Charles and Julie Woodrow

Charles and Julie Woodrow

Serving 30 years with Grace Missions Ministries in Nampula, Mozambique

UPDATE August 2020

In over 30 years I have reported on many remarkable manifestations of God’s grace here in Nampula – but the following report may be among the most amazing. I sincerely hope many will read the full story below and give thanks and heart-felt praise to God for what has happened so far.↓

COVID-19 in Nampula: AMAZING GRACE!

As I write this, Nampula is now 94 days into the local COVID-19 outbreak. The virus arrived at the capital on 22 March and the Ministry of Health fought tooth and nail to contain it. Within a few days, when as yet there were only seven known cases in the country, all the borders were closed. All the contacts of the seven positive cases were traced, tested, and quarantined as necessary. This intensive effort to isolate the virus continued daily for two months and was successful in confining it to two relatively small areas at opposite ends of the nation.
Then on 24 May, the virus broke loose from the Ministry’s tight control and suddenly erupted in a third location – our own city of Nampula, population 1.2 million, leap-frogging 865 miles from the capital where it all started. On the first day, as if to display its rapacious appetite, the virus at once showed itself in three disparate parts of the city.
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Twenty-eight days later, 60,000 people had already become infected, 5% of Nampula’s populace, based on a screening sample done of over 6000 inhabitants from various parts of the city. Our own neighborhood had a prevalence rate of 12%! This was a doubling time for the city of under 3 days and represented one of the fastest COVID-19 attack rates in the world. Although the rest of the nation remained unaffected except for the two smoldering but tightly controlled locations mentioned above, the explosive spread taking place in Nampula catapulted Mozambique to 17th place among the nations of the world in terms of rapidity of viral transmission.

This was what we had expected to happen in the crowded mud hut neighborhoods of Nampula where lockdown and social distancing are impossible due to the living conditions and economic realities of the people. Epidemiologists in the UK had said that in these circumstances, up to 94% of Mozambique’s population might contract the virus resulting in more than 64,000 deaths.

Local market sceneOf necessity, life carries on unchanged during COVID-19.

When our hospital was offered and accepted to serve as the COVID center for Nampula, I too had expected an overwhelming infection rate with a regular hospital census of 50 to 100 COVID patients, many desperately ill, and a death rate in our facility of at least one patient per day, assuming that only 20% of the population would become infected in the course of the entire epidemic. That morbidity is what would have happened if Nampula had been the US, the UK, Italy, Spain, etc.

Screening tests in the U.S. indicate that 217 days into the epidemic, 20% of Americans have now been infected by the SARS-CoV-2 virus with a death rate nation-wide of 546 persons per million population. By contrast, Nampula reached 5% in only 28 days and should have easily passed the 20% mark by day 60. If the virus had exacted the same toll here that it has in the U.S., assuming that only 20% of the population was ever infected and correcting for the fact that the older portion of our population is only one-fourth the percentage it is in the U.S., in the first 60 days we would have had 819 admissions, 164 deaths, and a daily hospital census of 137 patients squeezed into a 40-bed facility. That is in fact the situation that we were expecting, that we were dreading, and that we were desperately preparing for at the time my last report was written.Nurse stationThe COVID section of our hospital. The partition in the background is the entrance to the contaminated ward.

However, amazingly, during the entire 94 days of this outbreak in Nampula, only five residents have required treatment with supplemental oxygen, and only two have died! We have in fact admitted 16 patients with COVID, but 11 of them were admitted for treatment of other problems, with SARS-CoV-2 infestation merely a secondary finding. The mathematically smoothed graph of daily new cases in Nampula is displayed below and shows that we had already reached our peak in only 25 days. From day 50 forward we have had a constant low rate of new cases which suggests to me that the epidemic is essentially over for us. In fact, our COVID hospital is like a ghost town – the building is there, but it has been entirely uninhabited for three weeks now. Tomorrow we will begin dismantling the tent infirmary and staff ablution block. They have never been needed.COVID-19 in NampulaMathematically smoothed graph of daily new COVID cases in Nampula actually presenting at a health post – showing early peak and very low numbers despite massive infestationTent infirmaryWe had expected to fill the entire hospital and still require more space. We are thankful this 30-bed tent infirmary with iron scaffolding for piped-in oxygen lines was never needed.

