The Pleasing Aroma (International Women's Day)

by Julie Banks

International Women’s Day is an enthusiastically celebrated day here in Burundi. On March 8th, women come together in their individual communities and share a Fanta, a meal, and some laughs. We join in the festivities with the hospital staff each year, which is so fun. 

One particular way Burundian women celebrate Women’s Day is by making dresses and skirts from the same fabric. I wrote about it last year, so feel free to read that blog for more fun details on the matching dresses! 

This year we gathered at the hospital canteen, shared a meal, and celebrated not only women’s rights in Burundi, but also the way God has uniquely designed women with a purpose in His kingdom.

I shared the story of how Mary (sister of Martha and Lazarus) poured oil on Jesus’ head and feet and wiped the run-off oil with her hair. When she poured this oil it signaled to Jesus that she understood who he was, and what he was going to do. This was an anointing of Jesus, the King. The perfumed oil was also reserved for burial, and she understood that he was going to die for them. While some men balked at the idea of “wasting” this expensive perfume, Jesus praised her and promised that her story would be included any time the Gospel was preached.  The Bible says that when she poured out this perfume, the fragrance filled the whole house. The whole house smelled like Jesus, the King. And when Mary wiped the perfume with her hair, his fragrance was now on her, a part of her. Her hair was right under her nose, so she carried this aroma with her as a reminder that she is part of Him, and He is a part of her. And anywhere she went, she carried this fragrance of Jesus the Savior King with her.

I encouraged the women that as daughters of the King, we carry this fragrance with us. 2 Corinthians 2:14-15 says that Christ “uses us to spread the aroma of the knowledge of him everywhere. For we are to God the pleasing aroma of Christ among those who are being saved and those who are perishing.” To remind them that we are to God this beautiful aroma, I let them use my perfume at the end of the party. We wrapped up the afternoon with dancing, singing, and passing around perfume!

Burundian women are amazing, strong, and beautiful. Thank you for your continued prayer and support for these ladies.

Zigama Mama, final product

by Rachel

Eric and I have really appreciated everyone's support for our research/quality improvement project at Kibuye these past few years. Many of you remember the other blog posts that I wrote to introduce the progam (here and here).

Well, as of February 28, 2023, our journal article was finally accepted for publication in the "Frontiers in Global Womens Health" journal. You can read the article here. Even if you can't read all the medical lingo/jargon, the heart of the paper is this: There are a lot of barriers to good health care in Burundi. One of the ones that we could identify and fix was lack of good counseling for women who needed to deliver by Cesarean section, for one reason or another. We offered free ultrasounds as an incentive for these women to come in to meet with me (or another doctor) and provided education on risks as well as a scheduled date to come for a Cesarean section if it was indicated. The goal was to reduce emergency Cesarean sections that could have otherwise been avoided...and, it worked!

The other beautiful thing about this project, and one that is not listed in the article, is how the project has continued on (even after the study period ended). Even now, three years after the program "ended," we've continued to find funding for free ultrasounds, and our number of scheduled Cesarean sections remains high. Perhaps my favorite part is how the generalist physicians have taken up the mantle, so to speak, and now provide almost 100% of the ultrasounds, counseling, decision making, and scheduling for these women. I am involved almost not at all, unless a second opinion is necessary. Simple, sustainable care to improve outcomes and decrease mortality. Fitting that the article was published just a week before International Women's Day. I pray not only the our progam at Kibuye continues, but that other hospitals around the country will be able to replicate the program and improve outcomes for many other women in different regions.

And finally, a big thank you to our former intern Matt Nagy for being the impetus and the driving force behind publishing our study and findings. He is one of the smartest people I know and we are grateful for his wisdom and expertise (far beyond his years!).

Beautiful Burundi

 by Michelle Wendler

Here are some candid photos of everyday life, and a few interesting facts along the way. Enjoy! 

Bringing home the bean harvest.

Vegetable market.

Banana transport.

Sewing the good old fashioned way without electricity. 

Chicken transport.

School time!

An ancient artifact I found at Kibuye buried underground. Well not too ancient, just maybe around 60 years old, to when the first missionaries lived here. It's part of a kerosene powered refrigerator.. 

Termite wings on the door step.

Local kids having fun.

