COTW: Duct tape fixes everything

(New perspectives on our life and team being almost invariably a good thing, both for you our readers as well as for ourselves, we are happy to welcome Greg, our visiting anesthesiologist, and his reflections.  He and his wife Stephanie host a family blog, and you can find the link on the right sidebar.  -Eric)

Last night, my wife heard a knock at our kitchen door.  It was one of the medical students.  “Duct tape! Greg said you have duct tape!” she told him that she had returned the duct tape to the other visiting missionaries who had the foresight to bring such an essential tool.  And off the med student ran to find the duct tape. Now, we are relatively new to life among the Mcropders, so this would fall within the category of “new experiences” for us.  I have never before had to send a medical student to my house to get duct tape to make my anesthesia machine work.  

My name is Greg, and my wife, three children and I are serving along side the Mcropders in Kibuye for 9 months.  Yesterday evening, I was outside searching for an internet signal, when one of the hospital employees found me and handed me a note.  There was a 5 year old girl who had just arrived in the ER with multiple machete wounds to the head, inflicted by a “crazy person” in her village.  She had a skull fracture and was in a coma.  Agneta, our visiting surgeon from Kenya, had evaluated her and decided she needed to go to the operating room immediately for a decompressive craniotomy and exploration.  They called me because I am the visiting anesthesiologist.  

They have been doing surgery at Kibuye for many many years.  However, it was not until after I arrived 2 months ago, that we starting performing surgery under general endotracheal anesthesia.  Before yesterday, we had done a total of 4 general cases.  This very hurt little girl would be the fifth.  So, I went to work preparing the anesthesia machine, connecting it to the air compressor, then connecting it to the oxygen cylinder.  Unfortunately, this time, there was a large leak of oxygen around the connection between the tank and the machine, making it impossible to maintain pressure in the machine.  Sadly, I did not realize this until after the child was intubated on the OR table.  We managed to limp along until the student could return with the duct tape which we used to position the tubing at just the right angle to minimize the leak ... but it was not pretty.  In fact, it looked a lot like a sophisticated medical device ... held together with duct tape.

Back in the US I don’t see many craniotomies on 5 year olds, but I have to say, I was astounded by the work that Agneta did.  The child’s skull looked like a jigsaw puzzle.  Agneta, somehow took it all apart, repaired a dural tear, controlled the bleeding, and then reconstructed the puzzle, using Jason’s Dewalt drill and multiple sutures.  The girl remained stable throughout surgery, and was extubated (breathing tube removed) at the end of the case.  This morning, she remains in a coma but is otherwise stable.  We are praying that as the swelling in her brain subsides over the next few days she will wake up and make a full recovery.  

We are all so grateful to have had Agneta here this month.  She was trained at Tenwek hospital, with Jason as one of her teaching attendings.  She has a brilliant mind, gifted hands and a compassionate heart.  It has been massively encouraging to spend this month with someone who has benefited so much from the desire that God has given the Mcropders to teach and train African physicians.  Sadly, she returns home tomorrow.  And I can’t help but think that if this little girl had come in a few days later, she would have had little to no chance of survival.  We praise God for His gracious provision for our team, for our hospital and for this little girl.


Testimonies from our Medical Students

(by Eric)

Some things are easy to write about.  And some things are just as (or even more) important, but hard to write about, so they feature less in the blog.

One of the core items of our work here is the education and discipling of Burundian medical students (some are also from other countries in the region: Rwanda, Congo...).  It's a primary reason we're here.  As Carlan put it, "We're not the best people for this job.  Our students are."  Burundi has one of the lowest doctor/population ratios in the world, and these students form part of the remedy for a country with no to minimal access to quality health care.  So, we educate them.  Day in and day out, we are surrounded by uncomfortably large crowds of students.  They are bright and talented, and they are learning.  They will be a tremendous blessing wherever they are.

But what will they do?  What will guide them?  Will a good education be a ticket to a land with less need, or a way to simply increase personal prosperity, or will it be a calling, a gift of God for his purposes and not their own?

And this is discipleship.  Less tangible.  Harder to measure.  Like many less-tangible and hard-to-measure things, it is among the most important things of life.  We lead bible studies.  We teach classes.  And more than anything, we live side-by-side with them, and in our brokenness, God's grace shines through.

Currently, we are coming to the end of a 4-month stint with 34 medical students.  I will try to share a couple testimonies from them.  It is fitting for an American to write about this, just before Thanksgiving, since we are very thankful for these students, for their testimonies, for their growth, and for the opportunity that we have to be part of their lives.

