Sliding Down Mountain Roads

(by Stephanie)

“What about driving down the road at sixty-five miles per hour, only a few feet away from cars going the opposite direction at the same speed? Someone would only have to jerk his or her arm and you would be dead. I don’t think that’s morbid; I think it’s reality”
- Francis Chan, Crazy Love

To say I don’t like driving, or rather being a passenger, in cars in Burundi is an understatement. It terrifies me. During my first African driving experience, many years ago, I was listening to the book Crazy Love by Francis Chan. I distinctly remember listening to the part of the book quoted above and thinking, “The fact that I could die at any moment is at the forefront of my mind, this driving is insane and if we make it to our destination it will be a miracle." 

The majority of the roads in Burundi (aprox. 92%) are not paved. They are red dirt roads, rocky and rutted and slippery when wet. They are not heavily traveled by vehicles, which makes me feel safer, but driving on them leaves me feeling nauseous and tense as we bump and bounce and I try to brace myself from hitting my head on the ceiling.

Thankfully the main road from Kibuye to the capitol Bujumbura is paved. This is the road we as a team travel most often. It is a curvy mountainous road with areas of steep drop offs and many people, even small children, walking along the sides of the road. There are bicyclists, with their bikes overloaded, whizzing down the hills, and young men on bikes holding on to the back of vehicles to be pulled up the hills. There are boys and men who climb onto the back bumpers of semi trucks and hang on, catching a ride, as we drive behind them praying that none of them fall off and slip under our car. 

It’s a two lane highway with no lines dividing the lanes or restricting cars from passing one another around blind curves. This means that often you will see a vehicle coming directly at you as it tries to pass another vehicle. Potholes are another part of life on the road here. There are many, they are large, and people drive around them in the wrong lane. 

All these unsafe driving conditions have always driven me to prayer. However, my prayers while driving have changed over the years. They have gone from a place of anxiety to a place of utter surrender. I so obviously have no control over what happens in that car, over life or death or what any other driver will do. But, reality is, I never am the one who has control, even when I am sitting in my living room. God holds our lives in his hands and every breath that we take is allowed by His will. It’s just that driving brings this awareness to the forefront of my mind and I have to remind myself of these truths. I continue to pray as we drive around every curve, that God will continue to sustain our lives, and I get to praise Him when we’re still breathing on the other side.

Last month our family decided to go to Bujumbura for the medical school graduation and a little R&R. We left Kibuye as soon as the sun was up and it was still morning when we began our decent towards the capital. The road was wet from recent rain and as we rounded a sloped curve of the road our car began to swerve. I heard my husband say, “I don’t have control” as he tried his best to straighten us, but we slid into oncoming traffic. Our car slammed into the side of a smaller car and scraped along it's side until we came to a stop, in the wrong lane, facing a blind curve. We quickly shuffled our kids out of the car and across the street, afraid that another car would come around the curve and strike ours. By God’s provision three of our national partners were driving in a car behind us, they pulled over and came to our aid, helping Greg communicate with the other driver, who only spoke Kirundi. They stuck with Greg throughout the entire, complicated, multi hour process of negotiations and paperwork. Other teammates in another vehicle were also heading to the capital for graduation and soon arrived to help.

Our youngest was a bit shaken, as expected, but as we helped him retell the story of what happened we couldn’t help but highlight the wonder of the situation. Never before have we had teammates and national partners traveling behind us and available to help. We lost control before coming to the steep drop offs. The car in the other lane was a small one, not a tractor trailer or a bicycle, and it was not a head on collision. No one was injured. No one was walking along that side of the road to be struck. And there was an area across the road where it was safe for us to stand and for other vehicles to pull over. We do not know why we were in an accident, but, for being in an accident the situation could not have been better, and we see God’s provision over the situation, and on the peace that we all felt as we climbed back into cars and finished our trek to the capital.

The car, which has been named the Black Mamba, is now all fixed up and sporting 4 new tires with good tread. 


On Teaching And Huey Lewis

(by Greg)

A few years ago I saw Huey Lewis in concert (yes, he still rocks).  He had some new material, but as you can imagine, Huey Lewis can’t really have a concert without playing “The Power of Love”.  He introduced this song with something to the effect of “when I wrote this song in 1985 I never imagined I would have to sing it every single day for the rest of my life”.  I got the impression he wasn’t as excited about singing this song as we were about hearing him sing it.

Back to Huey in a bit.

