Missionary doctor says the coronavirus projection for Malawi is 'pretty bleak'

Rick Monroe

Special to Village News

When the last plane with fleeing foreigners left Malawi in March, medical missionary Christina (Metzler) Miller and her husband, Greg, decided to stay. She works in a small hospital in a rural town in the African country they've called home the past three years.

The coronavirus in the land-locked, third-world country is expected to be devastating.

"I was called to be a missionary 16 years ago, and this is a once in a lifetime opportunity to serve hundreds or thousands of people in need. This is our home now, and it's our calling," the 33-year-old doctor said.

That's a gutsy call for the 2004 graduate of Fallbrook High School. The Metzler family moved to Fallbrook 33 years ago, and Christina Miller said she knows her family is worried.

"After we made our decision, I wondered, 'Should I rethink this,'" she said in an April 6 phone interview. "I never thought I would encounter such a difficult decision, but this is the pinnacle of my calling. It's the right decision."

Miller is more than a medical doctor at Nkhoma Hospital. She is the only preventive medicine specialist in Malawi. In the hospital, she coordinates teaching sessions to help keep the team current on the latest guidelines and improve quality of care at the institution. She utilizes Nkhoma Hospital's network of community clinics and her husband's network of pastors and churches to bring education and healthcare prevention to communities.

"I'm in a position to help in a way no one else could do," she said. "This virus is terrible, but as a leader in health care here, I can help. And Greg is needed, too."

Her hospital may or may not treat COVID-19 patients directly. The government is still finalizing plans, but she knows it will be an impact because the country is just not prepared.

"I look around and see a lot of people with sniffles," she said. "I don't know for sure it's the virus, but I know it takes weeks before it's really evident. When it comes, it could be like an avalanche."

The doctor said the problem is, "The medical supply chain is desperate, and testing for coronavirus is unreliable. The two main cities in the country have 20,000 tests available."

"There's just nowhere on the continent to buy the masks," she added, saying there were 600 employees in her hospital, and they are down to 1,000 masks.

"We're looking at preventative strategies, including re-use of masks," she said.

She recently completed a draft plan with the Disaster Preparedness Committee at the hospital.

There was hope the virus would not find its way into Malawi, and through March there were no reported cases of the virus. However, Miller explained that was because no one had tested positive. The figure rose to three cases April 3, and she said there are 5,000 suspected cases now in the first week of April.

"It's here," she said. "There's been no mortalities, but we have our first high-risk case and it won't be long before it's really here. There's no way to contain it.

"We pray to be wise and as prepared as possible, but the projection is pretty bleak," she said.

On the positive side, she said her team at the hospital is excellent, giving the example of them placing 15 hand-washing stations throughout the hospital in one day.

"We cling to small victories," she said.

Her husband Greg Miller is a third-generation pastor and teaches Christian theology at Nazarene Theological College of Central Africa. Mawali is a country where 85% of people identify as Christian, but few have actually heard the gospel message. He focuses on teaching understanding and discernment to pastors. His goal is to train future church leaders in how to understand Scripture and think outside of cultural biases. He also developed a program for local pastors who have other jobs to become ordained.

"He's making great inroads," his wife said. "Pastors here are like chiefs and pretty much do what they want. Despite warnings about the coronavirus, some are holding church services. But some are listening because we've partnered with them."

There is a severe shortage of doctors in the country – 1 doctor for 50,000 patients in a country of 24 million people. The doctors continually see one patient after another. Christina Miller said she has seen her share of patients, but with her training, she also holds an administrative position and primarily works on writing procedures and protocol, providing resources and is now preparing for the pandemic.

Miller said she became interested in medicine after helping with in-home care for her disabled grandmother on weekends – and found it to be very rewarding.

"It was something I liked and was good at it," she said.

She and her family attended Riverview Evangelical Free Church, where many have gone on to be church workers and missionaries.

"The church did health care trips to Mexico and by the time I was 18, I had made a half dozen or more trips – and loved it," Miller said.

An honors student, after high school she went to Point Loma Nazarene University to study nursing, but a Fallbrook surgeon who attended Riverview suggested she become a doctor.

"He said I might tire of taking orders from doctors," she said, so she switched her major to pre-med.

After graduation, she took a semester off for a missions' trip to Indonesia, which solidified her desire to become a missionary.

After college, she graduated from University of California Los Angeles Medical School, then completed her residency at the Loma Linda Medical Center. She later earned a master's degree in preventive medicine and public health, which was good training for her current position in Malawi.

While at Loma Linda, she and her husband were involved in setting up soup kitchens and medical clinics for the needy. Greg Miller worked for a church and taught Bible classes.

A mission trip in 2016 to Papua New Guinea further strengthened Christina Miller's desire to become a missionary doctor. They discovered the World Medical Missions program by Samaritan's Purse would assign them a hospital to work at, teach the language and provide for their needs in a third-world country for two years. After that, they needed to raise their own support, which they were able to accomplish in 2019.

They began serving in Malawi in January 2017 at Nkhoma Hospital, a 220-bed facility founded in 1915. The hospital provides primary health care to a population of 60,000 and referral care to approximately 450,000. Nkhoma Is a one-hour drive from Lilongwe, the capital of Malawi.

Nkhoma has been their home, except for seven months of fundraising in 2019.

"We have finances through the end of the year, when God-willing, we will return to the U.S.," Miller said.

It sounds like a worrisome comment, but Miller said she wanted her mother to "please, please not worry." Her faith in Jesus is strong, and she believes she will be protected, she said.

The Millers can be contacted by email at [email protected]. They also have a blog at http://www.MalawiMillers.com for regular updates and information about how to join in advancing God's kingdom in Malawi.