Babysitting starts very early here. As early as 5 years old kids start to help care for the younger ones

Mr. Ezechiel, a man who works for us and has become like family.

Morning sunrise overlooking Kibuye valley.

Lake Tanganyika, the 2nd largest and 2nd deepest lake in the world.

Fishermen on Lake Tanganyika.

The house where Betty Ellen Cox lived, right outside our front gate! She was one of the first missionaries to come to Burundi. You can read her biography called "Simply Following"which is still sold on Amazon. 

"Take our picture!"

Found this on a trail...as is. 

An oil painting I did of a house in our village. The sunset brought out such beautiful colors.

Homemade toys are the best!

Coming home from the field.

The brick making process. They form the bricks out of the mud, then stack them into kilns and fire them in place.

I love the beautiful colors.

Came to church wearing her Sunday best. 

Morning fog.

Sunset behind the church.

Teaching English

(By Erica Ause)

Outside of my role as teacher for the team’s children, I am also an English teacher for a few groups of people who work at the hospital. This role has been a huge blessing to me, and one of the things I look forward to most each week. It has helped me make some dear friendships and given me an opportunity to peek into the Burundian culture. One group I teach are the medical students. This is open for any and all students who want to give their Monday night to English. The class ranges from about 2 to 15 students depending on the other things they have going on like exams, being on-call, or classes. For some, this is a chance to practice English simply out of interest. For others, it is vital as they have chosen to write and defend their theses in English. This is not an easy feat, but for those would like to study in another country, a competence in English is just short of necessary. This is the most relaxed class I have because I never know who will show up! One day, we had only two students, both of whom I know well. So instead of studying English we played ping pong in the student center for an hour, speaking only English of course. Another time we had so many that we split into two groups and worked on two different skills based on level. This class is full of students around my age who show me their passion for those who live in rural Burundi. They love their patients and teach me about the differences between life in the city and life here in Kibuye. They have also taught me cultural things I would not learn otherwise, like how people date and how to throw a party.

Another class I teach is a group of hospital staff. These four men are learning English to either be accepted into a master’s programs abroad, find jobs dealing in international relations, or for the sake of their role at the hospital. This class gives me some insight into the generation that already has children, and who grew up and work in rural Burundi. This is a different outlook on the world, and one that I am blessed to be privy to. From them I have learned how one shows respect to different people (for example, the students are always the ones who erase the board, never the teacher), when it is appropriate to ask a question in class and when to stay silent.

The third group is the most structured, and time sensitive class. The four men I teach are a part of the PAACS (PanAfrican Academy of Christian Surgeons) residency program that has recently started here in Kibuye. PAACS is an English based program, so although these four speak Kirundi and French at the hospital, all their conferences and tests are in English. This class is half me teaching English, and half me learning more about surgery than I will ever need to know as we review from their 2-inch-thick textbook. We do practice tests, presentations, language lessons, and a lot of speaking. One day, before they headed to a PAACS conference in Kenya, I turned my house into a "restaurant" to allow them to practice the vocabulary needed for that setting. I asked them to provide some of the foods they often eat, but which I had never tried. The wife of one of the residents brought supplies to our kitchen and taught me how to make the dishes. We made Ugali which is like a ball of dough made from hot water and casava flour as well as Ndagala, a small fried fish cooked in oil and lemon. We then enjoyed the meal around the table, and it was delicious. It was a wonderful time spent together, using conversational and restaurant vocabulary, learning about each other’s cultures around food, hearing stories about their childhoods, and discussing some of their fears and excitement for their trip to Kenya.

One thing I know for sure is that the best way to learn language is through speaking about anything and everything. This means that “English class” can range from a lesson to a dinner together. I just love when language learning and friendship overlap. Spending time with all these students has been one of the most fulfilling parts of life here, and I am so grateful for the relationships I have made through it.

Neonatology!

(by Jenn Harling)

Hey Everyone!

