Friday, 20 April 2007







Caught in the Crossfire of Collateral Damage and Global Inaction.

To appear in Vocation for Justice June 2007


Sometimes one particular patient can cause you to pause and reflect and Martha a 10 year old girl and patient on the Intensive Care Unit is one patient whose story I would like to share. She was abducted by the Lord’s Resistance Army, a rebel group that has been fighting the government in northern Uganda for 20 years and when the government troops caught up with the rebels she was shot in the leg in the crossfire. The wound was not severe but one week later she developed tetanus caused by a wound infection. Thousands die from tetanus in Africa each year and it is a distressing condition with a painful death. The body is thrown into very strong spasms and most die from inability to breathe.

Our first line drugs were not working so we decided to use a treatment which is more expensive and challenging to the staff because Martha would need a tracheostomy, an opening in her throat, and be placed on a ventilator for 3 weeks.

In 20 years of practice in Britain I cannot recall seeing a patient with tetanus because with a few injections almost the whole population is immunised. In Africa the weak infrastructure of basic healthcare means that many are just not immunised and with insecurity the weak infrastructure collapses completely. Even in parts of Africa where there is no violent conflict tetanus remains a major cause of death. In Africa most children like Martha don’t survive but we thank God for her good recovery and pray for a change of heart in those who justify war and its collateral damage. Martha was a victim of war in both her direct wound and secondly in her lack of immunity. Likewise the sick and poor of Africa are also the collateral damage of our global lifestyle and wrong choices of inaction.

The health statistics of sub-Saharan Africa are the worst in the world and the inequality is widening every year. Life expectancy is improving in every continent except Africa and despite many sound bites and photo opportunities of politicians and celebrities the structural changes which could easily be initiated to reverse this violence of poverty is not on the agenda even now. In 1970 a commitment to increase international aid to 0.7% of Gross National Product was made by all countries in the United Nations yet 37 years later it has not yet been met by Britain. In trade relationships Africa is in an even worse situation. In 2000 900 US$ was given to a European cow from the EU in subsidies annually and 8 US$ in aid to an African. Our political leaders have promised little and done almost nothing and until we face this reality the continued structural violence of poverty to Africans like Martha will continue. If effective action is to be taken of global significance then it must address the sacred cows of not only the European Union but also the sacred cow of military spending. In 2004 globally one thousand billion US dollars was spent on the arms trade each year while 78 billion US $ was spent on Aid and our government is a major arms trader. We have the funds if we chose to use them to promote life in Africa.

It is perplexing to see that there is no direct coalition between those who work for peace and those who work for development. Surely local Charity Law must be waived in the face of the present carnage of African lives and Christians should have a holistic approach. The current strategy is just not working and never will. The global resources are available to make a difference but we ask for too little. Slavery was present in Africa for 400 years and on current figures the slavery of absolute poverty will continue for another 400 years. Wilberforce campaigned for Abolition of the slave trade not for a partial alleviation of its worst effects.
On Ash Wednesday I had the privilege of joining other Christians at the Ministry of Defence, London in opposing our nuclear addiction to the greatest weapon of mass terror that humanity has ever invented. Our Chancellor has found the necessary funds for the potential holocaust of the Trident weapon system to be renewed at a cost of possibly 40 billion US$ yet the avoidable deaths in Africa are equivalent to a Hiroshima and Nagasaki occurring every week. The potential holocaust we plan for in Trident is already happening in Africa now.

The amount in aid from Britain according to Oxfam is worth one cup of coffee per person each week. The poor of Africa are relying on us to demand from our leaders on a different scale than has yet been done. Until we face this truth we can expect little global change and in 2015 we will record yet another series of broken promises for the poor of Africa.

Dr.Ray Towey is a lay missionary who has been working in East Africa for 14 years. raymond.towey@btinternet.com
Good web page

Wednesday, 21 March 2007

A COMPARISON OF ARMS AND AID GLOBAL EXPENDITURE





In 2004 the global expenditure of arms was one trillion $US, 1,000,000,000,000


The global aid given in 2004 was 78.6 billion $US. In visual terms this is the reality


The message is simple. Stop the arms trade if you want to solve poverty. The peace dividend is a human right.

http://www.youtube.com/v/VHrv1h1TS9s

Friday, 23 February 2007

ASH WEDNESDAY 21 February 2007





















24 Years ago I marked the walls of the Ministry of Defence and had the privilege of doing it again this year in good company again. I just never learn to behave, thank God.
Liz, Dan, Sr.Mary, Carmel, Ray, Sarah
a few of the oldtimers!..........................................................................................................................................................................................................................................................................................................................................................................................................
On the Revolution of Love
It "Changes the World Without Making Noise"

