Heat, humidity, and unique smells overpowered my husband and I when we stepped off the airplane. We had finally arrived in Portuguese-speaking Africa. We had anticipated this day for many years and had expected that our time living in Brazil would have prepared us for this visit to Angola. Little did we realize how different this African mission experience would be.
Dr. Tim Kubacki, a missionary physician, and his wife, Betsy, welcomed us to their home and showed us around the area. Then, after a few days of adjustment, we traveled to the village health clinic in the mountains. When we arrived, we saw people lined up, waiting to be seen. At first glance, it appeared similar to previous mission experiences, except for one key difference: I did not see water anywhere. No river, lake, or even a puddle was evident. This was a striking contrast to the jungles of Brazil.
The lack of water in this area of Africa, and evidence of dehydration on the faces of many individuals, was striking. As a nurse, I had witnessed poverty, but I had never seen people thirsting for water. As I worked with the patients awaiting medical care, I was struck by how many were suffering from dehydration. I cringed at seeing the flies buzzing around the children's faces. Dr. Kubacki seemed accustomed to this daily struggle. He came equipped with oral rehydration packets (See Sidebar 1: Dehydration and Oral Rehydration Therapy). I learned it was not unusual to need to run an intravenous infusion (IV) for a patient experiencing any type of infection; the lack of water led to poorer health outcomes for many.
Working alongside Dr. Kubacki, I diligently explained to the people the importance of staying hydrated. I asked them to point to their water sources and attempted to teach simple methods of measuring intake and output. One girl, Eva, smiled at me through the flies circling her face. She seemed accustomed to dry, cracked skin. I did my best to emphasize to her mom the importance of keeping Eva hydrated. They both smiled in agreement and shuffled out of the clinic. I watched in wonder at their apparent peace in living so close to dehydration on a daily basis.
After a few days in Angola, I realized how underprepared I had been for seeing the unique suffering of the people. I was struck by the realization that, just as the suffering in Africa is very different than the suffering I had seen in the Brazilian Amazon region, so each person's story and search for God is different. No training fully prepares a person to reconcile suffering.
While in Africa, I spent much of my nursing time teaching people how to prepare clean water to preserve the health of their physical bodies. While focusing on the physical aspects of thirst, the spiritual parallel was easy to see. Like pulling water from a well, it is only as we access the source—God himself—that the thirst of our souls can be quenched (See Sidebar 2: Maintaining Spiritual Hydration).
Never before had the image of Jesus as the fountain of living water been clearer to me than it became in the dryness of Africa. God alone can quench the thirst we each have, regardless of the sufferings we face. As we focus on this source of hope, we are able to help our patients in the way that matters most.
Sidebar 1. Dehydration and Oral Rehydration Therapy
Water is the major component of the human body. The average adult body is about 60% water. The body of an elderly person averages 55%, whereas infants' bodies are up to 75% water. Hydration is a measure of how much water is present in the body (Popkin et al., 2010). Dehydration—an inadequate level of water—results from illness, injury, perspiration, excess excretion (such as diarrhea), and inadequate fluid intake. Symptoms of dehydration are lethargy, dizziness, headache, dry mucous membranes, and reduced urine output.
Babies and young children are more prone to dehydration due to their smaller bodies, larger body surface area-to-body mass ratio, and increased metabolic rate, whereas older adults may become dehydrated due to a reduced sense of thirst, lower fluid intake, and age-related renal changes (Jéquier & Constant, 2010).
In developing countries, individuals often suffer from acute dehydration due to diarrhea and/or vomiting. In regions where water is scarce, dehydration can be chronic and sometimes associated with malnutrition. Oral rehydration therapy is commonly used, particularly in developing countries, to combat dehydration.
The Rehydration Project indicates (2014),
Oral rehydration therapy is the giving of fluid by mouth to prevent and/or correct the dehydration that is a result of diarrhea. As soon as diarrhea begins, treatment using home remedies to prevent dehydration must be started. If adults or children have not been given extra drinks, or if in spite of this dehydration does occur, they must be treated with a special drink made with oral rehydration salts (ORS).
Oral rehydration salts is an inexpensive dry mix combined with safe water for ingestion. It should be noted that if ORS is not started early, the ability to reverse dehydration without IV fluids is significantly decreased.
Sodium and glucose plus electrolytes are the ORS components recommended by the World Health Organization (Rehydration Project, 2014). Since adopting the widespread use of ORS, UNICEF reported that the death rate of children under age 5 due to acute diarrhea fell from 4.6 million per year in 1980 to fewer than 500,000 in 2018 (Nalin & Cash, 2018). The ORS formula is used for persons of any age experiencing diarrhea-induced dehydration.
In regions with low water supply or inadequate clean water, teaching communities how to make the unsafe water drinkable through removing particulates, disinfecting with heat, or treating with iodine or chlorine is a common practice (Rehydration Project, 2014).
—Karen Schmidt, JCN Contributing Editor
Sidebar 2. Maintaining Spiritual Hydration
People in North America carry water bottles everywhere; they sip and gulp throughout the day, increasingly aware that research demonstrates the harm—from temporary to lethal—that dehydration can produce in the body.
The results of daily spiritual dehydration can be easier to downplay or avoid, but the lack of spiritual thirst in one's life is as serious as a physical lack of fluids. Spiritual dehydration can come on gradually, prompted by intense life situations, overcommitment that leads to emotional exhaustion, a season of questioning God or one's relationship to him, or a dullness of spirit that is absent of joy and hope.
Any of these scenarios can dishearten one in the intentional pursuit of God and spiritual health, resulting in a dampening effect on prayer, less soaking in and meditating on Scripture, and a lack of meaningful relationship with God and other Christians.
Understanding the human need for spiritual hydration, Jesus purposely identified himself in the Gospels as the Living Water. He is our personal source of spiritual refreshing and vitality. If getting enough water for one's body is often neglected, how much easier is it to delay, forget, ignore, or minimize our need to drink from Jesus and his Word? Jesus invites us to maintain a vibrant healthy spiritual life by regularly filling up at the source: “If anyone thirsts, let him come to me and drink. Whoever believes in me, as the Scripture has said, ‘Out of his heart will flow rivers of living water’” (John 7:37-38, ESV).—Karen Schmidt, JCN Contributing Editor