On Fluency and The Art of Discouragement

(by Greg)

“Aren’t you fluent in French yet?”.  This is a question that has been posed to me by friends back home.  The short answer is, no … no I am not.  But when will I be fluent?  This is a question I have started to ask myself, which has caused me to think more recently about what it truly means to be “fluent” in a language.

Fluency in language is an interesting thing.  To be honest, some days I am not sure I am fluent in English.  Yes, I can hold a conversation.  However, there are still MANY words in English for which I still do not know the meaning.  And although I like to think I understand English grammar, I have a suspicion there may be an English teacher or two out there reading my blog who are twitching at each subtle mistake.  And regarding spelling … well, thankfully my computer now fixes most of my speling mistaikes.  

Before we came to France, BIniyam tried to convince me that he didn’t need to come because he was already fluent in French.  He knew how to say “bonjour” and “ça va?”.  He also claims to be fluent in Kirundi, Spanish and Japanese.  I think am going to be a little slower to apply this word to myself.  In fact, I am not sure I will ever reach the point where I feel confident enough to label myself “fluent”.  For me, that is a weighty word.  

The U.S. State Department has given me some guidance on this topic, as they have created a Proficiency Code, with a scale of 0 to 5.  In fact, anyone can take this exam, which will inform you of which level you fall under for a given language.  Level 5 means that you are able to use a language in reading and speaking, “fluently and accurately” on all levels pertinent to professional needs.  Well, I did “fluently and accurately” order a baguette this morning … does that count?

After studying French full-time for the past 3 months, I stand in awe of people who speak two or more languages “fluently”.  In fact, the place where I have met the most number of people who I would say fall into this group, are Africans, especially the medical students I work with.  Many of them switch back and forth between French, Kirundi, and sometimes English, with complete ease.  The students who come to us from Congo (where there are many more languages spoken) sometimes speak 7 or 8 languages with fluency.  

Learning a new language at the age of 42 offers daily opportunities for discouragement.  Although I tested into an intermediate level in our school, I continue to have opportunities listening or speaking, in which I end up completely lost.  We are so grateful for the language partners who meet with us each week.  There are dozens of men and women here in Albertville who donate their time each week to meet one on one with the students at our school to give us practice in conversational French.  These opportunities are massively important for us, but sometimes leave me feeling deflated and wondering what just happened (“wait … I agreed to do WHAT to your cat?”).

This morning I needed to respond to an e-mail I received from a nurse anesthetist in Burundi.  The e-mail was in French.  An e-mail that would have taken me 2 or 3 minutes to compose in English, took me 30 minutes to compose in French.  

I know I should be used to discouragement, having gone through medical school and residency, where one is often humiliated (sometimes in front of large groups of people), but somehow this feels different, and I am not sure why.  Perhaps it is because I have a family now, and the amount of time I have each evening to study is more limited.  Or maybe it is because trying to talk to people in a language that is new to you leaves you feeling vulnerable.  Or perhaps it is because the line between success and failure, or fluency and non-fluency, is a bit more hazy when it comes to language learning, compared to the study of medicine.  

So, I go back to the bible to encourage me, and once again I find comfort in the words of 2 Corinthians 12:9-10: “But he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness’.  Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me”.

Yes, I am making progress, and I am able to speak French better than I was 3 months ago, but I am weak, and I will likely continue to embarrass myself in front of native French speakers.  And some days I will feel like an utter failure.  But it will be okay, because His grace is sufficient.  

Our time here is important, and in fact is crucial to our success in Burundi.  We would not be here if this was optional.  We are grateful for this school, our teachers and our language partners.  And we are grateful for everyone back home who is supporting us prayerfully and financially to allow us to invest this year in our future work in Kibuye.  Ultimately though, we believe this is not our work, but is God’s.  And so, our “success” will rest not on our fluency, but on His grace.  

Mamertine Prison

(by Greg)

“Remember Jesus Christ, risen from the dead, the offspring of David, as preached in my gospel, for which I am suffering, bound with chains as a criminal.  But the word of God is not bound.” - 2 Timothy 2:8-9

The Bible is very important to me.  I start everyday by spending time in the Bible.  One part of the Bible that has been especially dear to me is 2 Timothy, the letter written by the apostle Paul to Timothy, his dear friend and brother in the faith.  I have had long conversations about this book with many in our church, especially our pastor Rob Berreth.  In the past 15 years I have gone back to this book time and again, for instruction, for encouragement and for hope.