VATICAN CITY, FEB. 18, 2007 (Zenit.org).- Here is a translation of the address Benedict XVI delivered today before reciting the midday Angelus with several thousand people gathered in St. Peter's Square.
Dear Brothers and Sisters! This Sunday's Gospel has one of the most typical, yet most difficult, teachings of Jesus: Love your enemies (Luke 6:27). It is taken from the Gospel of Luke, but it is also found in Matthew's Gospel (5:44), in the context of the programmatic discourse that begins with the famous Beatitudes. Jesus delivered this address in Galilee, at the beginning of his public ministry: It was something of a "manifesto" presented to everyone, which Christ asked his disciples to accept, thus proposing to them in radical terms a model for their lives.
But what is the meaning of his teaching? Why does Jesus ask us to love our very enemies, that is, ask a love that exceeds human capacities? What is certain is that Christ's proposal is realistic, because it takes into account that in the world there is too much violence, too much injustice, and that this situation cannot be overcome without positing more love, more kindness. This "more" comes from God: It is his mercy that has become flesh in Jesus and that alone can redress the balance of the world from evil to good, beginning from that small and decisive "world" which is man's heart. This page of the Gospel is rightly considered the "magna carta" of Christian nonviolence; it does not consist in surrendering to evil -- as claims a false interpretation of "turn the other cheek" (Luke 6:29) -- but in responding to evil with good. (Romans 12:17-21), and thus breaking the chain of injustice. It is thus understood that nonviolence, for Christians, is not mere tactical behavior but a person's way of being, the attitude of one who is convinced of God's love and power, who is not afraid to confront evil with the weapons of love and truth alone. Loving the enemy is the nucleus of the "Christian revolution," a revolution not based on strategies of economic, political or media power. The revolution of love, a love that does not base itself definitively in human resources, but in the gift of God, that is obtained only and unreservedly in his merciful goodness.
Herein lies the novelty of the Gospel, which changes the world without making noise. Herein lies the heroism of the "little ones," who believe in the love of God and spread it even at the cost of life. Dear brothers and sisters: Lent, which begins this Wednesday, with the rite of the distribution of ashes, is the favorable time in which all Christians are invited to convert ever more deeply to the love of Christ. Let us ask the Virgin Mary, the docile disciple of the Redeemer, to help us to allow ourselves to be conquered without reservations by that love, to learn to love as he loved us, to be merciful as our heavenly Father is merciful (Luke 6:36).

Sunday, 3 December 2006

AFRICAN VIEWS

Life expectancy improving every where except sub-Saharan Africa !! From 2005 Human Development Report. chapter 1, page 19
The Human Development Index produced by the UN is a measure of quality of life. It includes life expectancy, education, literacy, and financial resources of the average individual in that country. The closer to the number 1 the better the quality of life. For sub-Saharan Africa the index has not improved since 1985 while in virtually the rest of the world it is going up at great speed. The health care and education in Africa is tantamount to a crime against humanity. This graph was taken from the Human Development Report of the UN 2006. page 265
Try
 Youtube video

Friday, 1 December 2006

Service to the Poor

A Reflection January, 2002 Ray Towey, Tanzania

Service to the poor at a personal cost is a purifying process because the spiritual journey needs a painful removal of illusions previously held. There is no gracefilled experience without an emptying and there is no emptying without resistance. The poor are the gift for clarity of vision. When love of the poor replaces fear of the poor the kingdom of God is at hand, the poison of racist words has no power over you, the stranger is welcomed, our gifts are shared, nonviolence reigns as the greater power.
When you give from your excess you still remain secure, when you give from your core you change, and when you change, at the core, for the sake of the poor the Kingdom of God is at hand. VMM offers service to the poor at a personal cost; the location is Africa, an opportunity for personal transformation, an experiment with the Gospel demands where all outcomes are in doubt and all outcomes possible.
VMM offers no easy solution, no easy answers, just a few questions among friends. VMM offers nothing but a channel for a personal journey. We lack the security of an endowed institution. We proclaim a fractured Church and embrace it as our own. We are prudent for those in the field but you return to no private health plan, no cloisters of comfort, no team of counsellors, even no bed or home to lay your head unless you work once again for it as anyone, poor or rich in our own culture. The poverty of our institution means its smallness cannot obscure the journey. That is a blessing!

Service to the poor at a personal cost is not extraordinary. It is the ordinary chance meeting when time is spent and money not made, when money is given away and time is made, for the poor, for the community, at a personal cost. Until the personal cost is spent is it seen that the joy of the personal cost is the greater. There is no special debtor in the Kingdom of God because we are all debtors to the God who chooses life, who chooses us.

