Medical missionary experiencing breakthrough in reaching Malawi

Rick Monroe

Special to Village News

Fallbrook High School grad Christina Metzler Miller and her husband Greg have been missionaries in Malawi for four years. They've gone through a variety of challenges and successes there but are now experiencing a breakthrough in their "season" of learning.

Even with missionary training and help from local mentors, it's taken four years to really know the culture and pastors.

Metzler Miller is a medical doctor and has worked a couple of years in the capital city of Lilongwe, as well as the small village of Nkhoma. She graduated from Point Loma Nazarene University and UCLA Medical School before completing two residencies at Loma Linda Medical Center as well as earning a master's degree in public health.

Her husband Greg is an ordained Nazarene minister with a Ph.D. He has a heart for training pastors and is teaching at NTCCA seminary in Lilongwe.

For Metzler Miller, prevention and early detection are her forte and that was her assignment at the village hospital. As a consultant and co-leader of the COVID-19 task force, she initiated programs and made suggestions. During that time, she really learned the benefits and challenges of working at a 100-year-old mission hospital.

"A year ago, we realized the key is working with community pastors," she said during a recent phone interview. "That's how we can reach the most people. It's taken four years to know the culture and build relationships with the local pastors, but it's beginning to happen."

Following a sabbatical and fundraising trip to Fallbrook, the couple returned to Malawi in February, and moved from the village of Nkhoma back to the capital city of Lilongwe. Metzler Miller is working at the community hospital at African Bible College, where she was assigned the first two years the couple were in Malawi.

"Greg and I have been doing village outreaches, which are facilitated by local pastors, and are doing teachings ranging from women and child health with groups of 100 or more women, to agriculture and transforming world view with 20 to 40 pastors and chiefs," she said.

They are truly beginning their season of training and planting seeds for long-term, sustainable change.

"Just last Wednesday, I was able to speak to more than 100 women on menstruation and protecting girls," the doctor added. (See her account in the Opinion section page A-4.)

The past four months, since returning in February, the couple focused on meeting pastors. Significantly, they collaborated with Nixon and Thokozani Nzunga, a husband-wife team who initially planted and oversaw 13 churches.

"In the last year and a half, Nixon was promoted to the position of district superintendent, similar to the position of bishop, and currently oversees 200 churches and 78 pastors. He and Thoko have a huge heart for people. We're teaming with them to plan training and to follow up with community training in health," the doctor said. "The country is 85% Christian, and when people come to the pastor for prayer, it's an opportunity for the pastor to offer direction for additional care."

"That's what we really want to see," she explained, "where the church will meet the needs of the community."

And it's a way for the Millers to connect with the villages.

"We're so excited about these new opportunities and can't wait to see what the next years will hold," Metzler Miller said. "We are also hoping that the community development methods and life-balance we discover will help give good models to other doctors and missionaries."

"After one to two years of feeling we were not making a lasting difference, I feel we are entering a new season of being more productive in ways that can bring long-term transformation," she said.

She has directly been involved in saving several lives and guiding families toward the clinic in Lilongwe and at the same time still wants to focus on prevention.

Her typical week is divided equally with time in the clinic, electronic, teaching and mentorship, administration and planning, and community health.

"I'm passionate about making lasting changes," she exclaimed. "We're committed to long-term work here. When we started four years ago, we said we'd commit to 10 years and then see what was next. I look forward to the 10 years and would be super happy to stay a couple of decades, unless we work ourselves out of a job."

In addition to working at the Bible college medical clinic – in this age of people working from home – she is doing part-time work for the American College of Lifestyle Medicine, training doctors how to treat and reverse diseases with lifestyle habits rather than medications. "I'm a lead faculty for one of their training modules and editing faculty for others," she said.

"My friend and I also just won a large Health Resources & Services Administration grant to start training specialized doctors in Maternal Health outcomes at Loma Linda University," she added. "This promises to be another part-time job that I can do in my free time from here, which will have a big impact for the health of women in San Bernardino and the way doctors are trained to improve women's health."

"Both of these jobs in America promise to be income-generating, and to make me a better doctor for the work I'm doing here," she said.

The doctor said she works one day a week in America via telecommunicating, and that one position is project based and will continue into next year.

"Remember, Malawi is one of the poorest countries in the world," she said. "There are a couple million people, but there is one drive-thru (KFC) and no movie theater in Lilongwe. It's a capital city but is not much different from Fallbrook in terms of small-town feel."

"There is a lot of need and opportunity to help," she added. "It's easy to see patients one at a time, but little opportunity for long-term change due to infrastructure and mindset. I believe many mission hospitals have been doing the same thing for 50 to 100 years without seeing healthy transformations within their communities."

She explained that she tries to facilitate sustainable change using local resources. "We have a different mindset than most medical missionaries."

"We want to make a difference that will last," she explained. "When we leave, we don't want things to be the same as before – we want to see a carry-over."

She said COVID-19 made that clear. "My training is disease prevention, but the way policies, procedures, and mindset worked out in Nkhoma, COVID prevention was hard to implement and devastatingly difficult to maintain. It broke my heart. There were opportunities to make a difference, but fighting COVID in a reactive village environment was so difficult."

She said that most facilities in Malawi ran out of tests in the later half of last year.

"The mortality rate of adults on the medical ward tripled," she said. "Before COVID, 1 in 20 admissions died, but during COVID that number increased to 1 in 7 or 8. Many died before they even reached the hospital and many hospital deaths are not confirmed as COVID deaths. About half the deaths were from respiratory conditions, but many times we were unable to appropriately rule out COVID as a cause of death due to difficulties with testing."

The country is experiencing its third wave of COVID-19 now, the doctor said.

"It's a public health nightmare," she admitted. "Supplies, vaccinations and tests are all scarce. A government task force has been established, but there is a large number of under-reported cases. The reported cases are just the tip of the iceberg. There is only one major hospital in a region serving a couple million people, with only 4 to 5 ventilators in the country that may be working and accessible to people with COVID-19. It's tough."

Metzler Miller is thankful she caught COVID-19 while in Fallbrook this winter instead of in Malawi.

Their plan has been to return to Fallbrook every two years in December. That happened again this year, but the stay was extended to February because both she and Greg came down with COVID-19.

"We caught it at Christmas, and it hit me a bit hard," she said. "It took me months to be able to start running again. I had it really bad and think I gave it to my parents, but it was nice to be cared for here by family and know hospitals were nearby."

The couple are happy to be healthy again and looking forward to the opportunities in Malawi over the next few months and years.

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 their work in Malawi.