We are on a fall break from school this week and since we are living only about an hour from the Italian border, we decided to visit Lake Como in Northern Italy, to rest and recover from the past 2 months.  Since we did not know if or when we would get the chance to be in Italy again, we convinced ourselves that we really should tack on a few days in Rome … for the sake of the children:) 

Yesterday we got to visit some incredible sites, including the Colosseum, the Palatine Hill (home of Rome’s emperors) the Senate hall (the birthplace of democracy).  But we also got to visit a place that many people probably overlook.  It is the site of what was called Mamertine prison. This is the prison in which the apostle’s Peter and Paul were held before their executions.  It is also believed to be the site where Paul wrote 2 Timothy.  Our family got to stand in the very cell where these words were penned, these words which have been read for the past (almost) 2,000 years by people from every country on the face of this earth.  It was such a tremendous gift to get to visit this prison (now converted into a museum).  It was a tremendous encouragement to my faith to stand in that cell and to remember that this book I read everyday is not a fairy tale, but is history and was played out by men and women who held the Gospel so tightly, that there were willing to die rather than deny it.  I thank God for this opportunity, and for the reminder that He can even use a man chained in prison to bring hope and peace and life to countless people.  

“For I am already being poured out as a drink offering, and the time of my departure has come.  I have fought the good fight, I have finished the race, I have kept the faith.  Henceforth there is laid up for me the crown of righteousness, which the Lord, the righteous judge, will award to me on that Day, and not only to me but also to all who have loved his appearing” - 2 Timothy 4:6-8

 The outside of Mamertine Prison

 The cell where Peter and Paul were held.

Colosseum

Survival Mode

We have now been in France for 10 days, and I admit that I am guilty of not keeping our family and friends up to date on how things have gone so far.  For that, I am sorry.  To be honest, for the first week, we were very much in survival mode, just trying to figure out how to live and eat and to get around town.  This took a lot of energy and a lot of time, but I believe we are starting to get our feet under us and are just now beginning to get into a rhythm.  

We arrived at our new apartment on a Friday night and were warmly greeted by our teammates the Baskins, who are just finishing their year in Albertville, before moving to Burundi (Darrell is an ophthalmologist, and will be Burundi’s first ever retinal specialist).  They had dinner waiting for us, along with a supply of groceries to get us through the first few days.  Our apartment is on the third floor of a building which is off campus (about a 15 minute walk, or a 5 minute car ride). Many of the students live in a dormitory on campus, but we are grateful for have been assigned an off campus residence, as we hope it will compel us to better engage in the local community and utilize our French as much as possible.  Before we moved here, we arranged to purchase a used car from one of the outgoing students, a 2001 Opel Zaphira.  It is a well worn and well loved car, but so far, it has started every time.  

The first week was filled with meetings trying to get set up with a French bank account, phone and internet, car insurance and registration, and the kids schooling.  These meetings were exhausting, as they were all in French, which was a big stretch for me.  My French is probably on the level of a 7 year old …. so just imagine me sending Biniyam in by himself to set up a bank account, or to purchase car insurance.  I am not sure exactly what I signed up for, but put a great deal of faith in those who were helping me.

Thursday was orientation for Stephanie and I and was also the first day of school for our kids.  It became clear to us on Thursday that what we are asking our kids to do, is massively more difficult than what Steph and I are doing.  They have been thrown into schools with teachers and kids who speak no or very little English.  It was a hard day for them, but they all survived and girded up to return to school on Friday, which seemed to be a slightly better day.

This weekend we had a bit of time to exhale and to explore this gorgeous city, nestled in the French Alps.  We went to an artisan festival, and also hiked up to a medieval city on the mountainside (which we can see from our balcony).  We also spent time with our teammates who are here with us, the Baskins and Wendlers.  It seems I could keep writing for a very long time, describing our first 10 days, but I think instead I will close with some observations we have made about life in France.