Last Thursday, at our most recent bible study, 4 students volunteered to share testimonies.  Normally, these are incredible stories about the students' lives growing up, losing parents in wartime, being put in jail, unexpected deaths of siblings.  But this time their testimonies were about their time here at Kibuye. Here is a summary:

One young lady spoke of how she had neglected the church for several years, being sure that God was with her when she did good deeds.  But she was haunted by never doing enough, and every year she would promise God that next year, she would do better.  She said that here at Kibuye, for the first time, she knows that Jesus loves her, not because of what she does, but because of his love.  And this is transforming her.  She said that here she saw a miracle:  humble specialist doctors.  (This is a theme we have encountered.)  Doctors who care more for their patients, doctors who pray with them, who lead worship for the staff to sing.

Another lady spoke of how her time with the student outreach group has transformed her.  I love these stories.  The students from the city are often quite shocked by the poverty here, and form a Christian outreach group, to pray for their patients in the evenings, share with them, and collect money to buy them food or maybe medicines.  This is independent of us missionaries, which is probably the best kind of testimony.  =)  She spoke of how nervous she was going out to talk with these patients, but how the patients put her at ease, and with time she has grown in her capacity to pray and share with them, more than she would have imagined.

The next day, after the final lecture that I gave in the Christian Philosophy of Medicine course (this one on facing suffering), another student asked to talk to me.  She said that, prior to coming to Kibuye, she saw medicine as a job.  She wanted to do the right thing for her patients, to avoid her supervising doc pointing out her misdeeds.  But now, for the first time, she thinks she loves her patients, and she wants to treat them because she has found a new care for them inside her.  She said she now sees medicine as a calling, and is trying to figure out what God is calling her to do.  She wanted to know about missionaries.

After arriving here, she kept asking her friends what these Americans were doing here.  They gave such answers as "Maybe they are just adventurous tourists" or "Maybe they've always wanted to live in Africa" or my favorite "Americans do all sorts of weird stuff!  Who knows!?"  But she said, those answers didn't pan out.  We had our little kids with us (another common theme), and she couldn't even imagine bringing her little kids up to the country from the capital.  She recognized that we were here to try and follow God, to serve Burundi and to see him glorified here.  She wanted to know how we decided that was what God was calling us to do.  So we spent an hour talking about how much potential she has to glorify God in her country, about keeping our eyes fixed on Jesus, and about exploring possibilities with her church to join together and maybe send out some doctors to serve.

These words are joy and life to us.  We know that we live out these things so misshapenly, with so little grace, and often so much frustration.  And yet we believe ardently that here, seeking God and his will, we can all together find the source of life and of joy.  And so to find our students recognizing this same true source, is a great encouragement.


Operation Christmas Child

Well, it appears to be "shoebox" season again.  Our team is obviously closely connected to Samaritan's Purse, and as part of our Post Resident Orientation we DID get a tour of the OCC headquarters, but my history with the shoeboxes goes back to college.

One of the campus ministries I was a part of in the Twin Cities took an evening in December back in 1999 and volunteered at a SP collection center.  Inside the warehouse, there were thousands and thousands of donated shoeboxes ready for reviewing and packaging.  My job was to open each box, make sure that there were no inappropriate items inside, and then send it down the conveyor belt for packaging.  It was fun to see what people placed inside their boxes and imagine the look on a kid's face when they received one of the first gifts of their lives.

Fast forward 15 years.  I don't think OCC has ever delivered to our region of Burundi, but hopefully someday.  As I look around at all the Burundian children here at Kibuye, I am always struck by how little they have.  Toys are literally sticks and bits of trash.  Alyssa tried to do a developmental evaluation of kids and realized that no kid under school age knows how to hold a pencil because they don't have any.  No crayons, no markers, no pencils.

So with that in mind, I thought I'd compile a brief list of things that I think would be awesome gifts to include in your shoebox this year.

1.  Baby dolls (for girls).  I had no idea the kind of uproar that Maggie's Baby June doll would create when we took it out of the house for the first time.  The local kids loved it.  Toby's babysitter loved it.  I took it up to the hospital to use as a delivery model and everyone stared and wanted to touch it, including the nurses (one took it and I wasn't convinced she was going to give it back!)  It seems like no one here has ever seen such a thing.  So, girls of all ages would love a little doll, bonus points for dark skin.

2.  Matchbox cars (for boys).  Small, fun, hours of entertainment.  We would pass these out at Tenwek sometimes and kids confined to their beds would run the cars all over the bed for hours at a time.

