Free Fungus Tea

(from Eric)

Several months ago, I snapped a picture in a local grocery store of a row of the latest locally-produced beverage:  Free Fungus Tea.  It was a nice social media moment, with lots of proposed commentary on why one would want to name a beverage "Free Fungus Tea", and several urges to buy a bottle and inform the wider world.

Well, the next time I returned, I found only a single bottle.  I guess it was a hot seller.  I quickly procured it, and shared it with a few McCropder teammates (Rachel, Jason, and Greg) a week later (in order to have a broader base of opinion).  John, of course, would have been the go-to guy for the fullest color commentary, but he was, alas, unavailable.

Then, of course, our computer died, and with it, access to the pictures.  Then we got our computer back, but it didn't seem like a good Christmas post.  However, New Year's being a holiday well-fitted for beverage-related stories, I present to you our findings:

Here is the bottle along with a couple glasses of its contents.  I had a medical student (who happened to stop by the next day) translate the Kirundi tagline, and apparently it extols the many health benefits of this drink.

Here is the back label:  The Kirundi-English combo is not as surprising as you would think.  You never know what language people will go with here, but generally, if you want to show yourself progressive, English in the way to go, and I think we can all agree that Free Fungus Tea is nothing if not progressive.

I love the "Arise & Shine Company", because it is, in my mind, a quintessentially African enterprise name, which is to say that it is explicitly biblical but the connection with the product remains a big foggy.  The ingredients seem benign enough (we think that "Mate" is supposed to be "Malt", but we're not sure), with the exception of the "starter culture".

And for the tasting:

Well, having reviewed the title, it did taste quite a bit like a spiced ice tea with a "starter culture", though I'm not sure we could have identified such a flavor beforehand.  Another way of putting it would be a Southern Fruit Tea (yum!) that's been in the fridge a couple weeks too long (not as yum!).

So, yeah, it wasn't that great.  

And I can't say that I felt particularly healthy afterwards, despite all their claims.

So, not terrible, but can't truthfully recommend it for your upcoming New Year celebration.

Perhaps the best part came afterwards.  Akin to the treat in the cereal box that is waiting for you when you finish is the hidden logo of the bottle.  Look closely.

That's right, each bottle of Free Fungus is bottled in an old Heineken bottle.  ? Starter culture ?

But, a month later, at the same grocery store, there was a new batch of Free Fungus, with a slightly spiffier label to boot.  Apparently, someone is loving it.  Microenterprise at its best.


For Unto Us a Child is Born

(from Eric)

In the last several decades, international health efforts have significantly reduced the number of children under 5 years old who die.  It's quite a victory, though there is a long way to go.  Kids still die in terrible numbers from stupid stuff like malnutrition, diarrhea, and pneumonia.  But they do it a lot less frequently than they used to.

There is, however, one section of this problem which has had a notable lack of progress, and it is the neonatal period, or the first month of life.  If you get sick during this period, your chances of survival aren't nearly so much improved as if you get sick later.  The graph now looks like this:

If you can survive the first day of life, your chance of being a neonatal mortality is cut in half.  If you can survive the first week, it is cut in half again.  In other words, this is a very very high yield time to intervene.

So, why hasn't it changed much?  I don't know.  Maybe people think it's too expensive or technological.  If you walk through an American NICU, you will probably think so.  Maybe the pediatric people saw it as more of a maternal problem than a kid problem, and the maternal health people saw it as more of a pediatric problem.  I don't know.

Our time in Kenya gave us a good vision of the possibility of intervening for these little kids, and arriving here, Alyssa was determined to get a little neonatology department going.  The hospital administration graciously gave her a room in the maternity building, and Jason had a few incubators built from local materials.

It was a bit of a rocky start.  Just after the opening of the service, I covered for Alyssa during a one-week absence.  We had a few premature babies.  We weren't reliably weighing them (which is absolutely essential in these cases), and all the moms were saying that they had no milk because they had no food because they were stuck in the hospital with their premature baby who wasn't growing because they had no milk because...  It was enough to be quite discouraged.

But she persevered.  (My single contribution was realizing the inaccurate weight problem was because the nurses and students didn't know how the use the scale.  I wish all solutions were that simple.)

Now that Alyssa is gone, I have gravitated over to Pediatrics, and I found a marvel.  Somehow, in the last few months, this service has transformed itself into something young, simple, but very legitimate.  My first day rounding, I found about a dozen patients on neonatology.  The increase in numbers is expected, since there is absolutely nowhere else to go to get care for these kids, so they get referred to us.  I approached it with a bit of trepidation, but I found reliable records and growing babies.  A few antibiotics, a good feeding regimen, and mother's milk.  And you can save so very many lives.  Lives that will hopefully have many decades in front of them.

That first day I had the privilege of discharging this little baby (seen here in Jason's homemade incubator, modeled after those used at Tenwek in Kenya):

This little one was born around 900 grams (i.e. just a shade under 2 pounds).  900 grams!  Here, in rural Burundi!  In a wooden box made by Jason.  Milk and a few antibiotics.  There are many that size that we lose, and we will continue to lose them.

