Redefining Success In The Central African Republic: An Interview With Dan Guiles

Posted by parkejladd on Feb 9, 2010 in Featured {Article} | 3 comments

This past weekend I got to interview my good friend and fellow journeyman, Dan Guiles.  Fresh off his return from the Central African Republic, we sat down over coffee to discuss the people, the church, and his standard of success for moving forward both here in the States and in Africa.  Guiles, 25, is a fourth year medical student at the Indiana University School of Medicine in Indianapolis, Indiana.  He is set to graduate in three months and move on to a residency program specializing in internal medicine and pediatric care.  While it would be easy and impressive enough to define Guiles as another gifted physician in the making, his hope is to be defined by something else.  His deepest desire is to leave a legacy of love, and to use his skills as a doctor to spread the message of Christ all over the world.  This is his story.

Parke: How did your passion for medical missions get started?

Dan:  My senior year of high school I went to Brazil for six weeks in hopes of sharing the love of Christ with the people we came in contact with.  It was the first time I had done this on my own in a foreign country.  After returning from Brazil I knew taking the gospel to other people groups was something God wanted me to do with the rest of my life.  I also had a strong interest in science.  So, I began to explore how I could combine my interest in the sciences with my newly discovered passion for international missions.  I talked to a lot of trustworthy people, and many of them asked me if I had ever considered medicine.  From then on I began to view and understand medicine as a great way to help people both spiritually and physically, to bridge the gap between the two.  My life and early education turned into an attempt to figure out if both of my passions were compatible.  I wanted to know if being a doctor and a missionary, simultaneously, was possible.

Parke:  So is it possible?

Dan:  (laughing)  Yes!  Turns out it is possible!

Parke:  It’s been a few years since Brazil.  How have your passions for medicine and missions persisted and grown over time?

Dan:  As I have grown closer to God, my passions have grown as well.  The hindrance to growth is that it’s easy to look to the future and lose site of the present.  I have to continually remind myself that God desires my presence right now in this very moment. Throughout the past couple of years, I have been challenged to focus on what the Lord has for me right here, right now.  It’s easy to lose track of present opportunities when I become overly focused on getting my degree, moving forward professionally, or consumed with what’s next.  Growth has been a process of simply discovering what it is that God has for me today, right here in Indianapolis, in the community I am currently living in.

Parke:  Are our thoughts misguided when it comes to so called “missions”.  Don’t we often convince ourselves that “missions” are in Africa, Asia, or someplace far, far away?

Dan:  As Christ followers, we’re called to love God and love people.  In regards to missions, my “field” is right where I am–medical school in Indianapolis.  Medical school is not very conducive to talking about spiritual things, however.  Our days as students are consumed with becoming doctors.  So, I’ve really had to focus on building deeper relationships within the medical school community in order to show compassion and love to my colleagues.  I have to seek out ways to meet with people outside of the hospital.

Parke:  In a world consumed with busyness, it’s all about relationships?

Dan:  Right, exactly.  As Christ followers we need to be much more intentional in our relationships.  It’s easy to go to work, get stuff done, and then go home.  It’s easy to miss or ignore the whole “missions field” that is work.  I’ve been guilty of this a lot throughout my years in medical school.  When I’m tired, been up all night, and don’t feel like interacting with one more person, it’s challenging.  It’s hard.  And it’s humbling.  I think back on all of the missed opportunities to love people, and it makes me cringe.  Yet God continues to bring new people into my life every day.  It’s very humbling.  God is so gracious.  Despite our failures, He doesn’t give up on us.

Parke:  How did you wind up in the Central African Republic (CAR)?

Dan:  My Dad is on staff with Grace Brethren International Missions, and they’ve had a presence in CAR since the early 1920′s.  It started out very small with only a few committed doctors.  Over time they were able to build two hospitals and train a staff.  It was basic yet functional.  In 2002, unfortunately, the country experienced a major civil war, and all the missionaries had to leave due to safety concerns.  During the war, hospitals were looted and destroyed.  Ever since then nothing permanent has been established, yet it’s a country we really want to have a strong presence in.  So, when I approached Grace Brethren Missions about doing a medical trip overseas, they immediately plugged me into their CAR outreach in hopes of building on previous efforts and working to keep things moving forward.

