14.8.17

Kibuye Kitchens

by Julie

When people ask me what I miss about living in a developed country, my answer is usually: restaurants. I love going out, looking at menus, visiting local dives, trying new things, sitting in coffee shops. I love traveling to new places by soaking in the atmosphere of a restaurant – the lighting, the music, the smells, the sounds of sizzling coming from the kitchen. And ok, I’ll admit it, I like going out because it means I am not cooking or doing dishes! I finish my meal and someone magically whisks away the dirty dishes and I enjoy a cup of coffee and possibly a yummy dessert. Going out to eat has always been a treat, but since living in rural Burundi for almost a year, I have really come to appreciate the luxury of restaurants!

So what DO we do for meals here at Kibuye? Without restaurants or any prepackaged, frozen, or boxed food options, planning ahead is a must for every meal. I am definitely not a chef, but I have learned so much about cooking – and life in general – from the other women on our compound.
With limited ingredients available locally, these women amaze me in their creativity and “can do” attitudes! What they can prepare, some days without electricity or running water, is inspiring.

We all hail from different parts of the US, Canada, or UK, so each of us have different dishes that we cook to make our homes feel like “home”. For me it’s cornbread in a cast iron skillet when I’m homesick.  For Lindsay it’s the days-long process of making sauerkraut. Even with our different “specialties” and “go to” dishes, we all use the same basic ingredients, so there are some similarities in our weekly menus.

Breakfasts are usually oatmeal or zucchini bread, eggs and whatever type of fruit is in season. Bananas are plentiful and always a favorite! Very rarely someone will make a treat like donuts on a weekend, but ohhhhh, there is nothing better than biting into a piping hot homemade donut! Unfortunately (or fortunately?) they are very time consuming to make, so for the most part – we try and keep it simple.

All the Kibuye families seem to have the staple “rice and beans” at least one day per week. There is one type of bean produced locally and we all buy about 1 kilo dried beans every week. The dusty beans must be carefully inspected by hand before soaking because the bag is peppered with sticks, rocks, dirt and little bugs who love to burrow inside the beans. But they are very affordable, as is the rice. Many families have a big batch on hand not only for their family, but also to help feed the Burundian househelpers, gardeners, and night guards who help us with everyday life.

Another dish that appears almost weekly in most of our kitchens is pizza! Pizza has always been a favorite of mine. But I must admit I liked it because it was so easy. I could order right from my phone, wait about 40 minutes for the doorbell to ring, serve it on paper plates, and voila! Easy delicious meal with no clean-up!

Here in Burundi, “pizza night” is still just as fun, but it is anything but easy. If you have ever made your own pizza dough, you know it must rise, be rolled out, and placed on a carefully prepared pan. None of us have pizza stones, so most pizza at Kibuye is baked on a rectangular cookie sheet. We make our own pizza sauce from tomatoes grown locally, but Italian seasoning is not something you can buy here, so we have all packed some in our suitcases (or asked visitors to bring some with them!).

The cheese stands alone
We can purchase only one type of cheese in a shop about 30 minutes away. It is generic in its flavor, probably best described as a cousin to Colby or perhaps a very mild cheddar. So it’s not exactly mozzarella, but it’s our only option, and it works for us! Popular pizza toppings among the families are green bell peppers, onions, pineapple, and sometimes imported canned mushrooms or olives. Pepperoni is a rare treat from America that gets used only for special occasions!

Making pizza by flashlight
All meat, for that matter, is sort of a “special occasion” thing. There is a boucherie (butcher shop) about three hours away in the capital city, Bujumbura, but getting meat up the hill to us is no small feat. Someone from our team goes to Bujumbura at least once a month, and they may go by the boucherie, but there are many obstacles. The shop is not open on Sundays, and we tend to go to Bujumbura on the weekends. When we do buy meat, we put it in a freezer bag, which sits in a hot car for a few hours driving up the hill. We must put it in the freezer the moment we arrive at Kibuye, but often our refrigerators are without power for 12+ hours, so the meat may not sufficiently freeze quickly enough. I have unfortunately thrown out more precious meat than I would like to admit, so we have learned not to buy that much, and don’t depend on having meat a lot. The whole compound is either full-time or part-time vegetarians, by necessity if not by choice.

