Crossing Continents

By Alyssa

It's been a while since we've talked about the transitions of crossing continents and reverse culture shock here, but since missionaries spend 20% of their time (1 year out of 5) in the US, it continues to be a reality for all of us. And now it's my turn again. I arrived in the US a little over a week ago and will be here for the next five months. Since I just celebrated 10 years in medical missions, I have done this "home assignment" gig several times before and one would think that would make it easier. But the flip side is that it has now been 10 years since I have lived in the US, so actually it seems like more of a foreign place as time goes on.

So what is entailed in the home assignment process?

1) Gearing up. Logistics need to be arranged such as flights, car, housing, etc., but the main focus of this gearing up time is preparing to leave my Burundi home for five months. That means thinking intentionally through each of my various roles and making sure someone is covering them in my absence. It inevitably comes up when a teammate is gone that people realize just how much they were doing that we weren't aware of! And suddenly we're left wondering: Who has the key to the storage container? Who is feeding the bunnies and chickens? Who is boiling eggs for the malnutrition program? In my case, I tried to make a list a couple months in advance and to divide things up amongst my gracious colleagues. Of course I did forget a couple things and have already been asked where the documentation sheets are for the malnutrition program and what to do with the monthly pediatric mortality discussion notes. Thankfully there is WhatsApp to keep communication lines open! Since our housing is limited, the other aspect of my prep time was getting my house set up for visitors to stay there in my absence. That means hiding the imported chocolate chips (sorry, visitors!;)) and breakable items so that families with toddlers will be comfortable there and letting Heather know where guest sheets and towels are, etc.

Three days before I left, our shipping container showed up which was great timing as I was able to unpack the infant formula and the vitamins for sickle cell patients and get them to Logan to use in my absence. 

Gearing up is also a good time to take updated pictures of Burundi life to share with folks in the US:

The new pediatric building - three stories tall! The roof will be on by the end of the year! 

2. Goodbyes and the "Wood between the Worlds." Our team values intentional goodbyes and demonstrating our love for one another during transition times. Since I have a big birthday coming up this month, they even planned a special pizza night and early birthday party for me! And then most of the team managed to show up at 10am on a Monday morning for prayer and our traditional "tunnel of love" send off. I will miss them all so much these next few months!

Next comes the "Wood between the Worlds." For those familiar with C.S. Lewis's book "The Magician's Nephew" that was the in-between place that was quiet and peaceful. For me Europe is a nice place without the stresses of either Burundi or America. It's familiar since I lived there for a year during French language study and it's a great place to just blend in, unwind, and enjoy the scenery. (And it works out well for me that one of my best friends lives there, so I have free lodging!)

Best swing ever! 

3. Re-entry. Back on the other side of the pond, I'm welcomed enthusiastically by my family. Family time is the definitely the highlight of home assignment!

Nieces and nephew

Celebrating Lily's 6th birthday with a special trip with Aunt Alyssa to the American Girl store in Nashville

Enjoying fall leaves on a hike with my Mom and Maisy

And then I hit the ground running! Off to the Global Missions Health Conference where I spoke about rural medical education, reconnected with old friends, worshipped in English, represented Serge to prospective missionaries, and promoted Eric McLaughlin's amazing book. 

Matt and Joanna at the Serge booth with Eric's book. We gave away 50 copies to those interested in potentially becoming Serge missionaries!

My favorite part was getting to catch up with teammates Caleb and Krista Fader who are also currently on home assignment - for a whole year! 

Now on the other side of jet lag, I'm in cross-cultural (sort of) observation mode: What are people wearing? Oh, drinking straws are out? Interesting that there are TV screens on all the gas pumps. How do I communicate in a way that makes sense to people in this context?
And of course I'm doing the usual tasks of dentist appointments, eye exams, haircut, getting phone service, etc. I'm hoping to make significant progress on my thesis for my Master's in Clinical Education over the next few months in addition to the usual speaking engagements and travels around the country. I appreciate your prayers for grace, curiosity, and joy through one more transition and I know teammates would appreciate the same when it's their turn for crossing continents.

