Recently, Pastor John Piper joined PassionLife at one of our regional events. He gave an address formed specifically for that time and for this ministry, and the burden of it was risk-taking — risk-taking for fruitfulness, and risk-taking for life.

We have an opportunity in just the next few days to put that address into practice. We are heading off to one of the minorly riskier areas of the world.

Mozambique.

Where We’re Going, and Why It Makes Us Nervous

Geography is not a strength for most Americans, so it’s worth stopping to get our bearings. The continent of Africa is roughly three times the size of the United States. You can fit the United States into three sections of Africa and still have room left over. Mozambique sits in the southern part of that enormous continent, along the eastern coast.

Two of us are making the trip. Mark Nicholson, who has been laboring in this work for years and has taught across the continent, and Christian Harris, who makes PassionLife run smoothly behind the scenes as our operations manager. Christian sits with a computer the size of a small country and handles all the little things people never see but that keep a ministry functioning — the communications, the logistics, the details.

This is not Christian’s first time in Africa. The first missions trip he ever had the opportunity to go on was to Uganda in 2017 — Kampala, and then a few hours outside of Kampala, with friends whose college classmate was serving there full time as a missionary. They spent time with the local church, and it was a great experience. That was almost ten years ago now. It’s a full circle moment. But it is his first time in Africa with PassionLife.

We tried to get to Mozambique once before. In the first few days of 2025, we were traveling the continent — Liberia, Kenya, Uganda, Zimbabwe — and Mozambique was on the itinerary. We had plane tickets we couldn’t refund. We had hotels we couldn’t refund. We were already in Africa, already teaching, when we learned the situation had devolved to the point where that leg of the trip simply had to be cancelled.

Why was the door shut? A lot of things converge on Mozambique at any given time.

There are natural disasters — droughts, earthquakes, whatever else the land throws up. There is religious unrest in the north, where Islamic extremists tend to generate armed conflict that pushes down from the north, and how far south it comes depends on the season and the situation. And in early 2025 there was a third factor stacked on the first two: an election that, from the way we understand it, the majority of people in the country believed should have gone a different direction than it did at the ballot box. That is always going to be a controversy. Disruptions. Riots. Civil unrest. Arrests. Other bad things that happen in those windows.

So the door closed. This time, it’s open.

This trip was originally supposed to cover three countries — Mozambique first, then South Africa, then Namibia. It has been trimmed to one. And here’s what may be the most striking part: of those three, Mozambique currently seems to be the most stable. South Africa came off the itinerary not for our sake but for the sake of our African co-laborers, since Africans from other countries are running into real trouble inside South Africa right now. Namibia came off because of unforeseen circumstances there. Mozambique stayed.

Who We’re Working With

There is a pastor in Mozambique who has been calling for us to come for a number of years. He’s the same pastor we were going to work with before. He has connections in various cities and ties into a large network of pastors across the country.

We’ll also be joined by Pastor Wally, who is coming down from Kenya. We first met Wally in Nairobi in 2022, and he has been an enormous help to us in training the Four Questions in various parts of Africa over the last several years. Mark was with him earlier this year, in February, training and traveling together in Kenya. Wally is an excellent pastor, an excellent Bible teacher, an excellent communicator, and a good friend.

For part of the time, a representative from AFLA — the Association for Life Africa — will come down from Zambia to travel and teach with us. AFLA is an African, pro-life, life-affirming network that runs pregnancy care and training work all over the continent.

The plan is four trainings, on four days, with four different groups of pastors. Two of them will be in Beira, on the coast, where we’ll be landing. Then we travel inland to Chimoio, where our main pastor contact is based and well connected, for two more trainings in that region.

What we teach is the Four Questions — our attempt to take the enormous Christian ethical issue of abortion and reduce it down to four biblical questions that equip the local church to start helping mothers and couples in crisis. We’ve now taught it in multiple languages across the continent: Uganda, Zambia, Zimbabwe, Liberia, Kenya.

People are often surprised to learn that abortion in many countries of the world runs at a higher clip than it does in America, and that the United States accounts for only about three percent of the world’s annual abortions. That leaves ninety-seven percent of this crisis in front of us as a world missions challenge. A good amount of it takes place in African nations, for various reasons. That is why we go.

Five Ultrasounds in a Suitcase

There is a second reason Christian is on this trip, alongside teaching. Through the generosity of our donors, once we’ve worked with a place, we get the opportunity to equip it with portable ultrasound machines. We work directly with AFLA, and they distribute the machines to doctors, nurses, and pregnancy clinics all across Africa.

They need more. What a great problem to have.

We’re taking five machines and five tablets with us this time.