I did not come to Burundi to DO anesthesia, but rather to teach.  We are surrounded by an ocean of students, nursing, anesthesia and medical students.  Some students are assigned to my service for a day, some for a week, others for a month.  And so, I have an opportunity each and everyday to teach.  And given the limited duration I will have with each student, I have spent a significant amount of time reflecting on what is most important and how can I convey that information in a meaningful way.  Given that most of these students will work in settings with limited resources, how does one teach resuscitation and critical care to students who will work in hospitals without ventilators or defibrillators, and sometimes without oxygen.  

As a result, I have been trying to decide what are the 8 or 10 lessons I can teach that will impact the care these students can deliver, lessons that might one day save the lives of their patients.  And how can I present these topics in a way that will be cemented in their memories when presented with these problems in the future.  I have developed a series of “mini lessons” that I try to give every student who works with me.  And, as a result, I find myself giving the same “mini lessons” week after week, sometimes day after day.  And as I was teaching yesterday once again about the systematic approach to hypotension, the words of Huey Lewis returned to me ….. “when I signed up for this, I never thought I would be teaching the same lesson every day for the rest of my life”.  

It can be draining for sure.  And there are students who leave me frustrated and discouraged, and there are others who invigorate me and leave me filled with hope for the future of health care in Africa.  But deep down I feel confident that this is exactly what the Lord has called me to right now, and that there is no better way I could invest my time than in repeating these lessons day after day.  How does one find the strength to persevere in the face of monotony and sometimes discouragement?  Perhaps the answer is found in the words of Huey Lewis himself.  Maybe, just maybe it is found ..... in the power of love.  

Don't need money, don't take fame
Don't need no credit card to ride this train
It's strong and it's sudden and it's cruel sometimes
But it might just save your life
That's the power of love
That's the power of love
First time you feed it might make you sad
Next time you feed it might make you mad
But you'll be glad baby when you've found
That's the power that makes the world go round.



Dollar Street

(from Eric)

Via the BBC, I happened upon this very intriguing site yesterday, and I feel it's worth passing on.  Anna Rosling Rönnlund started the site as a way to "visit" homes and cultures and families all over the world.  Numerous countries are represented, and they are ranked on the home page according to monthly salary (the lowest being $27/month, a lady in Burundi in a province south of us).  

The base page is here.

You can enter and tour everyone's home.  For instance the tour of the Burundian lady's home, including her awesome toothpaste storage technique and her even more awesome smile can be found here.

You can also sort the homes by various filters.  For instance, you can sort for "Places Where Guests Are Served Dinner" all across the world here, or "Jewelry" all across the world here.

As American expatriates living in Burundi, we live in a world of extremes.  Both the wealth of our home country and the poverty of our host country can be very uncomfortable.  In the past, when we've recognized these extremes, we've wondered what the "global mean" is.  That's not exactly the point of this website, but it does give some wonderfully diverse glimpses into the homes of the world.  All from the convenience of your home internet connection (if you have one.  =)  )


Qu'est-ce que tu aimes faire ? -- Kids Video

by Logan

Julie has really enjoyed working with the kids of Kibuye Hope Academy in French class.  Several months ago, she posted the first video from their class: Trouver l'objet where they play an I Spy type game.

"Qu'est-ce que tu aimes faire" means "What do you like to do?"  The kids got to decide what things they like to do and make a short video about it.  Enjoy the peek into life here at Kibuye, as they share these activities with you in French.  If you don't speak French, then enjoy the mini-French lesson!

Qu'est-ce que tu aimes faire ? - Kibuye Hope Academy from The Banks Offshore on Vimeo.


Language and Great Laughter

(from Eric)

Language struggles are a part of our everyday life.  After many years, you become comfortable with French, but your patients only speak Kirundi.  The students can interpret for you, but not if they are from Cameroon, or not if the patient comes from Congo and only speaks Swahili.

Yesterday, I had a patient who struggles with language.  She is 43 years old.  Through the help of my student interpreter, I learn that, a few months ago, her speech started to become harder to understand, and this gradually evolved to where she can now only grunt.  She can understand Kirundi.  She can write without difficulty.  But she cannot pronounce anything.  She also cannot swallow.  Jason put a scope in her esophagus and all looks structurally fine, so he sent her to me with the idea of a neurological problem, maybe a mass growing somewhere in her brain.

