Our miss list

I certainly don't want to complalin about life here.  All in all, things here are going great.  We have all adjusted well to life in Burundi, and we are truly enjoying this time.  However, I would be lying if I said there were not some things that we missed about life back home.  So here it is, our "miss list":

Greg's miss list:

1. Family and friends - this is far and away the thing we miss most.  We are grateful for all the new friends we have made here, but we still miss, everyday, our parents, our friends and our church.

2. Consistenly running water - recently there has been an issue with our well, and so most days we have had very little running water.  And yes, I am beginning to emit a foul odor.

3. Consistent electricity - this has gotten better since the rainy season began (we have hydroelectric electricity).  But for the first several weeks, it seemed like we had more time without electricity than we did with it.

4. Fast internet - The slowness of our internet has certainly caused me to be less consumed by internet, which is probably a good thing, but still I miss my addiction.

5. Fabric softener - yes, I like my socks and undies to be soft and supple, and if loving this is a crime then lock me up and throw away the key.

6. Being able to hop in a car and run to the store or to Lake Padden.

7. Understanding people when they try to speak to me.

8. My bed.

9. My dog (we had to have Summit put to sleep before we left)

10. Scotch

What I miss from work:

1. Having more than 2 options to give patients for anesthesia (at home I have 3!)

2. Being able to give patients the medications they need to be comfortable (and sometimes to survive)

3. Clean toilettes

4. Understanding people when they try to speak to me.

5. Working suction

6. All the Skagit Valley Hospital nurses, surgeons and anesthesiologists.

7. Purell

8. An operating room without flies.

9. Having an intestive care unit to send patients to when they are critically ill.

10. Scotch

Steph's miss list:

1. Running lake Padden with friends, I miss the beauty, I really miss the talks.

2. My Thursday morning Bible studies, and the ladies who got up at 5 am to grow with me.

3. Jumping in the shower without pausing to kill the critters that have crawled up from the drain

4. Flipping a switch & having a light come on, and then stay on without flickering. Not a huge fan of fluorescent lighting.

5. My bathtub

6 . A glass of wine, especially ones drunk on the front porch while talking to my favorite neighbor.

7. Being able to go out and not be stared at.

8. My stove, and the fact that it doesn't take matches to light it.

9. Wearing pants

10. My pillow!

Burundi needs more surgeons

Last week I had the chance to go to two conferences in Bujumbura.  The first was a conference of the Christian Medical Association of Burundi.  Tuesday morning, Eric, Alyssa and I piled into the van with about 12 medical students for the 3 hour drive to Bujumbura.  It was a great conference, filled with stories of God's grace and provision in so many ways.  We drove back to Kibuye that afternoon.  Then on Thursday, Jason and I piled into the van again with about 12 medical students for a 2 day conference of the Burundian Society for Surgeons.  It was fascinating for me to learn more about the state of surgery all over the country.  I recently learned that there are only about 15 general surgeons in Burundi (a country of over 10 million people) and from what I understand, they all work in the capital, Bujumbura (aside from Jason).  I also learned that there are 3 other anesthesiologists (Reanimateurs) in Burundi, all of whom work in the capital.

After being here for 2 months, one thing that is obvious is that Jason needs help.  He needs help because there are so many people here who need surgery.  He works 7 days a week and there is just not enough time to operate on everyone who needs surgery.  He does general surgery, orthopedic surgery, neurosurgery, pediatric surgery, and urology.  And he would love some help.

During this surgery conference I also got to learn a bit more about Jason's vision for Kibuye.  He wants to start a residency program for graduating medical students who want to become general surgeons.  In order to do this though he needs a second surgeon and a long term anesthesiologist.  At the conference I learned that Burundi once had a general surgery residency program which involved 2 years of training in Bujumbura, then 2 years in France, then one more year in Bujumbura.  Sadly, this program was shut down during the civil war, and has yet to be re-started.  Another problem is that most of the surgeons trained in this program left for greener pastures (or wealthier pastures) and the other problem is that those who stayed all work in the capital.  There is no one (aside from Jason) working in rural Burundi.  