Parke:  How did your school, IU, respond to your request to leave?

Dan:  Well, IU needed my trip to be at least 2 months long in order for it to qualify for school credit.  The CAR team, however, was only going for a month.  So, I couldn’t go with IU, and for a long time I didn’t think it was going to work out.  Thankfully though, after reviewing my schedule, I found that I had a months worth of vacation time saved from the past year.  It was a huge answer to prayer.

Parke:  You went to the Central African Republic for vacation?

Dan:  Yes.  That’s right.

Parke:  (laughing) That’s weird.  But awesome!

 

Parke:  Describe a typical CAR hospital?

Dan:  It is a very scary place.  There are a lot of very sick people crowded into very small rooms.  The operating rooms are basic, usually composed of a table.  The walls are brick or cement.  On average, there are probably 10 patients per room.  Privacy is not an option.  One of the biggest obstacles preventing people from visiting the hospital is that patients have to provide everything.  In other words, if you want food to eat while in the hospital, you have to bring it.   If you want clean sheets, a pillow, a gown, slippers, medication, or even water, you have to bring it.  The hospital doesn’t provide any extra necessities.  On top of all that, the hospitals are not clean.  Hygiene is not a priority.  Everything we take for granted as normal health care here in the States is essentially non-existent in the CAR.

A couple of days ago during rounds we were debating whether we should order a CT scan or an MRI.  In the CAR you don’t have an option.  These test don’t exist.

Parke:  How can families afford this type of pay-up-front health care?

Dan:  Simply put, they can’t.  The people have very few if any material goods.  The patients we saw were mainly subsistence farmers who grew enough for themselves with maybe a little left over to sell in the market.  Maybe.  The people might sell something or work for some of the wealthier business owners, but most of them can’t afford to step foot inside of a hospital.   So, primary care is essentially non-existent.  The sick wait it out at home, hoping to get better.  If the pain becomes unbearable, people will usually end up begging extended family and friends for funds.  But even if they do make it to surgery, necessary medications are not even close to affordable.

Parke:  You’re saying you literally get the care you can pay for?   In the States, if you walk in the door, you can’t be denied treatment.  It’s obviously a very different story in the CAR.

Dan:  Right.  Very different.

Parke:  How were you able to do things differently?  Were you treating people for free?

Dan:  Yes.  We spread the word through the churches.  If church leaders knew of anyone who needed surgery, we asked them to send their sick to us during a specific time.  It was crazy.  The people don’t have much at all.  We had to give it away for free or no one would show up.

Parke:  How did your patients react to the care?

Dan:  Their culture is very hierarchical.  People in authority are well respected, but, unfortunately, they hold their authority over people.  They use authority and prestige and higher education to lord over people, not to serve them.  Doctors also tend to hold themselves in high regard, above their patients, and are not very compassionate.  Many of the doctors were not very caring or loving toward their patients because they are, from their cultural standpoint, “better” than the patient.  For example, during the process of surgery the doctors will have the patient undress and walk across the operating room completely naked, unclothed in front of everyone else.  That’s very humiliating for most people regardless of culture or status.  Also, a lot of our patients had never been to a hospital before. They didn’t understand what was going on or how to properly act in a hospital environment.  So, the doctors and nurses ended up yelling at them to move and lie down.  Everything we understand as procedural, they do not.  They are not familiar with hospital routine.  This presented us with a great opportunity though.  We were able to show love by simply offering patients something to wear.  We prayed with our patients before every surgery.  We smiled, shook hands, and said hello.  We attempted to be overly compassionate in every way.

Parke:  These small acts of compassion were abnormal?

Dan:  Yes, certainly.  Another example is that most white people in the CAR speak French, so our patients greeted us in French.  But we would respond to them in their native tongue, and that would blow them away!  To them, it showed great care and effort for us to actually learn their greeting instead of the typical French reply.

Parke:  Did the people wonder why you were there?

Dan:  Yes.  They would ask, “Is the government doing this to help us?”, and, “Why are you doing this for free?”  We would reply, “No. We are here because of Christ, and we want to love you and provide you with care.  We are here because Christ has changed us.”

