COTW: 6 years old

By Alyssa (written Sunday, Feb 21)

One of my first patients when I began work in Burundi over two years ago was a little 4 year old girl named Jeanette. She was unable to walk due to severe joint pain and she needed a blood transfusion. We diagnosed her with sickle cell anemia. Near the end of that hospitalization she began to walk again and recovered from that painful crisis.

 I decided at that point that I would like to follow up with her regularly and explained this to her mother. This was asking a lot of her mother as there was no known concept of regular doctor visits unless you were sick, and she had to walk many miles to come with Jeanette’s little brother on her back and sometimes carrying Jeanette as well. But she came. I consulted with some hematology doctors in the US on what we could do for sickle cell patients here and we did our best for her (and for our many other patients with sickle cell) with prophylactic antibiotics, folic acid, and pain medications. But Jeanette frequently was re-hospitalized with malaria, serious infections, severe anemia, and painful crises. You might recognize the below picture from the composite pic in our blog heading above. This was taken when she was 5 years old. 

I didn’t see Jeanette for many months after that hospitalization and I wondered how she was doing. She came back last week. Her mother was very excited to see me and said Jeanette had been asking if she would see me. Their financial situation had worsened so they had been unable to make the trip for her regular visits, but now Jeanette was sick again so they came back. I printed the above picture and Jeanette and her mother were happy to have it. Rachel mentioned that she saw the little girl carrying it around with her around the hospital while on her mother's back. 

But this time Jeanette was very seriously ill with shortness of breath, evidence of sepsis, and malaria. We treated her with our strongest antibiotics, quinine for malaria, oxygen and a blood transfusion. But after a couple days she wasn’t improving and she was no longer able to talk or move the right side of her body. She still greeted me weakly with a left-handed handshake on Friday morning, but it was clear she had had a stroke - one of the many possible complications of sickle cell disease. She died Friday night. Yesterday morning her grief stricken mother asked if there was anything that could be done to help with the hospital bill. She didn’t want to leave without paying but another family member was hospitalized as well and there was no money left to pay Jeanette’s bill. Thankfully we have a Needy Patient Fund for just such a case and we were able to pay her bill from that. The mother was overwhelmed with gratitude and expressed over and over how thankful she was for all we had done for Jeanette. I never know quite how to respond to such conversations - the precious little girl died, after all, what did we really do to help her? 

The translation of Jeanette’s Kirundi name is “I believe God.” And the faith of her mother who chose that name for her was very evident. Even in the midst of her tears of grief, she believed. And in observing her faith, I was reminded of God’s presence as well - even in the valley of the shadow of death. God is indeed the refuge and strength, an ever present help in trouble, for the families of the four young patients we lost at the hospital this weekend and for us as well. This world is broken and it’s not supposed to be this way. But it won’t be this way forever. And God gives more grace. “Jesus loves the little children…” and I’m thankful to know them and love them, too, in His strength. 

I close with one of our team’s favorite quotes which we’ve certainly shared here before but is apropos now:

"What about when the boy is not healed? When, listened to or not listened to, the prayer goes unanswered? Who knows? Just keep praying, Jesus says. Remember the sleepy friend, the crooked judge. Even if the boy dies, keep on beating the path to God's door, because the one thing you can be sure of is that down the path you beat with even your most half-cocked and halting prayer the God you call upon will finally come, and even if he does not bring you the answer you want, he will bring you himself. And maybe at the secret heart of all our prayers that is what we are really praying for.”                                          -Frederick Buechner

On Thievery and Treasures on Earth

(from Eric)

Two weeks ago, I was feeling like I had begun to get back on my feet.  Things had been going fine, but re-entering life at the hospital and the university after nine months away definitely left me with the impression of needing to dig myself out a bit.  There is just no escaping the accumulation of things that are waiting for you after such a period of time.

But it was going well.  I had just given a lecture that I thought went off well.  And now I was heading down to join everyone for a Chinese New Year party, where Grace was making dumplings, which are certainly a rare treat here in Burundi.  Rare and yummy.  I got there a bit early, and so I sat down and opened my laptop up (I had it with me since I came right from the lecture).  I put the finishing touches on a first draft of a new educational program and was quite satisfied with how it was turning out.

We had some dumplings (I might have had more than "some"), and then as it was getting dusk, we walked out to the field next to the church.  Our schoolteacher had miraculously procured a bunch of Chinese paper lanterns, and so for the next fifteen minutes, we were helping the kids get them lit and watch them sail off into the quickly darkening equatorial sky.  Of course, there was the usual gaggle of young male onlookers, especially since we were doing something so conspicuously odd.

When we were done, we said goodnight to the observers, and headed home.  About three minutes later, as I was carrying a tired Toby in our front door, it hit me.