This is of course unbelievable and staggering. Grace Missions spent $140,000 and invested much labor during several months preparing for a crisis which did not materialize – not because the virus did not show up and not because people did not get infected, but because somehow they were all protected: foreigners, Africans, visitors trapped in the country when the borders closed, chronically ill persons – everyone. And this with no prophylaxis, no vaccines, not even nutritional supplements with anti-viral properties.COVID wardLooking into the COVID ward

In all of Mozambique, there have been only 20 deaths in COVID-positive individuals. I know from experience in Nampula, where five persons are chalked up as COVID deaths, that a significant portion of those deaths were not due to COVID but due to the usual morbidity here striking down people who incidentally were positive for COVID.

To put Mozambique’s “trivial” COVID problem into local perspective, recently in one community 28 people died from cholera in only a few days, more deaths than the COVID outbreak has caused in the entire nation during 185 days. And though 20 persons have died from COVID since the coronavirus appeared in Mozambique, in the same time an estimated 6,000 people have died from the chronic daily scourge of malaria.Tent infirmaryUpon exiting the COVID ward and removing PPE, staff go straight to the showers!

To highlight Mozambique’s inexplicably low morbidity from COVID, during this same interval our neighbor, South Africa, has recorded 23,000 deaths above their normal death rate, 13,000 of which were confirmed as COVID related, though it is assumed the additional 10,000 deaths during this spike were from people dying from COVID without coming to a hospital. Compare South Africa’s 23,000 deaths (with twice our population) to Mozambique’s 20 and it is impossible to explain why the people on one side of our common border have been spared so miraculously. Our death rate of 0.6 persons per million (the U.S. clocking in at 546) is one of the lowest in the world, despite the fact that the viral attack rate must be one of the highest.

We at the center of this “miracle” view all this as a stunning display of God’s grace. Even if a physiological explanation is finally discovered, which would be a boon for the whole world to take advantage of, it is still a marvelous provision of God by which He has spared a nation that had virtually no financial or medical resources with which to face so great a threat (see section two of this report).Ablution blockShowers in the temporary staff ablution block

!As soon as the virus came to Mozambique there were unidentified people who I assumed were religiously naive sending SMS messages everywhere saying not to worry, that they were going to band together and pray an umbrella of protection over the country so that the virus could do no harm here. In fact, to date, something like that seems to have happened. Whatever the cause, spiritual or physiological, we are amazed and grateful. I regret the money, time, effort, and other resources “wasted” on getting prepared, but if we could have bought these results for $140,000 we would have considered it a bargain and gone away rejoicing. So we ARE rejoicing, despite the money spent, and are praying that God’s protection may continue to the end of this pandemic.

I hope this cheers our supporters as well, even though it means that a portion of the contributions many have supplied were spent needlessly – at least where treating COVID is concerned!

UTTER INABILITY
The section above describes God’s amazing grace to Mozambique. This section describes what should have happened and why. To appreciate what follows, it should be noted that in saving lost sinners, God ordered our circumstances in a way that would display His grace most brilliantly – that is, by placing it against the backdrop of our utter inability to help ourselves in the matter of saving our souls. Similarly, here in Mozambique where God has abundantly displayed His kindness and grace regarding COVID, there is again the striking backdrop of desperate inability to help themselves on the part of those who have received this precious gift.