Parke:  How did they respond to that?

Dan:  A lot of people responded favorably.  They really appreciated the care and the love, and they expressed their thankfulness through letters.  Lots and lots of letters.

Parke:  Any stories of gratitude stick out to you?

Dan:  Of course.  The hierarchical caste system rules everything in the CAR, and the Muslim group is, by far, one of the most inferior castes.  They are called the Fulani people.  One day we were able to operate on four different Fulani patients.  This was huge because authorities usually prohibit the Fulani from even entering the hospitals.  After the surgeries, however, the Fulani patients invited us back to their village.  So we were able to go and visit and share with the Fulani in their homes.

Parke:  Wow.  Christians hanging out with Muslims?

Dan:  Yeah, it was pretty cool.  They fully understood that we were there because of Jesus, and they were loving it.

Parke:  What are some of the challenges the people of the CAR face every day?

Dan:  The challenge for CAR is that there is nothing there.  No infrastructure.  No reliable government.  Nothing.   So, anything you try almost has to be funded by the West, and the way I see it, that can only last for so long.  The funds run out, or the next civil war comes, and we have to evacuate.  Ultimately, it comes down to redefining what success looks like in CAR.  I want to change the country.   I want to help all of the people.  I want to cure their illnesses.  But that would take a lot, and I can only do so much.  So, success became more than building a hospital or establishing a government or curing diseases or ending poverty.  Success became less about the overwhelming, long term initiatives and more about loving the people.   If I could demonstrate actionable love toward those around me throughout a day, then it had been a successful day.

Parke:  Based on the current situation, the structural issues aren’t going away anytime soon.  The bigger goals are there, but we need to focus on what we can do right now instead of only focusing on the future?

Dan:  This is like what we talked about earlier in regards to making an impact right here, right now.  The Central African Republic has so many basic issues.  The culture and value systems are so different than they are here.   We have to focus on what we can do today and not get bogged down with the bigger, change-everything-now, type of goals.   Others have tried to start businesses and hospitals, but those outsiders eventually left and everything fell apart.

There are really two approaches to the CAR.  First, it’s easy to look at them and judge them for being so corrupt and lacking in values.  It’s easy to say they are lazy people.  Second, it’s easy to throw up our arms and say, “What can we do.  How could we ever make a difference.”  I think both of these approaches are wrong.  Maybe our efforts won’t last 5-10 years, but if we can show people God’s love and allow the Bible to permeate into the culture, then, even if we leave, the gospel and Christ’s love will still remain.  That’s what’s important.  That’s what will have a lasting impact and make way for permanent change in the future.

Parke:  What’s the church like in the CAR?

Dan:  They have churches and pastors, but there is a large disconnect between claiming to be a Christian and living like a Christian.  During the civil war, everything was looted, and a lot of the people doing the looting were from the church, previously having worked with our missionaries every day.  The CAR culture says, “If you have something I don’t, than you should share it with me.”  So, to them, it’s not stealing.  It’s just sharing.  Their value system is slightly off.  We take it for granted that our values are pretty much founded off of Biblical standards.

Parke:  In moving forward does the church have a responsibility to stand apart and the lead the way?

Dan:  I think it would really help.  However, the hierarchical society has impacted the church as well.  Being a pastor or leader of a church is more of a position of authority rather than a position of service.  We were able to go to some churches where this was not the case, but it’s not wide spread.

A lot of people claimed to be Christian, but most of them had a myriad of other belief systems as well.  They had not turned completely to Christ.  Christianity was just something else they did because everyone else was doing it.

Parke:  Any times when God had to show up and He did?

Dan:  Oh yeah.  The minister of health had agreed to let us work at this newly remodeled hospital, but when we arrived to get things set up, we found the operating rooms completely empty. The rooms weren’t finished.  We had all of these American surgeons coming in from the States with no where for them to work, and we had no way of fixing the problem on our own.  We had no hospital.  However, the year before we had worked at a community hospital across town, and we called them up on a whim, and they agreed to help us.  It was incredible!  They opened their hospital to us from one day to the next.  It was amazing that they opened up to us so much with no warning at all that we were coming.

Parke:  That’s incredible.