It's hard to imagine what that's like.  To watch your ability to speak (in such an oral culture) slip away relentlessly.  I ask her to sit on the table, in order to check some other basic neurologic function in the face.  Fung'amaso.  I fumble on close your eyes, but she gets the idea.  Uravyumva?  I touch her forehead and ask if she can feel it.  Next, I want to see if her mouth muscles have any weakness, so I ask her to smile.  Now, in Kirundi, the word for smile (gutwengatwenga) is a form of the word for laugh (gutwenga).  Twenga, I say.  I think she understands what I'm asking, but her smile bursts into an embarrassed laugh.

Then she continues to laugh.  She puts her head down on her knees and laughs until tears run down her cheeks.  She can't stop laughing.  Her sister laughs.  The med students laugh.  I attempt a whole sentence in Kirundi: Uratwenga kuber'iki? (Why are you laughing?)  She looks up at me and bursts into a fresh round of laughter.  It's unclear at this point whether the roots of her tears are from humor or from sorrow, but somehow it's clear that there is joy in there, regardless.

This moment is a pretty good picture of our lives here.  I doubt we can find a diagnosis for her.  Even if (1) one of the three CT scanners in the country is working, and (2) she can find the $100 plus transport to get a scan, then (3) it is extremely unlikely that she could find anyone to fix it, even if we found something.

And yet, she laughs.  Her yellow teeth are bright against her dark face, and she makes me laugh.

There is sorrow, and in the midst of it, there is great joy.  And often, like yesterday, there is one of us random Americans in the middle of it, not at all sure what's going on, but finding the grace to enjoy the moment nevertheless.  In a nutshell, this is our life at Kibuye.

It could be better.  Yes, it could, and we long for redemption and for healing and for all the barriers that keep us from knowing each other well to fall away.  We long for God to fulfill his promises to save us utterly and completely.

But it could be worse.  I wish I could have helped this lady more, but I'm quite certain that, when she and her sister return home, and her family asks how it went, that along with more tears and more frustration, there will also be more laughter.  God's redemption and his grace are already at work among us.  They are the rip in the curtain that the light shines through.  These peals of heart-filled laughter from a woman who can no longer speak a single word are the first fruits of the fulfillment of the promises that God has given, and that he will, in the end, keep.


On a somewhat related theme (I feel like there is a connection here, and maybe you'll find it better than me), here is a great quote from Frederick Buechner's conversion (from The Sacred Journey):

And then there came one particular sermon with one particular phrase in it that does not even appear in a transcript of his words that somebody sent me more than twenty-five years later so I can only assume that he must have dreamed it up at the last minute and ad-libbed it and on just such foolish, tenuous, holy threads as that, I suppose, hang the destinies of us all. Jesus Christ refused the crown that Satan offered him in the wilderness, Buttrick said, but he is king nonetheless because again and again he is crowned in the heart of the people who believe in him. And that inward coronation takes place, Buttrick said, "among confession, and tears, and great laughter." It was the phrase great laughter that did it, did whatever it was that I believe must have been hiddenly in the doing all the years of my journey up till then. It was not so much that a door opened as that I suddenly found that a door had been open all along which I had only just then stumbled upon.


Looking for Some New Recruits

by Jess Cropsey

As our team has grown, the needs at the hospital and the scope of our work has also expanded.  And so we find ourselves needing more help in certain areas.  We're hoping that you, our faithful readers, will help us cast our net wide and pass this information along to anyone who might fit the bill.  And please be praying that God would provide the right people to help us in these critical areas.  

(Term:  1+ years)

  • Partner with our on-the-ground engineer (the highly talented Caleb Fader) to oversee hospital construction projects and renovations
  • Assist with maintenance for hospital buildings, equipment, grounds, & vehicles
  • Train local workers
Requirements & Critical Qualities:
  • Prior experience in developing world preferred
  • Resourcefulness, patience, & perseverance
Related Blog Stories:

(Term: 5 years)

  • Develop hospital chaplaincy program
  • Assist local chaplains with patient outreach at the hospital
  • Oversee discipleship programs for medical students and hospital staff
  • Assist with missionary team care
Requirements and Critical Qualities:
  • Prior experience in pastoral care, discipleship, and/or counseling
  • Language learning abilities (fluent French and some Kirundi important)
Related Blog Stories:
(Term:  2+ years)

  • Track project construction income and expenses
  • Assist with hospital project/team administration and logistics
  • Find and apply for grants (optional)
  • Create fundraising materials (optional)
Requirements and Critical Qualities:
  • Some experience with basic bookkeeping
  • Good organizational, social, and communication skills
  • Prior experience overseas and/or with a NGO would be great!
Related Blog Stories:
I'm sure you're surprised to see no blog posts in this department!  :-)  While this unglamorous, behind-the-scenes work doesn't lend itself to interesting blog posts, it is critical work.  None of the projects (like the new surgical ward or the upcoming pediatrics ward) could happen without someone keeping track of things.  