And so we come home and exchange our stories, the good and the bad, and continue to explore the journey and test out the Gospel to see if it is still good, to see if it is still news,
to the poor.

Article from Anaesthesia Newsletter 2003

This article was published in Anaesthesia Newsletter May 2003

In Shock and Awe………………A letter from Uganda


Dr.Ray Towey FRCA was a consultant in Guy's Hospital London, has worked for the past 10 years in East Africa and is currently working in northern Uganda.

Africa has a great capacity to put you into both shock and awe so as I write this letter from St.Mary's Hospital Lacor in Gulu northern Uganda forgive me for borrowing the sound bite from the US military planners for we here are also in a war zone in more ways than one. The real enemy in our situation is poverty, poverty of medicines, equipment, infrastructure, trained personnel, management and the poverty is indeed shocking. However what is awesome is the capacity of our staff and especially my African colleagues to cope with these deprivations and with amazing good humour to actually deliver a high standard of medical and surgical care, much cherished by the local community. In another way we are also in a war zone in that there has been a war continuing in northern Uganda for over 15 years and road ambushes by rebel troops are a weekly occurrence. This is not a high tech. war. There are no B-52 carpet bombing payloads or cruise missiles or weapons of mass destruction, (or should I say weapons of mass injury/murder), but for the local population being killed or injured by a AK 47, a rocket propelled grenade or landmine, all by the way imported from the so called "developed" world at a handsome profit, is just as devastating as being hit by high tech. killing systems. For us in the hospital the sense of security is good, that is while we remain in the hospital. Travelling is another story.

We care for both the government and the rebel injured and probably most importantly because the local mission in the person of Brother Elio will give a decent burial to any fatal rebel casualty, as an institution we have not been a target. This is awesome in a conflict that has defied almost all moral bounds in its cruelty. Last week in our ICU we had the incongruous sight of one rebel soldier lying next to one government soldier. The professional response of the staff to treat all injured the same is exemplary and yes it is awesome when you consider how much the local people have suffered in this conflict. We are about 4 hours driving distance from the capital, Kampala, on a tarred road. In my analysis I divide the world into three areas, the rich northern countries, the capital cities of the so-called developing world, and the rural areas of the developing world. In short we are in the final category, in some ways the final frontier. In my time I have worked in all three areas and each has its own stresses not to be minimised. We are a five theatre suite and we have the capacity to work all five at any one time though this is unusual. With so little resources how do we manage that? In a nutshell skilled dedicated staff and appropriate technology. Many anaesthetists are technophiles and I plead guilty. This article will reach you via the Internet by way of a radio modem and a modified boosted GSM type mobile phone. This connectivity from our location continues to amaze me. It is indeed a small world though much divided.

Our anaesthetic practice is founded on spinal blocks and draw over ether and halothane. It is hard to know what we would have done without the EMO and OMV vaporisers made by Penlon in Abingdon. If there is any Penlon staff out there, many thanks ! A supply of oxygen is always a concern for the rural practitioner and our hospital uses both oxygen concentrators and cylinders. Our paediatric ward has the capacity to treat 16 children using DeVilbiss oxygen concentrators with flow splitters and this frees up the cylinders for theatre use. Many thanks to Sunrise Medical, Wollaston, in the West Midlands ! Hopefully this year we will also have oxygen concentrators for theatre and we then anticipate a major reduction in oxygen cylinder usage in the hospital. As we can only obtain cylinders from Kampala, a journey not undertaken lightly, a move to oxygen concentrators will be much appreciated. To see this appropriate technology making a substantial contribution to the patient care in this remote area is a most satisfying experience. I think it would be fair to say that our anaesthetists can give very good conditions for almost all surgical procedures with our basic equipment. Of course we have limitations. It is appalling to see a patient in theatre with a ruptured uterus because she has been in labour for two days having had no access to any analgesia or any proper care transferred from a more remote area, or to watch someone bleed to death because we have no fresh frozen plasma or platelets, or to walk away from a patient dying from respiratory failure because our capacity to ventilate is limited to just a few hours.

Probably the most appalling example of inequity is the knowledge that a large proportion of our patients are HIV positive but cannot afford treatment. The shocking truth is that profit for the so-called "developed" world comes before life giving treatment for the rest. The national debt of Uganda is about $4 billion and each year $50 million is still being paid back to western banks in debt repayments. It continues to amaze me that most Africans have so little bitterness in the face of this appalling inequity. When $780 billion per year is spent on the world's armed forces, $17 billion on pet food in Europe, I have to ask, why is Africa still paying debt repayments and has almost no anti-retroviral drugs? In global terms this amount of debt is small change but for our patients it is a life to death change, so if you could help me with an answer to that question I would truly be in shock and awe.

Ray Towey