June 21, 2022 by

Serving the Isolated and Undeserved in the Heart of Eswatini: The Luke Commission 

 If you are one of the few people who are fortunate enough to know where Eswatini is, you are in the minority. I was not one of those people before this trip, so for those of you like me who are curious where Eswatini is, this is for you. Eswatini, formerly Swaziland, is a country located above South Africa and beside Mozambique!  

Our Journey to Eswatini 

My team of five students from Cedarville and our two leaders, Kim and Lisa, began our two-day journey to the small country of Eswatini the day after taking finals this spring. We were thrilled to have a long layover in Frankfurt, Germany, which meant we could explore the quaint European town with all three hours of sleep from the previous airplane. After enjoying a delicious German brunch, walking through the cobblestone streets, touring historic buildings, and taking in the beautiful architecture, we opted to close our German experience with a stop at the original Haagen Dazs ice cream store.   


The Who, What, and Why of Our Trip 

The country of Eswatini holds the highest rate of HIV/AIDS infections globally, as well as the lowest life expectancy. Tuberculosis, HIV/AIDS, and diabetes are some of the treatable diseases in Eswatini. Due to their low life expectancy, the majority of the population is under the age of 14. The clinic we worked with, the Luke Commission (TLC), is an organization that provides free, compassionate care to the isolated people of Eswatini, as well as shares the Gospel throughout care. The Luke Commission has a “miracle campus” where we stayed at, which is their main clinic with an outpatient center, surgery center, inpatient clinic, and pharmacy. They also provide many mobile clinics that reach the most remote areas of the country. During our trip, we had the opportunity to learn from The Luke Commission staff in the hospital, assist in sorting medical supplies, scrub into surgeries, travel on outreaches to remote areas in Eswatini, and work with the occupational therapist. Each day we were taught to be flexible and grateful (there was even a no complaint policy we adopted).  

Every Last One … this was the motto of The Luke Commission in treating its patients. No patient was turned away, no matter how grim their condition. Everyone can be shown the love of Jesus and was welcomed in to be treated as a mother, father, brother, or sister in Christ. I was inspired by the values at The Luke Commission. Yes, there are physical supplies and resources in the States that are unavailable in Eswatini. But that was not what stood out to me the most. Instead of healthcare being a duty, at The Luke Commission, healthcare was a joy. A privilege. An opportunity to serve, not meant to be taken for granted. Each patient was not a number, a disease, or a burden. The staff treated the patients with the utmost care and dignity, and fellow staff were treated with such as well. The no complaining and no gossip policy was not just an ideal, it was practiced every day.  

The encouraging tune of Christian worship music echoed throughout the hospital ward, as patients sat up to dance for joy, despite crippling diseases. The contagious smiles of the staff spoke louder than words and the prayers from the counselors and spiritual support team carried with them emotional healing to those who were dying. Doctors were not called by their title, simply by their name. They were humble, highly knowledgeable, and eager to teach us and let us practice the skills we have been learning in school. One of our team members witnessed doctors and nurses gather around a patient to dance and sing for him as he breathed his last few breaths. On Sundays, the windows and doors of the inpatient hospital are opened so the patients can hear the church service on the porch of the ward. Our team had the privilege of attending church at the hospital each Sunday.  

Pictured below: A young burn victim who loved any affection he received. His parents had not come looking for him in months.


A Day in the Life 

Our days started around 6 a.m. After waking up and reading our Bibles, usually on our porch overlooking the beautiful mountains (and monkeys), we would gather for breakfast and discuss our day. The Luke Commission gave us assignments each day, and we rotated who did which job. Breakfast was typically fresh eggs, toast, and peach yogurt. Those of us who were unashamedly addicted to our morning coffee had slight withdrawal when we had chicory instant coffee, which had very little caffeine to it. However, Lisa, one of our leaders, loves the idea of coffee but not coffee itself, and was highly impressed with the “coffee.” She said it was almost a cappuccino, which she also discovered for the first time in the Frankfurt airport. Grateful for our no complaining policy (ironic, I know), we gave the coffee a new chance each morning in hopes it would turn into rich espresso. Toward the end of the trip, we had some converts to morning Rooibos tea.  

After breakfast, our team attended Base Camp, the 10-week training program for new employees, at 8 a.m. We began with a prayer circle, traditional singing, and recitation of TLC’s core values and mission statement. After a sermon and discussion, we were directed to our individual assignments for the day. These varied but included the pharmacy dispensary, the pharmacy warehouse, a supply room for surgical sorting, the acute outpatient center, the cervical cancer/women’s health screening center, the inpatient hospital ward, rehabilitation, and vaccination mobile outreaches. For those going on mobile outreach, wakeup time was 4:30 a.m., and they were out the door at 5 a.m. to change into scrubs and climb into the Eswatini ambulance for a drive to the remote villages.  

During the day, we would gather for a quick lunch around 1 p.m. before heading back to our assignments. During these short minutes, we enjoyed the meals provided by the kitchen staff in between sharing what unique experiences we each had. This was one of my highlights throughout the day, as we shared our enthusiasm, excitement, laughter, and, sometimes, sorrow over the plastic tables with bananas, chicken, and rice. We shared about patients who were healed from diseases and discharged from the hospital, accompanied by dancing, singing, and praising God. We shared heartbreaking stories of children who were burn victims, without parents to come visit them in the hospital in the past month; stillbirths; and cancer diagnosis. We shared fascinating clinical findings, such as seeing rickets and cryptococcal meningitis for the first time. We shared exciting stories, such as being able to perform an ultrasound and watch the mom hear her baby’s heartbeat, being in surgery, or watching a 21-year-old man smile after sitting in a wheelchair for the first time and being able to be wheeled outside. After exchanging stories, and before we knew it, it was time to put our masks back on and disperse to our assignments for the rest of the day.  

