We began our day-long session with the rural clinic workers reflecting on Romans 12:3-8 and Luke 22:24-26, then quickly dove into the morning's work. Of the 30 rural clinic workers, only 4 were able to travel to the conference in one day or less, and 10 had taken 3 or more days of travel. Dr. Campbell Millar led off, a physician in his late 70's who had trained in Scotland after being born to missionary parents. He and his wife have devoted their lives to mission work in Africa, and now live in Colorado close to their pastor son while still working on evangelism in Somalia. His stories of his work in Ethiopia dating back many decades, and his heart for evangelizing in the nearly completely Muslim country of Somalia, were great testimony of a couple who have devoted themselves to the Lord.

As we engaged the clinic workers, we were impressed by both their dedication to their work (the average participant had been a clinic worker for over a dozen years) and the conditions they have worked in over the years. None had x-ray equipment. Medications were very limited, and the nearest hospital was usually at best many hours away. They also have to compete with the local herbal medicine practitioners who try to convince the people that the clinic care is inferior and may lead to their death. There are also bone healers, non-medical local people who attempt to set fractures and clean wounds without aseptic technique. Gangrene often follows. Patient follow-up is virtually non-existent, and the typical worker sees about 60 patients a day.

They asked fascinating questions about our health care system. One commented that he had heard that patients are no longer touched by doctors in America, because we have such sophisticated equipment that the physical exam is no longer needed. They had no concept of cholesterol, though they see many patients with heart failure. Another pulled me aside and asked "is it true that in America they will take out a sick heart and put in a new one?" They may know details of the complications of TB, yet one asked if snoring could be cured by antibiotics. Every one of them leaned forward in their chairs asking questions when we broke into small groups, eagerly soaking up any bits of new information they might glean from us.

We asked for examples of patients they had seen recently. A young woman pregnant for the first time, presenting with fever, blood pressure of 80/60 purulent vaginal discharge, and no fetal heart tones. No transportation is available to a hospital. A young boy with persistent weight loss, malnourished, cough and likely HIV +. A man carried in by relatives unconscious after a car accident. Another with marked edema, short of breath, weak, with a loud heart murmur. A pregnant woman with tapeworm infection, which is treated by medications contraindicated in pregnancy. A young man with fevers, nausea, chills, with possible malaria or typhoid. Yet another coughing up blood, likely with TB. For anyone in healthcare, it is hard to imagine caring for these problems in a clinic with such limited resources. This is however the reality of health care in Ethiopia.

Last night in the middle of the night I awoke, and had the thought of our hospitals contemplating the installation of new imaging systems costing several million dollars, and here no one in the clinics has access to an x-ray. Ethiopia is the poorest nation (#224, $800/per capita) in the world as measured by GNP. Their faith helps them realize that their riches will not be in this world. How grateful we should be for God's provision for us.