Earth. Mukhanyo, a Zulu word meaning light, and Masibambisane, a Zulu word meaning to bear each other’s burdens, both reflect the transforming power of Jesus Christ. I live in the land of the shadow of death, but Mukhanyo (the light) has dawned. Christ is working in us so that we can bear each other’s burdens (Masibambisane).

Randy Finkbeiner is an American volunteer working as a home-based care worker at the Nakekela project in South Africa.