"National Pride" Day

by Rachel

We often don’t celebrate American holidays on the days that the rest of Americans celebrate.  For one thing, obviously, they aren’t Burundian holidays and thus if the holiday falls on a weekday (as Thanksgiving always does) it’s a normal work day for us.  But I do want to celebrate, for several reasons.  One, I’ve grown up celebrating certain holidays in certain ways and feel quite nostalgique at certain times of the year.  Two, even though my kids have spent most of their lives outside the US, they will return some day and I’d like them to have a good understanding of certain holidays.  So this year, July 4th came and went.  My Facebook feed was filled with pictures of fireworks, sparklers, and berry topped desserts…and it all felt rather anticlimactic here, where a teammate graciously played patriotic songs for my kids while they colored flag pictures, and I worked a normal day.  

Fortunately, the team rallied and we decided to celebrate on July 8th instead. It wasn’t July 4th, and Burundian independence day had come and gone (mostly unnoticed by us) on the 1st….plus, the team is no longer solely Americans.  In honor of our Canadian teammates and our British short term visitors, we decided to name the day “National Pride” celebration day.  Since Canada and Britain aren’t independent in quite the same way. :)  In typical Kibuye fashion, the holiday needed to be modified somewhat to fit our resources, but we still tried to make it as “classic” as possible.  Scott and Lindsay picked up a couple of small Burundian “Jikos,” clay and metal pots filled with charcoal that are used instead of stoves, and created them into a small grill.  Potato salad, deviled eggs, and french fries appeared on the tables, along with a three layer red white and blue cake.  (And, to be honest, Indian style rice, papaya, and other local foods in lieu of chips and jello).  There had been an embassy 4th of July party (in June) and so a few people showed up with “Uncle Sam” style hats.  We ate on picnic blankets under the trees and a few rounds of horseshoes and baseball followed the food.
The grill master!
Jiko grill!
A good time was had by all.  It got me thinking about my heritage as an American, and how interesting it is to step out of my home culture and see it through new eyes.  It’s now over seven years since we left the US to work in Africa.  I identify less and less as a typical American, but not necessarily more as a Burundian.  I'm really grateful in a lot of ways for the culture in which I grew up.  There are things that I used to take for granted, that I now know are privileges instead of rights.  The freedoms I experienced (and still do) as an America are far from standard in the world.  And I think that working for similar freedoms for people of other countries--freedom to worship, free to pursue health and an education, free to live without fear of starvation--is a GOOD and even necessary thing.  Perhaps without my American "past" I wouldn't see things in the same light. 

Of course, living outside America has been a good thing for me too, and almost every day I count it a blessing to have had my world view expanded (and to have it continually expanded!).  To be able to see the joys and sufferings of people from a world far different from my own, to see how we are different and yet still in many ways the same.  To experience the challenges of communicating in other languages, to know how it feels to go without, to feel the shock of foreignness but eventually to accept the foreignness as the new normal.  So, happy independence day, America!  Thanks for the role you play in my life.  And happy independence day to Burundi!  Thanks for being my new home. May we continue to work together to make it a better place.


COTW: The Continuing Story of the Kibuye Triplets and the New Peds Building

(By Alyssa)

I’d like to introduce you to one family who will benefit from the new peds building (click link to see a 3 minute video). Some of the long time blog readers might remember the story of the triplets who Eric wrote about 2 years ago.
Well, the two remaining triplets are now 2 1/2 years old and they’ve been hospitalized three times on the malnutrition service - spending months of their lives at our hospital. 
October 2015 (10 months old)