But not all of them.

Not this one.

Here at Christmastime, we celebrate the coming of a baby.  God didn't skip that step.  It has been said that, in the incarnation, God ennobled the human race, and that we are to treat others with even more dignity because, not only are they made in God's image, but one time for all, God was made in our image.  And so a baby came.  A baby like this one.

Yes' ashimwe. (Jesus be praised)


What Is "Normal" Anyways? I'm Starting to Forget...

by Jess Cropsey

3 days ago, on Friday...

It started off as a "normal" morning -- John headed off to work at 7:30, the kids were getting ready for school & eating breakfast.  I was in the bedroom when I heard a knock at the door and one of the kids said, "She's trying to give us a chicken!"  I wondered who this person could be and hurried to the door to find a nicely dressed lady on the porch with her son, a rooster, and a box with holes in it.  She told me in halted English that her son was one of John's surgical patients and that she was so happy that her son could see well again.  (He has a rare syndrome called homosystinuria which, in his case, caused blood clots, seizures, and dislocated lenses in the eyes.)  John was able to successfully operate on both of his eyes and also got some special medication when he was in the U.S. for a conference a few months ago.

She continued to tell me that the rooster was for John and the items in the box were for the kids.

There was much excitement over the rooster and many pleas not to eat it right away.  The box with holes contained two pigeons which the kids were even more excited about.  The lady gave me all kinds of tips about how to care for them, what kind of cage to build, etc.  She thought it would be a good idea to release them in a room for a little while so that they weren't cramped in the box.  I decided that I'd prefer not to have bird poop all over my bathroom, so I let them loose in the schoolroom bathroom instead since we were approaching a weekend.

I'm not really a country girl nor an animal lover, but our family now owns a rooster and 2 pigeons.  Construction has begun for a bird house and plans are in place to turn the chicken into Christmas dinner (a 5:00AM wake-up crow isn't fun!).

Later that afternoon, we had a party for the construction workers to celebrate the completion of our house.  The McLaughlins had a goat roast (with 5 goats!), but after that it was decided that a whole cow was more economical and tastier.  The butchering of the cow began yesterday and all the kids wandered over to see the cow spread out all over banana leaves on the ground.  It was a pretty morbid sight.

Sammy & I checked on the food preparation progress throughout the morning.

Bananas cooking in water

Boiled bananas cooling on banana leaves so that they can be peeled

Bananas now being fried in oil to give them a crispy outside

The final meal (for over 100 workers!) included some meat and several fried bananas in a tasty sauce with a side of zucchini bread and a soda.  Yum!  

Boys helping to pass out napkins

As an early Christmas gift, we also distributed hats, many of which were donated by our church in Ann Arbor.  These were a huge hit!

As we were exiting the schoolroom earlier in the day, Heather commented how today would make a great blog and I had a moment of pause.  Oh yeah, I guess it would.  This isn't a usual day (at least for most Americans), is it?  I almost forgot.  It's all starting to feel so normal...


Christmas Catalog: Feed Our Hungry Patients

(from Eric)

Once again this year, KibuyeHope.com is presenting an alternative Christmas Catalogue: ways to support the work and community of Kibuye as a gift in honor of someone during this holiday season.  Click here for the full list of this year's options.

We would like to draw your attention to one item in particular: Our hospital feeding program.  Similar to many hospitals in our part of the world, there is no kitchen or feeding program for patients hospitalized here.  Patients depend on their family to bring them everything to eat and drink.  Given the poverty and hunger of Burundi at baseline (Burundi was recently given the dubious distinction of "hungriest nation in the world"), this only gets worse in the hospital, resulting in even worse nutrition right when they most count on it for their healing.

So, the problem is more than discomfort.  It is wounds that don't heal.  Moms that don't have enough milk for their premature babies.  Kids who can't beat their otherwise treatable infections because their bodies aren't strong enough.  In short, it is the cornerstone of all we're doing.

For this reason, we are starting in 2015 the first hospital feeding program.  2 meals a day, a mix of "Busoma", a nutritional grain mixture already made on site here, and other nutritional staples available in the region.  How much does it cost to feed one hungry patient at Kibuye for a week, thus enabling the healing of their whole body?  $3.

A few suggested pricing options for Christmas ideas:
$3 - feed a patient for a week
$13 - feed a patient for a month
$40 - feed the entire hospital for a day
$100 - feed the entire pediatric service for a week
$270 - feed the entire hospital for a week
$425 - feed the entire pediatric service for a month

You guys are bright folks who have likely already figured out that you can donate any amount to get any permutation of the above numbers.  All you have to do is click here, and enter your dollar amount (where it may already say "$3").  Gifts are tax-deductible.

Thanks for thinking of Burundi this Christmas season.  We are convinced that there is no better way to support the work of this hospital and this community than to follow one of the simplest mandates we've ever been given, to provide food for those who are hungry.

