Following 15 years of full time work as a nurse, midwife, teacher and counsellor in Zimbabwe I returned to the UK in 1995. Since then I have been privileged to return to my old haunts once (and more usually, twice) for short visits each year.

Each visit has held its own store of opportunity for ongoing valuable work experience, renewed fellowship, and (hopefully) input and encouragement for those who continue on a more full time basis. Armed with the knowledge that I had been asked to produce this article for MMA HealthServe, I travelled to Zimbabwe in August this year. It felt like an ideal opportunity to investigate the ‘hopes’ expressed by those I had met on earlier visits, and to enquire of those still there if, and exactly how, my visits were of any value, or whether they were no more than simply a whim and a source of personal fulfilment on my behalf.

What follows will perhaps serve to support the value of short-term visits to the developing world, as well as to encourage those who wonder if they have anything to contribute to seriously consider a regular annual / perennial link with a team of missionaries or a Christian hospital.

Zimbabwe remains a beautiful country, which typifies Southern Africa – full of the amazing beauty and the wonder of God’s natural creation. Last week we sat at the traffic lights – affectionately known as ‘robots’ in Zimbabwe. The jacaranda trees were just beginning to paint their thick bluebell coloured ‘carpet’– what a magnificent site against a cloudless blue, sun kissed sky. Either side of the road the huge bougainvillea “hedges” provided us with a fresh red, purple and yellow floral tribute to the majesty of their Creator. Suddenly up onto the bonnet of the car leapt 2 children – the girl, dressed only in filthy torn pants, held a hammer in her small, grubby 4 year old hand while the boy scantily clad in ripped trousers, at least 2 sizes too big, pressed his nose flat up against my side of the windscreen; he looked about 3.

The red and green shaded glass of the traffic lights had been removed – it makes excellent disco lights. The white light shining at the top moved to the bottom – I was on green - and I suggested the children get off the car bonnet so I could move. ‘Pay, pay, pay, tinoda mari’ (we need money) they screamed and I could see the implications of non-payment lay firmly in that hammer.

Palms duly crossed with a few dollars and a very colourful flyer that tells of the recently opened church facilities for street kids, they got off the bonnet, but not before the left wing mirror was dislodged and yanked off as they ran in one direction and I drove off in the other! It’s impossible to estimate how many very young children spend their days darting in and out of cars stopped at ‘robots’ in the centre of town – some appear very excitable and hyperactive, possibly the result of readily available street drugs. I felt I wanted to encourage them to avail themselves of a jolly good wash and to supply them with clean new clothes and a square meal! Most are from the rural farms and have come to the city with their displaced parents who are now without home, possessions, income or means to support them and the rest of their families. The land reform programme has little respect for colour, race or creed.

Visits into the city are not at all obligatory for all those who visit as short-term workers, but the following day I returned – this time with some food boxes and clothes. The same two children came for their share and after a bit of bargaining I managed to buy back my wing mirror – Tendai (Shona for ‘thank you’) had apparently slept all night with it in his hand and that day had planned to sell it to make ‘big money for food’.

My next stop was to meet a missionary for lunch. Her joy at receiving a small package in a real Boots carrier bag from home was tangible! The contents – 2 weekly newspapers from her home town, a week old Daily Telegraph, some chocolate and an Angel Delight brought tears to her eyes. We chatted and shared our feelings regarding the current situation in Zimbabwe and in particular where she and her husband are working. Here was an opportunity for her to have what she later called ‘quality fellowship and fun like she hadn’t had for 3 years!’ We prayed together, and after 2 hours had flown by, separated; it had been both a privilege, as well as very fulfilling for me.

Then it was off to see a group of counsellors. Plans were made for two seminars and a ministry session – all of which were later warmly received and left me, the facilitator, feeling very indebted to the very people I was supposed to be serving! God truly blessed us all that night. The counsellors are daily having to deal with the impact of lawlessness, trauma, farm evictions, mortality and morbidity issues arising from the AIDS pandemic as well as other more usual life events. It is a mind-blowing task, yet so many, though weary, are able to testify that when their resources feel at rock bottom and they have nothing left to give, God somehow comes along and takes over.