Mozambique’s Ministry of Health has never had adequate funds to meet the routine medical needs of its 29 million constituents, virtually all of whom depend on the government completely for their medical care. That means nothing at all is available for confronting a special health crisis like the COVID pandemic. At the outset, for example, there were only 34 ventilators in the entire country – none in Nampula, despite its being the third largest city in the nation – and no money in the health budget for buying more ventilators in the face of this looming threat. So government leaders approached donor nations requesting 700 million dollars in order to prepare for the coming disaster – but no money was given. There was a problem in 2013-14 when top government officials diverted a large part of a two-billion-dollar loan of foreign money to personal bank accounts. Since then, donor nations have supplied no funding to Mozambique’s government, insisting that the guilty parties first be identified and the money be recovered to the extent any remains. So there is no money in government coffers for COVID, and no donor funds either. Mozambique’s Ministry of Health is underfunded even in the best of times, and a 2014 scandal cut off donor money.Dr. Charles in PPEThe result has been shortages unimaginable in western nations where it is considered a terrible crisis if one must resort to reusable PPE, which is all doctors had available to them 50 years ago even in modern hospitals, and what I still use in our hospital to save money. Here in Nampula, not only are there no functioning ventilators, there were not even pulse oximeters or any lab machines for testing blood gases to gauge how severe a case of COVID may be! Still today, patients complaining of shortness of breath must be evaluated in the COVID triage center and a decision made to either send them home or admit them, all without the benefit of knowing their oxygen saturation levels. Even our COVID treatment hospital would have no pulse oximeters to check the oxygen levels of our patients if the Mission could not provide them!

Because of this lack of funding at the central level, to date the local health department has received no money whatsoever for fighting COVID. That means there is no money to pay the hospital electric bill which is costing the mission an additional $360 a month. Nor is there money to pay the water bill or maintenance costs.There is not even money to purchase $8.00 cell phones. One evening when I was rounding at the hospital I found there was only one worker on duty because of the need to reduce wages paid out to COVID care-givers. The worker was in the contaminated part of the hospital and needed help, but could not leave the patient to change out of his PPE, get to his personal cell phone in the clean part of the hospital, and call for a backup – nor could he have his personal cell phone in the contaminated part of the hospital as then it too would become contaminated and have to remain there. The need for a phone in the COVID ward of the hospital had been anticipated, but there was no money with which to make the purchase, nor was there a phone for the clean part of the hospital either!

Once we discovered the health department could not even supply phones, the mission purchased two, one for each section of the hospital, even as our donors also have covered the electric, water, and maintenance bills, supplied the pulse oximeters, absorbed the cost of obtaining reagents for COVID lab tests that are unavailable at the downtown hospital, bought an oxygen producing plant, initiated a $20,000 medication order, purchased a large generator to provide non-stop electricity to the hospital, and hastily erected ablution blocks and a 30-bed tent infirmary capable of piped-in oxygen to accommodate all the extra patients we expected.Treatment RoomWhile preparing our hospital for COVID patients, we installed equipment shipped from the States last June. This is the outpatient treatment room.

I am grateful God has given the mission this opportunity to serve our community and to aid government health officials who have power to help or hinder our own medical ministry in the future! But at the same time, I tremble to think of the burden the Ministry of Health senses as it faces this disease everywhere else in Mozambique with no more resources than are available in Nampula.

Though the donor nations gave no money to the government, they made a special effort to channel funds to foreign aid organizations in Mozambique who in turn are supposed to purchase and donate what may be needed directly to COVID centers like ours. But there is no central organization of this aid; the relief agencies are not experienced at providing comprehensive medical support; and the health officials at hospitals like ours have no idea what may be available in these agency warehouses. Even if we receive a good supply of PPE today from an aid agency, no one knows if any will be available next week. Planning ahead is impossible, and with no money, preparations cannot be made to meet tomorrow’s possible tidal wave of cases.Procedure RoomThe minor surgery and procedure room

.Our first patient death illustrated these difficulties. The first problem that doomed him at the start was the absence of pulse oximeters for measuring levels of oxygen in the blood of people suspected of having COVID. None of the aid agencies thought to obtain pulse oximeters or any lab equipment for measuring blood oxygen levels, so even in the COVID triage tent at the city emergency room this vital information cannot be determined. When our unfortunate patient appeared at the tent with cough, fever, and shortness of breath he was properly screened for malaria because of the fever, for tuberculosis (prevalent in Nampula) because of the pulmonary complaints, and COVID because of the classic triad of symptoms. Immediately the TB analysis came back negative, the malaria test came back positive, but the COVID results took two days to determine. While in the ER waiting to be admitted, the patient suffered a convulsion and never regained full consciousness. Because of the positive malaria test and the frequent reality of cerebral malaria here, his convulsions were ascribed to that, which at nearly any other time but COVID would have been the right diagnosis. But two days later the COVID test returned positive and the comatose patient was immediately transferred to our center where oxygen levels could finally be determined.

