Meet Josephine*. She should be dead.

It was January 2020, peak rainy season, and Josephine – still a teenager – was loaded into the home-made stretcher and carried the 5 scorching kilometres to the next village over. They’d come because the Hopitaly Vaovao Mahafaly community health team had arrived by Helimission helicopter the previous day. The small team was doing a combination of vaccinations, health education and Bible teaching, interspersed as always with distributing a few antimalarials and antibiotics to the unwell people they found out in these remote villages.

The villagers saw her coming, broke off from the question and answer Bible session that was going on that morning and helped them take her off the stretcher. There, one of HVMM’s experienced nurses (and a medical student from the UK tagging along for the village experience) took a closer look at her.

It was rapidly clear that she was pretty sick, probably beyond what the community health team could manage with their limited medical supplies and so the nurse phoned Hilde back at the hospital for advice. Hilde (the missionary team leader) agreed it was serious and quickly found one of the hospital’s experienced doctors to try to establish what was wrong.

That conversation allowed the doctor to identify that Josephine was suffering from a life-threatening medical condition. She was lucky to still be alive and probably needed urgent surgical intervention if she had any chance of surviving. Normally, to get to the hospital she would need to be carried through flood tracks and a couple of rivers.

Enter Helimission! Hilde took charge and discussed with the helimission pilots, who were based at the HVMM hospital in Mandritsara for the week. Yes, they had time in their flight schedule to fit in an extra trip today, yes, they could land in that village and yes, despite the cyclone gathering out in the West, the weather was OK for the moment. Less than an hour later, the village children’s football game was temporarily postponed by the helicopter landing on their pitch and Josephine was on her way to HVMM.

On arrival she was assessed by the surgeon on call, who confirmed the provisional assessment that she needed to have an operation that evening. It was amazing that she’d got this far - but unfortunately things were about to go from bad to worse.

Popping into the hospital after the team Bible study to ask the lab technician if he’d found blood for a different patient, another of the project’s doctors discovered Josephine’s father and brother being tested. In a hospital without a blood bank, family are always the first port of to see if they are compatible donors. An urgent call from theatre had come for 4 units of blood RAPIDE. Concerned by this Dr Nathan stuck his head round the door of the operating theatre where the surgeon, Ted, scrubbed and sweating, explained in no uncertain terms that although he had performed the critical surgery, Josephine now needed a blood transfusion ASAP or she would die on the table.

Nathan ran back to the lab. Bad news: none of her family members had compatible blood groups. There were no other potential donors with her. Fortunately Nathan was able to donate a unit of his own blood whilst simultaneously texting the rest of the team to see if there was anyone on site who might also be compatible. One unit would undoubtedly not be enough.

By the grace of God, a visitor only in Mandritsara for a 10-day visit turned out to be B-positive and was able to donate a crucial second unit which allowed Ted to get her stabilised. Even at this point Josephine was still bleeding, but Ted completed the operation and the team began to pray. God had done so many amazing things to get her to this point it seemed crazy that He’d let her die now. Yet we knew she was still bleeding, needed a third unit of blood when there were no donors left and was also showing the early signs of post-op sepsis.

But God is so good. Although not every story we tell here has a happy ending, in Josephine’s case He answered prayer after prayer after prayer in just the way we hoped for. The lab technician found a security guard with compatible blood who, although mortally afraid of needles, eventually consented to give his blood too for the third unit that night. Ted took Josephine back to theatre 36 hours later and, contrary to our medical expectations, her situation was looking much, much better. And after an 8 day course of intravenous antibiotics her fever finally settled too, she began eating, drinking, and then finally walking around and smiling. And most importantly of all, she listened. She listened to the gospel talks on the ward each morning.

She listened as the hospital evangelist explained that everything God had done to save her life in this crazy week paled into insignificance compared to the lengths he’d gone to to save her soul when Jesus died for her on the cross.

As she listened she began to understand how deeply God had loved her and what it would mean to follow Him in return.

Knowing where people have ended up with Jesus is always difficult across the language and cultural barriers here in Mandritsara. But one of the experienced nurses on the surgical ward was quietly confident that by the time she left the ward, 10 incredible days after she arrived in the helicopter, she’d not only been snatched back from the jaws of death by God’s incredible provision of exactly what she needed medically at each stage, but had also passed from death to life spiritually too.

Come and see what God has done!- reflecting back on the lengths to which God went to save Josephine’s life and call her into His kingdom blows my mind: please pray for her as she recovers post-operatively and steps out on the road of faith, for Ted as he sees her in outpatients and chances for him to speak further about God’s saving love and how we go about living a life of thankful obedience to the one who’s saved us all.

And please pray for us all as a missionary team, and as a the project staff more generally that this reminder of the breath-taking magnitude of God’s saving grace would spur us on to tell everyone who comes our way how much God has done for them, even if they’ve not been evacuated from their village by helicopter.

And praise God for Josephine- she should have been dead and is alive, she was lost and now is found.

*Not her real name. Pictures used with permission

Due to COVID-19 restrictions, MAF and Helimission flights are currently unable to operate normally in Madagascar.