Radically Dissimilar but Full of Promise

(from Eric)

My intern is presenting a new case:

"The patient is a 20 year old male from Makebuko commune who is presenting with two weeks of cough and increasing difficulty breathing."  He moves from section to section of the well-established presentation format.  It's oddly a bit like a familiar song, and each word creates suggestions in my mind as to what this young man's problem is and what we should do for him.  The intern's information is a bit scattered, since he is still learning, but the structure is like a couple of deep wheel ruts that keep him from straying too far.

He tells us about his past medical history, including a seizure disorder, for which he is on chronic medicine.  He talks about a developmental delay.  Then he gets to the physical exam.  "His weight is 23 kilos" (about 50 pounds).  23 kilos?  Yeah, he is the size of a child.  Does he speak?  No, he's never spoken.  Does he walk?  No, he's always been bed-ridden.  He has some bedsores, but they are clean.

This is actually an incredible story here in Burundi.  There is a bit of context that is necessary to understanding just why this is so incredible.  People with significant handicaps usually don't survive very long here.  In fact, I have never seen someone this disabled who has survived to this age.  They are often neglected and devalued.  Even if they are not, something goes wrong.  They have an injury or an infection somewhere that goes unnoticed for too long.  Until it's too late.

"Well," I say to my gathered team of nurses and students,"this family deserves our admiration for taking such good care of their child for so long."  Actually, his family abandoned him a long time ago.  He's been raised by Catholic nuns in a home for handicapped children.  "Oh," I say, "then I guess we owe that admiration to the nuns.  They have shown just how serious they are that every person bears God's image.  Let's try and do our best to continue the same while he's under our care here in the hospital."

After we're done discussing, we head out to starting seeing our patients.  We go from bed to bed.  After we finish our normal wards, we head over to see an old man who has suffered a massive stroke. When the surgery ward building was built in 2016, we added 8 very nice private rooms.  They each have private balconies, and the best of them are on the second floor with a gorgeous view of the Burundian hillsides.  I jokingly call the top one the presidential suite.  The old man's family has a bit of money, and he is hospitalized on the bottom floor.

View of the balconies of the private rooms (on the right)

When we leave the room, I get ready to leave the building, but the intern says, "No, upstairs."  Who is upstairs?  "The young boy that came in yesterday."

We climb the stairs, and there, in the 2nd nicest private room, is our new patient - all 23 kilos of him curled up into a fetal position, breathing oxygen through a pair of nasal prongs.  He's dressed in a nice t-shirt, and his helper is in the bed next to him.  It's a truly beautiful moment, and it reminds me of two quotes:

"The church exists to set up in the world a new sign which is radically dissimilar to the world's own manner and which contradicts it in a way which is full of promise." - Karl Barth

"So the last will be first, and the first will be last." Jesus in Matthew 20:16

I shared the application of the second quote with my team, even before we left his room.  I thanked his caregiver for her great work, and she smiled at her feet in obvious embarrassment.  Here, in a world full of scarcity, the church (and as a confirmed Protestant, I give my Catholic brothers and sisters full appreciation for their example-setting in this arena) has taken a small non-verbal boy, who doesn't usually even survive to this age, and hospitalized him next door to the presidential suite.  He bears God's image.  The last has become first.  The church has set up a sign which has contradicted the world in a way which is full of promise.  We were there to see it.  It was just a glimpse of what's to come.

A Way Forward

(by Greg)

According to the World Health Organization and the World Federation of Societies of Anesthesiologists, a country the size of Burundi should have 600 physician anesthesiologists.  Today, if I include myself, there are 8.  Most of the anesthesia care in Burundi is carried out by non-physician anesthetists, who are working under difficult conditions, without supervision, with inadequate supplies, sometimes without even the most basic equipment including oxygen.  For anesthesia care to advance in this country, what is needed is more physician anesthesiologists, to teach, to lead, and to advance the peri-operative care of this country.  People around the world are dying each and every day for lack of access to safe and affordable anesthesia care.  If you live in the US or Canada, you don’t see them, and you don’t hear their stories, but they are there.  This is the reality.  