Many farmers have been extremely traumatised by the land reform. Some have been personally tortured, most have witnessed extreme trauma to wives, children or many of their farm workers as property has been burnt and looted and physical punishment is vigorously served for those presumed to oppose the Government regime. Farm animals and pets have also been badly affected. Many have, along with property and assets, been abandoned at extremely short notice while others have been poisoned or killed.

One elderly farmer had watched as his elderly wife was beaten up; she subsequently died. Another Christian couple had been in bed in their beautiful farmhouse when, at 01.00hrs, they awoke to the sound of noises in the house. Upon opening the bedroom door the husband was met by overwhelming billows of smoke. Both he and his wife fled their home through the bedroom window. He went back into the house to collect his car keys and then, with 30% burns to face and arms, he drove them both to safety. As they looked back, their entire home was in the process of being gutted by fire which began as a result of sacks being soaked in diesel and placed strategically around the rooms before being ignited. What a privilege to meet with these three dear folks and to hear them testify to God’s goodness and faithfulness to each of them.

The three-hour journey to the hospital began late one afternoon. Our vehicle was bulging with the provisions that the driver had been able to find and essential equipment for the generator. Provisions are becoming more and more difficult to procure and this trip had been no different to others in that the shops held neither bread nor cooking oil and only half the required maize meal (staple diet) was available at three times the price it had been the previous week. There’s always room for more people and luggage so in we all bundled and away we went. We talked, sang choruses and prayed much that God would keep our journey safe! Three roadblocks, one flat tyre and a bit of a dodgy drive through the river later, we arrived! Everybody came out to greet us. Local etiquette dictates that all hands must be shaken and there must be singing, dancing and prayers of welcome before we move away from the vehicle. This took over three quarters of an hour, and then as the African sun set in all its orange, red and golden glory on the horizon, the night sounds peculiar only to the African bush initiated an overwhelming thrill and joy to be back! I just longed to get on with whatever I could in the few short days I was to be there.

We hugged and laughed and talked and prayed way into the night. At 1 am we were all set for bed and Andy was about to pray the final good night prayer – the radio went – help was needed in Maternity.

My bed was extremely welcome some seven hours later. We had delivered five babies – two by vacuum extraction, one with a symphisiotomy and one set of twins! We had also admitted and begun treatment for four patients, and two young babies who had sadly died. The regular mission staff had slept for the remainder of their night without being called. Andy’s big grin said it all – he had slept a full night for the first time in eleven nights!

The following afternoon I met Tanya and Jake, newly qualified nurses who had come for three months to ‘suss out Africa’ - they decided to shadow me as we finished outpatients. 140 people had already been seen since 05.30 that morning and it looked like about another thirty to go! The services of Tanya and Jake meant that the three mission staff could enjoy their first afternoon off for a month.

Tanya also came to the maternity unit and had an on-the-job learning experience in feeding three orphaned prems and delivering her first baby! Her words of ‘wow’ and ‘yes’ seemed to indicate that the ‘sussing’ was going well. Later reflection suggested the nurses came feeling they would have nothing to give and everything to learn. However, although they were leaving feeling they still had lots to learn, both acknowledged they had been able to contribute far more than they ever imagined. At their farewell tea I feel sure they were left in no doubt of their worth and value to the hospital team. They both plan to return for short periods each year and hope to be able to give as much as they can, although Jake commented that he felt sure he would always feel as if he knew nothing. He had found it so hard not having enough antibiotics to go round and he emphasised how tired he felt. Tanya reiterated how her preconceived ideas of what it would be like had been shattered and she felt amazingly blessed and overwhelmed by her experience. She had especially found the amount of deaths she had seen hard and became emotional as she described the ravages of AIDS, the feeling of uselessness as she could not treat it and its impact on absolutely everybody at the hospital and in the local surrounding community.