(Term: 1+ years)

  • Repair and maintain hospital equipment
  • Train a small team of local technicians
Requirements and Critical Qualities:
  • Prior experience in developing world preferred
Related Blog Stories:

(Term: 2 years)
We are always looking for teachers to help us educate the many kids on our team.  There is a huge need for teachers on many other Serge fields as well.  

Related Blog Stories:
Kibuye Kids Clubs
Africa Class
The Brick Factory (field trip)
Gearing Up for School


6 months later

(By Alyssa)

I returned to Burundi this month after six months of "home assignment." I'm thankful for the sweet times with family and friends, the continuing education opportunities, the fundraising God enabled me to do, and the creature comforts of life in a more developed place. But I was definitely happy to return to my Burundi home! And I was enthusiastically welcomed back by the team:

Six months is a time period that feels both short and long. I wondered what Burundi would look like on my return. Well, except for some new traffic lights (!) in Bujumbura, things looked about the same - until I got to Kibuye! I thought you might be interested in what has changed here in just 6 months (lots of pictures to follow):
 The biggest change is the beautiful new surgical building which opened shortly after I left in July.

New minor OR for wound care, etc. - a huge improvement over the old space! 
Surgical ward with unique new bed design with privacy curtains
Surgical ward nursing station

And as we enter the season of respiratory infections, it makes such a difference to have this new oxygen concentrator. For the first time we have wall oxygen in the NICU and in other key places in the hospital - life saving treatment!
We're not quite ready to begin construction on this new 80 bed pediatric ward, but in the meantime, renovations of existing space have increased our bed count just in time for the rainy (malaria) season.
New temporary pediatric ward
Renovated pediatric room to open soon
 Now that surgery patients have a new building, internal medicine has renovated their old space - new ceiling, beds, windows, etc. Previously one of their patient rooms (for 5 patients) had no windows at all - which meant it was pitch black even in the middle of the day when the power was out! So this is a great improvement!
New internal medicine call room
New internal medicine work space and nursing office
 Physical therapy has a newly renovated space, too, complete with equipment for helping patient rehabilitation. 

And new patient showers and toilets
There are lots of solar panels around now including this one for heating water in the laundry. And more solar panels will be coming soon to improve our electricity! 
Infrastructure is absolutely essential! Here's our new water reservoirs hooked up to the second well  providing water for the hospital. These tanks hold 100,000 liters of water! 
Even the emergency department got a makeover with new curtains, paint, cupboards, etc. 
New isolation ward mostly for tuberculosis patients
Isolation ward
New landscaping by our second ophthalmology building which opened shortly before I left
 And the residential area is expanding, too. Above is Caleb and Krista Fader's newly completed house and below is Logan and Julie Banks' house under construction. 

But six months doesn't just bring many new buildings/renovations, but also brings new babies like these sweet boys. Francine (left) helps clean and cook for me 3 days per week, so I now have a pack n' play set up for her baby in my dining room - not that I've figured out how to assemble the pack n' play (I think you need an engineering degree for that!) 

 And all the kids have definitely grown - above the middle schoolers have kindly volunteered to teach preschool in the afternoons to these 4 year olds
And the guinea pigs have grown, too ;) 
It's fun to participate in chapel again at Kibuye Hope Academy on Fridays - though we're missing friends from last year and paradoxically also thankful to have new kids here this year
Medical students have definitely made progress. Above are four successful thesis presentations from last week. These students have come a long way as we've seen them from the beginning of their clinical years until now. They'll graduate next month! And in general, the quality of theses has improved over the last couple years. 

And finally, team life is both different and the same each season. As I said above, we both miss teammates who are now in the States and are thankful for new and returning ones. There's a new book for book study and different special imported treats (thanks, Miller family, for the cheese and crackers!), but the general rhythms remain the same. It's a joy to walk through the ups and downs of this Burundi life together! 


The Marathon

(by Greg)

I do not like running.  If someone has told you that I do, they are either misinformed or a liar.  I feel quite confident that God did not create my body to run.  I believe He created some bodies to run, just not mine.  I more enjoy a nice stroll.  I also appreciate a comfortable chair.  