This problem is not isolated to anesthesia.  In most of Sub-Saharan Africa there are not enough doctors of every speciality, but obviously God prepared me to speak into this particular problem, in this place and time.  

Last night, I had a wonderful opportunity to gather with the other anesthesiologists working in Burundi, in the hopes of creating a society, recognized by the government, which can lead the way forward in this struggle.  These are men who trained in Burundi, Belgium and France.  They understand the magnitude of the challenge that lies ahead, and they are ready to fight for the needs of their country.  It was an honor to be invited into this group.  I want to do everything I can to strengthen and encourage them.  

The anesthesiologists of Burundi (I am the one second from the left)

Next week I will be travelling to Chicago to present to the board of PAACS, the Pan-African Academy of Christian Surgeons.  A small group of anesthesiologists working in Africa will be pleading for them to allow us to begin training programs under their umbrella for physician anesthesiologists in Africa.  If you are reading this blog, would you pray for this meeting, and for a way forward in this global challenge?

The needs at our hospital in Kibuye are massive.  Many days I feel overwhelmed.  And then when I step back and consider the needs at Kibuye multiplied by tens of thousands of other hospitals that are facing the same challenges, the burden is crushing.  All this drives me to my only hope, God, who cares more about this problem than I do, who alone can speak creation out of nothing, who loves us and who loves our patients.  His love is so great that He sent his Son Jesus to offer us eternal healing from our broken condition, and eternal hope.  It is because of Him that my family and I are here in Burundi.  It is because of Him that our team has been able to work here for the past 5 years.  And it is because of Him that one day this massive burden will be lifted.  

Behold my servant, whom I uphold, my chosen, in whom my soul delights;

I have put my Spirit upon him; he will bring forth justice to the nations.

He will not cry aloud or lift up his voice, or make it heard in the street;

a bruised reed he will not break, and a faintly burning wick he will not quench;
he will faithfully bring forth justice.
-Isaiah 42:1-3

Here Comes the Bride

By Julie Banks

A beautiful thing happens in Kibuye in the fall.  Dry season ends, and rainy season begins.  But it is not just the appearance of rain that signals the beginning of a new season.  We receive a uniquely beautiful gift.  The jacaranda trees bloom.  Bright purple blossoms seem to appear overnight drawing our eyes up these tall trees.  But they are in bloom only for a brief amount of time which makes the experience rare and special.  The violet flowers are so delicate that the lightest rain, or a drifting gust of wind, will cause the petals to fall out of the trees.

This is my fourth "fall" at Kibuye.  So it's my fourth time seeing these jacarandas bloom.  In past years I remember saying "oh those are pretty" or maybe I even snapped a picture on my phone.  Perhaps I was too distracted by the start of a new school year.  Maybe I was feeling sorry for myself because I missed Midwestern falls with orange and yellow leaves that crunch when I walk.  I don't think I ever truly saw the jacarandas.  Until this year.  This year I saw them.  I really saw them.

For a brief time, everyday I stepped outside, I noticed the jacaranda blossoms.  Tiny purple flowers fell into my hair as I walked.  Purple petals covered the ground around me.  I looked down at my feet where each step was cushioned by a delicate flower.  As I walked, my heart fluttered, and I thought, "I feel like a bride!"

It was as if someone had gone before me to sprinkle flowers along my path.  And then I remembered the image of the Church - us - as the bride of Christ. My neck lengthened as I walked a little taller.  A little slower.  I felt anticipation.  I felt loved.  I felt seen.  I felt... beautiful.

Here, in the midst of poverty, struggle, sickness... was beauty.  God was literally laying down for us a beautiful carpet of purple to walk upon as we walked our everyday paths.  Our path to KHA to teach the kids.  Our path to the hospital to see patients.  Our path to the neighbor's house to say hello.  Our path to Church.  For a brief moment these worn down walkways looked like a beautiful isle prepared for a bride.

