Ballet in Burundi

by Jess Cropsey

As a parent, it’s easy to question yourself when it comes to your kids.  It’s one thing to decide that God has called me to move to Africa.  It’s another thing to make that decision for my children, knowing that doing so sends their life in a very different trajectory and also exposes them to additional risks (health, safety, etc.).  I have come to a place where I can trust God with those things (most of the time!) and am confident that this is where He wants our family to be for this season of our lives.  And, yes, my children have lots of wonderful opportunities that other kids don’t have, but part of me still wants them to have the best of both worlds -- piano lessons, sports clubs, dance classes, swimming lessons, church youth group, etc.  We do what we can in those departments, but our human resources just aren’t the same.  Me functioning as the art teacher for over half the year is a perfect example of this!  So, it brings me great joy when visitors come with a vision to minister to us and our children.  In the last few months, we’ve had some special visitors here who have done just that.  While most of them had medical spouses serving at the hospital, they shared their talents with those of us on the home front.  

Last Thursday was the first day of ballet class for the little girls.  Julie Banks (who, along with her physician husband, served with us in Kenya for 5 months) is here for two weeks and graciously brought leotards and tights for our little princesses.  The girls have been thrilled to learn some ballet moves from their beautiful and talented teacher and can’t wait until 3:00 every day!  

Several weeks ago, Rachel's brother (starting a graduate degree in music therapy) and sister-in-law Heidi supplemented our weekly music class.  

In April, Hannah Willis came prepared with several fantastic art lessons for our kids -- a major improvement from the instruction they were receiving from me!  A young teen, Nina, also put together some VBS material for our kids during her 3-week stay with us.  Around that same time, a couple came along with their grand-daughter and blessed the entire team with a generous 2-day get-away at a nice resort in Bujumbura.  It was the first time our entire team had been together outside of Kibuye since our arrival and the kids absolutely loved time at the beach, pool, and playground.

Visitors who intentionally seek out time with our kids (in conversation, playing games, etc.) are also a tremendous gift, especially since our kids have limited access to adults who speak their heart language.  These visitors are often remembered and talked about for many months afterwards.        

Thank you, visitors, for sharing your time & talents and blessing us and our children!  

Ebola Update

We've recently received an influx of visitors from the US, which has been fun.  Over a group discussion one night, we realized what a big deal ebola has been in the US news.  Really, it hasn't been something we've been thinking about every day here in Burundi, but have gotten a number of questions from friends and supporters, so we thought we'd send out an update.

1.  Is there ebola in Burundi?

No.  Absolutely not.  There has never been a confirmed case of ebola in this country, including previous outbreaks.  In fact, to the best of my knowledge, ebola in this current outbreak has not left West Africa.

2.  Is ebola likely to spread to Burundi?

No.  Being one of the poorest countries in the world has its advantages.  People don't have money to travel, and people from other countries often don't travel here.  There is far more travel between West Africa and the US than there is between West Africa and Burundi.  Think of it like we're in El Salvador and you're in the US.  Same continent, but very far removed.  

3.  Are you planning to go to Liberia to work?

No.  Although we applaud the doctors and nurses who have volunteered to provide much needed treatment and care to West Africa, we have no plans to leave Burundi.  We feel like our work is here.

4.  Will you stay in Burundi if ebola comes?

Difficult to say.  We'll cross that bridge if we come to it.  Here's a great article talking about the decision to go or stay in times of difficulty.

5.  How is Kent doing?

As far as we know, Kent is expected to make a full recovery.  Samaritan's Purse has released a statement saying as such.  Thanks for your prayers.  We are in full support of what Kent chose to do and are glad that we can continue to count him as one of our colleagues.

6.  If you're interested in what it's like to live through an ebola outbreak, our regional field leaders, Scott and Jennifer Myhre, were living in Bundibugyo, Uganda during the 2007 outbreak (Bundi is one of the oldest Serge Africa sites).  Their kids were evacuated, but Scott and Jennifer stayed.  She's a great blogger.  If you go to their website paradoxuganda.blogspot.com, choose 2007 on the right side link and start in December for a ton of articles and posts.

Thanks for all your prayers and support.  Please keep praying for the thousands of African lives being affected by ebola. We'll let you know if anything changes, but for now, everything here is "sawa sawa."

Happy Anniversary!

by Rachel

Arrival at Kibuye, Nov 2014

August 6th marked our one year anniversary in Burundi.  It seems very surreal for most of us, unable to believe that we’ve been here a year (and some days unable to believe it hasn’t been longer!).  One of the reasons that it’s hard to believe is that there have been so many transitions this last year.  Arrival in August, three months in Banga, move to Kibuye in November, start at the hospital in January, McLaughlins moved into their house in May, etc.  It’s amazing how much has been done when we reflect on it, which is good because in the midst of day to day living we tend to focus more on what still needs to be done.  We are so incredibly grateful for everyone who has supported us.  It is because of your help that we have been able to move “full steam ahead” for so long now.  And it has been amazing to see so many dreams and plans and goals finally come to fruition this year.

Since our arrival in August, all of the adults spent at least three months learning Kirundi.  This means various things for various people, but we can at least all share greetings and communicate on a basic level with our neighbors in certain contexts.  Listening to the “muzungu” speak Kirundi never fails to bring a smile from the locals, sometimes even applause.

The four oldest kids have completed a year of school in the newly formed Kibuye Hope Academy.

An emergency room, eye unit, and neonatology (NICU) unit have all been created.  I think Alyssa, John, and Carlan would say there is a lot more development that needs to be done in each of these units, but they are functional, where there was nothing before.

