Randy English has served as a missionary to the South and Central Pacific island nations for the past few years. He has assisted in establishing several indigenous (i.e., locally managed) congregations on many islands. He also directs the Pacific Islands Bible School, which offers Bible correspondence courses to the 25 million citizens of the 29 countries in the Pacific Ocean. As short-term medical missions have proven to be a very effective tool for spreading the Gospel in many parts of the world, Brother English made tentative plans for medical mission works to the locations where the church has been established. This work is tentatively named "Pacific Islands Medical Missions." It was felt that the first medical mission to this area should be attempted on Christmas Island, where the church was established in June 1990. Several short-term mission trips have been conducted to this island since that date and 25 people had been baptized. The island is located about 3 hours by airplane south of Honolulu, Hawaii. Christmas Island is on the northeastern side of the Republic of Kiribati (pronounced "Kiribas"). [There is no "s" in the Kiribati alphabet.] Dr. and Mrs. Tim Ashley and Dr. Michael Cole were recruited for the first team, which would assess the feasibility of doing short-term medical missions on a remote Pacific island.

Air Nauru provides scheduled flights to Christmas Island from Honolulu International Airport only once per week, leaving about 10 AM each Tuesday morning. At present no other flights are available. The original date (8 September) for the medical mission work was postponed within 12 hours of departure time from the States, due to problems with jet fuel supply on Christmas Island. It was not possible for the Ashleys to travel at the later date. They have indicated a desire to travel on a mission in the near future. The decision was then made for Jeannie (Mrs. Michael) Cole to accompany Michael on the trip.

Michael and Jeannie left Fort Smith, Arkansas, at 6 AM, Monday, 28 September 1992. Prior to departure at the airport, Mat Griffin, an elder from the West-Ark church of Christ, met with them, providing encouragement and saying a prayer in their behalf. Another elder, Bob Fisher, and the mission committee chairman, Jerry Canfield, arrived at the airport minutes after the Coles were boarded on the plane. Before the plane left, a letter from Jerry was delivered by an airline employee to Michael to be given to Randy English. The Coles changed planes in Dallas for a non-stop flight to Honolulu. Arriving in Hawaii in the early afternoon, they were met at the airport by Randy English. Randy spent the remainder of the day preparing the Coles for the culture of Christmas Island.

Mr. Bill Paupe, Honorary Consul at the Consulate of the Republic of Kiribati, is very helpful in arranging some of the details of the mission trips to Christmas Island. Mr. Paupe met the Coles and Brother English at the Honolulu airport on Tuesday morning, 29 September, and stamped their passports with admission visas. The fee per visa is $15. He also issued the airline tickets.

The team left Honolulu on Tuesday about 10 AM. The plane landed on Christmas Island at about 1 PM (same time as Hawaii, 5 hours behind Central Daylight Time). A few Christians met the team at the airport. The customs inspector was new to the job and insisted that everyone entering the country that day would have their luggage thoroughly searched. Though the team had no papers from the government, the inspector accepted explanation for the medications being brought in. A modern rental truck that had a sun canopy and built-in padded seats had been previously arranged and was waiting at the airport. After a short ride to the Captain Cook Hotel, everyone was quickly provided a room.

The hotel rooms were quite adequate. As in any developing country, it is not safe to drink the water from the faucet. The rooms had a small refrigerator where purified water was available in pitchers which were refilled daily by the hotel staff. The hotel is able to provide rooms for about 50 people, but there were only 7 guests while the mission team was there. It is a site frequently visited by fishermen from the U.S. and divers from Japan. The food was good and plentiful at the hotel restaurant. Breakfast usually consisted of a ham and cheese omelette, toast, and juice served at 7 or 7:30. Supper always offered fish at 5 PM. There was no air conditioning, but the nights were very comfortable as the beach was close and a breeze was usually blowing, keeping the nightly temperatures in the mid-70's. The sound of the waves hitting the beach provided pleasant background noise by which to sleep. The sun was up at 6:15 every morning and made it difficult to sleep beyond that time.