And then I thought about the color of these petals.  Purple.  Royalty.  Priesthood.  Kingship.  This purple ground belongs to the King.  The King is here.  The words take off your sandals for the place where you are standing is Holy ground echoed in my ears.  The Most-Holy is here.  He is at Kibuye.  He loves Kibuye.  He loves these people.  He is already working in this place, and somehow we have been invited to join Him on the journey.

Pray for us on our path in Kibuye.  Sometimes rocky.  Sometimes muddy.  Sometimes beautiful.  May we hear God's voice.  May we see His blessings.  May we continue to be awed by His grace.  His love.  His forgiveness.  And may we, as brides, draw others to Christ.

And the Spirit and the bride say, ‘Come!’ And let him who hears say, ‘Come!’ And let him who thirsts come. Whoever desires, let him take the water of life freely. Revelation 22:17.

Photos by Darrell Baskin and Julie Banks

Putting the "Word" in "Word and Deed"

by Alexis Karasiuk

This blog is called “Word and Deed” because God calls us to share the gospel with others through both of these means. It is not hard to see how our team shares God’s love through “deeds” every day via medical work and service to those in need. The “word” part, on the other hand, may be less obvious, but it is also happening! My name is Alexis Karasiuk, and I am a medical intern and MK teacher here at Kibuye for the year. Since I arrived in September I have had the privilege to attend two local church visits along with members of the team who were asked to speak. I’m going to share with you the experience of my first visit!

Pastor Pascal's church

It was a few Sundays ago when I hopped in the land cruiser along with the Banks family, Nimmon family, and a member of the church’s leadership team and his wife (and their adorable baby) and we headed off to a local church. About 15 minutes later, we left the main road, which meant that we also left all pavement behind as we ventured down narrow dirt paths and over sketchy log bridges. Arriving at the church, we clambered out of the back of the cruiser and were welcomed by Pastor Pascal. We followed him down the aisle to the front as the congregation sang a vibrant song to welcome us to their church. We each introduced ourselves, and Scott got a warm laugh out of the congregation as he addressed them in Kirundi. Sitting on benches at the side of the stage, we had an up-close view of the various choirs and their dances as they belted out songs and worshipped God! Their footwork was especially impressive.

Introductions

One of the choirs

After the worship, it was time for Logan to share the message. He spoke in French and a pastor translated into Kirundi. His message was on the passage in John 2 where Jesus turns water into wine. He emphasized the faith of the servant who had likely never heard of Jesus before and certainly had not seen him do a miracle, and yet who had faith to do what Jesus told him to. Logan acted out part of the story from the servant’s perspective, and the congregation laughed and engaged with what he was sharing. After the message, Logan returned to his place on the stage and the pastor lead a prayer. A funny thing though was that while he was praying, a skink (a small lizard) that was crawling on the ceiling fell off and landed on Logan’s shoulder! He didn’t make a sound (I would have!), but he gave a bit of a start and everyone who noticed had a good chuckle. I bet there are few churches outside of rural Africa where that has ever happened.

Logan preparing to share the message

When the service was over, we headed outside and greeted some of the members of the community. There were many children and as we stood outside the church, they spontaneously started singing a worship song. More and more joined in until they had all formed an impromptu children's chorus. Post-serenade, we headed into a classroom at the elementary school across the road and shared a meal with the pastoral team and church council members. It was very generous and delicious!

Our visiting group

The "children's choir"

A delicious Burundian meal

With full bellies and much waving and ‘thank yous’ we climbed back into the land cruiser and headed back home. 

This church visit was just one of many opportunities that team members have to share the Word with people here. Just yesterday morning, I went on a visit to a church farther out in the district where Carlan was preaching.

Carlan preaching from Colossians

Enthusiastic dancing!