Their mama understands what nutrition they need and does her best to care for them at home, but repeatedly she watches them become thinner and sicker, and finally she decides to take the arduous four hour walk to our hospital carrying both kids. I recently read a study highlighting the high (20%) mortality rate of twins in sub-Saharan Africa - three times that of non-twins - and that includes countries with much better infrastructure than Burundi. So it’s easy to imagine that the mortality rate of twins or triplets in Burundi is much higher. We always have several sets of twins in the hospital - usually premies in the NICU and kids on the malnutrition service. It’s so hard for mothers who are also malnourished to have enough milk for two babies at once. 
One of the twins with Anna in April 2016 (16 months old)
Eliana (left) and Rita (right) are both 2 1/2 years old!
So for Emery and Rita it’s two steps forward and one step back - especially this month. They were doing great and ready to go home (though still only weighing 10lbs and 13lbs) but I wanted them to stay in the hospital a little longer so they could learn to walk with Judith and Anna through some intensive physical therapy. 
May 2017 (2 1/2 years old)
Learning to stand
Emery learning to walk with Judith
I regret that decision now as they both caught serious infections in the hospital partly as a result of our overcrowding and they almost died. Praise the Lord who healed them one more time! They’re thankfully heading home once again now, and the mother will continue the physical therapy at home. But I look forward to the day when we will have a new pediatric ward with enough beds for each patient and a dedicated play room to help with the development and sensory stimulation for these kids. And I hope that when patients are no longer sharing beds, that the risk of them also sharing infections will decrease dramatically. Please pray with me for Emery and Rita and the many other patients we take care of with severe malnutrition and pray for God to provide the funds for a new well-lit, clean space in which to care for them. 
Going home in June 2017, pictured with Anna and Abi Fader


New Peds Building

(By Alyssa)

Burundi doesn’t have seasons like those familiar to folks who live farther from the equator, but it does have rainy and dry seasons. In the US and Europe, winter is the busy time in pediatrics as everyone is inside sharing all their cold and flu germs. But we also have dramatic seasonal variation in pediatrics in Burundi with rainy season being both respiratory infection season (like winter in the US) and malaria season. And every year I’ve been here, our patient numbers have increased. We had approximately 40 patients on the peds service each day during rainy season in 2014, 60 patients in 2015, and then last year we broke the hospital record with 89 patients (for 30 beds). That’s when our engineers Tony and Caleb came to the rescue and constructed a temporary ward in just 3 weeks adding 20 beds. But this year we smashed the record again with 117 patients (now in 53 beds)! Once again, thankfully, the engineers are saving the day as they have designed a fabulous new 80 bed pediatric ward to serve our precious patients for many years to come. Watch the below video to learn more about this exciting project - and feel free to share it with your friends!

Kibuye Pediatrics from Seth Chase on Vimeo.

First floor

Second floor
Site of the new peds building

Current overcrowding

Patients and mothers sharing beds

If you would like to participate with us in caring for these sweet children in Burundi, click here to donate through the Kibuye Hope Hospital fund (type "pediatrics" in the memo line). All donations are tax-deductible. Thank you!


If I Want To Be Here To Help...

(by Eric)

It's been a particularly hard stretch on the adult medicine service.  Of the last ten patients admitted to our service, seven have died.  It's been a mixture of problems.  Our malaria epidemic is tailing off, which means that our most-treatable problem has become less frequent.  We've had several infrastructural difficulties, with oxygen shortages during long blackouts, and currently our X-ray machine and our blood count machine aren't working.  Certainly some of these things have made a negative impact.  The biggest factor is just that the patients only come to the hospital because their situation has become so dire.

However, when they arrived, I had hope (if not certitude) that they would get better.  They didn't arrive with an obviously mortal problem.  It was only after several days of steady worsening despite all we could do that it became evident.  That's a particular challenge, since it feels like their being in the hospital is associated with them getting worse, instead of better.  With death, instead of life.  I know it's not like that, but that cognitive knowledge doesn't automatically vanquish the feeling.

We have new medical students this month.  Very green, but making steady progress.  For almost all of them, they have never been this entwined with taking care of sick people before.  I wonder what kind of toll this is taking on them.  It's obvious that it's difficult.  Is this just a necessary crucible?  Can I say something to help them endure, beat off cynicism, and retain hope?


After rounds, while walking through the hospital, I shook hands with one of our nursing assistants.  She used to be on my service, but is now on another service.  I say hi, and remember that her adult son was hospitalized last year with a bad case of nephrotic syndrome.  I ask her how he is doing.  She says he is doing fine at home, with no medicines.

This morning, I was taking our kids on an "adventure walk", back through the small footpaths in the hills.  I passed a guy carrying a baby.  It's a little odd to see a guy carrying a baby.  Then, I realize I know him.  It's the (hopefully formerly) abusive husband of my paralyzed pregnant patient Spes, that I wrote about previously.  The baby looks good, and I turn around to see Spes walking towards me with a cane.  She smiles at me and shakes my hand.  The fact that she can make it this far on her own, and that her incredibly fractured life is doing this well is a joy.


