An English nurse embraces the challenge of a lifetime on Lake Tanganyika.
"The minute we saw the lake I said to my husband Chris: 'That's it. I'm home.'"
Ever since she was a little girl, Nicola (Nicky) Tiltman had cherished a passion to become a missionary nurse. She had never even heard of Africa's Lake Tanganyika until the couple applied to OM and learned that a nurse and person with administrative skills were required in the lakeside town of Mpulungu. The job descriptions suited them both.
Chris and Nicky moved from England to Zambia in 2012 and by April they were settling into a vastly different lifestyle along the longest freshwater lake in the world. Their team had 40 missionaries, 33 of whom were Zambian.
"As a Good News II Medical Ministry Team, our first priority was to build a relationship with the local government clinic while making trips to the villages on the lake," relates Nicky. "Almost a million people live on the Zambian shoreline and OM has workers in five villages. Initially we are focusing on three villages. Two of them have no clinic and in the third we are working together with a local Christian community health worker. The most prevalent conditions we find are severe malnutrition, malaria, skin conditions and opportunistic infections related to HIV and AIDS. Our response is at primary and preventative healthcare level including education about nutrition, hygiene and sanitation.
Nicky adds that the need in the villages is not just physical but spiritual. "There are churches in some villages, but most who attend them also have a heavy reliance on witch doctors. Men, women and children bear scars from small charms implanted under their skin. When we visit a village, our team encourages the local church, does ministry with the children and often shows the JESUS film."
Nicky says that serving in Lake Tanganyika has given her a heart both for Africa and for people living with HIV. "Mpulungu has a population of about 100,000 permanent residents, and an HIV rate of 15 per cent amongst those who are tested. When I arrived I had the opportunity to work within the HIV department of the local government clinic. This clinic does have a conventional machine for obtaining a CD4 cell count, the test needed before a person can commence antiretroviral therapy. One of the challenges, however, is the cost of transporting people to Mpulungu for testing and the fact that it takes two days to get test results. Another problem is that Voluntary Counselling and Testing is not routinely conducted along the lakeshore, so many people do not know their status. The local Ministry of Health is desperate for us to go and offer this service."
Now, thanks to funding supplied by OM UK through their "Just Christmas" appeal, the team has taken delivery of a UNAIDS-approved CD4 cell count testing machine. The machine is lightweight and portable and does not require a laboratory technician to operate it. Nicky and her husband attended and passed the manufacturer's training in Lusaka; now they plan to train a number of local workers. The main benefit of the machine is that it analyses a CD4 cell count in a sample of blood taken from a finger prick, giving a result in only 20 minutes. This means that a person who is HIV positive can get their CD4 cell count and start on treatment within 30 minutes.
"Please pray for a continuous supply of antiretroviral medication to the government clinic we are partnering with to offer HIV services," urges Nicky. "Also pray for a change of mindset in the villages, where people are living in bondage to fear. We are dealing with 12-year-old girls who are at risk of early marriage and trafficking; with women who have no right to say no to sex and with men who have multiple women at different fishing villages. Many of them still believe that having sex with a virgin will cure them of HIV."
"There's a huge job ahead," she admits. "Illiteracy is very high so I am making a pictorial teaching tool. It's a challenge not to feel that we are fighting a losing battle. But that's where faith comes in. God is able to do abundantly more than we can ask or think or even imagine!"