If you’re used to ultrasound at all — you or someone in your family has had a child and gone in to the doctor — you’re picturing a big machine on a cart. The technology has moved. The probe is a little box smaller than two packs of cigarettes, and it holds an entire ultrasound machine. Pair it with a tablet the size of an iPad and a doctor or nurse can provide those exact services portably, without internet, without all the infrastructure we take for granted in the States. It’s accessible even to the least of these.

We’ve watched what happens. In one French-speaking part of Africa, a pastor in a red PassionLife t-shirt — printed in French, because that’s the language there — helped us present a unit to a local medical provider while the Four Questions were being taught in French. In Uganda, we handed one to a young woman who had just finished her education in ultrasound, and within ten minutes she had found all the bells and whistles and figured out how to run it off the tablet. The local team had brought in some pregnant volunteers they’d been counseling in their center. She took the unit straight into the next room, and you could see the baby immediately.

That’s the whole point. When a mother and a father can see their baby on ultrasound, it makes a dramatic shift in their decisions for life. This is one small way we get to play a part in that.

It’s also why crossing a border with five ultrasounds in your luggage is a genuine matter of prayer. It’s no secret that corruption exists in various countries, including America, but Africa is well known for difficult borders and for things being confiscated for reasons that may or may not be legitimate. Medical technology is a prize for thieves who can grab it and resell it fast. Years ago, the pregnancy help clinic we started in Miami was broken into and the machine stolen; the investigators told us it was probably already on a boat to South America. In Ethiopia, we arrived with two laptop-version ultrasounds and the people at the airport tried to take them from us. We sat down, folded our arms, and said we were not giving them up and we were not leaving until they were in our possession. It was the middle of the night, and the standoff lasted a couple of hours. We weren’t going to leave, because if we had, those machines would have been gone.

We got them delivered. So we need people praying us over the border with these.

Not Just Dropping Them Off

Part of the operations work is making sure a machine like this is never placed in the hands of whoever merely seems best suited for it. That takes prayer and it takes research, and it takes making sure the right people are equipped to use them correctly — in ways that honor the Lord and that fall within the guidelines we hold for them.

Those guidelines matter. These units are for life-affirming use. They are not for diagnosing medical conditions or providing that level of medical care. They are for confirmation of a live pregnancy and verification of an intact uterine pregnancy — so that a woman can make an educated decision about how to proceed.

To do that well, we train. We’re blessed in the States with several OB-GYN doctors, sonographers, and ultrasound technicians who work alongside us to train up providers in other countries. Earlier this year we flew a dear sister — a sonographer and ultrasound technician who is part of AFLA — to the United States, where she worked alongside one of those OB-GYN doctors and learned these specific devices. Now she travels with AFLA across Africa, placing units in locations we’ve identified as having genuine need, with people who have been trained in the Four Questions and are prepared to offer life-affirming care. Sometimes AFLA is the one making the final call on where a unit will be used best. The goal is discipleship duplication: she doesn’t just know how to use it, she knows how to train others to use it.

Then there’s follow-up. We’re not dropping a machine off and hoping. We have processes for monitoring use and confirming that units stay in good standing — that they’re still operational, that providers aren’t running into problems, and that when something breaks there’s an open line back to us. Just last week someone called to say his machine wasn’t working, and we were able to get him back up and running.

This matters because after nearly forty years in this work, we’ve seen the alternative. Even in the United States, during the great rush to get ultrasounds into pregnancy centers, we would visit centers with a machine that had sat in a closet for a year or two because nobody knew how to use it correctly. It’s easy to think you’re making progress and find out you’re not. Training people, and helping them train others, is what continues the line of care. It’s also basic stewardship: making sure the money given for technology is actually achieving what we believe it’s achieving.

For about $6,000, we can purchase one of these units, get the tablet, and hand deliver it to the right person. People ask, so there’s the answer.

Upstream of the Machine

The ultrasounds are downstream. Upstream, we’re working with pastors — giving them the biblical foundations for why they need to train their people to do what Proverbs 24 calls all of us to do: rescue those being led away to the slaughter. We go to teach pastors the biblical calling to rescue the innocent, and to do it in a way that brings good news to the guilty. What we’re after is a rescue movement across Mozambique.

How to Come Along Without Leaving Your House

There’s a way to be on this trip with us.

We run a text update stream during our travels, and it has been very popular with the people who use it. You have to opt in yourself — we can’t sign you up. It’s on the landing page of the PassionLife website, down at the bottom.

The reason people love it is that in real time they know where we are, what obstacles we’re facing that day, what training is about to take place, and how to pray specifically for those things as they’re happening. They really do feel like they’re on the trip.

So go to passionlife.org and sign up for the text updates. Pray for our covering. Contribute as you can. And let’s stand for life all over the world together, in the name of Jesus Christ.

God bless.