Nonetheless, in Burundi, I try to run two or three times each week, in a vain attempt to stave off death.  I have yet to find a 24 Hour Fitness in Kibuye.  I run with teammates, teammates whose bodies I suspect were in fact created to run, and I am happy for them.  And I enjoy our time together.  However, I would enjoy it more if we were not running.  

As I have been huffing and puffing my way up and down the hills of Kibuye, I have had a lot of time to think about the difference between a marathon and a sprint.  If you asked me to do one or the other, I would choose the sprint.  I like things to get done fast.  I like a finish line that I can see.  But the work we have entered into in Kibuye is not a sprint, it is a marathon.  While there are projects that take place over weeks or months (eg. a new surgical ward, the installation of an oxygen concentrator), the big changes we are working toward will take place over years, decades and perhaps generations.  We are here working for transformation in healthcare in Burundi and gospel transformation in the lives of our students and our community.  For these, it is much more difficult to see a finish line in sight.  

Working toward this sort of long term vision runs counter to all my natural instincts.  I went into anesthesia, partly because I like to see the beginning and end of a project in the course of a day.  I did not choose internal medicine, in which you might prescribe a blood pressure medicine for a patient with high blood pressure, then see them again in 3 months and maybe slightly adjust the dose, then see them again in another 3 months.  No no, I certainly do not have the patience for that sort of work.  When presented with a patient with hypertension, I want to squirt something in their IV and watch as the blood pressure falls over the course of seconds.  Much longer than that and I am prone to lose interest.  

I realize that in my own power, I cannot run this marathon.  I have to rely on the strength of another, someone who can provide me with the endurance and patience I need to get out of bed everyday and labor toward goals with no end in sight.  Without faith in Someone guiding me, leading me, reminding me of the hope I have in Him, I would likely throw in the towel.  Thankfully, I do not do this work alone, but instead am surrounded by a team who can remind me why we are doing this and who we are doing it for.  And I get to run each day with Someone who has the strength and the endurance and the vision to accomplish these goals, Someone who has the stamina and the steadfastness to get to the finish line.   For now, I just need to keep my eyes on Him.

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


There is no fast food in Kibuye

By Michelle

Hello Everyone! I thought I’d give you a glimpse into what life is like here on a daily basis when it comes to food preparation. Julie wrote a great post on this topic (Kibuye Kitchens) but I'll touch on some different elements. 

Food shopping:

There are no supermarkets in Burundi and the only “store” closest to us is in Gitega. While our food choices are limited, we are thankful to have food and to eat on a daily basis. Sadly, with many of those in our community this is not the case. 

Each week we place a produce / food order that looks like this:

I have found that meal planning is a must when one is limited to getting food once a week. If you run out of something midweek, you usually can borrow from your neighbor. But on the plus side, this gives us women a chance to communicate on a daily basis. 

The food arrives in a basket like this. 

There is a market behind the hospital that has a few options such as eggs, tomatoes, avocados, onions, pineapple, and carrots.


The food options here are seasonal. If something is not in season, then you wait until it is. The last few months we had lettuce in the garden: 

But now that it’s been used up we need to wait until more grows before eating salads again. It definitely teaches you to be patient and to be thankful for what you have!


Milk is delivered a few times a week: When it arrives you need to cook it for a period of time, then let it cool and strain it before putting it in the refrigerator. The availability of fresh cow milk is a recent luxury for which we are very thankful. 
In Gitega we can can buy bags of floursugar, and rice. If you want any kind of bread product, you or your house helper needs to make it from scratch. There's nothing like freshly made bread!

The cheese we can buy comes in wheels and is made in Congo. It's not always the best quality but we are thankful to have cheese! 

It is very difficult to buy meat other than goat meat in our area. There is a butchery in the capital that has more options so we have found that if one has the freezer space it's best to stock up and eat sparingly.

Our team has put together a cookbook that uses mostly the limited ingredients we are able to get. Check it out! There are some gems in there!

Kibuye Cookbook

Speciality meals: For Christmas, Carlan and I made a lasagna with cheese we had made from scratch, freshly made pasta noodles, sauce from scratch, and herbs grown in our garden. It took a lot a work but it was worth it!

Kibuye gourmet: Fried Termites. For those with a strong stomach there is always something new to try.

Conclusion: Each time we buy food, we are thankful for the hard work of many that had to grow, pick and transport this product by manual labor: