DOCTOR RETURNS FROM AFRICAN MISSION TRIP

Dr. C. John Ritter

Dr. C. John Ritter admits there were days during his recent mission to Mozambique when he wondered just what he had gotten himself into.

Ritter, who retired earlier this year from his Cape Girardeau medical practice, spent three months in the African nation as a Methodist volunteer-in-mission at Chicuque Rural Hospital on Mozambique's eastern coast.

The country, considered the poorest in the world with an average annual income of $89 per person, is recovering from a 17-year civil war that left most of its infrastructure and its society in shambles.

"They have a horribly disrupted country," Ritter said. "They're trying to get it all back. The people's lives are very primitive. In order to get away from the rebels, they moved into the cities, so there's no agriculture."

Crime is very high in Mozambique, he said, and he heard horror stories about carjackings and robberies everywhere he went.

It took him a while to get comfortable, Ritter said.

"For the first three weeks I was there, I was ready to get the heck out of there," he said.

Doctors from five countries -- the United States, Germany, Brazil, Nigeria and Mozambique -- were working at Chicuque during Ritter's stay.

Malnutrition is a big problem, he said, and the doctors also had to deal with a high number of difficult childbirths because it's very common for girls as young as 14 or 15 to have children.

Tuberculosis, malaria and hepatitis are common, Ritter said, and land mines, sinister remnants of the country's civil war, kill and injure many Mozambicans every year.

Many of the injuries Ritter and his colleagues treated were caused by land mines, he said.

"During the civil war, between one and two million land mines were put out, and they're still active," he said. "We got quite a few land-mine injuries."

One day, a truck carrying 16 people in Chicuque hit an anti-tank land mine, Ritter said. Nine people were killed, and seven were injured.

AIDS, which is rampant in western Africa, is just beginning to make a serious appearance in Mozambique, he said.

"It's not too bad," Ritter said. "Because of the war nobody came there. But now they're seeing more AIDS cases since the peace began."

The average life expectancy for Mozambicans is 47. The mortality rate for children is under age 5 is 15 percent, and another 10 percent die by the time they're 15, Ritter said, mostly due to disease and injuries.

The Methodist church plays a big role in Mozambique life. During Portuguese rule, the only education made available to Mozambicans was through the church. The years of warfare since the Portuguese pulled up stakes meant there was no opportunity for a public education system to be set up.

Medical supplies and funding were limited at the rural hospital where Ritter worked, and little lab work was available.

A hydroelectric dam at nearby Cambine was destroyed during the civil war, knocking out the region's power supply, and a cistern had to be built to supplement the hospital's iffy water supply. The volunteers-in-mission took care of both of those items.

Ritter's wife, nurse Marcia Southard-Ritter, the vice president of patient care at St. Francis Medical Center, was one of the volunteers who helped build the cistern. She also worked in the hospital with her husband.

Southard-Ritter joined her husband for the last three weeks of his stay in Mozambique.

Both said they were shocked by the poverty and the high mortality rates for children and adults.

"There were a lot of deaths," Ritter said. "We averaged probably three or four deaths a day at the hospital."

"I thought I was prepared for it, have done other missions in undeveloped countries," Southard-Ritter said. "But it was so much sadder than I expected it to be. Seeing children die who would have had an excellent chance of surviving if they had been here or in another developed country was incredibly sad for me."

Ritter retired from his private practice in January to pursue medical missionary work full-time. It's something he's always wanted to do, he says, and a chance to put his skills to work to serve people who need it the most.

The trip to Mozambique hasn't changed that dream. But he's learned it can be grueling.

"I need a little time off between these things," he said, laughing.

He didn't take much time off. He left Friday for a week-long "scouting" mission to Copper Canyon, Mexico. Southard-Ritter said her husband went to see if he would be needed there and may eventually plan a longer trip.

Ritter and his wife both did mission work on the Caribbean island of Barbados in 1993 and in 1995, and Ritter went to India earlier this year with a Rotary Club exchange group.