Getting a tour of the area surrounding the church

Eric, and George were also speaking at two different churches in the community yesterday. Next week Greg is headed a ways out to speak at a rural church that very rarely has visitors. Weekly on Wednesdays, various team members share a message at the hospital morning chapel and on Tuesday nights several members lead and participate in a bible study with some of the Burundian doctors and interns. These are many of the ways that the Word is being actively shared here. Please pray for the team as people continue to speak God’s truth and love into these communities in these ways as well as through individual conversations. Deeds speak loudly, but the direct Word is important as well!

Our home church in Kibuye where Eric preached this past Sunday (photo courtesy of Darrell Baskin)

ITEC Video

(By Caleb)

In a blog posted in September of last year we talked about the installation of solar power at Kibuye.  As we had previously struggled with inconsistent power and crippling fuel shortages, the impact of consistent and clean power on Kibuye's ability to provide quality care has been massive.

The system has now been operating for just over 14 months.  In these 14 months we have harvested just shy of 160 MWh of power from the sun.  This is a bit hard to wrap one's head around, but it is roughly equivalent to the average power consumption of 15 US homes over the same period.  

We are very thankful to ITEC for their tireless effort in supporting this installation.

Isaac and Oliver Lewis are brothers who came as volunteers to help with the installation last year.  I was recently made aware of a video they created about this and I wanted to share it with all of you:

Eric's Book Releases Today!

After several years in the cooker which have certainly refined it like a fine vintage, Eric's book Promises in the Dark: Walking with Those in Need without Losing Heart, is available for purchase.  You can buy it from Amazon or from New Growth Press (better deal for bulk purchasing), as well as read a slew of great endorsements on either site.

"Eric, I'm excited about this book!  I'm definitely going to read it myself!  But what can we do to help get it in the hand of other people?"

First of all, let me thank you for such a gracious offer.  Here are a few ideas:

• Post on social media.  Anyone can do this, and it can be a great resource for others who considering getting the book.  Write about why you think the book is valuable (consider a quote that you enjoyed).  Let the book's content, rather than your connection to the author, be central.
• Post a picture with your book (or ebook) and tag me in it on Facebook.  We can play the game of "how many people will hold Eric's book before Eric?".  Include the hashtag #promisesinthedark
• The book includes discussion and reflection questions for each chapter which work great for a small group study.  Consider if there are others in your circles who might benefit from reading it, either alone or together.
  
  
  

“So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day.” - 2 Corinthians 4:16

ZM Part II: Into the Community

by Rachel

At the risk of inundating all of you with more Zigama Mama news (see here for part I), I wanted to continue to share the next part of the story with everyone.  When ZM was set up, part of the program was not just training nurses and doing ultrasounds/scheduling C-sections, but actually going out to each of the 17 health centers in our district to make sure the program was going ok, requirements were being followed, and collecting some data sheets from each center.

I've actually been really excited about this part.  I've come to realize that in my six years here in Burundi, I have become very much a creature of habit.  I used to think of myself as somewhat adventurous, but now I go to the same places and do the same things every day.  I shop in the same one store, I take the same route to Bujumbura, I visit the one tourist destination by us (the waterfalls), I walk the same path to the hospital every day.  Even in Buja, we visit the same restaurant, the same grocery, the same hotel with swimming pool.  Part of this is finding the thing you like and sticking with it, part of it is that there's just not many new places to go or opportunities to go there.  Or that everything starts to look the same, and you wonder if it's worth the effort to keep exploring.  But the health center visit was a chance for me to actually venture off the beaten paths (sometimes literally) and see a totally different aspect of life here.  Months went by with many cancelled trips and I started to despair that these visits were ever going to happen...but as usual here, all of a sudden one day last week the pieces came together and the next day I found myself in the hospital truck with one of my OB nurses and the district health officer and we were off!

We are located in Gitega province, right in the middle of the country.