Over the last several years, I have come up against these questions many times, with students or with new or visiting doctors, and each time I'm of course talking to myself as well.  Two things, in particular, continue to be an encouragement for me.

First, if I want to be here to help, I have to be here when I can't.  Every time when my patient unexpectedly dies, or the test comes back positive for the non-treatable possibility, or I'm forced to admit that my last therapeutic option just isn't working, part of me wants to abandon ship.  Part of me wants to run away from all that I can't do.  I know that running away won't help my patients, but I guess I want to pretend that such situations don't exist, at least not in such a common and stark form.

You can't know ahead of time who you can help, and the patients won't divide themselves up like that anyways.  Sometimes we can make a great medical impact.  Other times, we can't.  The two are inextricably linked.  Part of what we love here is the chance to dramatically alter someone's life for the better.  Yet there is another side to that coin, because the magnitude and frequency of the tragedies go up, in a seemingly proportionally manner.  It is something to be endured, but not just endured.  This other, and difficult, side of the coin is another place where we have to learn to trust God and find some way to bless and comfort these patients with the blessings and comfort that God has given us (2 Cor 1:3-4).

Second, as Paul writes: Fight the good fight.  It feels like a fight.  It is a fight.  But it's a good fight.  So let's keep fighting it.


I've been reading Keller's book Every Good Endeavor, and he is posing these questions about our professions.  What are your professions' idols, hopes, and fears?  What is the storyline told by your profession?  How can Christ complete the story in a different way?

I don't yet have a concise answer for these questions regarding the medical profession.  Surely, there are many things we fear.  We fear that we will make some great mistake.  We fear that the trust people place in us will be misplaced.  We fear not making any difference.  

The storyline of medicine says that people's bodies and minds can be broken, but that medicine, if properly developed and applied, can fix them.  It's not a bad storyline, and I'm grateful for its recognition of the brokenness of my reality.  However, the solutions do leave us wanting oftentimes.

What does the story of Christ have to say?  I think it's that both the brokenness and the healing run deeper than we know.  It's not just my patient's body that is broken, but also our society and my profession, as well as my own heart.  There are cracks all through, and no one helps from a standpoint of being completely whole.  

But the healing is part of a redemption deeper even than the fissures of our brokenness.  Yes, the healing comes through a faithful and just application of the principles of medicine, and we ought to be thankful and use it as well as we can.  But our great hope is that the extent of the healing going on in the world does not end with the limits of medicine.  God is bringing his newness in every way, in every domain, in every corner of this earth.  Through us, and thankfully in spite of us and beyond us.


Internet: The Hardest Part of My Job?

(from Eric)

We've never explicitly blogged about the work that has gone into enabling us to blog from rural Burundi.  Maintaining "reasonable" internet access has been quite a journey since 2013, and though we've made a lot of progress, I'm sure it will continue to be a big issue in years to come.  Given the distance between us and many of the people that know and support us and our work, internet has been an essential tool.

I'm only half joking when I refer to it as "the hardest part of my job".  Comparing to some of the dramatic hospital experiences we have, it may not seem like much.  However, I have felt so ill-prepared to try and handle this technical area that it has, at times, been a primary source of stress for me.  My team has always been gracious towards my insufficiencies, but it has been an ongoing struggle for me not to feel their frustrations with our internet as personal failings.  But enough about that.

2013:  When we first arrived, we hoped to be able to use USB flash modems to connect to the internet via the mobile network.  Everyone in the city thought this should be doable, and we talked to several people in the mobile world here to inquire about it.  However, as it happened, Kibuye campus was uniquely located in the shadow of a hall that lay between it and the nearest mobile towers.  Thus, the signal was limited, and no mobile company seemed to do anything about it.  So, the first few months were characterized by long periods of waiting on this little modem to download emails.  If you gave it about 15 minutes, it might have loaded a web page.  But usually not.
USB flash modem
2014:  After several months, we came to grips with the idea that the best option for us was a satellite modem (VSAT), which was reliable, but quite expensive for what you get.  We were obviously bandwidth limited (mostly 512 kbps) and most of the next several years, we were also data limited (each family usually got about 3GB/month).  I won't tell you how much we paid for it.  =)  It was an essential service, and usually worked pretty well when the power was on.  However, it developed a bad habit of getting fried by lightning, and the modem had to be replaced several times.
Our VSAT with nearby lightning rod
 2017:  After 3 years of VSAT usage, one of our Burundian friends helped us get connected to a mobile company, who was willing to run a fiber-optic line to Kibuye, which increased our bandwidth about 10 fold.  It was several months in the installation, but a beautiful day when the fiber (seen here on a "natural pole") arrived on campus.  We have noted that, even with the increased power outages (currently often less than 4 hours of power per day), we have enjoyed an improved ability to communicate with the rest of the world.<4 able="" and="" been="" better="" communicate="" day="" electricity="" frequently="" have="" hours="" more="" of="" outside="" p="" per="" still="" the="" to="" we="" with="" world.="">
Fiber optic cable looped over the last tree
How does a signal get from this single point to the rest of the campus?  That question has been a saga in and of itself, which many chapters and lots of help from many people.  Suffice to say that the current set-up has some kind of connection in every home, though we have all spent many hours sitting outside the "internet cafe" at the container-plex (our central hub for internet) during various phases of these connections breaking down.

Homes are connected via a combination of directional antennas, CAT-5 cable, coaxial cable, and a cool new unit from Ubiquiti called the AirMax Rocket.  They all come together in one of our old container crates, that has been converted into our internet hub: a combination a wires, switches, and multiple layers of electrical protection.
A converted container crate, now our internet box
How does a doctor learn how to do all this stuff?  He doesn't.  I still feel like I don't have any idea what I'm doing oftentimes.  However, we have been blessed with much great advice and help, most notably from Shawn Quinn and his friends at MoxieGroup.  He has been out here twice, most recently brought his family.  Thanks to all!
The Beloved Quinn family with their Knox teammates


Top 10 Things I'll Miss About Burundi

(from Audrey)  

A week from today, I’ll be flying back to the states after nearly ten months here in Kibuye. In honor of those ten months, I’d love to share ten things I know I’ll miss about Burundi:

1. The night sky. Besides charcoal fires, the mountain air in Kibuye is the cleanest I’ll probably ever breathe. The pure atmosphere and the lack of electricity mean that nights are heart-stoppingly beautiful. During a new moon, the stars burn in a multi-colored display of inconceivable distances. You can even see another galaxy with your naked eye if you know where to look.

2. The weather. Crisp and chilly in the mornings, hot but breezy in the afternoons, and almost never humid, thanks to our 6,000 ft elevation. Windows are always open and there’s no need to heat or air conditioning. It’s lovely. Rainy season and dry season each have their own particular beauties.

3. Community living. The kind where you’re close enough that if you get horribly ill, your neighbors will probably know it before you even tell them and will ask if you need anything. 

4. “Miss Audrey, watch this!” “Miss Audrey! Come tell us a story!” “Miss Audrey, wanna play capture the flag?” “Miss Audrey, come see my guinea pig!” “Miss Audrey, come sit in this hammock!” I love all the kids on the compound and how they clamor for attention even if I just walk past them on my way to the hospital.

5. Hearing choir practice from all the churches dotted around the valleys. The choruses echo through the mountains like birdsong every Wednesday and Saturday in addition to Sundays. 

6. Fresh avocados and pineapples and oranges and lemons and passion fruits from the market each week. The avocados here are enormous, at least four times the size of American avocados, and incredibly cheap. I’m typing this while eating some freshly made guacamole I quickly whipped up in my kitchen. Mmmm.

7. Hikes up to Kibuye Rock, or the Far Kibuye Rock, or on the big 8-mile loop past the cell towers across the valley. (We’ve only got a few big landmarks.) 

8. Jeannine, my French language tutor, who is quiet but loves to laugh. She is so patient with me and I’ve loved learning new aspects of Burundian culture as we talk about food and education and work and family life. It’s also fun when she asks me questions about American culture (“How do American parents talk to their children about relationships and dating?”), which forces me to think about my own culture in a new way as I try to explain it—especially when I have to stumble around with broken French!

9. Seeing kids’ faces light up when they discover a new fun science fact or when we get to do an experiment. I’ll miss the way they all wanted to race me to the school when the bell rang and took pride in being THE VERY FIRST person in their seat for science class. I’ll miss the chorus of “Awwwwwww but that’s a cliffhanger!!” when we had to stop a read-aloud book in the middle of the chapter at the end of class.

10. Learning from the dedicated doctors here, both the Americans and their Burundian colleagues and students. The doctors here are great teachers and I’ve been able to absorb much more than most pre-medical students ever get the chance to observe! But I haven’t only learned about diagnosing sickle cell anemia or performing a c-section or interpreting ultrasounds. Beyond the medical, I’ve learned a lot about compassion and perseverance. 

The doctors here persevere even when they have to use headlamps for surgeries because the electricity keeps cutting out, and even when there’s no running water and the wards are hot and crowded and smelly, and even when they have 95 inpatients on their service (for something like 40 beds), and even when malaria medicine runs out. I’ve seen amazing abilities to keep a sense of humor and to creatively solve problems. I’ve seen rejoicing when a patient on the brink of death returns to health and grief when children die because they dared to be sick in the third-poorest country in the world. I’ve seen how medicine needs the soul and body of the doctor as well as the patient. 

I’m so thankful for my almost-year here in Kibuye, Burundi. It has confirmed my desire to become a doctor and to work in underserved areas. It has also taught me gratitude for the body of Christ as an active community, even if there’s conflict or lack of resources or homesickness. I look forward to flying back to America, but I’m guessing that I will soon miss my life in Burundi.    


Weddings, Funerals, and other General Confusions

by Rachel

There are days in this crazy life I’ve chosen where I totally feel like I’ve made it.  Meaning, communication seems clear, the system is understandable, my life is full of rhythm and routine and all is well.   I go grocery shopping without getting lost.  The milk I ordered actually shows up in the amount I ordered.  I can lecture in French and sit through a meeting and understand the ideas discussed, and once in awhile I can even say a few lines in Kirundi.  But, rest assured, those days are so not the norm!  Even after four years I still feel like I flounder through most of my days.  Easier than the beginning yes, but “arrived”?  Hardly.

I heard another missionary once say that every year he spends in his host culture he is able to understand another 1% of what’s going on.  So based on that, I should be understanding about 4% of what happens around me!  That might be underestimating, but in all honesty the longer I’m here, the more I realize I don’t know.

This “principle” can be illustrated by a couple of sort of humorous but definitely misunderstood events I’ve attended this last year.  My teammates and I are invited to a goodly number of weddings every year.  Social events like this are understood to be important for relationship building and community involvement, but they can also be decidedly uncomfortable...sometimes quite time consuming, definitely difficult in terms of communication, and awkward socially.  So we usually send a “team representative” and share the load.  Last August, Caleb and Krista and I decided to go to the wedding of  one of the hospital nurses.  Wedding invitations always include the location of the ceremony and reception, but not exactly an address.  More like the name of the church and the neighborhood it’s in (and we’re not really familiar with neighborhoods in Gitega).   So, off we went, dressed in our wedding finest.  The wedding was taking place at a Catholic church and after asking around we were told it was located on the far end of Gitega.  Easy enough, there’s a large Catholic church right on the road that we’ve passed many times.  We parked and went in to the huge sanctuary.  At the front were no fewer than 6 couples getting married at the same time!  We found a seat towards the back, as the service had already started.  But after a few minutes of searching, we all realized that 1-we didn’t recognize any of the guests, 2-we didn’t recognize any of the couples, and 3-this actually wasn’t the right church.  

Back to the car.  We followed some sketchy directions down a side road, and then multiple other side roads while getting directions from another half dozen passers-by.  We finally found the “paroisse Yoba”, probably a 10 minute walk from the last church, and walked in just in time to see the bride and groom walking out down the aisle (along with 3 other couples, must have been a very popular day to get married!).  On the upside, it was a very short time commitment. :)

On the other side of the spectrum, one of our long time hospital employees, Jean Dukundane, died a few weeks ago.  He has faithfully served in the surgical department since the 1980s, and his death is a significant loss to Kibuye.  Wanting to pay my respects, I paid close attention to the information of the service and burial.  It was to take place the day before Easter, in our local church, starting at 11am.  So, John and Caleb and I walked up around 11:15 and found a seat in the back.  The pastor spoke for a very long time in Kirundi, and we understood almost none of it.  The Bible passage was Matthew 27, Jesus’ crucifixion, so I spent some time pondering if this was either an appropriate passage for a funeral service or perhaps this wasn’t actually the funeral service.  After about an hour, I finally realized that 1-I didn’t recognize any of the hospital staff there, 2-there was no casket or photo or anything, and 3-I actually wasn’t in the right place (found out later it was jut a regular Easter Saturday church service).  I walked up to the hospital and found the “viewing” in our morning staff room, 1 1/2 hours after the event was supposed to begin.  From there, everyone DID go to our local church for the funeral service, which began around 1pm.  

We’re trying, we really are.  And in my better moments I laugh all of these things off.  It can be hard and frustrating and uncomfortable to try to participate in something without knowing any of the “rules” or instructions or social/societal cues.  But, we press on because we know it’s the right thing to do.  And every time gets a bit easier.  I went to a wedding in Gitega last weekend (at the “original” Catholic church from the first story) and we made it to the right place at the right time, and it was nice!  I take heart that maybe if I can understand just 1% more each year, by the time we’re done in Burundi maybe I’ll be getting close to understanding half of what takes place around me. :)  But it also helps to continue to enlarge my perception of the world, to see new ways and ideas of doing things, to realize that things aren’t always easy for the immigrants in MY home, and to remember that no matter where we are on this earth, we are foreigners in a foreign land, looking forward to a permanent home.


The People Behind the Scenes

by Jess Cropsey

We are privileged to work alongside some amazing people here in Burundi.  Behind every big "accomplishment" -- a new building, a new program, a special event -- there are dozens (or more) of Burundians who have made it all happen.  These people have graciously guided us as we have transitioned to life in this very different place.  They have endured our cultural blunders and language stumbles time and time again.  We could not be here and do what we do without them.      

Today, I want to introduce you to a friend of mine, Thérèse, and give you a small peek into her life.  She is a well-known figure in the Kibuye community.  As a teacher for the last 33 years, she has taught many of the adults & children in the area at some point in their lives.  She is a widow in her 50’s, with three grown children (one of whom is married to the head nurse in the eye clinic) and three grandchildren.  When her twins were 6 months old, her husband got sick and within 24 hours died of an unknown illness.  Being a widow in a paternalistic society like Burundi is incredibly difficult, yet somehow she has managed to flourish and thrive.  

Thérèse is one of the lucky ones because she actually has a job, though the pay is less than $50 a month.  While teaching is her “day job”, she stays busy with tending her fields, pastoring at her church, being involved in local community government, and starting or participating in various community organizations.  She maintains more than 10 fields scattered throughout the local area where she grows peanuts, peas, beans, corn, soy, wheat, and sorghum.

She is a Free Methodist pastor and is active in her local church where she preaches, sings, plays the drum, and assists those in the congregation with food & clothes.  Given that she is a widow herself, she has a special heart for these women and has been involved with an organization called Sister Connection that provides financial assistance and vocational training for widows.  She also organizes a day of prayer once a month with and for these women. 

Thérèse is incredibly industrious and knows how to make soap, soy & peanut milk, and avocado oil.  She shares this knowledge with others, particularly those who are too poor to buy oil in the market or to own a cow (for milk that children and pregnant women desperately need in this malnourished country).  [Interestingly, the avocado oil can be used for cooking, for lighting lamps, and as a hair product.]  In addition, she teaches basket-making, sewing, and cooking.  

She is also a representative for her local district in a health care association that assists its members with hospital bills (for a small membership fee of less than $10/year).  She also started a small association for widows at the local Kibuye church.  Every month, these women contribute 1,000 frambu each (about 50 cents) and save their money together until they have enough to buy something as a group (like a goat).  

You would think that all of these activities would keep her plenty busy, but she is also studying in a degree program designed for teachers to advance their training and provide an opportunity for further study in a university.

Despite the challenges that Thérèse sees in her community and experiences herself, she is full of joy.  She loves the Lord and takes great delight in teaching children.  She is incredibly patient and full of life.  It has been an honor to get to know her over the last few years and we have been blessed to have her as a Kirundi teacher for the missionary children at Kibuye.  Below is a photo from a visit we made to her home a few months ago.  

Always a teacher, she is constantly trying to help us learn Kirundi, with every greeting and every activity.  Below, the kids are removing corn kernels from the cob (which will later be taken to the mill to turn into flour).  All the while, she is patiently reviewing basic vocabulary with the kids.  