1. The French people have been, for the most part, incredibly warm and kind to us.  I think the French have gotten a bad rap in recent years, and I can only assume this comes from some bad experiences that Americans might have had in Paris or another big city, but out here, far from the big city, people are warm and generous and kind, and most of them have been very patient with my 7 year old level of French.
2. Everything here is much smaller than in the US, including roads, apartments, and toilets (some of us need to work on improving our aim:)
3. France (or at least the part of France we are living in) is an incredibly diverse part of the world.  In our apartment complex, we live above a Kabob shop owned by a very kind Turkish man, also above a family from Poland, and below an Arab man and French man.  
4. France has a culture that is in many ways different from American culture.  This will take time to understand and to learn how to adapt.  I am not sure that a year is enough time to wrap our minds around it, but we will try.
5. In France, your kids are released from school every day to have lunch with their families.  I am grateful for this time as a family each day, and even more so as it gives us some time to check in with our kids in the middle of their day, and give them a respite from the onslaught of French coming toward them.

Again, I am sorry for all the emails and Facebook messages that I have not responded to, or responded to very slowly.  In addition to the busyness of these past several days, we just got internet set up in our apartment this weekend, so we have had few opportunities to access the internet prior to this.  Please continue to keep us in your prayers.  Although a year in France may sound like a year long vacation to many, we know this will be a year with many challenges both for us and for our children.  But we hope that in the end, we will have the depth of French that we need to re-enter into the work we have been called to in Burundi.  

Connecting Two Worlds

There is much I will miss about our lives in the U.S., but one of things I am going to miss deeply is the people I work with at Skagit Valley Hospital.  The nurses, techs, surgeons, everyone there has been so supportive of what we are doing in Burundi.  It is truly an incredible group of people, and I have never felt so at home going to work each morning, as I have for the past 8 years.

It is such a joy to connect people to our work in Burundi, and the people I work with have supported us in so many ways, from financial support, to sending us care packages while we were in Kibuye last year, to simply reading our blog posts and staying engaged.  And so, you can imagine my excitement when two of the general surgeons I work with agreed to travel to Kibuye and cover for Jason for 2 weeks each, consecutively.  When people ask about specific needs in Kibuye, there is so much it is hard to know where to begin, but one thing we always need is surgeons to go and cover for or work alongside Jason, who is massively overworked.  These two surgeons sacrificed a great deal to go and work in a hard place (made harder by the fact that much of the long term team was out of the country at our mission agency's retreat, which happens once every 3 years).  They got to experience firsthand the need and the challenges of healthcare in Burundi, and they both returned deeply affected by their experience.  I am truly grateful to both of them as well as to all of my friends at Skagit Valley Hospital who have encouraged me in so many ways.  I will miss you all.

I hope in the years to come I can continue to connect friends back home to this work, and I hope more and more people will go and serve.  The work is hard, but it is good.

The Journey Begins

Some of you who live in Bellingham, might be wondering where the heck we have disappeared to.  Our moving to Burundi to serve as missionaries, involves several preliminary steps.  And the first step involves a month long training in Colorado Springs at Mission Training International.  So, last Saturday, we packed up the minivan, loaded up the kids, put a “for sale” sign outside our house and started driving, and driving, and driving.  We drove through Bozeman, MT stopping to visit some old friends, then spent half a day driving through Yellowstone Park, where Ella’s hat was blown by the wind right into a boiling hot springs (despite the children’s pleadings, I decided not to wade in to fetch it).  Then we drove through the rest of Wyoming, then through Nebraska and ended up (for now) in Lincoln, where we stopped to visit Steph’s parents and her sister’s family.  Thursday night Steph and I then flew to San Francisco, where we had an appointment at the French consulate to apply for our visas for language school, then flew back to Lincoln Saturday morning.  We will stay here through the weekend, then Monday morning, we will load up the car again and drive 8 hours to Colorado Springs.  

So far, the kids have done a great job, and we all feel like we have gotten to see a lot of this beautiful country … maybe too much.  And for those of you who think that Lincoln has nothing going on, the night before we arrived, Justin Bieber performed at their local arena.  That’s right people ….. Justin Bieber.  