For those of you who don't know the system, Burundi is divided up into provinces, much like states in the US.  We're right smack in the middle, Gitega province (which is the most populous overall, according to Wikipedia at least).  From a health standpoint, each province is divided up into districts, and each district has its own hospital.  So, we are Kibuye district.  Then, each district is divided up into communes, and there are 4-5 health centers spread across each commune.  We have 4 communes and 17 health centers in our district.  Health centers are mostly like outpatient clinics, except that they will do "small surgeries," occasionally admit patients, and all do basic maternity care--prenatal visits and deliveries.  Each health center will refer their complicated cases to us at Kibuye Hospital, and our ambulance is responsible for going out to each health center to pick up the transfer, no matter what time of day or night.

The first thing that impressed me was the actual travel to each health center.  We were on paved roads for the first 5-10 minutes of the day and then spend another hour on dirt roads, usually smooth but occasionally a bit hairy given the recent rains, before we arrived at the first health center, Mahonda.  So, driving a decent vehicle still took over an hour from the hospital to the health center.  Most patients are not in decent vehicles--they walk, take bicycles or small motorcycle taxis, or sometimes ride in a rickety-looking station wagon-type taxi.  Thankfully, women is labor who need a transfer get to ride in the ambulance, but still...if the transfer is because she needs an emergent C-section or the baby is in distress, there is no quick way to do this.

Road leading to Mahonda health center

Road leading away from Buriza health center

The second thing that impressed me was the actual center and staff.  They have a hard job--located in the middle of "nowhere," seeing sometimes 100 patients a day in a much more resource limited setting than Kibuye, with no doctors to ask advice from.  The nurses need to be able to do suturing, wound care, deliveries, general medicine and pediatrics, and then figure out who needs to be transferred vs what they can handle themselves.  And they know that they can call an ambulance and at minimum, it will be over an hour before the ambulance shows up...if it's not out picking up a patient from a different health center first, or even worse, broken down and out of commission for days or even weeks.

CDS Mahonda staff, along with my OB nurse Moussa and the district health officer, Melance

CDS Buraza, one of the "super" health centers in the center of their commune

CDS Buriza, the newest health center in our district (opened by the president a year ago in August)

Finally, my third observation was just a reminder about how hard it is for my ladies to access care.  Even with free care for pregnant women, and community health centers.  Even with Zigama Mama offering free ultrasounds and consultations.  There are still barriers.  The nurse at Mahonda told me that patients have been refusing to come to Kibuye for a free ultrasound because it still costs 16,000 Fbu in transport costs to even GET to the hospital (reference: around $6 roundtrip.  also reference: for our househelpers, who make more money than the average Burundian, this would be about 4 days' wages).  This is on some level very discouraging--we remove one barrier only to discover that there are so many more still to be surmounted.  But on another level, little by little, barriers ARE being removed.  I was excited to see that each commune has a special, "super" health center being developed, where the government is committed to posting a midwife and improving training protocols and available medications for mothers and newborns.  I am happy to see that, even despite distances and transport cost, over 200 women have decided to make the effort to come in to Kibuye for a free ultrasound and consultation.  I am encouraged to see many nurses and other workers committed to providing health care in challenging places without many resources available to them.  And I hope our program and visits are encouraging to them, too.  To the nurses, to the women--they are seen, they are heard, they are loved.  Someone cares enough to try and make their lives a little bit better.

Thanks to all of your for your support and enthusiasm for our project.  I look forward to seeing its impact continuing to unfold over the next year, and even beyond.

Beautiful terraced hills on the road to Buriza

To Save a Tooth

By Stephanie 

In some ways living in a medical community in rural Burundi can mean minor medical problems get diagnosed much faster then they would in the US. If you see a new rash on your child's arm you can just run over to your neighbor the pediatrician, or if you’re having persistent abdominal pain your teammate, the ER doc, can do an ultrasound on you in the comfort of your own living room. But one area of medical care that we have no resources for here in Burundi is dental care. We have had dentists interested in joining our team, but reality is that routine dental care is beyond the financial ability of the average Burundian. Here in Kibuye when patients have a tooth abscess the medical care that they receive is getting their tooth pulled, usually being unwilling to pay the less than $3 to have the area numbed first. 