We make sure our families are getting protein from non-meat sources, but this highlights one of many reasons there is so much malnutrition in Burundi. If our families, who have refrigerators, electricity, cars, and money, struggle to get protein into our diets, imagine how much more difficult it is for the average Burundian to incorporate meat into theirs!

Some Burundians might periodically buy a goat kebab, or brochette, sold at a local stand in our village. They are really tasty, and it’s fun to watch them cook, but you need to buy them on the right day, at the right time, if you want good meat!

Some days I can allow my mind to drift away to large grocery stores and cool restaurants. I can even feel sorry for myself at times that I don’t have everything at my fingertips like I used to. And yet, when I look around me, it seems almost ridiculous the amount and variety of food that I do eat here compared to the Burundians we see every day. It is a paradox. In some ways we feel like we “do without”, but we know we also have much more than is necessary. So this is what we grapple with. Even food reveals our sin nature. But we carry on, being thankful for what we have and letting ourselves splurge on occasion without guilt.

We appreciate your prayers as we daily face the severe poverty around us, wanting to help, but wanting even more to help empower the future leaders of this nation to care for their own. Pray for our families. Pray that our homes and dinner tables will be places of peace, laughter, and thankfulness.

And if you ever come visit us in Burundi, you will have the opportunity to taste African rice and beans and goat brochette from the village, but you may also be surprised by the culinary creations you will find in any of our homes!

Bon appetit! 



6.8.17

Africa Is Not Poor

by Greg Sund

During our time in language school, each semester we were asked to research and present an “expos√©” on a subject of our choosing (in French, of course).  One of my classmates, a surgeon heading to Togo, gave a presentation entitled “Africa Is Not Poor”.  His presentation was based on a recent report which explored the movement of wealth into and out of Africa (specifically Sub-Saharan Africa) each year.  The results were surprising.  Despite the billions of dollars flowing into Africa each year in the form of aid, grants, loans and investments, the net outflow is considerably more, an estimated 41.3 billion dollars annually.  


While so many people living in Africa remain trapped in poverty, we need to remain cognizant of the fact that Africa is in many ways rich: rich in potential mineral resources, biodiversity, business, music, art, and of course rich in people who are strong and intelligent and capable of achieving great things, if given the opportunity to develop these gifts.  Yet much of Africa has been and continues to be exploited by foreign powers.  For many years this occurred in the form of colonialism.  More recently this exploitation tends to occur through multinational corporations in the form of tax dodging, exportation of commodities, illegal logging and fishing and a myriad of other mechanisms.  

“Africa is not poor. Whilst many people in African countries live in poverty, the continent has considerable wealth. A key problem is that the rest of the world, particularly Western countries, are extracting far more than they send back. Meanwhile, they are pushing economic models that fuel poverty and inequality, often in alliance with African elites.”
This is without a doubt a complicated problem, and I certainly don’t claim to have the answers to this problem.  Furthermore, I don’t want to suggest that the answer is cutting off investment in Africa.  I think investment in Africa is a positive step.  But I do believe that the world needs to look more carefully at how that investment is taking place, and if the practices in place now are truly fair and just.  The article outlines nine policies that it suggests are needed to reverse these resource outflows, including enabling transparent and responsible lending, elimination of companies exploiting tax havens, and a transformation of how aid is delivered and used in Sub-Saharan Africa.  
How can we, a team of missionary physicians serving in a rural hospital in Burundi work for transformation of this global injustice?  To be certain, while our sphere of influence is limited, one does exist.  We have influence in the lives of our students, who we hope will become the next generation of African physicians and community leaders in Burundi and it’s neighboring countries.  These East African students can be empowered to understand practices and policies that will lead to greater equity for THEIR people, not just equity of healthcare but equity of investment and aid and human rights.  
The key task is to dismantle the system extracting wealth from Africa. This requires action by African civil society organisations to press for change in their countries, and action by civil society organisations in the countries that are enabling this wealth extraction to take place … Global elites have no intrinsic interest in changing a system that benefits them. It is critical for civil society organisations to expose the role of multinational corporations and Northern governments in impoverishing Africa and to step up their work in building coalitions to end tax dodging and other unfair resource transfers out of Africa.”
How can one teach and empower another people group to understand and work toward justice?  I believe that one needs to see justice from the eyes of our Creator.  And in order to have hope, one needs to have confidence that He cares about every form of injustice on this earth.  We as a team believe that it is through the power of the Gospel, that this deeper understanding of justice is revealed.  And so we are working not just to teach medicine, but to come alongside our African partners as they seek answers to much bigger questions.  As we see the massive importance of justice to our Creator, and the massive role that justice played in our redemption through Christ our Savoir, we are transformed and empowered to see, to understand and to respond.  Transformation is possible.  Indeed, all things are possible with God.  
For those interested, here is a link to the full report: Honest Reports