3.  Crayons and paper/coloring books (see the above comment on holding pencils).

4.  Picture books.  I wouldn't have thought of this one before, since most books are in English and most kids in the shoebox distribution areas don't speak English.  But again, when a kid has nothing, no books in ANY language, picture books can be an amazing past time.  For example, we bring the Jesus Storybook Bible to church many weeks and draw a crowd of kids every time we open it.  The pictures are beautiful, there are tons of them, they tell the story of Jesus, even without understanding the words.  And the JSB isn't that expensive, less than $20 on amazon.

For more info on the OCC program, check out www.samaritanspurse.org  


Happy (Second) First Anniversary!

by Rachel
Part of the deal with our transient lives as of late is that we have a lot of first anniversaries, but no second anniversaries.  We are hoping that this phenomenon will change for us now that we are settled in Burundi.  November 1 marked one year from our arrival to Kibuye.  So, while we have already had our one year in Burundi anniversary, there was much happy reminiscing on Halloween 2014 that one year ago we had been packing up and preparing to leave Banga for language study.

Coming to Kibuye felt like paradise in some ways, the freedom of having our own place, running water, steady (steadier) electricity, putting down roots.  A year later there are days when it feels less like paradise, but never the less all of us are still so grateful to be here.  So many changes in this one year.  Three homes have been completed.  We have been working in the hospital for 10 months already.  The kids have completed a school year and started another.  We've gotten to know our house helpers and even to communicate with them in Kirundi (some of the time).  This year, we also have new temporary teammates, and team gatherings are getting bigger and LOUDER all the time!  It's starting to be ... home.  

We look forward to another year of changes as 2015, and we also look forward to celebrating our first SECOND anniversary as the McCropders at Kibuye.  It has been a year of blessing and increased dependence on the One who led us here, and He will continue to lead for all the years to come.


A Song for the Day

Today was another smallish size day for the Internal Medicine service here at Kibuye, so I thought I'd give another random sampling of patients.  We had 7 total (i.e. one for each medical student.  Yes, we have a lot of students.  But they are good at learning from each other's cases…)

1. Jean-Phillipe (no real names) is a 32 year old guy with HIV who has been here 27 days.  We've done some good things for him.  We have successfully treated his tuberculosis, and corrected his HIV-med regimen (he was only taking them half the time…).  We've tried to check his CD4 count, but they only send them once a month, and I guess there is a quota, and we missed out last month.  But he still has nightmares and vomiting.  And now he says he looses consciousness.  I'm not sure he would know, because he is always alone.  We've tried everything.  The student suggested some HIV-related brain lesion, which is a good idea, but we can't test for it or treat it.  I talked to Jason and he may get an endoscopy tomorrow.

2. Juvenal is 47, and is his neighbor in the isolation building.  He doesn't have HIV, and is being treated for TB also.  He's a bit better, but not enough, so now we're entertaining concomitant emphysema, given a long smoking history.  He maintains a good spirit despite a long hospitalization.

3. Across the little hall is Luc, a 29 year old taxi-driver with severe malaria: blood in the urine and vomiting.  He was treated with quinine at another hospital.  We brought him in and gave him the exact same treatment, and he is getting better.  I don't know why this happens.  What goes on at those other places?  Are they missing frequent doses?  At any rate, he is looking better, but had a fever last night, and I can't figure out why.  For now, we're hoping it doesn't come back tomorrow.

4.  Rounding out the 4 beds in isolation (all mine for the time being) is Gloriose, a 70 year old lady who came in with dysentery, and sure enough, got better with appropriate treatment.  It's nice to have something go smoothly.  She's going home today with some Cipro.

5.  Gilbert is a 35 year old guy who admits to being a vrai buveur (a real drinker), which might not have been so bad if he didn't also have Hepatitis B.  He's in florid liver failure, and there is not much we can do.  We gave him some diuretics, and drained 4L from his belly.  But then Friday he slipped into a coma.  Honestly, I'm surprised he's still alive.  His coma is a bit lighter, and we're trying to treat everything we can, but he's very sick.  He has a couple faithful friends with him that seem to appreciate that we care about him.  We prayed with them on Saturday.

6.  Marie is 70 years old, and showed up last week all confused.  It seems to have been a bladder infection, and she is getting better with antibiotics.  It's a good simple case for the students, because they can never believe that a bladder infection would do that.  But then, there are only 2 neurologists in the country, and they are long overdue for their neurology course, so it's a little hard to blame them.