I had set my computer down to help with a lantern and left it there.

I sprinted back, searching with my flashlight.  The computer was gone, and so were the gaggle of young strangers.  A swift multi-person search into the nearby area ensued, the local police took some details, and our good Burundian friend (who thought he had recognized a couple of those guys passing by) headed out into the dark hills to try and ask around.

It was my 6-month old MacBook Pro.  It is password-protected, with no power cable, and about 20% battery life.  I can't imagine what a rural Burundian is going to do with it (especially since Macs are utterly unknown in this country).  I offered a substantial reward.  Many friends were searching the hills for signs of its whereabouts.  It was even announced in church.

Two weeks later, there is no sign of it.

Coping with this has been a multi-faceted experience.  First, there are the logistics.  It's a substantial financial hit.  But we'll live.  I thankfully had a back-up from three weeks prior, but still I had done a lot in those three weeks, and I am still annoyed by discovering yet another document that isn't on the back-up.  It will be several months before I can get a new computer (though I'm borrowing an extra).

It was hard for a couple days to walk around and wonder at the people I was seeing.  Was this unknown young man the guy who took my computer?  Does he know who did?  It's not a very fruitful lens for the world around us that we are called to sacrificially love and serve.

One of our teammates' first concerns was that, if they caught this guy, he wouldn't be subject to undue punishment.  It's not impossible that local village punishment could result in him never being able to physically take anything ever again.  So, we pray for our enemies.  We pray for their repentance.

In a certain sense, I don't really blame whoever took it.  These folks almost invariably live on the brink of poverty and even starvation.  I am obviously wealthy.  The rich white doctor can buy a new computer (and in fact, I can.)  They might be able to easily sell this for (if they knew it's worth) three years of the average Burundian GDP per capita.  I doubt he went out that night with an intention to steal.  He didn't break into anyone's house.  He just seized an opportunity afforded by my mistake and distraction.

On the other hand, it's stealing.  It's not good for him, any more than it is for me.  And if he would do it to me, he might also do it to others, and those other people might suffer a lot more from it.  I've thought about this in the very gracious response from my Burundian friends.  They have really exerted themselves to try and find this computer.  I think that is because they care about me and value the work I do.  But also I think they don't like the idea of someone in their neighborhood who is willing to steal valuable things from other people when the opportunity arises.

In the end, there is trust.  God, I believe you have called me here to do this work.  Why have it hampered in such an unjust way?  I don't know.  When we don't know, we are called to trust.  Called to consider the possibility that there could be a reason beyond what we can figure out.  At the very least, we are called to keep going despite the setback, trusting enough to release whatever hesitations and unforgiveness are in our hearts.

"Do not lay up for yourselves treasures on earth, where moth and rust destroy and where thieves break in and steal, but lay up for yourselves treasures in heaven, where neither moth nor rust destroys and where thieves do not break in and steal.  For where your treasure is, there you heart will be also."  Matthew 6:19-20 

Farewell, First Students!

by Rachel

About 25 months ago, we started work at Kibuye Hope Hospital for the first time.  Looking back, I’m pretty sure I didn’t have much of a clue what I was doing.  I didn’t know where to find things, how to get things done, who anyone was...and certainly not how to educate medical students in French.  But, despite that, one week after our start date at Kibuye, our first medical students arrived.  This was their very first clinical rotation.  Many didn’t know how to use a stethoscope, and when I asked if they had questions they wondered if I could teach them how to take a blood pressure.  I didn’t know how to say 50% of what I needed to say and when I’d try out a new medical term, they had no idea if it was a real word or not!  It was so, so basic.  I think those first three months we learned a lot from each other.  And at the end of their time with us, it was fun to see how much they had grown and learned.  I guess I had grown and learned a lot as well.

Fast forward two years, and this past week the same class was saying goodbye to Kibuye.  They came up once in 2015 as well (Eric and I were in the US though and missed seeing them) and now were spending their last 3 month block at Kibuye.  It was a pleasure to see students again and remember names.  It was nice to watch them care for patients in a competent manner and complete tasks they couldn’t have 2 years ago.  The longitudinal education we can provide here is actually really encouraging for me.  

The students threw us a goodbye/thank you party as they got ready to leave on Wednesday night.  They’re heading back to Bujumbura for the last 11 months before graduation, finishing classes and rotations, developing research projects, writing and defending theses, before hopefully graduating this December.  We enjoyed a delicious meal, kind speeches, lots of pictures, and several fun musical numbers performed by the class.  In my experience, Africans seem to do a good job “appreciating” people, and we felt very appreciated.

I am excited to see where this class goes in the next years.  It would be great to welcome some back to Kibuye as interns or doctors.  They will always have a special place in my heart as our very first HAU class.