In the States at the start of COVID, if a patient could not keep his oxygen saturation above 90% even on relatively low levels of supplemental oxygen, he had to be placed on a ventilator to prevent potentially catastrophic complications such as convulsions and brain damage. This patient had an oxygen saturation of 68% when it finally could be determined two days after showing up at the downtown hospital! Clearly he was suffering from advanced COVID, not from cerebral malaria which does not cause a drop in oxygen saturation. But without a simple pulse oximeter, how could the people who first saw him know that? The patient was quickly placed on our maximum level of oxygen supplementation, but now the second problem arose.

The hospital was woefully under-supplied with oxygen, which is very expensive here. The health department did not have funds to buy even one tank of oxygen and was dependent on inexperienced aid agencies to dole out what they thought was appropriate. Though Grace Medical had purchased a massive oxygen producing plant that could provide all the oxygen needed every day for 50 COVID patients on maximal O2 therapy, it was still being manufactured far away in Europe. 

A U.S. aid organization, to whom we are immensely indebted, buys oxygen tanks for the COVID center when they are needed, but because of problems with a shortage of oxygen regulators and basic tools for changing over oxygen tanks, only two tanks were available when this patient was admitted. A normal pneumonia patient can be supported for several days with one tank of oxygen, but I knew COVID patients in the States would go through a whole tank of oxygen in just 1.5 hours! When I saw the puny supply of oxygen brought in the day our hospital was turned over to the health department, I told the staff they needed at least ten full tanks at all times, even before any patients showed up, but they were incredulous.

Sure enough, when this patient came in, though they cranked up his oxygen to the maximum flow rate (one fourth of what is often used for COVID patients in American hospitals), they could not lift his blood oxygen above 70%. And to their surprise, the first tank was gone in just six hours. They switched to the second tank, but that one also ran out in six hours, and suddenly there was no oxygen for an already comatose patient needing maximum oxygen therapy just to barely stay alive! Within minutes with no supplemental oxygen, the patient expired. He was 37 years old, doubly doomed by the profound shortage of such fundamental COVID materials as oxygen and oxygen sensors.

The purpose of this story is to illustrate our marked inability here to help ourselves in the face of this COVID threat.Consultation RoomConsultation room

Oxygen and oxygen sensors are critical, but so are medications. Here aid agencies can offer no help whatever. The rules and regulations in effect forbid anyone from bringing meds into the country apart from the National Pharmacy Board. Even the Health Ministry must go through them to import their medications. Early on, Grace Missions initiated a $20,000 order of COVID medications, enough to treat 100 COVID patients each requiring a 10-day hospitalization. Though we are doing this via the Health Ministry whose own experienced personnel are guiding it through the Pharmacy Board’s gauntlet of requirements, we still have not received permission to submit our order to the suppliers in Holland due to the impossible Gordian knot of regulations erected by that board in the name of protecting Mozambicans from bad drugs.

With no help from either the Mission or the aid agencies, Nampula is in dire straits for medications. When the first COVID patients began to roll in, I was pleased and grateful that the Health Ministry supplied all the meds needed in the COVID treatment protocol (not big-pharma designer molecules – those cost a lot of money!) – but I wondered how long that would last. As it turned out, not very long. After treating a mere 16 patients only one COVID drug remains in stock, the steroid dexamethasone. Imagine our despair if we had had to treat 819 patients already with no COVID medications. This would have been the patient load if Nampula were the United States but with only one fourth the U.S. percentage of vulnerable-age persons!