7.  Our last girl is Goreth, a 23 year old high school student (due to financial problems, high school often goes until the mid-20s) who came in Saturday:  difficulty breathing, semi-conscious, big swollen legs, and distended neck veins.  Sure enough, we did an echo of her heart, and found severe heart failure.  Why?  I don't know, but I suspect bad valves, maybe rheumatic, based on her echo.  She had a low blood pressure when she came in, and almost all such patients die here.  However, she is still alive, and even looks a little better today.  We keep praying that she can get through.

7 cases.  7 individual stories.  We will see how they continue on.  They bump into us.  We bump into them.  Life.  Death.  Healing.  Scars.

A couple years ago, I wrote a song about Revelation 22 called The Leaves of the Trees.  This vision of the heavenly city speaks of a Tree of Life.  But that's not all.  The leaves of that tree are for the healing of the nations.

And sometimes that idea makes me ache.  Because it rings so true.  Yes, we need life, and badly.  Pure unspoiled and unthreatened life.  But we are who we are, wounds and all, and the fact that God would take that in hand, and provide us with healing, in addition to life, strikes me as a beautiful salve.  A key that fits the lock of our brokenness exactly.  There is joy, and there is sadness.  There are scars, and there are so very many moments in which all we do is just palliative.  Maybe even every moment.

But at the end, there is a promise.  There is life and healing for all our wounds.  There is, simply, that which we need.

(to listen, click on the play button.  Download for free.)


WORD (and deed)

(by Eric)

Many years ago now, we chose to title this blog "Word and Deed", and I can tell you that I would have nabbed wordanddeed.blogspot.com if the domain hadn't been already occupied.  (Strangely, mccropders.blogspot.com was still available.)

I think that people probably read what they want to into that title.  The people who want to champion the "Word" will react with "Yeah!  You gotta have Word with the Deed."  Others who want to champion the "Deed" will react with "You bet!  The Deed is just as important as the Word."  And that's fine.

However, the point of the title is that we are committed to the ever-difficult task of holding on to both of these things as intrinsic and important at the same time.  It is not Word for the sake of Deed, or Deed for the sake of Word, but rather Word AND Deed.  We believe that both are essential in God's eyes.

But that doesn't mean that we always have a 50/50 split in each of our days.  It varies from season to season, and some of us are more Word, and some are more Deed.  Since arriving to Kibuye, I would say that Deed has been a larger part of my work.

But these last few weeks, that has been changing.  I have been offered many more opportunities to speak, and I hope that we will always rise when such opportunities come.  Four elements of my week:

1.  This past Tuesday in Bujumbura, the Christian Medical Student Fellowship held the first annual Christian Health Care Providers Conference.  It was a great time, very encouraging, and we decided to take the van down for the day, including 8 medical/nursing students and two of our Burundian docs.  The morning of departure, I was asked to give some closing remarks, and so I spent the drive down working out with Alyssa what to say.

2.  Thursday evening, I lead my half of the med student bible study, which takes place every Thursday night.  This has been a great way to develop ideas on a more in-depth basis, and yesterday we talked about legalism in the church, which is a very a propos topic for anyone, but maybe especially for us here.

3.  Friday morning, I took the plunge and spoke for the first time at hospital devotions.  The bishop of our partner church here has apparently voiced an opinion that a high priority for the church here is to really learn what it means to find salvation in God's grace, and not in the good works we do.  We have found nothing in our experience that suggests otherwise.  Quite on the contrary.  So I spoke on Philippians 3, and where we put our confidence.  

4.  And then, just a few hours later, I spoke for our Friday afternoon lecture.  Our med school's curriculum has a curious little course, required for all students, called "Christian Philosophy of Medicine".  We were asked to teach half of it (10 hours), and our subjects will include:  Imitating God as a Physician, Medicine in the Kingdom of God, Vocation, Holism, Evangelism, Facing Limits, Facing Suffering, and Bioethics.  

It's an exciting opportunity, because the junction of medicine in faith is an interest that runs straight down the middle of our time.

So we speak.  We discuss.  It is Word, and it is Deed.  Pray for us, that we would speak truth and speak it in love.  Pray for those who hear, that it would edify them.


One Hen and other African Children's Stories

(from Heather)

For anyone who is interested in children’s picture books highlighting African children and African cultures, here are three of our favorites which might be available at a local library.  Our elementary school-aged kids particularly like these books, all of which are based on true stories, and all of which have fantastic illustrations.

