ARE COUPLE WILL RETURN TO BARBUDA; RITTERS ENJOY MEDICAL MISSION WORK

FAMILY AFFAIR: In both Africa and the West Indeas, families of hospital patients spend much time with them and provide their meals. In Africa, the families also bathe the patient and change the beds. Here relatives of a young boy with a fractured leg posed in Mozambique.

A reporter landing on the West Indies island of Barbuda would not have to ask "Dr. Ritter, I presume?" when meeting John and Marcia Ritter.

While the Cape Girardeua County couple would usually be the only caucasians in the interior of the island, any local resident would be able to point them out. When the Ritters return to Berbuda in September, it will be their fourth medical mission trip to the tiny island.

Ritter, a Jackson native, retired as a physician in 1997. Since that time he and Marcia have logged in 16.5 months of medical missionary work. More than six months of that time has been on Berbuda. They have also made African trips and have survived a hurricane, two outbreaks of civil warfare, several hostile checkpoint guards and bouts of malaria.

The payoff has been great, though. Ritter has seen his presence (and that of other volunter doctors) make a huge impact in natives' lives in both the West Indies and Africa.

"Marcia and I became itnerested involunteering in 1993," Riter said. "We foudn an organization that sent medical volunteers over a month at a time. We were both working at the time, so it was an ideal situation for us."

The couple made their first trip in Octl, 1993 and have also made trips in 1995, 1997, 1998 and 1999. Their first trip to Berbuda was in 1995, six weeks after a devastating hurricane had damaged 90 percent of the island. The doctor's house was nealry destroyed in the storm and the island was without power for a long period of tiem.

The Ritters got to experience a hurricane in person in Oct., 1999, when Hurrican Jose inundated the island for 36 hours.

The doctor's residence sit on stilts and is screened in on all sides. Only the bedroom has walls. Visitors have remarked that "it's like living on your front porch." Winds of 120 miles per hour, with occasional 150 miles per horu gusts and hard rains had the couple concerned.

"No rain hit the ground," Marcia said. "It was raining hard, but it was so windy that it was comign down horizontally. The actual eye of the hurricane came between Berbuda and Antiqua."

"There was a danger of it picking up the hosue, or of flooding," Ritter said.

As withother dangers, the couple survived -- as did the house.

On the typical day in Berbadu, the Ritters would get up about 6 a.m. and go get in line for bread.

"We'd walk into the village, or drive in our little truck. By 6 or 7 a.m. a crowd will be there to get bread."

The fresh bread is a staple in the native diet. On Tuesdays and Fridays the most popualr baker makes special sweet bread, with raisins.

Ritter woudl usually be at the clinic from 9 a.m. until Noon or 1 p.m. Of course he was also "on call" at all times. Marcia woudl usually go to one of the beaches during the morning.

"I would typically see a lot of children and adults with diarrhea, hypertension, ashma and skin problems. We're very limited with what we have. The medical community here has been very good at giving medical supplies for us to take. It's not quite as bad as Africa, but what you take with you is basically what you have to work with."

Children are treated free, while adults are charged $5.

Marcia, a former hospital adminsitrator at St.Francis Medical Center in Cape Girardeau, did some consultation with nurses at the Barbuda hospital. During the Afridan trips, though, she served as hospital administrator.

Things were more bleak in Mozambique and Liberia, where poverty was almost beyond comprehension and dangers such as outbreaks of civil war a continuously looming presence. The presence of medical volunteers and supplies, though can make an even bigger difference.

"Before we got there, they were losign four or five patients a week in the hospital," Ritter said. "Just by making the rounds and paying attention, only two died in the four and a half or five months we were there."

"Africa is a sad place," Marcia said. "We treated chidlren who were dying for lack of (what would have been) 50 cents worth of medicine in the United States."

Conditions were more primative in Liberia. The Ritters had electricity in the hospital four hours a day and running water two hours a day.

Two bouts of malaria put a stop to Ritter's trips to Africa. He still works to generate funds and medical supplies for Ganta United Methodist Hospital in Liberia. Help is desperately needed there. While reluctant to mention his own gift, Ritter noted that a $100 donation he made was able to buy two 50-kilogram bags of rice and fed 1,000 people for four days.

In 1998 and 1999 the couple nearly got caught in the middle of bloody fighting in Liberia.

"Fighting broke out while we were in the capital city," Ritter said. "They were shouting at the U.S. Embassy becasue the embassy had given refuge to someone they were after. We were told to leave the country. If it had happened an hour earlier we would have been in the middle of it. They killed 600 people that night."

Fighting broke out again in 1999. That, and Ritter's malaria attack, cut short their final African visit, after two and a half months. He recovered in a hospital in Rome.

During the fighting the usual four checkpoints between the capital city of Monrovia and the village of Ganta, where the Ritters lived, was increased to more than a dozen. Ritter had to rely on his wits to keep from being robbed by one guard.

"He kept insisting that we open the car and let them search," Ritter said, noting that the checkpoint guards significantly bolstered their pay by raiding vehicles. "I kept refusing. Finally I asked him to take off his glasses. I said 'Your eyes are yellow! You have malaria and probably have six or seven horus to live if it isn't treated. You need to get to the hospital right now!' He took off and we were able to get through. I was pretty proud of myself that time."