Parke:  Tell us about the orphan crisis in CAR.

Dan:  Well, due to AIDS a lot of the adults have died.  In the CAR the population is getting younger and younger.   Most of the patients we saw were kids or teens.  There are a lot of orphans.  The way families are traditionally organized, they tend to take care of their own.  The problem, however, is that there are so many parents dying that the ordinary, familial safety net is under huge strain, and families cannot afford to take care of their own.

There’s such a huge need for someone to help these kids.  Their parents are dead so they’re living with distant relatives or neighbors with zero direction for their life.  Kids are not given a lot of value; they are disdained and are not well respected.  Most of the emphasis, even within the church, is placed on adults, and the kids are largely ignored.  This has led to a mass exodus of kids from the church.

Parke:  This is all so overwhelming.

Dan:  Yeah.  It really is.  You really want to attack it.  You want to solve the issues and rescue everyone, but we have to remember that this is not just about us and what we can do.  It’s so easy to forget how great our God is.  It’s not up to us to completely change everything on our own.  It’s up to the Lord.  When I set out on this trip it was all about what I could do.  Could I train people to live better, more well-managed lives?  Could I build a hospital?  Could I revolutionize a health care system?  But day after day the issues became so overwhelming that I got to a point where I was asking, “Lord, can I actually do anything?”  And then God revealed to me that I can simply love these people.  I can respect them when no one else will.  That was a huge moment for me.  So, maybe I won’t change health care in Africa, but maybe I can do a surgery or smile at a hurting patient or share the gospel with someone in need of love.  Once again, it’s all about redefining success.

Parke:  How did this trip change you coming back to the states?

Dan:  It’s been very hard.  Thinking back it seems like I was in a completely different world.  I came back here and everything was so familiar and comfortable.   It’s so weird.  Here’s the challenge.  Lots of people travel and say, “I have seen the face of poverty. I have experienced people who can’t afford to buy food, medication, or receive care.”  They travel, come back, and say, “Here I am in America complaining about my $30 data plan so I can have the Internet wherever I go!  I need to change!”  Lots of people say that right at first, but I’ve never seen people act on it.  I’ve never seen people change their lives based on what they saw “over there”.  So, my challenge, and what I’m thinking through currently, is how can I truly live a simpler life?  How can I use my money in a way that is more beneficial to others around me and not just myself.  I’m still thinking this through.  I want the experience to change me and not just be another great story to share.  What should I value?  How should I spend my money.  I hear it too often that people go to third world countries, vow to change their ways, yet don’t alter the way they live once back in the States.   I want it to change the way I think, act, spend my money, and invest my time.

Parke:  We’ve gone everywhere and seen everything.   Our generation is probably the most traveled generation ever.  How do we put what we saw into action?

Dan:  It’s like thank God I’m back in the States with a cool story to tell.  Thank God I’m back in safety.  We easily fall back into the normal comfort of our lives here and lose site of what we saw in other parts of the world.  It really is hard to transition back from discomfort and poverty into a world of comfort and wealth.  How do I take it in?  How do I implement what I learned and saw and the changes that I know I need to make in my life?  It’s tough.  For starters, we have to keep loving those around us, right here, who need love.   We cannot become complacent.  We cannot become comfortable.  There are sick and hurting people around us all of the time, every day.  Go there.  Love them.

Parke:  What’s next for you?

Dan:  In the CAR, patients in need were in abundance.  If one of us didn’t show up and help that day, people were going to die.  In America, in Indy, if I don’t show up, patients can go down the hall or to the other hospital down the street.  I’m taking a cue from one of my team members, Dr. Kennedy.  Who, before every surgery, would introduce himself and say, “Hello.  I’m here because of Christ.   I’m doing this because of His love.”  Before every surgery he made it extremely clear that he was working because of God’s love for him and his patient.  I want to live, work, and introduce myself like that.  That’s what’s next.

Parke:  Wow!  What if we really did that here in the States?  If Christ followers introduced themselves and started every task and conversation with, “Hi.  I’m here because of God’s amazing love, and He has sent me to serve you.”  That’s a dangerous idea.

Dan:  (laughing) Yeah.  It could change everything.