Christmas Island was discovered by Captain Cook on Christmas day, 1777. Christmas Island, the world's largest coral atoll, is located 119 miles north of the equator. The surface area is 248 square miles, about half of which is lagoons inhabited by 18 species of marine birds. The land is quite flat, only 5 feet above sea level. The population is about 2,500 people, greater than 99% Gilbertese natives who have moved there from other islands of Kiribati. There are four villages on the island. Poland village is 2 1/2 hours from the hotel and has not been evangelized. The Japanese operate a satellite tracking station on the island.

The country of Kiribati gained independence from Great Britain in 1979. The nation consists of 33 inhabited islands, spanning about 2,000 miles of the Central Pacific Ocean. The capital is on the island of Tarawa, which is a day ahead and 2 hours behind Christmas Island. The country uses Australian dollars as the legal currency. The people are Micronesian. Their native tongue is I-Kiribati, though most speak some English.

The predominant religions on Christmas Island are Roman Catholic and Kiribati Protestant Church (K.P.C.). The Church of God of North Carolina, the Mormons, and the Seventh-Day Adventists are also legally recognized by the government.

The islanders dress often in a lavalava, which is a loose wrap around garment. T-shirts are most commonly worn, though the women will sometimes wear a tibuta, a blouse with short gathered sleeves and neckline. Shoes are rarely worn. The men often wear shorts. The people are very modest and are not seen undressed in public.

The locals are friendly, though a bit shy. They are extremely hospitable. They are fun-loving, easy-going people. The local Christians are fine examples of New Testament brothers and sisters who look out for one another, encourage one another, meet one another's needs, and spread the Gospel by word and deed. They frequently meet together for fellowship and study. Their happiness in the Lord is very obvious.

On the first afternoon on Christmas Island, permission was sought from the local authorities to use the public maneaba (meeting place) in London village. Payment was made to rent this opened-walled building for each of 6 nights. The remainder of the afternoon was a busy time locating the local brethren and inviting them to the Bible classes that would start at 7 PM.

Also on Tuesday afternoon, Randy and Michael met briefly with the local physician at London to determine whether the national government had sent him documentation about the church's medical mission interests. (Randy had been at the capital the previous week, had spoken with the necessary authorities, and was granted verbal approval to allow an American physician to provide medical care to citizens of Christmas Island. Written permission was supposed to be provided, but did not arrive prior to the team's departure from Christmas Island.) Arrangements were made with the doctor to meet with him the following morning.

After supper Randy drove to those Christians' houses who lived too far to walk to London and gave them a ride in the back of the truck to the Bible studies. At this time of day one will find hundreds of sand crabs on the road, some quite large. Though most would scurry out of the way, it was not possible to avoid running over a number of them. The birds would clear the roads of the dead crabs by the time we would be traveling the next morning.

There were 22 in Bible class on Tuesday night. Everyone sat on the concrete floor of the maneaba, which is about the size of a basketball court. It is appropriate only to sit with the knees bent and the legs crossed. (This sitting position should have been practiced before leaving the U.S., as it would get extremely uncomfortable for those not accustomed to it.) Randy spoke first, using an erasable board. Teetan, a local brother, served as translator. The lesson was an evangelistic one and lasted about 1 hour. Michael then taught a Bible lesson about sin. This lesson also lasted about 1 hour and made use of the translator.

Randy taught each night and on Sunday morning. His lessons were all evangelistic in nature. Michael also taught each night following Randy. Michael taught the men's Sunday morning Bible class. All his lessons were about various sins that are often not recognized as sin. Jeannie presented Bible lessons for the ladies on Wednesday, Thursday, and Sunday mornings. Friday morning Jeannie assisted the Christian ladies in teaching the Gospel to 2 of their non-Christian friends.

Often the brethren would ask several Bible questions after the nightly classes. Then many members were given a ride back to their homes. The usual bedtime for the mission team members was 10:30 to midnight.

At 8:30 Wednesday morning, Michael and Randy met with the local physician, Dr. Tawita Tira, at the clinic in London village. He was given a very detailed explanation about what was planned for providing medical care through Christian medical missions. Though a local nurse aid, Miss Tekan Korere, was assigned to Tabwakea village, there was not yet a clinic built there. The plans for conducting a medical mission clinic at the Church of Christ maneaba at Tabwakea were also discussed in detail with the District Principal Nursing Officer, Mrs. Tie Teewa, who offered her services to assist in any way she could.

The nurse then accompanied Randy and Michael to the government offices on Christmas Island. There inquiries were made of the highest ranking official on the island, Francis Ngalu, Senior Assistant Secretary, whether the message had arrived from the capital providing the team with permission to provide medical care to the local people. (Higher ranking officials of Christmas Island were at the capital as Parliament was in session.) It became apparent that no one on the island knew of the plans for conducting a medical clinic and using it as a tool for teaching the Gospel. After hearing the details about medical missions, Mr. Ngalu granted his approval. (If he and the local physician had not granted permission, the team would have cancelled the clinic, but would still have been allowed to teach the Bible to anyone who would listen.)

The nation of Kiribati has 12 physicians on the main island of Tarawa where there is a small hospital. The only other island in the country with a physician is Christmas Island. Dr. Tira stated that he is generally kept stocked with medical supplies. He is able to pull teeth and do some simply surgeries under spinal anesthesia. There are no dentists among the 72,000 people of Kiribati. Common medical problems on Christmas Island among the adults are hypertension, diabetes, gout, and asthma. Many children are malnourished. Asthma and cough due to nasal drainage are common pediatric problems. Most adults smoke a mixture of tobacco and the local plant pandanus (the screw-pine) and thereby have many respiratory problems associated with such. Every age group has excessive ear wax, consistent with frequent contact with water in the ear canals. Cuts are frequent and generally seem to heal without much attention.

The fruit of the pandanus are heavy ball-shaped, cone-like aggregates. A section is easily broken off and is chewed and sucked on, reminding an American of a popsicle. It seems to be a favorite of the children. The plant has long, narrow, palm-like leaves, which are used for roof thatching, mats, ropes, twine, and baskets.

On Wednesday, the local nurse from London village and the nurse aid for Tabwakea were brought to the clinic site chosen by the medical mission team. Patients were screened at the Church of Christ maneaba at Tabwakea. This opened-sided thatched-roof building has a gravel floor. Mats have been placed in the center for sitting. It is much smaller than the public structure at London. In the small meeting place it is necessary to remove the shoes before sitting, as one must sit bare-footed on mats. Patients did not begin to arrive till 1:45 PM on the first day of the clinic. The small size of the team prevented one-on-one Bible study with individual patients so a class was ongoing, frequently repeating important points as new people arrived. Many were taught the Gospel in this group setting, both before and after visiting with the physician. Dr. Cole saw 33 patients the first afternoon, having to quit at 4 PM.

The building for the church was erected on land owned by a local Christian brother and sister, Taukaro and Teeua (husband and wife). Taukaro works as an electrical engineer for the government. Without any recommendation from Randy, the local Christians had constructed a maneaba for the congregation to meet under, immediately in front of Taukaro's house. The house of these Christians was used for the clinic. (One takes the shoes off before entering someone's house.)

Though many patients could speak some English, it was basically limited to conversational language and therefore most were not able to communicate their medical problems except in their own language. The Gilbertese nurse was invaluable in assisting the physician with translation. Also the nurse and her aid kept records about certain patients seen so that they might follow-up on their particular problems. The nurse brought posters each day to assist in teaching the local people about proper nutrition. This was very needed by many of the mothers. Too often a mother would allow her child to simply eat whatever food that child liked the most. Children suffered from malnutrition due to maternal ignorance about the need for a varied diet. Too many children were eating nothing but fish and rice and drinking nothing but coconut juice. A baby died at this village Tuesday night (29 September) from malnutrition because its mother fed it nothing but biscuits (i.e., crackers). The baby had plenty to eat, just not enough variety.

Wednesday night Bible class was again conducted at London village. Randy and Michael were forced to speak without an interpreter available. The nurse lived close to the meeting place in London, so she attended the lessons on Wednesday and Thursday nights.

Looking back on the situation, perhaps it was not wise to have classes at London, as this was too far away to walk for the people of the village being medically served. Had the Bible classes been presented at the church's maneaba at Tabwakea, perhaps more local non-Christian people would have had opportunity to attend. However, the people are very hesitant to enter the building of someone that they do not know very well. There were fewer non-Christians at the public maneaba at London than had been hoped for.

Thursday morning (1 October) Randy and Michael and Brother Teboua, who served as translator, studied with Napoleon, a man who expressed an interest in hearing about what was being taught. His wife had taken their child to the clinic the previous day. After Bible study, Napoleon indicated he wanted to be baptized. Michael baptized him in the Pacific Ocean behind Taukaro's house.

Teboua and his wife had been taught and baptized by the local brethren only a few weeks before this mission trip. He was converted from Catholicism after reading the Bible correspondence courses sent to another person on the island.

Thursday the ladies prepared tuna, rice, and papaya for lunch.

The nurse was picked up about 12:30 from the clinic in London and brought to Tabwakea. Though the clinic was to begin at 1 PM, the first patient did not arrive until about 1:45. Twenty-eight people were examined and treated before the clinic was closed at 4:10. There were many people who came who were quite healthy. This was especially true about some children whose mothers merely asked that they be checked. There were no large crowds of people who had to be turned away at the end of the day. Not enough variety of medications, nor adequate supplies, had been taken due to the uncertainty whether the government would even allow them to be brought into the country or whether the medications could be allowed for a clinic. Nevertheless, many patients did find good quality health care at the clinic. Those patients who had needs that could not be met were recorded by the nurse and her aid so that attempts could be made to obtain the needed medications. A few patients with high blood pressure were identified and follow-up evaluation and treatment was anticipated.

Randy coerced Michael to wear the traditional lavalava for Bible class on Thursday evening.

Friday (2 October) was Randy's son Garrett's third birthday. It is unfortunate that doing the Lord's work can take one away from one's family on an important family day. Hopefully, the family is strengthened by such efforts and not weakened by absences of this sort. (Saturday was Michael and Jeannie's son Steven's birthday.)

On Friday morning a young woman, Kaetieti, was picked up at Banana village and taken to ladies' Bible class. Instead of teaching the class prepared, Jeannie taught the Gospel to her and another non-Christian woman, Bwenaua, with the help of the Christian ladies there.

Friday morning at 1 AM, a Christian woman, Nikawara, delivered a baby. She had been examined by Dr. Cole at the clinic the previous day. The baby was examined Friday morning about 9 AM and found to be doing fine. (She had named her first child "Randy," who is now about 2 years old.)

Friday morning Randy met with the customs official to offer assurances that the T.V. and VCR that was being held should not be subject to import taxes. The equipment was meant for use only by the church for religious education. The official cleared the T.V. and stated that it would be available for pick up in the afternoon.

On Thursday afternoon Randy had talked with Bwenaua and Temataake about their living together without marriage. He showed them from the Bible that this was not acceptable to God. They were both very interested in learning more about Jesus and the church. Friday, while Jeannie was teaching the women, Randy and Michael and Teboua met with Temataake and taught him the Gospel. He indicated he wanted to be baptized. He was taken to Taukaro's house where it was discovered that the two women wanted to be baptized also. Much discussion was made about the sinful relationship that the unmarried couple was involved in. Before their baptism, it was decided that they should be married that very afternoon. (The country allows a marriage to be completed after 21 days if $3 are paid; or one may pay $40 and have the wedding that very day. Randy and the local church assisted in paying the $40.) The 3 were then baptized in the Pacific.

It was a bit of trouble to get everything completed for the wedding and find all the necessary officials to perform the ceremony that afternoon. Only a bit of difficulty presented itself that the church of Christ is not legally recognized in Kiribati and supposedly is not allowed to perform weddings. The problems were quickly resolved. Randy recommended to the happy newlyweds that the groom should carry the bride into their home as is done in America. (Most of the women and not a few of the men are moderately obese.)

Again the clinic was held starting at 1 PM on Friday. Many of the Christians asked to be examined and to check their children. This was done before the first patients from the village began to appear. The local physician came and observed what was being done at the clinic from 2 to 4 PM. The clinic continued till 4:30 as Randy was not back from getting the marriage completed till then.

Supper was a bit late that evening. A truck load of people were picked up to take to the Bible study. Unfortunately, the government officials had failed to return the key to anyone that day so the gate to the public meeting place was found to be locked. Teetan and Nitara lived very close, so the Bible classes were held in their home. Many Bible questions were answered that evening till 10:30 PM. Bedtime was about 12 midnight that night.

Saturday morning (3 October) the team travelled to Banana village where a brother and his non-Christian wife were examined and given medical treatment. He was strongly encouraged to remain faithful to the Lord.

Later Saturday morning the local brethren travelled by a large flatbed truck to a beautiful lagoon where a picnic was prepared. There is a small maneaba there where everyone could eat. A pig had been butchered the day before and was barbecued at the site. The men caught fish which were grilled whole and served for lunch. Also served were canned peas, pork and beans, white rice, and breadfruit. The men and Jeannie were served first. Then the other women and the children ate. A pan of water and a towel was passed around after the meal to allow one to wash the hands. After a brief rest, everyone was treated to Halloween size packages of M&M's brought from the States. This proved to be very popular. With everyone alert, Randy then conducted a brief Bible study about the importance of working in the Lord's Kingdom (Titus 3:1).

Bible study was again held at Teetan's house that evening at London village.

Sunday morning Bible class started at 10 AM with Michael teaching the men's class in Taukaro's house and Jeannie teaching the ladies in the maneaba. Worship was conducted in the maneaba from 11 to 12:30. The order of worship was after the pattern set by the local men, who conducted the entire service except for the sermon presented by Brother Randy. The Lord's Supper had home baked unleavened bread; the fruit of the vine was made from raisins. (Another method used on occasion to make grape juice is to boil the alcohol out of wine.)

After lunch, while the men met for a "business meeting," Michael and Jeannie walked to the beach to look for seashells. A man, Utimawa, came out of the water with a moray eel that he had caught. He was very curious about why they were picking up shells. He asked if they were with the Church of Christ. He asked if the Church of Christ was from America. He was told, "No, it is from the Bible." Though he spoke English poorly, he expressed an interest in receiving a Bible. He was told that he could get one at the house. He went home to change his clothes, then returned to the maneaba. After being given a New Testament and a tract, Michael and Teboua studied the Bible with him. He was baptized in the Pacific Ocean at 4:30 PM.

The new TV-VCR was tested with a Bible lesson on videotape. It seemed to be a good tool for the local church.

After Sunday evening Bible classes at Teetan and Nitara's house, the local Christians presented the team members with T-shirts.

On Monday morning Kaetieti gave each team member a shell necklace that she had made. A local Christian, Ataiti, took Dr. Cole to visit his grandfather who suffers from pain at the site of an old below-the-knee amputation. The man was given some medication that should ease the discomfort. (Ataiti's wife, Temantang operates one of the small stores on Christmas Island.)

Jeannie spent the morning with the Christian ladies where she helped answer Bible questions from Kaetieti regarding the Catholic doctrine which she had abandoned. The ladies constructed headpieces similar to the Hawaiian lei which they presented to the team members before departure.

Monday morning Michael and Randy visited with the island physician and left all the medications with him that had not been used during the medical mission. These seemed to be very appreciated. A storekeeper, who also rented videotapes, asked Randy if he could get Bible lessons on videotape. The storekeeper, who is not a Christian, wants to duplicate them and distribute them to the islanders. Soon thereafter, a man who had been attending some of the Bible classes told Brother Randy that he wanted to be baptized, but could not that morning because of his job. He wanted to be sure that the local brethren could do this after the team departed. Later at the post office, a man working there mentioned that he was searching for the truth. He was given a Bible, but time did not permit study except to show him Romans 16:16.

As the team was going to the airport, several of the local members asked to ride so they could see them off. Nitara mentioned that she had studied with 4 people that morning. Teboua was studying the Bible with 2 people when the truck came to pick him up for the ride to the airport.

After paying the exit fee of $5 (Australian), the team departed Christmas Island at 3 PM. It was necessary to stay overnight in Honolulu. The team stayed at the Pacific Marina Inn, near the airport. The Coles arrived back in Fort Smith at 9:30 AM on Wednesday, 7 October. Several members from West-Ark church were present to welcome them home.

Total cost for this trip for the Coles was $3,489.68 (not including souvenirs or other items purchased not related to the mission). Because Jeannie's ticket was purchased so close to the date of departure, her expenses were greater than would normally be the case. The cost should be expected to be about $1600 per person.

Offering medical missions at temporary clinics, with an emphasis on evangelism, will be beneficial for the Lord's cause at the congregations in underdeveloped areas of the Pacific Ocean. Let all be done to the glory of God.

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