I'll re-introduce myself as I still consider myself one of the "newer" team members... but in all acutality we've been here since January 2020!  I'm Jenn Harling, married to the ever-so-talented Michael Harling (surgeon / IT extrodinaire / internet guru / biomed guy / fixer of all the things our children break) and mom to Amelia, Madelyn, and Mark.  I'm a pediatrician but I like to call myself a self-trained budding neonatologist. I love all the children of Kibuye and really enjoy treating all of them, but there's something about those newborns that gets me!  While Alyssa is here, I focus mostly in Neo, but while she's gone I cover all of peds.  And I also love love love teaching... but that's for another blog.  Since our return from home assignment in July 2022, I've been working to improve the quality of care given in the Neo unit with small changes here and there. I attended a Neonatology conference in Tanzania in October 2022 and lerned so much and am excited to hopefully implement a lot of what I learned over the years to come.  

Our unit in the new Peds building (if you want more on that, you can see one of Alyssa's old posts about the opening of the peds building... actually there are TWO posts... here's the other one) is on the top floor and can hold about 40 babies.  One thing I think is really neat and possibly unique is taht the mothers get to have a bed on our unit as well.  You can see in the video that the "incubators" are attached to the end of a patient bed. The mothers stay in the bed and are the major caregivers to their babies. This is necessary as sometimes we have very high ratios of patients to nurses. 

Recent changes include a hand hygeine initiative, using a white board to track patients, keeping nurses in the unit rather than having them rotate to different services, and re-vamping some of our protocols.

Rather than ramble on and on, I thought I'd just give you a tour in person!  Hope you enjoy the petit tour. 

(Also, this is my first time uploading ... ahem... trying to upload a video so let me know if it doesn't work and I'll ask my husband for advice 😂)  

The 6 Ps

The 6 Ps of Acute Limb Ischemia Driving in Burundi

by Eunice John

For non-medical people (like myself), in medicine, there is something called the six Ps of acute limb ischemia, which occurs when there is a sudden lack of blood flow to a limb. Doctors often use this in the assessment of whether the limb can be saved with emergency surgery or not. 

The “Six Ps” include pain, pallor, poikilothermia (aka perishingly cold per the graphic below), pulselessness, paresthesia, and paralysis. 

Many years ago, even before our family’s arrival, a teammate(s) creatively came up with another “Six Ps” but for driving here in Burundi…and the story begins: 

Our family doesn't travel away from Kibuye too often. And I would say even our teammates who have to travel more (i.e. to the capital, a 2.5-3hr drive one-way), still only drive down maybe 2-3 times/month. While Burundi is indeed beautiful, driving here can definitely be stress-inducing, for both the driver and passenger(s) alike! 

Back in Dec 2019, there were 2 weddings on the same Saturday in Bujumbura, the largest city and former capital. Our family and some teammates were headed to one (for which our oldest was the ring bearer!). A couple other teammates were headed to the other. Before leaving Kibuye, I was asked to pray over the travels ahead. I prayed and we were on our way.

Maybe an hour into our drive down the mountain, we see some…traffic?? There is a line of vehicles backed up and definitely NOT moving. We slowly come to a stop. Why are they all stopped? What happened up there? Where is “up there”? How long has everyone been here? How long will we be here? Oh no…we’ve already driven over an hour…there’s no turning back. Are those people getting off that bus and walking??

While one of our teammates got off to do some scouting, the rest of us hung out in the car. Another teammate jokingly noted that I hadn’t prayed for all the six Ps! 

Well, fast forward to this past December, our family was driving back to Kibuye after some holiday travels, and I kid you not: during those 2.5-3 hours, we encountered all six Ps* (some more than once!). All that to say, these sorts of things tend to stick to my brain, so I wanted to share them with all of you. Now, in no particular order… 

We pray for protection from… 

1. Potholes

2. Pedestrians 

3. Presidential parades and the likes (this one was a sudden but short one)

4. Pikis (Swahili for motorcycle) 

5. Puke (we give each of our kids an empty "Blue Band bucket" aka margarine tub, to use as a barf-bucket; the sanitizing wipe from Ethiopian Airlines came in handy!) 

6. Pluie (French for rain) 

Note: In this picture, you can see pluie (look closely at the dashboard), pedestrians, and pikis! 

In all seriousness, we always pray for travel mercies and are thankful for every uneventful trip on the road. The next time you’re on the road or you think of our team and wonder how you can pray for us, you can just remember the 6Ps and our travels in general! 🙏

*The 6Ps were very slightly modified for this post. There is actually another P that is not listed here for mindfulness reasons.