We have been told that being a missionary means your lives will be filled with transitions.  In fact that is one of the topics I believe will be addressed at this training in Colorado, dealing with these frequent transitions (both for us and our kids).  There will be many hellos and there will be many good-byes.  This will undoubtedly bring much joy but also much sadness.  But in the end, we believe it will be worth the price.  But more than that, we believe we have been called into this by a good God who cares about us, and who cares deeply about the people we have been called to serve, the people of Burundi.  

A snapshot of our lives over the past week

Leavenworth, WA

The famous carousel in Missoula, MT

Yellowstone

 The French consulate appointment really took it out of me

The joy of cousins!

Perspective Of A Third Culture Kid

By Ella

Q. What is a third culture kid?

A.  A third culture kid is a kid who is growing up in a different culture.

That’s what we are going to be soon, third culture kids. 

Some of the questions we get asked the most about Burundi are things like “ What was school like?” or “ What was your favorite part” and most of all, the basic question of “ Did you like it?”. The answer is YES!!!!!!! We all loved it there! What kind of kid wouldn’t love to run around outside all day with friends? Certainly not us! Burundi gave us a whole new perspective on life anywhere. This is an essay I wrote for a school assignment.

                                         Less is More 

   I never knew, but sometimes, less is more. When people are less fortunate, you learn to appreciate the things that you do have. I learned about that first hand.

   My family was working at a mission hospital in Burundi, East Africa, for nine months last year. We could only bring limited supplies, and most of our bins were full of resources for the hospital. We had to adjust to living with less.

   At first it was hard living without the things we were used to, but as time went on, we learned to appreciate the little things that we did have.

   Whenever one of our friends back in the U.S. would send us a package, we would be so exited about chocolate chips or colored pencils, even though normally we would just have those things instantly.

   I started to realize, the less we had, the more appreciative we were.

   In March 2016, Burundi was named the most unhappy country in the world, with Denmark in first. My family and I came up with the solution that they must have interviewed people in the capital, Bujumbura. Out in the country, where we were, people were very happy. The people in the capital know what they’re missing, but with no internet, no connection to the outside world, the villagers are grateful for the little that they do have. 

   This is an important lesson to learn. A lot of times, when people have many things, they don’t appreciate the small things until that’s all that’s left. Appreciate all your things, because sometimes, less is more.

A Global Challenge

For the past two years through this blog we have shared many stories.  We have shared stories of individuals in Burundi who have benefited from the medical and surgical care delivered at Kibuye Hope Hospital. These are the personal stories of the patients who have made it to the hospital. What we have, however, neglected to talk about is a global problem we are currently facing. Today there are 5 billion people who do not have access to safe and affordable anesthesia and surgical care when needed, according to a recent Lancet Commission on Global Surgery.  If that number sounds like a lot, that is because it is a lot.  In fact the total population of the world is 7.125 billion.  That means the MAJORITY of the world does not have access to safe and affordable anesthesia and surgical care.  

This same commission estimated that 16.9 million people die every year for lack of access to safe and affordable anesthesia. This is more than twice the population of Washington state ... dying, every year.  This figure is four times higher than the number of people dying annually from malaria, HIV/AIDS and tuberculosis COMBINED!  

According to the World Federation of Societies of Anesthesiologists "a lack of training in anesthesia, along with a lack of vital anesthesia equipment in low and middle income countries, is a huge part of what is making this number so shockingly high.  In many countries anesthesia and surgery are simply not safe".

It is hard for people to wrap their minds around this. It is hard to make people care about numbers so large they are almost unfathomable.  I'm sure it would be more vivid if we were all looking at the problem from inside the circle with the other 5 billion people who simply have no way of getting a needed surgery. 

This is the crux of what we are doing. We can go to Burundi and train anesthetists and surgeons and treat patients with safe and affordable care.  What can you do?  You can support those who go and those who are laboring to change these statistics.  

We need a team of monthly supporters fueling the work we are doing in Burundi. If you would like to join our support team there is still plenty of room. We are currently at 41% of our monthly support goal with the aim to reach 100% by June so that we can deploy at the end of the summer. Will you partner with us to be a part of the solution to this global challenge?