In mid September our 10 year old son began complaining of tooth pain. He’s never had a cavity and saw the dentist in the US this summer, so we assumed that his pain was related to a new tooth coming in and pushing on his other teeth. However, as the week progressed so did our son’s pain, to the point that he wasn’t getting any sleep and we had him on ibuprofen and tylenol around the clock. Then he started being lethargic, staying in bed all Saturday while his friends ran around the compound. By evening he had a fever despite the tylenol. We also noticed that one of his adult teeth had become wiggly.

We went to Saturday family worship with our team and asked for prayer. After the service a teammate offered the name of a dentist in the US, Dr. Hank Willis, who has willingly consulted on their dental questions in the past. We e-mailed him right away and immediately received a response. We sent him some pictures and he asked us some questions. Our son didn’t seem to have pain when we pressed above his teeth and in fact we weren’t even exactly sure which tooth was having the problem.  One of the questions Dr Willis asked was about reconstructive work to our son’s teeth. We missed that question at first as we answered others, but then realized that our son had had a chip to his left lateral incisor fixed this summer. Could that be the problem? The chip was the result of a fall 2.5 years ago. Dr Willis told us the tooth was probably necrotic and our son would need a root canal. He was even kind enough to offer to do the root canal for us …. if we wouldn’t mind flying to Idaho.  

                                                                                                                               Dr. Hank Willis

This threw us into high gear. Where could we go in East Africa to get a dental opinion we could trust and the level of care we wanted for our son? We had heard that there was a Canadian dentist who was setting up an office in Kigali, Rwanda. But we weren’t sure if his practice was open yet. Was he in Rwanda or Canada at this time? How do we get in touch with him on a Saturday night in order to arrange to travel ASAP? Well, we turned to another team friend and missionary in Gabon, Dr. Drew Huang. Drew is one of those guys who knows everyone! We gave him a call and sure enough he had the private e-mail address of the Canadian dentist in Rwanda, Dr Jesse Wong. We e-mailed Dr Wong and started our son on oral antibiotics. 

Early the next morning we received an e-mail back from Dr. Wong. He was indeed in Rwanda and could see us at 8am Tuesday morning. We booked airline tickets for two, a hotel, arranged transport, then borrowed Rwandan money and SIM cards from teammates. We also hunted down our passports which were in the capitol for visa renewal.  As we arranged all this our son was back out playing with friends, only occasionally complaining of pain. Had we not consulted Dr. Willis we probably would have believed that the antibiotics were taking care of the issue and stayed put in Kibuye. 

Monday we began our journey to the dentist with a 3 hour car ride to the capitol where we were able to find the correct office, wait for someone to arrive, and pick up our passports. We then flew to Kigali. And as is typical with African travel, the airport visa line was long, our hotel driver was not there to pick us up, our SIM card did not work…. but we sorted things out and got to our hotel.

Tuesday morning we went to the office of Dr. Wong at DMC Dental. The clinic was 

clean and modern, even having a TV mounted in the ceiling for our son to watch as they worked on his tooth. Dr. Wong was quick to see the issue on x-ray, a large infection above the tooth that had been chipped in the fall years ago. The infection was so large that Dr. Wong left the hole in the tooth open to drain overnight. Our poor boy spent the rest of the day spitting out draining puss and watching The Peanuts Movie in our hotel room. On Wednesday morning we returned to DMC Dental where Dr. Wong cleaned out the tooth again. He really wanted to finish the root canal for us then, but there was still too much drainage from the infection. He put medication in the tooth and we will return to Rwanda in November to assess the infection and hopefully finish the root canal.

  

During this episode our son asked us “What would have happened if I were a Burundian?” So we talked about the lack of pain control that would have been available to an average Burundian boy, the delay in diagnosis because of the cost of a medical consult, and how his adult tooth probably would have been pulled.  Medical care is improving in Burundi, but there is still a long way to go. Events like this make us feel our privilege in being able to access the best medical and dental care for our kids, even if it means traveling to another country.