By RYAN CHRISTNER

rchristner@dailynews.net

QUINTER --Out of sight, out of mind.

That's the way Eliamani and Alphaeus Shayo sometimes feel about their situation, tucked away in the shadow of Mount Kilimanjaro in eastern Africa, caring for the terminally ill.

"There are many people who are not informed about our problems," Alphaeus Shayo said last week during a stop at Gove County Medical Center's independent living apartment complex.

The Lutheran pastor accompanied his wife, who is director of the palliative care program at Marangu Lutheran Hospital in Moshi, Tanzania, during a visit to northwest Kansas to learn more about hospice care in the United States and, hopefully, inspire others to provide financial assistance for their efforts.

"If people get to know about the problems," Alphaeus said, "if people come into contact with people themselves and if people know that, if I give this money it's not going to pay for the expenses of a certain organization, this money is going direct to where it is supposed to be going, then they get motivated."

The couple spent three weeks here and traveled extensively throughout the region with representatives from Hospice Services in Phillipsburg. The two groups have been linked in a partnership since 2007 through the Foundations for Hospice in Sub-Saharan Africa and now work to share money, medicine, supplies and ideas.

To say the least, hospice facilities in Africa face difficulties unlike any seen in the United States. Most of the 200,000-some people who live within the Marangu hospital's service area do not have access to any form of health insurance policy. Nor would they likely be able to afford it, according to Hospice Services social worker Missy Lamont.

"(They are) destitute," Lamont said. "Poor doesn't even begin to describe it.

"It's like a whole different world. We just really and truly have no idea how some people live and in turn how some people have to die."

Alphaeus said most outsiders who visit Tanzania are drawn into the scenery and wildlife and rarely choose to interact with the native inhabitants.

"The big interest is only to visit our animals, to climb Mount Kilimanjaro," he said. "They're coming with touristic cars, with tinted glasses. They don't want to have any contact whatsoever (with local people). They stay in the luxurious hotels, and after that they go back."

But that was not the case during their stay in Kansas, where those they met with seemed responsive and sympathetic to their problems.

And problems are in no short supply.

With a staff of only five, Eliamani is responsible for 1,200 patients, 500 of whom suffer from AIDS and cancer.

Her hospice program receives support through the U.S. Agency for International Development, but that contract ends next month and she is uncertain of the possibility for renewal.

That makes the Shayos nervous, as HIV/AIDS is an epidemic in sub-Saharan Africa.

"We say that HIV/AIDS is the world problem," Alphaeus Shayo said. "But we ... have been struck more than the others."

While official statistics vary slightly, Alphaeus said 70 percent of AIDS cases worldwide originate in sub-Saharan Africa, which accounts for about 10 percent of the world population.

He said he has heard that, unless a drastic change occurs, the entire black African race effectively could be eradicated.

"It is high time that the world communities should do something to prevent this -- I call it -- catastrophe," he said.

One reason for the extremely high numbers is due to the stigma African people place on those diagnosed with terminal illnesses, which makes it difficult to encourage locals to seek testing and treatment.

That should change in time, Eliamani Shayo said, as they work on education efforts.

Hospice Services has a goal of sending $5,000 annually to their African partners. That covers the cost of a nurse, social worker and a month's supply of medication for nearly 100 patients.

Any money raised by the Phillipsburg-based organization that is intended to be sent overseas will be kept separate from regular fundraising efforts that support the 13 northwest Kansas counties covered by Hospice Services.

Donations made to Hospice Services for the palliative care program at Marangu Lutheran Hospital should be marked specifically for that purpose.

"The amount that that will do to help those people over there, it blows your mind," Lamont said. "Whatever we send over there will help them tremendously."