Dear friends:

Since my report three months ago, we have enjoyed two marvelous developments here in Nampula. Both were borne out of a state of distress, which turned out to be only a prelude to unprecedented blessing. 

“The full soul loatheth an honeycomb, but to the hungry soul, every bitter thing is sweet.” That is a principle stated in Proverbs 27:7 and explains why God often precedes His bounty by a spell of famine. God planned for Adam to sense the want of a helpmeet suitable for Him prior to creating Eve, that he might better appreciate the great blessing she was. Peter and Andrew fished all night catching nothing – to enhance the joy and to underscore the divine element in the amazing event which took place the next morning when Christ stepped into their boat. Even so today, God may lead His people into trial simply as the means of helping them savor the blessing He was planning for them all along.

Our first unprecedented blessing was our sudden ownership of two much needed automobiles. It might appear that we surfeit in vehicles already, having two Land Rovers and two hardy off-road troop-carrier trucks and a Toyota pickup. But all of those vehicles are between 30 and 40 years old except for the “new” Land Rover which is 15 years old. None of them can be driven across the country without costly, major breakdowns stranding us in the bush every time. Recently all five vehicles were out of commission awaiting major repairs. The Mission was forced to depend solely on Grace’s car, only available because she was out of the country. All projects that required a truck were suspended for weeks.

We have not bought an unused vehicle in 32 years because the funds did not exist for such purchases. But when we found ourselves with no functioning transportation, Grace Medical sent out a request for help, and in only 14 days $90,000 was supplied via many friends in the US! South African believers savvy in such matters immediately obtained for us a brand new 8-ton truck that exceeds anything we would have dreamed of owning before, followed soon after by a 2019 like-new Toyota twin cab pickup. After driving Land Rovers for 30 years and now looking forward to a comfortable air-conditioned vehicle, Julie and I feel we are in the lap of luxury even though we are still in Africa. Thank you to all our friends! And we say thank you to God who makes such things possible!

The second remarkable and far more important chain of events took place in the medical work.

We are glad that in Nampula, COVID remains a non-event. No one has an explanation for this. If Nampula were in South Africa, our next-door neighbor, our hospital would have admitted 2,300 patients by now for oxygen treatment, for an average daily census of 114 patients, with 500-1,000 total deaths already, or 2.5 to 5 deaths per day. Instead, we had 11 patients in June when the epidemic first passed through, four in July, and then only six over the following five months! We thank God that only three patients have died, not 1,000!

Part of our preparations for the anticipated devastation involved ordering, shipping, and importing a massive oxygen producing plant from Europe that filled a 40-foot container and cost $83,000 to obtain. We spent another $10,000 importing from South Africa the oxygen plumbing and fittings required to supply a 30-bed tent infirmary with oxygen at every bedside, beyond the 38 oxygen ports already inside the hospital. This would have allowed us to treat 68 patients with oxygen, the maximum our oxygen generator could accommodate. Note that if conditions in South Africa prevailed here as well, we would have needed oxygen for an additional 46 patients daily, impossible for us to give! The preparations we did accomplish were paid for using money Grace Medical had saved for funding the first year’s operation of the hospital while we searched for ways to make the center self-supporting financially.

The oxygen plant arrived in September and today it sits on our property still in its crate and original packing material. Though so far it has not been needed for treating COVID patients, through the remarkable chain of events described below, it has been the means of propelling forward our medical plans, solving in quick succession three long-standing and perplexing problems!

Those problems were:

1.      A seven-month delay at the Health Ministry in signing the agreement for our hospital to begin treating patients.

The two most important elements in the agreement were 1) freedom to charge for services according to each patients’ ability to pay without forfeiting our privileges as a non-profit hospital, and 2) assistance from the Health Ministry in importing medications and medical equipment obtained through our own suppliers.

We were thankful that, at least by external appearances, everyone at both the local and national level had favored our proposals and had sought to be helpful. However, the Ministry’s hesitation to formalize the agreement grew more and more perplexing with each passing month.

2.      My admission into Mozambique’s physicians’ guild.

Membership in this guild is equivalent in the U.S. to holding a license to practice medicine. Since I will be the only physician on the hospital staff until other missionaries come on board, our hospital would not be permitted to open its doors without my first being received into the guild. Though I have renewed my original Mozambican license year by year, when the guild was inaugurated some time ago I was not practicing medicine and so was unaware of the need to upgrade my license to conform with the new regulations. Since I have been licensed previously in Mozambique, but also have been inactive in medicine for many years, acceptance into the new guild could be made easy or made impossible depending on the disposition of the authority overseeing my application.

Unfortunately for me, when I consulted a former Minister of Health, chief surgeon of Mozambique, and personal friend of mine from back in the days when I was active in surgery, I was warned that the individual controlling admission of surgeons to the guild was the very man who had made strenuous efforts to close our surgical block years ago, an effort that boomeranged when the Minister of Health chose instead to let us build and operating our own surgical hospital. I mentioned this ominous fact in a previous newsletter and noted that it would be interesting to see how the Lord got us past this obstacle. The answer is in this report, and it was a surprise to me when it happened.

3.      Constant opposition from the National Pharmacy Board.

This board has consistently denied all our requests to import supplies vital for the hospital to function – not only medications but also seemingly harmless materials like EKG and ultrasound gel, surgical lubricant, oxygen masks, the tubing for anesthesia machines, colostomy supplies – almost anything of a medical nature! Even if we could obtain pristine materials donated straight from factories in the U.S., and even if the items were desperately needed to save lives during COVID – material such as oxygen masks and our oxygen generator – we were never allowed by the Pharmacy Board to import them, even under special once-off emergency dispensations.

Like David’s miserable circumstances at Ziklag (I Samuel 30:1-6) just days before the surprising events that caused the men of Judah to summon him to return to Israel and reign as their king, this story of God’s special favor began with a sleepless night chafing at a trap I thought had been set by the evil one.

Our miserable circumstances were these: Grace Medical had just invested three months and $83,000 ordering and shipping the oxygen generating plant needed to treat patients at our hospital which was serving as the COVID treatment center for our city of 1.2 million people and as the COVID referral center for the province’s additional 4 million inhabitants. Before the plant could leave the port in Germany, we had to obtain “prior authorization” from the National Pharmacy Board to import it once it arrived at the Mozambique port. We knew the board would refuse this request regardless of how desperately oxygen might be needed, but we had arranged to get around this problem by having the Ministry of Health handle the importation in our stead. According to the agreement which had been worked out in our as yet un-signed pact with the Health Ministry, the Health Ministry would import in its own name all the medical items we ordered and shipped, and then it would deliver them to our hospital where they would be given back to us.

As planned, the importers for the Ministry of Health secured approval in their name from the Pharmacy Board for the importation of the O2 plant, permission Grace Missions could never have received, and with that authorization the 40-foot container was allowed to depart from Germany. But two days before the ship reached our local port, the clearing agents for the Health Ministry informed me that Mozambique customs was refusing to process the paperwork for the oxygen plant without the Ministry first presenting a deed of ownership for the machine in their name. According to them, I had no choice but to sign over ownership of the plant to the Ministry of Health. I told the Ministry I was willing, but first I needed a written statement from them promising to deed the plant back to Grace Missions after importing it. This they refused to give. With no other option open to us, they insisted that while we might be allowed to use the oxygen plant for our hospital, the “goose that lays the golden eggs” would forever belong to them if they imported it.

The problem was that this costly investment was needed by Grace Medical only during COVID. Once the pandemic passed, we planned to sell the plant and get most of our money back so that we could proceed with opening our surgical center as originally planned with funds in hand to cover the first year of operation. Deeding the plant permanently to the Ministry of Health not only jeopardized any long-term use of the machine, it also made selling it impossible.

So I refused to transfer ownership. I called the National Pharmacy Board pleading with them to let us import the machine in our own name, but this was futile. We were trapped in a situation with no resolution. Given the existing circumstances, the machine could never be imported; we would lose our entire investment; we would have to pay heavy fines for shipping a medical item to Mozambique without prior authorization to import it; we would have to pay $200 rent for every day the container sat on the dock, or $6,200 per month; and the device would save no one’s life, the only way we could justify what we had already invested from the Mission’s resources! For a while I wondered if it was all a scheme by individuals who coveted for themselves what we had arranged for the people of Mozambique at great sacrifice to the Mission.

So it was that I spent a sleepless, frustrated night, tossing in bed and contemplating the bitter situation the Mission was in – oblivious to the fact that God had led us to this point for good, just as surely as He once led the children of Israel onto a sandy isthmus at the edge of the Red Sea. Though it seemed impossible, God was about to provide a marvelous deliverance – more than that, an overwhelming blessing – that to me was still unimagined.