Here she is again in "teacher-mode" from a home visit two years ago, showing us how to cook a Burundian meal.

Learning how to make bricks...

This unexpected friendship with someone whose life is so different than mine has been a blessing to me.  She has taught me about contentment, perseverance, and patience and it has been a joy to share life with her.    

These photos are from the "putting the baby on the back ceremony" for her grandchild, which is basically the Burundian equivalent of a baby shower.    


Shame Resiliency

(by Greg)

Shame.  It is something we all experience.  It is something I have experienced in every significant relationship I have.  It is something I have experienced in every phase of my life, from childhood, to college and medical school, during our time raising support to return to Burundi and in every phase in between.

Last year I read (or rather, listened on audio) to a book called Daring Greatly, by Brené Brown.  Ms. Brown is a sociologist who spent years interviewing people and researching the subject of vulnerability and shame.  The results of her research are as follows:  We all experience shame.  It is unescapable in this life.  However, it is those people equipped with what she terms “shame resiliency” who are most successful in life, whether that be in their work, in their family or in any other domain of life.  It is those people who can experience shame and not become paralyzed by it, who are most likely to allow themselves to be vulnerable again and again and who will ultimately live the richest, fullest lives.  The title of the book is based on a quote by Theodore Roosevelt:

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

I found her ideas compelling, and it has been during our year of language learning that I have seen these ideas play out in a fresh and surprising way.  When learning a new language, you are constantly confronted with opportunities to feel shame.  In the US, I like to think I can have a reasonably intelligent conversation with most people.  On the other hand, in France, every time I open my mouth, inevitably something comes out that I did not intend.  I make mistakes.  Many many mistakes.  And I often walk away from these conversations with the idea that I came across sounding like a moron.  I walk away feeling shame.  Among those who are studying a new language, I don’t think I am alone.  And so, I am confronted with a challenge.  Will I get out of bed today, and enter into the ring once more, allowing myself to experience shame again, or will I shrink back?  Will I keep my mouth shut, and will I avoid these situations.  In my head I know that the only way to progress, is to be vulnerable, to engage French speakers and to accept the fact that I am occasionally (or often) going to sound less than intelligent.  

What has intrigued me most about this subject, is watching the same ideas play out in the lives of our children.  Our daughters, who are 11 and 12, also experience this shame.  And as a result, they have done everything in their power to avoid speaking French to French people.  I believe that sadly, this has hindered their language learning.  They have made great progress with their French, but I know they could have made even more had they allowed themselves to better engage their French classmates.  However, there is one family member, who as far as I can tell, has been significantly less affected by shame.  This is our 8 year old son Biniyam.  Biniyam will happily launch himself into a conversation with anyone without appearing at all embarrassed or ashamed.  I have heard him talk to French kids in his class, stringing together what few French words he knows, and despite his errors, he usually gets his point across.  I don’t know how much of this is due to his younger age, and how much of it is due to his personality, but it seems to me that BIniyam is incredibly “shame resilient”.  And because of this, he takes risks, he is vulnerable and he is making incredible progress in French.  He is also forming great friendships with the kids at his school.  It is truly a beautiful thing to watch.  

As I process these thoughts it occurs to me that the most powerful response that we have to the challenge of shame is the Gospel of Jesus Christ.  He was the one who bore our shame, bearing it gladly, out of love for us.  He was the one who made Himself vulnerable and humbled Himself to the point of death, even death on a cross.  And He did all of this for our sake, that we might be reconciled to the Father.  I truly believe that the more we see our identity in this light, and the more real our relationship with Christ becomes, the less we will experience shame, and the more we will allow ourselves to be vulnerable, out of love for our wives, our children, our friends and those who are hurting and suffering far away.  As we meditate on what Christ has done for us, the opinions of others fades into the background.  And we are finally free.  We are finally free to climb into the ring and to “dare greatly”.

Therefore, since we are surrounded by so great a cloud of witnesses, let us also lay aside every weight, and sin which clings so closely, and let us run with endurance the race that is set before us, looking to Jesus, the founder and perfecter of our faith, who for the joy that was set before him endured the cross, despising the shame, and is seated at the right hand of the throne of God. - Hebrews 12:1-2


The East African Community Conference on Health and Research

(By Logan)

A couple of months after our family arrived at Kibuye last fall, the team received an important email from the rector of Hope Africa University. 