So, where is the hope?  Well, there was an announcement made at this meeting that pending the approval of the East African Coalition for Surgery, Burundi plans to re-start the surgery residency program next year.  This is good news, but obviously it would be years before anyone finished this program and is ready to practice alone.  Jason also got to meet with the other general surgeons at this conference and expressed his interest in starting a program at Kibuye as well. The other surgeons welcomed him and seemed very receptive to his plans.   It was also encouraging to meet several of the graduating medical students who very much want to become surgeons. 

This week a visiting surgeon who was a resident in Kenya under Jason arrived to serve here for a month.  It is greatly encouraging to meet this woman who has already benefited from the heart for teaching that God has given Jason.  I feel like her being here has given me a window into the future of surgery in Burundi.  And there is hope.

Eric speaking at the Christian medical conference (they informed him the night before the conference that he was one of the speakers).

Dinner Friday night in Bujumbura, with Jason and three of the medical students eager to enter into surgery.  One of them from Uganda, one from Kenya and one from Burundi .... and we are eating at an Ethiopian restaurant.  It was truly a pan-African experience.

Spider Trivia

Given our slow internet service, we were wondering if any of our blog followers might be able to identify the spider pictured below.  We would also be curious as to whether or not it is poisonous.   Stephanie and two of the other wives noticed it while in our garden.  One of these women called the guard over and asked him (in Kirundi) if it was dangerous.  He said something (in Kirundi) and she translated for us, “I think he said that you can eat this spider ….. no, wait … he said this spider will eat you”).  Slight difference.  

Whoever can correctly identify this spider will win free room and board in beautiful Kibuye, Burundi (airfare not included).

Reanimation update

Yesterday, the first group of 6 medical students finished their Reanimation rotation at Kibuye hospital.  To celebrate, Stephanie and I inivited these 6 students over to our house for dinner last night.  I can't tell you how much I have enjoyed working with these students.  They are bright, hard-working, eager to learn, kind and compassionate with their patients, they all speak between 3 and 5 languages and switch back and forth with great ease, and each of them grew up in a country ravaged by civil war (something they rarely talk about).

Last night, one of the students who is actually from the D.R. Congo began talking about the teaching he has received at Kibuye and how drastically different it is from anything he had ever experienced before.  The students at Kibuye work with doctors who are patient and kind to their students and their patients.  They are doctors who are humble enough to admit when they have made a mistake and also to admit when they don't know the answer to a question.  As this student was talking I thought I sensed his voice beginning to crack a bit, and then he admitted that he gets emotional when he talks about this.  

It occured to me that with all the changes going on at this hospital with this team of American physicians, perhaps the greatest change is that of atmosphere.  This long-term team (and I hope the short-termers like us as well) are modelling for dozens of students each year what it means to be a physician who is humble and patient, and who treats his or her students and patients as human beings created in the image of God.  And these students will then graduate and go on to be leaders in their hospitals and their communities and I believe they will become the kind of doctors that they are studying under now.  Last night was a great reminder to me of why we are here. 

Five of the six students (the sixth was out of town)

I also got this new fancy stamp!  I am told that you are not a real doctor in Burundi until you have your own stamp.  Also, I could not officially graduate this group of students without this stamp.  What does one need to get ones own stamp?  About $25 and a short trip to Gitega.  No need to show any proof that you actually are a physician.  Next week I am thinking of becoming a neurosurgeon!

The Rainy Season has Begun

Last week daily storms would roll in with the sound of thunder, then torrential rain. The deep trenches dug around our house suddenly make sense. And yes, that is our laundry on the line. 

The Beauty of Burundi

Greg and I are in Gitega this weekend, a city located about a half hour from Kibuye, and we have (slightly) faster internet access, so we are taking this opportunity to upload some photos of this beautiful country.  