Currently, it seems one of the most difficult things for many of us is the amount of AIDS related disease. One night found me called to three babies and two adults, all of whom had finally lost the battle for survival. The next morning Andy commented on his feelings of helplessness and hopelessness which he felt more keenly in the night as he walked back to his house after being unable to physically save yet one more life.

Currently Zimbabwe almost tops the world statistics for HIV related illness. Statistics can be very misleading and seem somewhat distant when one is plunged into a situation that appears and feels completely overtaken by such a disease. We do not have the facilities to test or specifically treat someone who is HIV positive yet we do have the facility to make a difference to the lives of those who suffer, their carers and families. A vigorous preventive programme is under way as children and young people are targeted with culturally sensitive teaching and discussion. Health education is given in the hospitals and during rural outreach clinics. One of the four hospital chaplains accompanies every outreach mobile clinic. Another chaplain remains in the hospital and it is an amazing experience to be present as people turn to God and accept Jesus as Lord – lives and situations which appear to all intents and purposes to be utterly devastating take on new meaning and purpose.

During my visit last year and again one evening this year, I was called to the Adult Male ward. Shamu had been for a ‘total patient care’ nursing assessment the previous week. That evening he was listening to evening prayers and decided he would accept Jesus as Saviour. His discipleship discussion had gone into the night and now, four days later he had sent for his three wives to come to the hospital. Two of them had accepted the Lord as Saviour, and they too had been discipled. So why had I been called? I arrived as the old rusty accordion and Pastor Peter were playing the ‘Old Rugged Cross’. The atmosphere was one of celebration and joy. The main focus of attention seemed to be the small bathroom at the far end of the ward. ‘Come, come and pray for us’ – I was beckoned to the bathroom. The water had been warmed and poured into the long, old tin bath. There was Shamu resplendent in white sheet about to be baptised in water and behind the door in their ‘sheets’ stood his wives. Too weak to walk, Shamu was carried to the bath where the pastor baptised him followed by his wives. The singing and rejoicing went on for hours and the service resulted in four more patients finding salvation. How the accordion kept going I am not sure – one part hung very precariously and every now and again a note or series of notes would obviously not be available, but where those notes failed the drums and tambourines compensated more than adequately!

The following day Shamu’s wives went home to collect various significant things, which needed to be renounced. They returned with a scotch cart (small, open wooden cart pulled by two oxen) laden with paraphernalia and as Shamu issued the instructions for burning, he and they renounced everything associated with witchcraft and traditional practice which was not, according to the scriptures, of God. The singing, dancing and praise to God was deafening. The bonfire burnt into the night.

Shamu died three days later. His funeral was at the hospital cemetery and conducted by the pastors. Some 12 or more funerals are conducted every week. Shamu’s wives and 9 of his 15 children are now part of the local church – their lives, they acknowledge, have been changed forever.

And so the time for my visit drew to a close and I was very soon off on the return journey to town and then, the following week back to London.

Short-term visits usually involve personal funding and utilising holiday allocation from work. Initial visits may be a steep learning curve, as one adjusts to all the often bewildering aspects of a new culture, in the areas of day-to-day living, the practice of medicine and the approach to nursing care. One quickly learns there are indeed more ways than one to skin the proverbial cat, and equally more ways than one that have essentially good and successful aspects to them. Certainly the experiences of the nurses above indicate that a short-term visit can be of value – even on a first attempt. However regular short-term tours to the same area could provide a deepening, mutually satisfying experience for all concerned.

It perhaps goes without saying that to embark on such visits one needs clear indication from God that it is the right place and right time. A sense of purpose and self-awareness along with an appropriate support network are all invaluable.

Are these visits worthwhile? I’ll leave you to decide!

All names have been changed to protect the identities of those involved, and the author has also asked to remain anonymous.