At some point during the night the thought materialized that people use oxygen for industrial purposes as well as medical. The next morning I asked the factory in Europe to email a new invoice for customs describing the machine as being for industrial use only rather than medical purposes. We hired our own clearing agent and processed all the new paperwork in the name of Grace Missions, stating the plant was for industrial, not hospital use. No pre-authorization to import was needed, no permission from the National Pharmacy Board! To our relief, this time the paperwork went through customs with no questions raised!

It was still frustrating that now the machine could not be used to save lives, but at least we had the possibility of recovering our investment by selling it to someone else who could use it that way. I called the hospital suppliers in South Africa where COVID was creating an acute need for oxygen, letting them know we had a brand-new oxygen plant already on the continent and available for immediate sale. Within days potential buyers from different hospitals in southern African nations began contacting us.

We also spoke with the donors of the Provincial Hospital being constructed across town, telling them how much money they would save if they bought and installed our machine in the new facility. At local rates, our plant produces enough oxygen to pay for itself every nine days. They put us in touch with the procurement engineer responsible for outfitting the new hospital, a man who works directly under the Minister of Health and is responsible for the medical infrastructure of the entire nation. We called his number and to our surprise, the man was visiting relatives in Nampula even as we spoke, expecting to fly back to the capital the next day. He had been spending a fortune on oxygen in Maputo, and when he heard we had an oxygen generator there in the city together with all the plumbing and fittings for hooking it to 30 hospital beds for only $93,000, he delightedly hastened over to inspect everything before leaving the city.

He could not believe the boon he had discovered in his own hometown, and he returned to the Health Ministry determined to accomplish this long-term acquisition thanks to emergency COVID funds now available through foreign donors. He was meeting with the Minister in two days and begged me not to sell the machine to other buyers until then. I agreed, but said I would appreciate it if he would give the Minister a letter from me about assistance we were needing with our hospital. Specifically, I explained in the letter the bewildering seven-month delay in signing the agreement reached with the Health Ministry last February, our trials with the National Pharmacy Board which had thwarted our every attempt to help, and the difficulty I feared would arise in submitting my request for membership in the Physician’s Guild.

The response was like in a dream. The Minister said he would take care of everything, and letters were dispatched to the chief of each department.

A week later I traveled to Maputo for a wedding of two of our church members. While there I went by the Ministry of Health where the signed pact was immediately given to me.

I also dropped off my application for membership at the Physician’s Guild and in four days was contacted by an amazed secretary saying everything was already accomplished. She volunteered that she had never seen an application processed so quickly.

I also called the National Pharmacy Board, who arranged a special meeting within the hour. They explained how they had been bound by law to refuse all my prior requests for assistance because no hospital is allowed to import medications or medical supplies, something never divulged to me before. Nevertheless, they were determined to help us, and explained that if the Mission set up a pharmaceutical importation company legally owned by someone other than the hospital, the Pharmacy Board would issue a license for that company to import whatever medications and equipment we needed from wherever in the world we might find the best offers.

We have since formed and legally registered “Grace Pharmaceuticals” owned by missionary associate Hannah M., our administrator Bonifácio Alberto, and a doctor in our church. We have completed all the requirements of the Pharmacy Board for licensure and are now submitting our request for inclusion in their registry. Pray that the urgency in effect two months ago will still be working when they receive the application!

Surprisingly, despite obvious motivation, the Health Ministry has been unable to produce the funds needed to purchase the machine. The World Health Organization is pressing for the sale to take place and is seeking donors, but WHO itself does not have funds to make the purchase, and neither does the Health Ministry. Since I am informally obligated to the Minister, thanks to his assistance with the above matters, I have told other buyers that the machine is no longer on the market. So it sits idly in its crates on our property, and I wonder if perhaps God knows that our day to battle COVID will yet come.

After long delays, we finally received the reagents for our laboratory from the States, and now we have the oxygen from Europe. We also have ventilators provided by local donors to the health department. When we receive our license to import medications, we can finally order the drugs we need as well. Once we are fully prepared, we will see what happens regarding COVID – hopefully nothing!

September and October were months of impossible circumstances being quickly overturned by the hand of God. We are amazed anew at His kindness and power, and we are thankful for people who faithfully pray down His blessings upon our work.

There are other exciting developments which will await the next letter – a potential new sponsor for the hospital; remarkable growth in church membership despite restrictions due to COVID; ongoing improvements to the hospital building; and a highly qualified American surgeon (who has been training surgical residents for 15 years and is currently a governor of the American College of Surgeons) making preparations to join us in Nampula. Please continue to magnify God with us and remember our needs in prayer!

Specifically, please pray for: