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Reaching Madagascar

“I clearly remember God calling me to Africa, but I did not want to go alone,” said Dr. Aaron Santmyire ’00. Aaron felt called to be a missionary to Africa at the age of 12 while attending a youth camp where evangelist Greg Hubbard was speaking. Several years later, Aaron would meet his wife, Heather (Seymour) ’01, a missionary kid who was born and raised in Zimbabwe for 12 years. Heather also felt called to missions and to work with orphans in Africa. With a similar calling and passion to reach the lost in Africa, Aaron and Heather would move to the country of Madagascar as full-time missionaries with the Assemblies of God in 2007.

Their journey began while they were undergraduate students at Southeastern. “She dropped a picture from a recent wedding, and I held onto the picture so I would have a reason to talk to her. Eventually, our friend Brandon orchestrated a date and the rest is history,” Aaron said. The two were married in August of 2000 and now have two children, Isabelle, 11, and Josiah, 9.

Although Aaron graduated with a bachelor’s degree in missions, he worked as a registered nurse while taking classes in order to help pay his bills and graduate debt-free. He received his associate degree in nursing from Allegany College of Maryland prior to attending Southeastern. He first went into nursing as a means to an end. “I wanted a profession that I could use overseas as a missionary,” he said. Heather graduated with her bachelor’s degree in elementary education to pursue her passion of teaching and working with children.

The couple first moved to Africa in 2004 to work in the country of Burkina Faso. During the two years they were there, Aaron worked in clinics treating women and children infected with HIV/AIDS. He also helped educate the community on the virus and disease. While Aaron worked in the clinics, Heather taught English and social studies at the local Bible school.

In 2007, the couple and their two children packed up everything they owned and moved to the island of Madagascar. The island is located off of the southeast coast of Africa. “Madagascar is Asia meets Africa. It is a unique blend of the two continents with great diversity, but a people united in being Malagasy. The landscape is diverse, from desert to tropical rainforest,” he said.

As Aaron transitioned from Burkina Faso to Madagascar, his medical focus and research shifted due to the need that was prevalent amongst his patients. Aaron has worked as a family nurse practitioner since 2006 focusing more recently on skin diseases.

“In Madagascar, we use nursing skills to conduct medical clinics and more recently to work with skin diseases, such as leprosy and chromoblastomycosis (a chronic fungal infection of the skin). I am also able to care for the broader missionary community’s health needs,” he said.

Santmyire_3Aaron and a Malagasy doctor often fly to a remote town and treat over 200 people for their skin diseases on a medical bush mission trip. They specifically look for leprosy and chromoblastomycosis, but also treat all common skin diseases, such as tinea versicolor, acne, eczema, psoriasis, bacterial infections and many more. “The patients walk for up to four days to come and be treated. We show the Jesus film, GodMan and Magdalena film and present the Gospel message,” he said.

As an American family nurse practitioner serving in Madagascar, Aaron has had to overcome various cultural barriers. One of the first barriers he faced is that most people in Madagascar are not familiar with the role of a family nurse practitioner.

“A cultural barrier we face is communicating and verifying the care we are providing is effectively understood and applied. So much is lost in translation or in western-style medicine. Most doctors never tell the patient bad news because doctors are supposed to help, not discourage their patients with bad news. In the west, we are taught to be compassionate but direct. Trying to find a balance is sometimes very difficult,” he said.

Similar to other African countries, witch doctors have a strong hold on the Malagasy people. “The spiritual side of care is very rarely considered in health care in the U.S. but is prevalent in the developing world. Oftentimes in Madagascar, the patient has been to the witch doctor multiple times, and when their money is all used up, they come to our clinic, broke and with a disease process that is far more advanced than it should be. Fear and intimidation of the witch doctor has a powerful hold in Madagascar,” Aaron said.

Living in a country where skin diseases like leprosy are prevalent, Aaron has continued to learn more about them not only through experiences but also through furthering his education. He earned his master’s in nursing in 2006 and completed his doctorate in nursing practice from West Virginia University in Morgantown, West Virginia, in 2013. His research for his doctoral degree focused on skin and soft tissue infections in the age of community-acquired methicillin-resistant staphyloccous aures — meaning skin infections from bacteria that are resistant to antibiotics. Aaron has been able to apply what he studied in what he is currently doing.

“We used a change model as a structure to train practitioners on the guidelines to treat these infections and provide resources to empower them to do so. It was published in a few places,” he said. His research article “Challenges of Implementing Evidence-Based Practice in the Developing World” was published in the May 2013 issue of The Journal for Nurse Practitioners (JNP). He also had two articles published in the Journal of the Dermatology Nurses’ Association.

In addition to serving in medical missions, Aaron and Heather currently serve as team leaders in Madagascar. “We have a great team of missionaries who love Jesus, love their families and love Madagascar. You cannot ask for much more than that,” he said. They have also found their house to be a “Grand Central Station” in the evenings, as many people come and go who are sick or in need of health care.

Heather teaches English and a class for transformation at the local Bible school. She continues to take classes in order to keep her teaching license up to date. She has also lived out her calling of working with orphans, as she coordinates Hope Orphanage. The orphanage was started as a partnership between Africa’s Children and the Malagasy National Church in the early 1990s. The Santmyire family works together to oversee the orphanage, which is currently home to 19 children.

Isabelle and Josiah attend a French-speaking school and are bilingual in English and French. When they are not at school, they help out at the orphanage and often help Aaron with bush medical trips through taking blood pressure and temperatures of patients.

Santmyire_4Aaron balances his time between going to the bush for medical outreaches, teaching at the Bible school, helping maintain the orphanage and working with the Assemblies of God national churches. Aaron also teaches in a nursing school to train future nurses and helps equip their national church pastors to be community health agents.

When asked what advice he would give to future Southeastern alumni about pursuing a career in medical missions, he said, “Try not to accumulate debt. Dr. Rodney White gave me that advice, and that was very wise counsel. Secondly, keep your focus. If God has called you to serve in the developing world, all decisions need to be held in light of that calling.”

Aaron and Heather have been in the United States for the past year in order to raise support to return to Madagascar. While in the States, Aaron has been working with his sister, Beth, at her dermatology office, Appalachian Spring Dermatology, in Fairmont, West Virginia, to maintain his licensure. The Santmyire family will return to Madagascar in the summer of 2016.

As team leaders in Madagascar, Aaron and Heather’s goal for when they return is to work with their team on focusing more on discipleship and developing more Bible schools. “As our regional director, Gregg Beggs, so clearly shares, ‘There will be no lost people in Heaven.’ We treat physical needs to show the compassion of Christ and believe in the importance of proclamation of the Gospel message,” he said.