It is against this desperate backdrop of inability that the magnitude of God’s kindness and grace must be appreciated. He has spared Mozambique from what our far more advanced neighbor, South Africa, has endured just across the border, and what the other sophisticated, self-sufficient countries of the world have had to bear.Consultation RoomConsultation room

The final vignette I want to share will drive home even more dramatically God’s mercy toward us. It is the sad story of our second COVID death. He was admitted to us on the fifth day of symptoms and had a steadily downward course which finally took a sudden plunge toward death on the ninth day of illness when he developed the feared cytokine storm. Unlike the first patient, he did not have the “luxury” of being unconscious during the final stage of disease. I was called to the hospital late Sunday night to open the medical cupboard to restock the medications the caregivers hoped would help him, but there was nothing of use to give. I changed into my PPE to check on the patient myself, whose pitiable cries could be heard all through the hospital. It was distressing to see his agony. His oxygen saturation had dropped to 35% on maximal supplemental oxygen and he was desperate for air, breathing 60 times a minute but with no relief. With every gasping exhalation he yielded up an anguished cry to Allah. I could not believe he was still conscious and for his sake I hoped the end was very near. In any American hospital he would have been paralyzed, sedated, and placed on a ventilator long before this, when his oxygen level got down to 70% if not sooner, with the machines and nurses doing everything for him after that. If he died, he would not die conscious or in agony. But here there are no ventilators and nothing to give that did not seem like euthanasia. I left him after an hour expecting him to die very soon – but desperately he held on, conscious, for another 10 hours with an oxygen level of 35% until he was just too tired to breathe any more, at which point he suffered a cardiac arrest and died.‌

He was a 45-year-old Indian, a friendly shop owner in a town 55 miles away. People who knew him said he was a congenial fellow liked by everyone.Operating roomOne of our two operating room

If the effects of COVID in Mozambique followed the American trend, our center would have endured one such awful death every 14 hours from the onset of the epidemic until today – assuming we have still not exceeded a 20% infection rate in the general population, which would increase all the numbers. The agony of these patients dying from oxygen starvation is distressing, and I had planned to place those who progressed to that point in a corner of the hospital where the other patients would not have to witness or overhear the torture they too might soon experience.

How I thank God that for reasons inexplicable thus far, only two patients have suffered this fate – not the 164 that would have died if Mozambique were subject to the conditions controlling outcomes in the United States and Europe.

Some suggest that people in Nampula must be dying of COVID, they just are not coming to the hospital. Having observed the agony of this fully conscious patient dying from oxygen starvation, it is hard to imagine anyone enduring that without seeking help if a hospital were within easy reach. But to investigate this possibility, the health department began doing nasopharyngeal swabs on all persons brought to the morgue after dying at home.

To date, only three home deaths have tested positive for COVID. A Mozambican city of 1.2 million people should have a daily death rate of 55 persons, buy I cannot say how many home deaths end up at the morgue in Nampula, nor how many days the health department has been testing cadavers. But with only three positive tests so far, it appears that dying at home because of COVID is very rare.

I believe people just are not getting sick. Of the 5% who tested positive for COVID antibodies early in the epidemic, two thirds had had no symptoms at all during the three months prior to the test, and only 14% had experienced more than one symptom of illness in all that time, which may have been due to some other malady and not COVID.Anesthesia roomAnesthesia prep room

Some people might wonder if the antibody test was giving false positive results and Nampula did not really have so many infected people early on. False positives can happen in up to one percent of people tested if the test is particularly unreliable – and so there have been disparaging statements made about some COVID antibody tests, saying they are not worth doing if only 1% of the population has been infected. But when the test shows that up to 12% of the population has been infected, as in our neighborhood, or 21%, as in the population of venders at the downtown market, it is reliable, as only one of those 12 or 21 percent’s could be ascribed to false results. So it is not possible to dismiss the results of the study by saying all those asymptomatic people testing positive for COVID antibodies were never actually infected, nor to say on the other hand that there are a lot of sick and dying people from COVID who just do not come to the hospital.

I am satisfied that people are getting infected, but almost no one is falling ill. There is an explanation for this wonderful phenomenon, but so far only God knows what it is. Whether it is prayer, divine mercy, or some physiological get-out-of-jail-free card God has built into this virus for people living in Mozambique, we thank Him for it.

THE RESULTS FOR GRACE MEDICAL
So what are the results for Grace Medical? For one thing, we have spent $140,000 needlessly.