One Hen: How One Small Loan Made a Big Difference - by Katie Smith Milway – a fun look at micro loan enterprises through the story of a young boy in Ghana who gets a chicken and an idea.

I Lost my Tooth in Africa Рby Penda Diakit̩ - the experiences of a girl visiting Mali, West Africa, with themes of losing a tooth, raising a chicken, experiencing a different culture, and traveling to and from Africa.

The Boy who Harnessed the Wind – by William Kamkwamba and Bryan Mealer - a true story of a boy from Malawi whose ambitious ingenuity helps him overcome obstacles.


Landscaping 101

by Rachel

Now that two houses are completed (the Cropseys were able to move in to their place several weeks ago, hooray!) and two more are well on their way (Alyssa's house is getting cabinets and closets, almost done, and the Faders' house has a roof), we are turning our attention more to the surrounding landscape.

Ogden house garden
One of the original houses at Kibuye, the so-called "Ogden house,"  has a grassy yard and many nice flowering plants and trees.  One of the older missionary wives told us that in its heyday, the yard looked like something out of Better Homes and Gardens and it's fallen far since then.  But we still think it's quite nice (and wonder what it USED to look like!).  It gives us an idea of what would some day be possible at the new homes.
poinsettia trees
Ogden house arbor

flowers picked from Kibuye campus
Basically, we built our homes in an undeveloped area, slight hill, mostly scrubby trees.  The McLaughlin house is at the "top" of the property, and there is a gradual slope down to the Cropsey's house, at the "bottom" of the property.  Not being a civil engineer (I think this is who would be the expert) I really have no idea about water systems and retaining walls, but an awful lot of cement and concrete and stone was used to put up walls and gutters and septic tanks and the like.  It seemed like overkill, but then we had three days of torrential downpours at the beginning of October.  It was quite a kickoff to the rainy season, and potentially damaging, as the rains caused stripping of topsoils, floods, and leaks.  It's the kind of rain that can damage crops and cause erosion.  And in our own homes, we were able to see the power of the rain on a muddy hillside.  Over the course of an hour, the Cropsey yard turned into one giant swimming pool, almost flooding their downstairs basement.  There was standing water and mud everywhere.
The original lot before home construction

So the guys got back to work and started relandscaping our yards.  First, they dug holes and installed drainage systems under our wall.  Then they dug trenches across the yards, filling them with stones to serve as drainage fields.  

Landscapers hard at work

Grass clumps after planting
They planted grass…and when I say planted grass, I mean they literally took little clumps of grass and stuck the clumps in hundred of little holes all across the yard (no sod or grass seed here, I guess).  They fixed gutters and roofs.  And after all that, the rains stopped. :)  But probably not for long, as the rains usually continue more or less through April.
McLaughlin side yard, "finished product"
We are also excited about the possibility of having flowers and fruit trees in our yards.  The more greenery we can have, the less damaging the rains will be.  Plus, after cutting down so many trees to build our homes we're feeling a bit like the Onceler from the Lorax, or maybe Sauruman from Lord of the Rings.  We love trees, and hope to replant everything that was lost.  Carlan has started a little nursery of trees/plants, and the hospital has also hired an "agriculturist" to help with the hospital property and our homes as well.  Much has already been planted and we look forward to seeing how things grow and develop in the next 10 years.

Carlan's tree nursery
Carlan supervises the younger generation


COTW: Loss and Redemption

by Rachel

One of the downsides to being a physician in our setting is lack of follow-up.  We don’t have “continuity” patients the way docs in the US do.  I remember one of my attending docs at St. Joe’s, where I did my residency, telling me once that he had just delivered the baby of a woman that he also delivered 20+ years earlier (he had delivered her and now, 20 yrs later, he was delivering her baby, if that makes sense).  Delivering two generations in one career, wow.  Here at Kibuye, I see women for a day or two and then they disappear.  Sometimes there are sad stories, sometimes happy, but I don’t know if I’ll ever know the rest of the story or experience the rest of their lives.

Today I got to experience two stories.  A story of loss, one that I hope will one day experience redemption but that time is not yet.  And a story of redemption that had a history of great loss, great pain, but now joy.  The first woman had been on our service for several days.  She has a healthy 9 year old, but 6 years ago her second baby died just after a C-section for unknown reasons (common here).  Then she had a miscarriage.  Now she was coming in a week after her due date.  We did a few small things to try and get her labor going naturally, but this morning she had a low-grade temperature and had made no progress so we decided to repeat the C-section.  There had been no evidence whatsoever of fetal distress.  My student and I did the C-section and pulled out a very limp, misshapen baby.  There was a heartbeat, but the baby did not breathe.  Minute after minute my colleagues worked on the baby.  She took a few shuddering breaths, but that was all.  I was stunned.  How could we explain this to the mother?  After such a tragedy six year ago, she had waited and waited for this child, only to experience tragic loss again.   What is there to do?  What is there to say?

As we were finishing up in the OR, a second woman came in to the hospital.  Fourteen years ago, she was a teenager in labor.  Long labor.  The baby didn’t come and didn’t come and eventually when she was able to push the baby out, it had already died.  Worse yet, due to the length of the labor, she developed a fistula.  Many of you reading already know what that is (many famous talk show hosts and activists have raised awareness of this terrible problem).  Basically, a woman with prolonged labor who doesn’t have safe access to a C-section can develop a hole in between the bladder and vagina.  It happens because the long labor puts enough pressure on healthy tissue to cause the death of that tissue.  After the fistula forms, she leaks urine constantly, causing her to smell, to develop infections, to be ostracized by her family and community, and sometimes to be divorced by her husband.  

This lady suffered for 10 years.  And then, hope arrived.  The organization Doctors Without Borders set up a training site for fistula surgery in Gitega, 30 minutes away.  She received surgery, and it was successful.  Now, four years later, she arrived at Kibuye, pregnant with her second child, coming for a C-section that is available to her now.  I delivered the baby, a boy.  He was beautifully healthy, with screaming lungs and pink tinged skin.  This woman has waited for fourteen years, and this afternoon she held a baby in her arms.  

That’s the story of redemption.  I didn’t see the beginning of her story, but I’m privileged to be a part of the next beginning, the new beginning.  It was, for me, a day of loss and redemption, so common here in our setting.  Highs and lows, joys and triumphs, successes and failures.  We don’t always get to see the redemption story that we long for, at least not here on earth.  May the second be a story that carries me through the days of loss like the first.  Days that have come, that will come.  May these two women be stories that remind me that someday, all of our losses will be gathered up, all our our tears will be dried, and we’ll see a beautiful picture of love and grace woven together to make up our lives. 


Dogs: A Cross-Cultural Window

(from Eric)

There are no dogs here at Kibuye.  I mean, none.  It's getting a bit weird, because now if we (or especially the kids) see a dog, it's more of a mix of fascination and trepidation than it should be.  Why don't they have dogs?  Doesn't everywhere have dogs?  You can form your own hypotheses as well as we can.

A couple days ago, one of the hospital staff was sharing in morning devotions from Revelation 22, where it says "Outside are the dogs…", referring here (presumably) to a shameful or evil person.  Calling someone a "dog" seems to have the same meaning for Americans as it did for the 1st century church as it does for Burundians.

But that was not the speaker's assumption, and for somewhat compelling reasons.  "Before I go on," he said, "I think I must explain what this means, because I have heard that for Westerners, dogs are good things.  People even consider dogs like their children.  Even better than their children.  So, maybe, when Americans refer to a person as a 'dog', it is a compliment.  We know this is true, because they even let dogs go in their car!  But, for us, you must know, that it is not a good thing to call someone a dog."

Their is a wealth of cross-cultural observation there.  First, Westerners and their dogs.  They are, in fact, a member of the family.  They are well fed and groomed.  They are up-to-date on their vaccination schedules, and if sick, sometimes get very advanced medical treatment.  So, in some ways, the speaker was right:  Often, we do treat dogs as our children.  They do ride in our cars.  In favor of that, God has made these creatures, and we care well for them.  Perhaps the odd thing is why calling someone a "dog" is still derogatory in American English.

Now, the flip side.  When the speaker mentioned that dogs are allowed to ride in cars, everyone laughed, including all the Americans.  John turned to me and said, "Maybe they wouldn't have a dog in their car, but they would have goats and chickens."  And that is the amazing truth.  Americans couldn't imagine riding several hours with your family goat or a couple chickens, but for Burundians this seems pretty normal, and seemingly not at all unsanitary in the way a dog would be.  

Several years ago, Tracy Kidder wrote a book called "Mountains Beyond Mountains."  More than the content of the book, we frequently quote the title, as a way of say "I never dreamed there were this many layers of complexity and opportunities for confusion."  Dogs.  Never thought much about that one before.  I would have put there mostly in the category of "things our cultures have in common".  

Mountains beyond mountains.