Leaving behind relatives and friends, community and country - never mind the comfortable lifestyle of a physician's family - to serve as lay missionaries in a foreign land has to be one of the toughest choices any modern-day Christian makes.

Dr. Dick and Loretta Stoughton have done it twice.

In 1971, after the young physician had finished a two-year residency in Santa Rosa, the couple with their five children in tow moved to then-Rhodesia, where Dick worked in rural African hospitals.

Working mostly with blacks on a segregated government communal land reservation, he quickly learned that the major health problems were tuberculosis and other infectious diseases along with rampant malnutrition. The challenge was to develop a local immunization outreach program from scratch against measles, whooping cough, polio and other infectious diseases, which Dr. Stoughton did simply with the help of a book, "Health in the Developing World," and some advice from English physicians.

The results were amazing. Hospital admissions for measles went from 150 a year and 40 deaths to 40 admissions and only five deaths. Polio and whooping cough stats also dropped drastically.

After 5 ½ years in Rhodesia, the Stoughtons returned to the states in December 1975, settling in the small town of Shawano, Wisconsin, 35 miles west of Green Bay. Dick joined a group of private practice doctors as a family physician. Loretta raised seven children and became involved in church activities, including prayer groups.

"It was a real cultural shock coming home back then," she recalls today. "All the choices: food, clothing. The way that people used money. I was always thinking, 'Oh, a child could go to school for a whole year on what parents spend on toys.'"

After 25 years, Dr. Stoughton was getting ready to retire. The couple, who met as college students in Omaha, had talked a lot about what they wanted to do, but never could come up with a definitive answer. Then while on a retreat, they took a walk after a workshop, and Loretta said maybe they were being selfish thinking they couldn't leave their grandkids.

"We both knew we did want to go back," Loretta recalls, laughing.

Dick nods. "Within an hour, I had a to-do list of 20 things before we could."

"We told the children," she reports, "and no one was surprised."

"They said, 'We knew you were going to do that,'" he says and breaks up. "We didn't, but they did."

About a year later, in 2001, they were back in Rhodesia, now the nation of Zimbabwe, at St. Theresa's Hospital, another rural mission outpost two hours from where they had been in the 1970s.

A death a day
The good news: childhood infectious disease had virtually disappeared in Zimbabwe. There were no measles, no whooping cough, no polio. But the bad news was overwhelming. AIDS and TB related to it had decimated the region. Sixty to 70 percent of admissions to pediatric and women's wards were because of AIDS. And nearly every day, somebody died from the disease or its complications.

When Dr. Stoughton arrived, St. Theresa's medical staff, without proper medications, couldn't do anything to stop the spread of AIDS. Then in April 2004, the hospital began treating a few patients with Anti-RetroViral drugs (ARVs). And the following year, the treatment program was "ramped up" when Zimbabwe's Ministry of Health started supplying the hospital with free drugs.

Since then, more than 530 patients have been started on ARVs with good results. Sixty-five percent are alive and doing well, while 13 percent have died. The rest have either stopped treatment or been transferred to other care centers.

"People hear that 35 percent who have died or gone off treatment and say, 'Oh, my God! That's too high,'" Dr. Stoughton points out. "But it was 100 percent fatal before. Now 65 percent are alive. And we've had some fantastic success stories.

"People were absolutely at death's door, and we were able to get them better enough from TB or some other severe illness so they were able to get on ARVs. You see them and they're walking skeletons. One woman doubled her weight from 65 pounds to 130 pounds. But almost everyone gains 30 to 50 pounds."

The successes, according to the physician, stem mostly from two recent grass-roots efforts.

A "Mother To Child Transmission" (MTCT) prevention program educates pregnant mothers and their husbands about how crucial it is for the mother to be tested for HIV. If she's positive, she receives an Anti-RetroViral drug during labor and her baby gets a dose after delivery.

Program workers also instruct the mom in proper breast-feeding technique, and tell her not to feed the infant any supplemental food for the first six months. Both mother and baby are closely monitored after being discharged. The goal is to reduce the transmission of HIV virus from about 50 percent for six-month-old babies to 10 to 15 percent.

The other program is called "Faith Based Approach to HIV/AIDS." Local church leaders, who often believe AIDS is caused by sin, are educated about its medical roots and encouraged to spread that knowledge throughout their congregations and villages. Practical preventive measures are also given and stressed.

Bedrock faith
Loretta admits that the first few weeks back in South Africa were a "real crisis." Their new home turned out to be a tiny block house with a number of structural problems.

But at daily Mass, she would meditate on how the eight Dominican sisters, whose community owns and operates St. Theresa's, had given up their whole lives to serve the sick poor. Suddenly, living in the block house didn't seem all that bad.

She got more involved in the community, starting a school-based prayed group to pray for students. One group led to another, until today there are more than 100 with some 900 members. "It's exploded since we started saying, 'God has given us this message to take to you, and now it's handed on to you to spread,'" she explains.

Loretta has also spawned a cottage industry by buying baskets from native women and selling them to family and friends as well as at Mission Doctors fundraisers to support the almost 50-year-old ministry, started by Msgr. Anthony Brouwers, founder of the Lay Mission Helpers, in 1959.

The Stoughtons --- both now 69 --- agree the same bedrock faith that motivated them to be lay missionaries in the 1970s sustains them today. If their health stays good, they plan on staying in Zimbabwe until 2009.

"To me, it's a huge factor," Dick stresses, before adding with a chuckle, "Maybe it's going to save my soul. We're much more attuned and have a better prayer life, going to daily Mass.

"This is our call," says Loretta. "We've been called to this work. But everyone has their own call to lead a Christian life --- whether you are taking care of elderly parents or just raising a family or going to help people who are sick or teaching religious education in your parish. Ours just stands out. But everyone is called."