A few random events

The past couple weeks have been good.  I feel like we are starting to hit our stride with living here.  There continue to be challenges, but overall, we feel well and are grateful to be here.  I thought I would describe a few of the highlights from our past couple weeks.

Last Friday evening, the 4 anesthesia students as well as the full time anesthetist here came to our home for a visit.  It was wonderful to see them all out of the hospital, and to have the opportunity to serve them tea and zuchinni bread.  They came bearing gifts as well, a beautiful basket filled with 3 pineapples (one for each of our kids).  We found out the following day that it is Burundi tradition that when someone brings you a basket such as this, you remove the gifts, then place something back into the basket as a gift for the visitor.  I wish we had learned this one day sooner.

I have now twice had the opportunity to visit other churches outside Kibuye with the local missionaries.  I am eager to accept these invitations because to be honest, I am getting a little stir crazy here on “the compound”.  Both times involved 30 to 45 minute drives through beautiful hills and villages.  Both times involved being greeted by mobs of people (mostly children) and both times involved being seated behind the pulpit facing the congregation (yep ... awkward indeed).  Oh yeah, and both times involved services lasting 4 hours (our Kibuye church service only lasts for 3 hours).  The first church we visited presented us with gifts halfway through the service, a small gift-wrapped box containing 4 eggs.  They also presented our local Burundian pastor with a live chicken, which rode home with us in the car.  Mekdes joined me for the second visit, and somehow managed to sit through the entire 4 hour service.  This was undoubtedly a miracle. I later found out that she’d completed a full week’s worth of math in the math workbook she brought with her, with the entire church watching her.  After each service, we were again mobbed by hundreds of people who wanted to shake our hands and then just stare at us.  I guess this must be what Brad Pitt feels like when he goes out in public.  Yeah, that’s right ... I just compared myself to Brad Pitt, what of it?

The past couple Monday afternoons, Steph and the kids visited the hospital, bringing paper and crayons to draw pictures with the kids in traction.  These poor kids lay there in bed for weeks at a time with nothing to do, and they seem grateful for the distraction of a bunch of Muzungu kids playing with them.  On their first visit to the hospital Steph and the kids were a bit surprised by the herds of rats scurrying around the ward.  The rats here are not shy ... and they appear to be well fed, sometimes more well fed than the kids in the hospital.  In fact, we’ve been told that the malnutrition rate among children in Burundi is 60%, but that’s a topic for another post. 

We are continuing to learn new things, and meet new people everyday, and are grateful to be here, and to have the strength to continue in this ministry.

Free Range Children

I have fond memories of childhood.  The long summer days when I’d jump on my bike and join the other members of the Camouflage Club (previously known as the Clue Club) in the woods near our house to build our fort, climb trees, solve whatever mysteries came our way. We’d be off on our own playing outside until my parents, quite literally, blew a horn signaling it was time to come home. 

I’ve often bemoaned the fact that the world we live in is too different for me to allow our children the same freedoms I had.  When we moved into the our house back in the US I was excited about the woods that lay beyond our fence, “The mysterious beyond” we labeled it and encouraged our kids to go explore.  That is, until we saw the tarp, the sleeping bag, the evidence of a campfire.  We live in a small city, there are many homeless, occasionally they camp just beyond our fence.  Neighborhood kids are fun when home, but often busy with activities, or our kids have activities. If they want to play at a park, I’m there with them.  I don’t want to be a helicopter parent, but in the US it is hard to have free range kids.  

On our first day in Kibuye, Anna, the other 9 year old, asked if the girls could join her for a walk.   “We don’t know, can they? Is it safe?” And so our motto came to be “If Anna’s parents let her do it, then it’s okay, you can too.” And off our girls went with Anna into the woods to walk past tea fields and Burundians hoeing and to find a mound of red earth just beyond the bamboo fence. They spent they next few days shaping the clay into bowls and animals, creating “claytopia”. Ella even had a Burundian boy paint her face with the red clay.  (We like to tease her in saying that we’re pretty sure this means that they are now engaged.) They let Biniyam join them and I unpacked in peace and strange silence. 