He informed us that there was going to be an international medical conference in the spring hosted by the East Africa Community Commission on Health and Research. This was apparently a large annual conference that was held in a different East African country each year (Kenya, Tanzania, Uganda, Rwanda, Burundi, and South Sudan). This year was Burundi’s turn to host and the university wanted a strong showing at the conference.  If there was any way possible we should try to submit a proposal that we could present at the conference. There was only one problem: we found all this out only 2 days before the deadline for abstract submissions. 

However, it seemed like there was precious little time to dedicate to writing up abstract proposals for a medical conference that none of us were really familiar with. Everyone was engrossed in full-time work at the hospital. 

Everyone, that is, except me. 

I had not yet started full-time at the hospital, while I adjusted to life in Burundi and studied the local language of Kirundi. Of course, I had also not participated in any research whatsoever in Burundi. 

After letting the team know that I was willing to help expediently write some abstract proposals (OK, it’s possible I used the phrase “throw something together”), I learned that there were some possible submission ideas already on the team. Working feverishly, along with Eric and Alyssa, we submitted two applications, squeaking them in just under the deadline. 

With that off my plate, I promptly forgot all about it. 

For about the next 4 months that is. To be more precise: until 3 weeks prior to the conference. That is when I found out that our proposals had actually been accepted as poster presentations. That meant that I had less than 3 weeks to make all the arrangements to attend the conference in Bujumbura, turn the hastily prepared abstracts into professional appearing academic posters, and then figure out how to even get a poster made in rural Burundi. 

With a lot of help from Eric, Alyssa, and even a colleague from Cox FMR the posters came together. I found out that one of the lab techs at Kibuye Hope Hospital knew a guy who could make the poster in nearby Gitega. About a week before the conference, I entrusted to him the USB drive that contained pdf’s of the posters. And then I waited.

And waited.

Each day for that next week I would stop by the lab and check with him on how the posters were coming along. He assured me they were being made and I would have them before the conference. Finally, on the night before the conference, at 7:30pm, the posters arrived via motorcycle taxi. With fold-creases and just a little mud splashed on them, they certainly had the appearance that they had just arrived by motorcycle taxi. But with enough pressing and a warm wash cloth the wrinkles and mud stains came out.

I made it to the conference and started to put up the posters in the poster area, which was actually an area outside under a breezeway by which people would pass during breaks. As I was working, I was standing on the carpet in the middle of the aisle, checking to make sure the poster was level, when an employee came over to me and said, “Excuse me, you can’t stand here, the President is walking here.”

“Oh! I’m so sorry!” I said, jumping back quickly and looking around. But then I got confused because there was literally no one around.

I looked back at the employee, trying to understand. “Ohhhh! I get it!” I thought out loud. “You mean, that, like, at some point in the future, the President WILL walk on this carpet, so I should get off of it now… Ummm.  Right!  Of course! No problem.”

The conference got underway, and the President did in fact walk on that carpet. There were many opening speeches by many dignitaries in the East African Community, including the U.S. Ambassador to Burundi as well as His Excellency the President himself. 

Alyssa and Sonia, one of our Burundian colleagues at Kibuye, were also able to come down to Bujumbura to attend the conference and present the new Kibuye NICU design as an example of low-tech and low-resource techniques to help decrease neonatal mortality.  

The theme of the conference was “Outbreaks, Epidemics, and Antimicrobial Resistance”. There were some interesting presentations ranging from efforts to limit the purchase of over-the-counter antibiotics to the demonstration of antimicrobial resistance from cultures of hospital cockroaches. It was especially interesting to see the antibiotic sensitivities presented in regards to the common antibiotics that we use at Kibuye since we don’t actually have the ability to do microbiology cultures. But at the same time it was quite alarming, because we could see just how much resistance is developing to these common drugs, even though they are often the only option we have available.

Overall, this was a good opportunity to share our work with the East African Community, as well as learn from and be inspired by what some of the larger hospitals and medical schools are doing in this part of Africa. I’m not sure where the conference will be held next year, but I think it would be worth attending again. As long as I’m not “pulling it together” at the eleventh hour.

(the cockroach abstract, for those interested...)