Here is a video of Alyssa (done by Carlan) with some great information about malnutrition in our area and the Busoma community feeding program already in place (not to be confused with the hospital feeding program to be soon implemented.)



What's in the bag?

By Jason

Heather and I have been in the States this past month.  We came back to be with family after my grandmother passed away.  We also used this opportunity to get a breather from the never-ending responsibilities at Kibuye, to attend a medical missions conference, and to stock up on some supplies.
After being at Kibuye Hope Hospital for a year there are some things that we found we needed/wanted at the hospital and at home, so being back in the States (with an Amazon Prime trial) gave us a great opportunity to acquire many of these things.  We are taking back quite a smorgasbord of items in our suitcases and it causes me to cringe thinking of trying to explain to the TSA agent the various items we have in our bags.  Here is a sampling of what we packed in our suitcases.
A huge monkey wrench to do maintenance on the water system
Contact paper to make the Operating Room windows opaque

A new biography about a Burundian runner
Various medical textbooks for me and for students
A nail gun air compressor to run the anesthesia machine
Air hose and other things to hook up the air compressor to the anesthesia machine

A flower box which will be used to soak long instruments in sterilizing solution.  I also got some catheters that aren't available in Burundi so that I can do prostatectomies.
Some spices not found in Burundi

Various homeschooling/ESL books
Pictures from a Burundian refugee family we met in Pittsburgh - to be delivered to her family in Bujumbura!

Some plumbing putty and goop for various persistent water leaks

Intramedullary nails to replace the ones we have used already

Skin graft meshing plates (it is amazing what you can find on e-bay!)

Spray bottles for prepping patients in the Operating room with Betadine

Wire clippers for various orthopedic procedures

And more...
Tums, Iron, Bowel prep pills (some medications aren't easily accessible)
Asbestos repair kit (leaky roof in the hospital)
Nail brushes (for cleaning hands before surgery)
Fuses for our van
Drawer sliders for a desk I am building
Speakers for the Operating Room (its nice to listen to music during long operations)
Foot pedal to operate the endoscope
Ultrasound machine which was repaired while we were back
Table Saw blades for various construction projects
Headlight (it's hard to operate when the lights go out)
Transformer (to convert 220v to 110 volt electricity)
Humby knife (used to remove skin to use for skin grafts in burned patients)
Nasal Canulas (for giving oxygen to patients)

Please pray that we'll just breeze through customs. : )


(Some of the Reasons) Why We Love Uncle Carlan

by Rachel

I think that if you asked missionary parents what some of their biggest fears are, or some of the biggest sacrifices to taking their kids to the missions field, one of the most common responses would have to do with health care for their kids.  We know missionaries that have moved to rural parts of Chad, India, and Tanzania, to name a few, and have been hours and hours of rough travel away from clinics and hospitals.  These are brave parents that have much faith.  Over the years, I have come to realize how unique our situation is, to not only have access to a doctor but to MANY doctors, not only access to a clinic but to a whole hospital which, while it has its limitations, is set up to provide most of the care we and our kids could possibly need.

Everyone on our team has their role to play.  Alyssa acts as the official "team physician" but the rest of us fill in for more specific situations (no one on the team has let me deliver their baby yet...ahem...).  When Carlan joined our team, we initially thought of him as another primary care doctor, but he has rapidly created an important new position and emergency room at the hospital.  We also had no idea how important it would be to have an ER doc as our neighbor.  Maggie actually stuck a bean up her nose last December.  I guess I always thought, who are these kids sticking beans up their noses and in their ears?  My daughter, I guess.  Carlan was able to fish it out with some random ENT equipment that we found on the bookshelf.

In the past month, we have had several more serious mishaps that Carlan has helped to patch up.  First, Sammy accidentally got his entire pinky fingernail ripped off while outside playing with rocks.  I have no training in fingernail repair, but Carlan was quite familiar with the necessary steps to making sure that the fingernail WILL someday grow back (seems to be a success so far).

Then last week, Maggie fell off a retaining wall outside our house and we immediately suspected a broken arm.  We called him and he arrived to do a complete exam in less than 2 minutes.  He and Eric carried her up to the hospital, got an X-ray, diagnosed a "greenstick fracture" (like an incomplete break in an immature/young bone), made her a splint, wrapped it up with fun bright blue wrapping, and brought her home.  It was literally less than an hour since they had left.  I know of no place in the entire world where you can get care like that.

And really, he's very affordable. :)  He would probably see us for free, but in the interest of generating some more income for the hospital we did pay the specialist fee of 10,000 Fbu.  I would say that the care he provided was definitely worth the $6.50.  In all seriousness, we are so grateful for the protection that God has given our families, for the provision of equipment and doctors when there IS a problem, and for good med-evac insurance when the problem is beyond us.  We pray for much more of the same in the years to come.

Of note, I had just finished writing this post when John stopped by.  His face accidentally collided with a metal pole.  Guess who sewed him up?  Our team seems to be a bit more accident prone than usual lately...