Click here to join our support team

Heroic

This morning I was reflecting on our time last year in Burundi, and remembered a particular moment that I am not sure I ever shared in a blog post.  It was an afternoon during Reanimation (critical care) rounds, and I was seeing patients with my 6 medical students.  There was a patient, a middle aged man, who was very sick with tuberculosis.  We were seeing him together in the "isolation" ward.  I put "isolation" in quotation marks because if you have ever been in an isolation ward in an American hospital, this is nothing like that, but is rather a building separate from the rest of the hospital, with open windows to facilitate good ventilation.

The man we were seeing was sitting up in his bed gasping for air.  There was no oxygen in the hospital that week to give to him.  After discussion with the internal medicine team, it was thought that he might have a pericardial effusion (a collection of fluid compressing his heart) as a result of his tuberculosis.  It seemed to me that if we could do an echocardiogram with our ultrasound machine, we could decide if this was part of his problem and potentially remove some of this fluid.  This MIGHT help his breathing.  However, in order to do this test, I would need him to lie down.  He said if he was to lie down, he could not breath at all.  I told the students that if we could at least get him into a reclining position (maybe 45 degrees) I could do the exam.  However, the beds in Kibuye are not adjustable.  You are either sitting up or you are lying down.  I could not think of a solution to this problem, and so I looked at my group of students.  One of them had come up with a solution.

He took off his white coat.  He climbed into bed and seated himself behind the patient, then put his arms around this man's waist and gently leaned him back against his chest, so that I could do the echocardiogram.  It was hard for me to not let myself cry as I watched him do this.  This patient was sweating, he had likely not had a shower for weeks, he was HIGHLY infectious with tuberculosis.  And this student made himself into a human pillow, so that we could do the exam we thought needed to be done.

As I think about this afternoon, two thoughts keep churning in my head.

What this student did was so beautiful to me, because I saw in it a picture of the Gospel.  I saw in what he did a reflection of the work of Jesus Christ, who took off His kingly robe, and embraced those who would believe in Him.  He ate with sinners, he washed the filth covered feet of His disciples, He invited dirty little kids to come and sit on His lap.  He humbled Himself out of love and compassion for His people.

The second thought is this.  We are moving to Burundi to teach, train and disciple African medical students.  And as much as I like to think that one of things I am going there to teach is compassion, oftentimes, it is they who are teaching me compassion.  To be honest, I would not have done what this student did.  I am far too selfish and too concerned with my own health and my own cleanness.  I am grateful for the example he was to me.  I am grateful for the opportunity to work with students like this, who are bright and compassionate, students who are, in my eyes, heroic.

My Bad Dream

Have you ever had a dream where you realized you were back in college and it was final exam day, and you had forgotten to attend class or study or read for the entire semester?  Or perhaps you have had the dream where you showed up for a presentation in front of a class and after beginning realized you were naked?

During my last week in Kibuye in November, I had the privilege of having my own "bad dream" come true.  I got up to present at our hospital's grand rounds, in French ... and quickly realized that ... I don't actually speak French.  Okay, I speak a little French.  

Shortly before my arrival in November, the team at Kibuye decided it would benefit the medical students, national doctors and the rest of the hospital staff to hold a weekly grand rounds, an hour lecture on a specific topic, usually given by one of the missionary doctors (although we hope soon the national doctors will be able to participate in this as well).  My first two weeks in Kibuye I learned a lot about cranial nerve palsies (from John) as well as evaluation and treatment of abdominal pain (by Jason).  On my third week, Jason asked me if I would present.  I chose to present on the topic of "Anesthesia for the Pregnant Patient".  Jason offered to find someone to translate for me, but in my foolishness, I declined, thinking it would be a good opportunity for me to practice my limited French ... in front of the entire hospital staff.  Sometimes I make poor decisions.

Through the use of my broken French, a lot of hand waving, and a bit of interpretive dance, I got through it, and hopefully my next presentation will be a bit more polished.



If I smile long enough, perhaps they won't notice I forgot what I was supposed to say.

I think this photo really captures the joy and laughter my French brought to the room.