29.7.17

Things That Go Bump In The Night: A Guava Tale



by Logan

Sometime around the end of May, the rains suddenly stopped and dry season began. Shortly thereafter the first guavas began appearing on the trees outside our apartment. For the Banks family, this is our first dry season and our first guava season. At first, this novel new fruit was welcomed by all. As more became ripe, the crowds and enjoyment grew. I’m not sure how to describe the taste exactly, there is a sweetness and a tartness. My boys describe the taste like a mix between a strawberry and a peach. I’m open to other suggestions. I was just excited to have such a delicious fruit growing right outside my backdoor. 

Zeke enjoying his first guava

That is, until they started falling off the trees. And landing on my tin roof. In the middle of the night.

The guavas were becoming so ripe and so numerous that they would get too heavy for the branch and would fall off the tree. The problem is, many of the branches extend out over our roof. When the guavas fall and hit the thin layer of metal, it can sound like a gunshot going off. As more and more ripen, these loud noises are becoming more and more frequent. During the day, they are only mildly annoying and easy enough to ignore. But at night, as darkness and quietness descend on the compound, the guava rears its ugly head and goes, “BANG!!” 

I have been woken so suddenly in the middle of the night by these loud noises that I have found myself in the middle of the living room, arms raised in a kung-fu pose, ready to protect my family, before I realized it was just a guava. 

This fruit is starting to make me think of that guy at a party that doesn’t notice a hush has fallen and keeps talking in a too-loud voice. Only a guava can't feel embarrassment, he just continues making outburst after outburst. 

At night, it takes me about 45 minutes or so to get the boys settled down for bed, read them a story, sing a song and pray. Then as I slowly leave their room and shut the door, it’s hard not to spend a few minutes cringing waiting for the next guava to bounce off the roof. And it usually doesn’t disappoint.

So recently I decided to take matters into my own hands. One afternoon, I found a very long bamboo stick and started whacking the guava tree outside my backdoor. I have to admit it felt pretty good. I enjoyed hearing those dozens and dozens of BANGs that were happening at 3:00 in the afternoon instead of 3:00 in the morning. I whacked and whacked until no more would fall. I must have knocked down a few hundred. There were still some guavas left, they just weren’t ripe enough to be knocked out of the tree. The boys helped me collect them and it made a nice gift to all the guards and night watchmen of the compound. 



video


This situation has reminded me of the different seasons of life. Some are joyful, some are sad. Some we can’t wait to begin, and some we can’t wait to finish. But God has a plan to teach us something during each season. Even in the season of mild-guava-frustration, God is there, reminding us that there is still sweet fruit waiting for us. Fruit that He has provided. So as guava season is beginning to come to a close, I am encouraged to appreciate this season for what it is. And to enjoy the sweetness and the tartness that life has to offer. 


Ecclesiastes 3:1-5
For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die; a time to plant and a time to pluck up what is planted; a time to kill, and a time to heal; a time to break down, and a time to build up; a time to weep, and a time to laugh; a time to mourn, and a time to dance; a time to cast away stones, and a time to gather stones together…



24.7.17

Building 19

There are few things more rewarding in life than watching someone you love, do something they love. It was such an honor to watch my husband work on this new two-story surgical ward from the very start (18 months ago) to it's completion (last week!). Although building hospitals in rural Africa has been one of Caleb's life-long dreams, the job is not without it's fair share of difficulties. Caleb has repeatedly mentioned how grateful he is that God provided the best mentor for this first major project through a wise, humble engineer with EMI, Tony Sykes. Together, with about 250 Burundian masons and builders, these men built one of the most beautiful hospital wards in all of East Africa. And on July 14, 2017, the President of Burundi came to open it up.

Please enjoy these pictures of the journey.



13.7.17

"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.

3.7.17

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

29.6.17

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!

27.6.17

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.

20.6.17

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

11.6.17

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.