That night I had a nightmare in which I was back in the US.  I was unpacking and Biniyam ran into the room, he said some people brought him home and wanted to talk to me. They were from DSHS and they said they had found my 5 year old wandering around town by himself and why wasn’t I watching him? Once awake I found the dream amusing, pointing to the big reason I don’t allow my children to roam free in Bellingham. I’m afraid of other people, that they will hurt my kids or what hassle they will make for me. I fear people looking at their phones while they drive and not watching for kids crossing the street. I trust my kids, I don’t trust the community at large.

But here they have a controlled area in which to roam, and it’s of a pretty good size.  There is one short road and rarely does a car open the barrier and drive slowly through.  They have multiple houses in which to play (for example, I currently have 3 children playing at my house, none of whom are mine, my children are playing at someone else’s). Before school they will often head out and find friends to play with and after school until dinner they’re with friends.  They spend a lot of time in our “art studio” room drawing their characters for whatever storyline they have going that day and then they head outside to act out their stories. They catch toads and lizards, they climb trees, they play chase, they build forts, they solve mysteries. They don’t complain of boredom, they don’t beg for media time, they fall asleep quickly and sleep through the night. This is my favorite part of our life here in Burundi, watching our kids experience this childhood of freedom and exploration. 

Making history can be painful

The anesthesia students have been very excited this week.  That is because today, we scheduled the very first surgery under general endotracheal anesthesia at Kibuye hospital.  There has been an anesthesia machine in the OR since I arrived, but it had not been set up or used until today.  This week, Jason and I worked on getting it ready to go, connecting an oxygen tank to one port, an air compressor to another and filling it with expired halothane and expired CO2 absorbent.  So what could go wrong?

After discussing the plan with the students, drawing up the medications and preparing the intubation equipment, I handed my ipad to one of the students and asked him if he would take a couple pictures of the intubation to memorialize this historic event.  So, we injected the induction drugs, and this patient turned out to be one of the most difficult intubations I have ever encountered.  The reason for the surgery was to remove a tumor on his neck.  This tumor was apparently distorting his airway, making visualization of his vocal cords almost impossible.  So, what should have been a 15 second induction of anesthesia turned into a 45 minute scene of chaos and mayhem.  At one point I could not ventilate the patient and so his oxygen level dropped to undectable  levels.  The medical student with my ipad continued to take pictures this whole time, 133 photos to be exact.  And I remember thinking at one point that I REALLY wished I had not asked someone to take photos of this historic event.

Alas, by the grace of God, the endotracheal tube finally found its home, the man had his surgery, woke up and appears to be doing fine, and hopefully our next general anesthetic will go a little smoother than this one.  

A few of the less incriminating photos .....

This is the air compressor which is driving the anesthesia machine.

Our quirky house

We really do love our house here in Burundi.  From what we know, it was built in the early 1980s and was the home of Frank Ogden, an American missionary surgeon who lived here for many years (for those of you employees of Skagit Valley Hospital, Frank worked for a period of time at SVH during the Burundian civil war .... small world).  We love the yard with all of its beautiful trees and flowers, we love all the space we have inside (much more than we expected).  However, there are a few things about our house that I can only describe as .... quirky.  Such as:

This cheetah skin hanging on one of our walls

Or this machete and spear which we found in our bedroom the day we moved in.  I like to imagine Frank using these to fend off attacking lions.  Although, I dont think there are any lions around here.

Or this antique phone .... ironically hanging right above the internet modem.

And this, my favorite part of our quirky house .... electricity central.  In the middle of this rats nest of wires is a switch which we have to turn on everytime we want to take a hot shower.  Some days, this elicits a small spark, which is very exciting.  Dont worry grandparents, we have STRICTLY forbidden our children from EVER entering this room.

Home sweet home.