Four houses (McLaughlin, Cropsey, Fader, Pfister) have been started and are in various stages of completion.  The McLaughlins have already moved in and the Cropseys will hopefully be moved into their home within a month.  Alyssa and the Faders hope to be in their homes by Christmas.  “Container plex” has also been built.

There is running water in the hospital.

We have had a part in educating over 70 medical students, developing and presenting over 30 lectures in French.

The operating room, under Jason’s direction, has close to tripled the amount of surgeries since last year.  And we are eagerly awaiting a US anesthesiologist who will help provide further education for our staff.

Our sending agency (which has also undergone a name change this year) has approved two new families to join us in our work here, which total 4 adults and eight kids!

Countless relationships have been formed with local pastors, nurses, doctors, community workers, etc.  

There are many more things to list, but in truth, it is not our work but God’s, and we are blessed to be a part of it.  We pray that we have been and will be faithful stewards of the gifts given to us.  And we look forward to many more “happy anniversaries” to come!

Kids enjoying our celebratory "crepe anniversary party"

The team in July, 2014

COTW: Maternal Mortality

by Rachel

A woman died on my service Thursday.  Now, people die every day around the world, and of course people die every day in Burundi.  Even more so in the hospital.  But this was a woman I had fought for.  Was fighting for.  A defeat in many senses of the word, which is always hard.  

She had come to a health center, in labor with her 5th baby.  You would think that birth becomes routine, especially after four normal deliveries.  But this time, something went wrong.  Instead of the baby’s head coming out first, an arm slipped into the birth canal and the baby turned sideways.  She was transferred to Kibuye Hope and my colleague did a C-section to deliver the baby.  It was a little bloodier than some, but went well overall...until they finished the surgery and pulled off the drapes to discover that she was lying on the table in an ever expanding pool of blood.  I was called in to assess the situation.   By then there was blood everywhere.  We did a hysterectomy and I removed her uterus as quickly as I could, although I left her cervix behind (a common variant of the hysterectomy often used after a C-section because it’s quicker and easier).  The bleeding seemed to stop, and we wheeled her back to maternity.  I have no idea how much blood she had lost by this point, but I do know she was in desperate need of a transfusion.  Our blood bank was empty (again).  Our neighboring hospital in Gitega, 30 min away, sent one unit by ambulance.  I returned to her bedside an hour after the hysterectomy, and the blood had just arrived.  She was still unconscious and now having gasping respirations.  And unfortunately, she was now in another giant puddle of blood.  We rushed her back to the operating room and I discovered that, perhaps all along, the cause of her profuse hemorrhage had been a large tear on the inside of her cervix, perhaps due to the baby’s arm, maybe due to the delivery.  I repaired it.  The unit of blood was emptied into her veins.  There was no more blood to give.  She died less than 30 minutes later.

Burundi has one of the highest maternal mortality rates in the world.  Almost one in every 100 deliveries ends in the death of the mother.  So, if a woman has on average 5 children, she stands a 5% lifetime chance of dying during or immediately after one of her pregnancies.  Incredible.  Incredibly sad and tragic.  Most of those deaths are due to hemorrhage, infection, or obstructed labor without access to a C-section or other proper care.  I don’t even know how many of these deliveries ends in the death of the baby, but it’s also quite high.  This particular case hits harder because she came to us.  She was in the best place possible.  She had a US-trained OB-GYN caring for her.  And we failed her.  Maybe that’s not true, but it feels like it to me.  

I grieve for her baby, born alive but who stands a high chance of dying in the next few months because there is no mother to give milk, to provide care.  I grieve for the husband and four other children who have lost a mother and wife.  I grieve for a country that doesn’t have the basic infrastructure to provide life saving blood (On a side note, reading US literature on postpartum hemorrhage/PPH, the protocol states that as soon as you diagnose PPH, order SIX UNITS OF BLOOD from the blood bank.  I doubt there are six units available within a 2 hour drive of here).  And although it seems selfish, I grieve for myself.  The “What if” game is a hard one to play, especially as a physician.  If only I had managed her differently, perhaps one unit of blood would have been enough.  I know that the outcome probably would have been the same, and on most levels I feel like I did everything I could.  But it’s hard on these days, to be a stranger in a strange land, to feel like I’ve given up quite a bit of normal life to be here for just such a time as this, and to feel a woman slip through my fingers.

Many times people read our blogs and ask, what can I do about this problem?  It’s a tough question to answer.  I do have some thoughts.

1.  Raise awareness.  Every day, the number of women who die in childbirth is equivalent to a 747 jet crashing into the ocean.  It’s awful.  There are organizations that seek to fight this.  You can start here.  I can’t speak to the specific ethical issues of every organization involved, but it’s a good place to start.

2.  Give blood.  Women’s lives are saved every day in the US because of the selfless gift of blood donation.  If not for that, the mortality rate after US deliveries would probably be quite a bit harder.

3.  Be grateful.  Sometimes I hear Americans in support of home birth use the argument “A hundred years ago, everyone gave birth at home.”  Yeah, and a lot more women died.  I’m not saying that home birth is the wrong choice for some people.  But be grateful for the medical resources that save lives every day.  Be grateful for your access to them in case of an emergency, no matter what.

4.  Pray. Pray for justice and healing and a world where things like this no longer happen.  Where every woman has access to a safe and healthy delivery, where women don’t have to be afraid of losing their life every time they get pregnant.