PAULLINA, Iowa | Dr. Tim Wester and his wife, Ann Wester, have evacuated steps ahead of civil war in Africa.

They have returned to their home in Africa, to discover their household possessions stolen or wrecked.

The Westers, residents of Paullina, have known hardship, war and disease.

They keep going back, to Africa, rolling up their sleeves, digging in at the hot spots.

It's what you do as medical missionaries, raised as children in Africa by parents who worked as missionaries, those who served the poor in a place often called, "The Forgotten Continent."

The Westers did not forget. They returned repeatedly as adults, having served seven 4-year terms which generally consist of three years in Africa and one back in the U.S. They look forward to an eighth term.

Dr. Tim Wester, 60, is asked why he and Ann keep returning. He answers with a question of his own.

"If you see a group carrying a heavy log and there are nine people on one end and only one person on the other end, where would you go?" he asks.

It runs in the family. Tim has four siblings, all of whom have done mission work, three of them in Africa. Ann's trio of siblings have toiled as missionaries in Africa as well.

The couple's children also follow their parental footsteps. Daughter Lydia Wester, is currently doing her OB/GYN residency in Tuscon, Ariz. Son Andrew Wester oversees a $1-million agricultural development for refugees in eastern Congo.

As various places in the world race ahead with education, technology, jobs and longer lives, Africa struggles in attempts to break cycles marked by abject poverty, war and sickness. The Westers work in this environment, often joined by professionals like them, men and women who practice medicine and Christianity, doing both where many from the West rarely stay.

"My folks were evacuated in political uprisings as far back as the early 1960s," Tim says.

It didn't stop him from heading into turmoil following his graduation from the University of Iowa Medical School in 1981, an event that was followed by a three-year stint in family practice in Des Moines.

"Ann and I wed in the summer of 1984," he says. "We went to France and spent a year learning French to prepare for this."

Ann had worked for seven years as a teacher in a boarding school in the Congo.

From France, the coupled traveled to Belgium and completed a class in tropical medications. In March 1986, they landed in Congo, where Tim served a decade as the medical director at a 220-bed hospital that boasted of 35 outlying clinics and a nursing school.

That 10-year hitch ended in civil war. The Westers returned to the United States for a short time. Upon their return to Congo, they discovered their living quarters ransacked, their personal possessions pilfered.

By 1997, the ongoing conflict had the Westers looking for other missionary opportunities on the continent. One surfaced in the Central African Republic, so the Westers moved and partnered with another mission, serving a hospital that, until Dr. Wester's arrival, had no doctor.

In 2003, another civil war erupted. The Westers evacuated again and all their possessions were stolen. They landed in Yaounde, the capital of Cameroon and served in various capacities until 2005, when they headed to the western edge of the Central African Republic, to the city of Gamboula, home to 5,000 residents.

"I'm a family doctor serving a 180-bed mission hospital, the only doctor there," he says.

For nearly a decade, it's the place he and Ann have called "home" when they're not in Paullina.

Thirty nursing assistants help the Westers. The couple is thrilled about a registered nursing program that seems to be flourishing. When Ann isn't teaching, she assists her husband and the nurses of Gamboula in fighting malaria, AIDS, measles and more, both in treatment and education.

"Five to 10 percent of the population in the Central Africa Republic is HIV positive," Tim says. "In some areas of Africa, the figure is 30 percent."

Tim Wester knows disease in Africa, first-hand. He had polio at age 7 in the Congo, during the 1950s, just before the vaccine. He walks with the support of crutches.

He credits polio with helping lead him to a career in medicine. As a boy, he endured five orthopedic surgeries. He watched surgeons work and was soon hanging around the hospital, digging in to feed his curiosity.

"Growing up in the Congo, raised by parents who spent 43 years in church planning with the Evangelical Free Church, I got to watch closely how surgeons there worked," says Wester, the son of Merle and Eleda Wester, of Cherokee, Iowa.

"I now see some polio cases," he says. "Just last year Cameroon had new cases."

There are also exciting developments in agriculture in and around Gamboula, as 10 U.S. adults work to establish acreages while teaching the benefits of composting and introducing new crop varieties.

It has to be done, the Westers note, as 30 percent of the children they see suffer from malnutrition in a country that rates among the world's 10 poorest.

"When we treat these kids we have their mothers work in our gardens," Tim says. "And then we send them home after a time and we send with them seeds and a hoe."

The area, Ann notes, remains unstable. Just last week, 1,000 troops serving the United Nations went into the region, a place destabilized two years ago on March 24 when the capital city, Bangui, fell to an alliance consisting of six rebel factions.

In a matter of hours, the Westers and other U.S. mission workers fled to Cameroon, where they resided until August 2013, when they returned to Gamboula.

In the meantime, they hear of medical personnel who have been in danger. Schools fail to meet, out of fear. It is estimated that half of the 4.5-million people living in the Central African Republic have been displaced.

One camp some 20 miles away in Cameroon is now home to 20,000 refugees.

In the U.S., we hear little about these developments in a country where the U.S. Embassy has been shuttered for two years.

Oh, Tim cautions, people do hear about the strife. He and Ann and their work is supported by 15 churches and 100 individuals, all givers who believe in the mission.

And so, the Westers anticipate their return. They plan to travel to Cameroon late this summer. From there, they will monitor elections before heading back to Gamboula to resume their lifesaving work, a common, if not sometimes frayed, thread that runs across families; their family, they say, as well as God's family.

"We sense God has called us," Tim Wester concludes. "The safest place is being at the center of God's will."

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