But the money has not been wasted. The thirteen-unit ablution block and laundry we built for patients in the tent infirmaries cost $6,500 but will be very useful during the conferences we hold on the property with over 400 persons present.LatrinesA section of our thirteen-unit ablution block and laundry

We hastily bought and installed a massive generator which cost $25,000 to accomplish, knowing that it was essential for the COVID center, but it will also be needed when we start admitting our own patients later.Utility rampUtility ramp with backup power and pressurized water

To monitor the condition of COVID patients, we spent $7,000 on an emergency importation of special lab reagents which have been held up by customs agents in the capital for three weeks and are still unavailable. But when they finally get here, we can make use of them for our own future surgical patients even if COVID has passed.Hospital laboratoryOur laboratory

We spent $85,000 for the massive oxygen generating plant which will finally reach Nampula on 9 September. Though it turns out we have no need of it, on location in Mozambique where oxygen is so expensive, it is a goose that continuously lays golden eggs. It is worth far more than what we paid. We expect to get our money back by selling the plant, and already the downtown hospital is eagerly trying to obtain funds to cover the purchase.Oxygen machine being loadedThe oxygen plant on its way to a port in Germany for shipment to Nampula

We tried to spend $20,000 importing life-saving COVID drugs, but thankfully we were consistently blocked by the National Pharmacy Board. And so the money remains safely in our bank account, the meds remain in Holland where they cannot harm any Mozambicans, and the National Pharmacy Board sleeps soundly in their beds, assured that no one is dying due to failure on their part to maintain diligent control over what gets into the country.

Discounting all of that, it turns out that the mission has spent only $4,500 to no benefit. Offsetting that loss, however, UNICEF has spent $23,000 on improvements for our facility, building an incinerator and a water pressurization and storage plant.

improvements!Making furniture for administration roomMaking furniture for the administration roomCabinet makers prepare cubicles for the admin suite

And the other benefits for the mission have been immeasurable, much to my happy surprise. We are constantly in touch these days with Mozambique health professionals at every level, from the Minister himself, to the provincial authorities, to both of Nampula’s provincial governors, to many sectors of the downtown regional referral hospital, right on down to the doctors, nurses, orderlies, and cleaning crews who have staffed our hospital. Grace Medical is a well-known name even in the top floor corridors of the Health Ministry far away in the capital. For the mission, this has turned out to be a divinely engineered public relations campaign I could never have imagined or produced no matter how much I may have wanted to. For me, I have developed a sincere appreciation of and respect for each person in the health program that I have interacted with and worked beside at all of these levels – the one exception being the National Pharmacy Board.

And in terms of getting the hospital ready to open – we are there! As the pictures accompanying this report show, virtually the entire facility is either already functioning or is ready to function. The only thing lacking now is a physician current in surgery.Doctor officeSurgeon’s private office

Evangelistically, the experience has been a disappointment. I was quite naive to think I could have deep, meaningful conversations with people while trying to be heard and understood through N95 mufflers and reflective face shields that stop your words and throw them back at you. I had expected to spend a lot of time in the hospital following up scores of COVID patients. Instead we have admitted only 16 patients during 12 weeks, of whom only 5 were under any threat from COVID. The time it takes to get in and safely out of PPE, then carefully disinfect it prior to washing and arranging it for the next use is a great disincentive when one is already far behind on other work and the patients do not need medical attention anyway. I wish I could have done something to help the anoxic, dying Indian patient, but by the time I even knew about him what vestiges of mental energy remained to him were totally and painfully engaged in gasping for air. For him, the time to prepare for eternity had clearly passed.

But for countless thousands of Mozambicans, their lives have been spared. The London epidemiologists who predicted a potential attack rate in Africa of 94% also forecast more than 64,000 deaths for Mozambique. God has overruled those predictions of death, though without stopping the coronavirus from spreading like wildfire, at least here in Nampula where lockdowns and social distancing are impossible.