Once our tasks for the day were complete around 5 p.m., we typically went for a walk around the dirt path surrounding TLC’s campus. I looked forward to this time to unwind, debrief, and enjoy the beautiful view of the mountains, lake, and sunset (yes, the sun set at 5 p.m. since it’s winter in Eswatini!). Our evening routine consisted of microwaving whatever dinner was placed in our fridge, sharing our testimonies, playing games, and drinking tea. 


Mobile Medicine 

I mentioned that our team assisted with vaccination clinics bright and early at 4:30 a.m. This was part of the trip that we did not plan for or envision ourselves doing. We were told by those who had been on the trip prior that most days, teams help with mobile clinics, bringing healthcare to the villages. However, TLC is a highly adaptive organization, anticipating healthcare needs, and during our trip, vaccination outreaches were a higher priority. We had the privilege of attending and working at these clinics. My team members and I were amazed at the poverty and lifestyle of those in the villages we traveled to. I clued into the fact that we were in a VERY remote area by the cow crossings, potholes with road in between, and lack of road signs. I was equally impressed and curious as to how we got where we needed to be each time! The driver informed me that he memorized all the main roads in the country and when he’s in the area he needs to be in, he simply asks someone walking in the street where he should go. Also, people did not have addresses. When a patient’s information was placed into their health profile, their location included their region in Eswatini and the name of their neighbor.  

I would tell you the clinics lasted from 5 a.m. until a designated time, but that was not the case. The clinics last until the clinics are over. We treated every last patient, turning no one away. This means you could be home at 2 p.m. or 11 p.m.! The patients we treated in our vaccine clinics did not have transportation and walked to our location. It is a sobering thought to think that these patients do not have access to healthcare since they can only walk and transportation costs money. The average monthly salary in Eswatini is the U.S. equivalent of $30. When faced with the choice of paying to feed children and paying for transportation to healthcare, typically it is the healthcare that gets left behind. It was sad to watch patients receive their Stage 4 cancer diagnosis, that would’ve been caught much sooner if they had access to healthcare.  

Many times, we set up clinics at a school and vaccinated the children, as well as handed out HIV test kits. The students were exceptionally grateful, and some would request pictures with us. Others were a little too grateful and asked to marry us, even offering the typical Eswatini dowry of cows. Nothing creates more confidence than being told your value in cows. Unfortunately, the cows wouldn’t fit in our carry-ons, so we turned down our offers.  


Lessons From The Luke Commission 

I am confident that I can speak for my team that this was a life-changing experience, full of exhilarating days and challenging days. Each of us brought home many lessons we learned from our experience.  

One of the themes from the trip, reinforced by the executives, was that, although our team was WELCOMED and INVITED, we were not needed at The Luke Commission. This can be a humbling thought for a missions trip; however, our team was grateful for the fact that the work of The Luke Commission did not start when we arrived and end when we left.  

Another takeaway we had was observing how those at TLC prayed. Each prayer was different and powerful but had a few key phrases. We were challenged to pray that God would startle us each day. We also noticed that in praying for meals, it was often said, “Thank you God for this food. It comes easy to us and difficult to many others.” This was a constant reminder to not take for granted what we have.  

In processing our emotions after watching patients die, receive a terminal diagnosis, have limbs amputated, and literally waste away due to poverty and malnutrition, it was easy to feel guilty for what we have in America. The Luke Commission team reminded us that God does not desire for us to be guilty; rather, we are to be grateful for His blessings while stewarding them well. It is not about how much we have but how well we handle what we have been given.  

Some of the most sobering moments were working in rehab. For instance, a 14-year-old boy, Caesar, was diagnosed with muscular dystrophy. Muscular dystrophy is an incurable disease of the muscles, where they are progressively affected from the torso throughout the rest of the body. Eventually, patients die of heart failure, since the heart is a muscle. Caeser was full of joy and had a contagious, bubbly smile. He was fully cognitively functioning and enjoyed what most teenage boys his age enjoyed. Unfortunately, Caeser was developing respiratory difficulty and most likely had less than two years to live. We worked with Caeser on strengthening his breathing, through practicing deep breaths and blowing a paper across a table. Sadly, Caeser had trouble blowing the paper into my hands at the other end of the small plastic table and had to take a break after each agonal breath. We also worked on loosening his hip joints, to make moving him into and out of his wheelchair more comfortable. Watching Caeser struggle to do the most basic of tasks, breath, reminded me how much I take for granted. Also, we realized that Caeser will have to face death sooner than most people ever think about it. However, none of us know how much time we have left on earth, and the joy on Caeser’s face despite his grim condition was a reminder that this world is not our home. In the words of Paul, the apostle, “If only for this life, we have hope in Christ, we are of all people most to be pitied” (1 Cor. 15:19).  

My trip to Eswatini taught me the joy of serving, the importance of unity, the beauty of God’s creativity and design, the sovereignty of God’s plan, the value of prayer, and the habit of gratitude. There are many aspects of Eswatini that I miss, such as the enthusiastic singing before work each day. I miss the smiles exchanged between the employees and patients each day. I miss the excitement of releasing patients bedridden for weeks. I miss the eager faces of children who are hopeful that The Luke Commission can cure them of their illness. I miss the sunsets behind the colored mountains and lake on campus. Those things I could not bring home. But what I could bring home is a newfound joy in service, regardless of title, status, or certification. I strengthened my desire to be in healthcare as a ministry, even if it is not in full-time ministry overseas. These lessons will last me a lifetime and will hopefully make me a better, more compassionate, godly healthcare provider in the future. 

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