We praise Him for that, and were it not for the many other problems assailing the country, would suggest that Mozambique change its name to what we have called the property we are developing for future missionary homes five miles outside of town: Land of Grace! Gate of Quinta Graça

UPDATE May 1, 2020 from Charles

Our hospital is almost ready to open, and when the SARS-CoV-2 virus suddenly surfaced in Mozambique on 22 March I and the Grace Medical leadership felt we should offer our hospital to the Ministry of Health to assist in the COVID response.  That precipitated a sudden succession of visits from increasingly important people in the government, finally culminating in a very large entourage of dignitaries that included the Secretary of State (supreme governor of the province appointed by the federal government), the governor (elected by the people), the Provincial Health Director, the Surgeon General of the province, the Director of the Central Hospital, and many others, accompanied by all the press and television film crews.  We only heard one hour before their arrival that this was not just another routine inspection.  No special preparations had been made, but by the grace of God the grounds and the building were in mint condition on that day, something that normally is not the case without days of advance preparation.  We had not prepared for the previous inspections as they were informal and not considered significant – and we did not know this visit was going to be any different until one hour ahead of time.
Everyone was so impressed with the facilities.  We had been told by previous visitors that our hospital would be the nicest one in the province and that when it opened everyone would want to be admitted to our facility when they became ill, but I assumed such comments were only to please the Mission.  But the dignitaries called the hospital “spectacular” and it made a great splash for a few days.
The result was that we have been appointed the only COVID treatment center for our city of 1,200,000 patients.  Everyone needing admission for the virus will be sent to us.  The hospital will be administered by the government, but I will be on the management team and one of the attending physicians with full access to all of the patients.  I had asked to be appointed the hospital director, but they said that position had to belong to someone in the chain of command of the Health Ministry.  But I am satisfied that I will have complete freedom to evangelize all the patients, which is the only certain benefit we can supply as there are only 34 ventilators in the country and extremely limited supplies of bottled oxygen at this point – only enough to last four hours every three days.
So Hannah Malone and I together with the rest of our team have dedicated ourselves to trying to get past the many obstacles in the way of a meaningful medical response to this situation.  On Monday we will be presenting a detailed list of the needs to many of the embassies in the capital and are praying for a good response.  We will need around $800,000 to do a credible job of meeting the need if the virus finally breaks out.  
The silver lining for me is that, even if we are unsuccessful in getting the resources to treat people medically, there will be the opportunity for all the infected patients to hear the gospel!
So far the virus has been present in the country for 41 days but only 80 people have been infected instead of the 8,200 that should have tested positive by now.  The virus is mainly in a work camp at the far north of the country and has been confined there so far.  A second locus is in the heavily populated capital, but they caught it early and have been able to put the few people infected there on home quarantine.  But we do not know how long the virus can be kept from breaking out. We have had emergency measures in effect for 30 days and so the entire population is still susceptible.  At this rate all will continue to be susceptible when restrictions are finally lifted – and then there should be the serious problems people have predicted for Africa barring restrictions which are too costly economically to be kept in place for long.

In the service of the King!
Charles

UPDATE April 15, 2020

God Works Good from Crisis for Dr. Woodrow’s Clinic

Using the Spirit-inspired description Paul gave of his ministry in Romans 1:5 and adjusting it to Mozambique – our purpose is “to bring about the obedience of faith among all Mozambicans, for His name’s sake.” In this declaration, we see 1) the goal of ministry, obedience or submission to God, and 2) the only means of carrying it out, through fostering faith in Jesus Christ. 

Grace Missions was founded in 1985 to send missionaries to Mozambique. Before 1985, no mission board was active in the country due to government opposition to Christianity. Softening of the government’s position toward Christian work was evident, however. At the same time, God was calling out missionary candidates to work in Mozambique. Grace Missions was established as a means of sending these missionaries to Mozambique and granting them spiritual oversight.

Grace Missions Mozambique was incorporated in 2000 to build, own, and operate a surgical mission hospital in Nampula. From 1990 to 1997, Grace Missions provided a missionary surgeon and all the supplies necessary to maintain the surgical block in a local government hospital. When the Minister of Health granted the Mission’s request to establish a surgical hospital, Grace Missions Mozambique was set up to oversee the medical-evangelistic work, freeing Grace Missions to focus exclusively on church planting and church-related ministries.

Grace Missions
723 South D Street
Oxnard, California 93030
(805) 377-7830

Grace Medical Mozambique
P.O. Box 34531
San Antonio, TX 78265

Dr. Charles Woodrow
C.P. 748
Nampula, Mozambique, Africa
258-82-601-1240