International Women's Day

by Rachel

This post is a little late in coming, but March 8th was International Women's Day (thanks for the reminder, Facebook).  I actually had a patient that day wearing a traditional Burundian dress made out of fabric that featured the words "mars 8" and "la journee internationale des femmes."   I don't think that in the past, I would have paid all that much attention to a day celebrating women.  In my own life growing up, I didn't see that there was all that much gender inequality in the world.  I was able to get into the schools I wanted, the profession I wanted, the job I wanted.  I was able to choose marriage to someone I loved, decide when to have children and how many.  I knew (know) a lot of fantastic women doing a lot of amazing things, so I supposed a day celebrating women was fine.

Then I started living and working overseas, and the idea of International Women's Day has taken on a whole new meaning.  I wrote a post on March 8 expressing my feelings of the day:

March 8 = International Women's Day. Hooray! So glad that I chose to be an OB-GYN 12 yrs ago. At the time I had no idea how perfect this field is for impacting the lives of women around the globe. I am privileged to work with women who have had no advantages yet remain resilient and strong the in face of much adversity and heartache, and I pray that I am bringing hope into their worlds. I wait and work for the day when women won't have to worry about finding food to feed their families, they won't have to bury their children due to preventable diseases, and they won't have to fear childbirth as a likely cause of death. Today I celebrated by helping a woman get pregnant, preventing a woman from getting pregnant 

smile emoticonstopping a postpartum hemorrhage, diagnosing a tubal pregnancy, and delivering a healthy screaming baby. Some days I love this job.

As so often is the case, though, there are many ups and downs in this work.  Several days later I came home dejected and defeated.  The lady with the tubal pregnancy had gone home before her surgery because her husband refused to allow it.  He was too concerned with the potential decrease to her future fertility to understand that she could most likely die if left untreated.  Another lady requested a tubal ligation during her 5th C-section (this time for two dead babies) and the staff strongly advised against my performing it, since her husband wasn't there to give consent.  A third patient came in with a bad infection months after a C-section, and told me her husband had already left her because of the chronically draining pus.  And then later that day, I walked in to the OR to find Jason debriding burned skin off of a little 9 year old girl whose father had pushed her into a cooking fire because he was trying to beat her mother, and she was standing in the way.  

Oh, the stories that we see and hear.  It is amazing that these women will continue to get up and go back to their homes and keep living.  Keep caring for their families.  Keep toiling in their fields.  And even, sometimes, keep smiling.  And I'm realizing that International Women's Day isn't just a day to celebrate women, although we should.  And it's not even just a day to talk about equal opportunities in the workplace and increased salaries for working women.  It's a day to look around at the world, to see where women have been overlooked, abused, taken advantage of, beaten down, and to try to do something about that.  To try to ensure that they receive basic human rights.  To offer love and prayers and hope that it won't always be this way.  It's hard to fathom that somewhere between 1 in 16 and 1 in 20 women here in Burundi will die because of a complication of pregnancy and/or childbirth.  How is that even possible in 2016?  How are we allowing that to happen in this day and age?  I wish I had a good conclusion to these thoughts.  I do know that God sees every woman and her pain and heartache.  And I pray that He would give us the desire and the courage to see those women too, and to work for change both in our own lives and also globally.  Perhaps we will see that in our lifetime.

Depth of Mystery: A Tale of Two Patients

(from Eric)

A couple weeks ago, the morning report of overnight admissions informed me that we had admitted a 75-year old lady with malaria.  The severity of the illness had taken its toll on her.  Her blood pressure was low and she was quite agitated and "talking crazy" (to attempt a translation of the French).  These were all very bad signs.  Her husband had been admitted the same night, at the age of 82, also with bad malaria, but he was looking even worse.

They were placed in two different rooms, across the hall from each other.  The next day, the husband passed away.  In the other room, his now widow had regained her rightful mind, but had become acutely short of breath, and so was placed on one of our precious oxygen canisters.  Her children had not told her about her husband's death, afraid that it would cause her to lose hope.  I told the students that it reminded me of the story of King David and Bathsheba's first son, which remains incredibly realistic after 2500 years.

***

There is a third room in that hallway, one that I always jokingly refer to as the "Ward of Darkness", due to its utter lack of windows and our frequent power outages.  The same days that I was seeing this struggling, frail widow, a new lady came into the "Ward of Darkness".  She was thirty-one years old, and had delivered a baby three weeks before.  She started having trouble breathing, and the local health center referred her quickly to us.

Unlike most of our patients, she looked strong, well-fed, and healthy.  But something had gone wrong, and she was now floridly infected with something.  Her temperature soared and her blood pressure dropped.  We started her on antibiotics and lots of IV fluids.  The next day, we did some more tests, and broadened her medicines.  Nothing would bring her fever down.  Her newborn baby would lay on the bed, nursing from her mother, who didn't have the strength to rise and whose milk supply was rapidly diminishing.  Her husband stayed by her bedside and carried their newborn around.

We talked some more, and considered every diagnosis we could treat.  We treated her in the face of negative tests.  My student (also a mother of four) was worried for the baby.  We examined the baby, ran a couple tests on him, and Alyssa donated a tin of baby formula.  The next day, the mother died.

***

The widow survived.  She slowly got off her oxygen, and I remember her last day as she smiled at me, greeting me and shaking my hand with both of hers.

It was all very juxtaposed.  The young healthy mother, with a family and a newborn.  She falls away while this elderly widow beats the odds once again to go home.  Why would this happen?

But then again, this family had just lost a father, and though ancient by Burundian standards they might be, they were spared the tragedy of losing their mother in the same week.

***

These things are just utterly impossible to weigh out.  And yet I try.  I try to make some kind of sense of them by looking at them from different angles, trying to see how the light is outweighing the darkness, and my only conclusion is that I will never see deep enough into the mystery of the manifold world to be able to make a call one way or another.  Who knows?  Who knows what just happened here?  We tried.  There was great sorrow and there was some great joy and some moments of great beauty.  But what is the sum of it all?  Any pretense on my part to be empiric in one judgement or another would be foolish.  Who knows?

***

About a week later, we were in morning prayer for the hospital staff.  What this means normally is that I do my best to understand the rapid-fire Kirundi and consider it a success if I can grasp the Bible passage we are reading, and then I try and think about it on my own, since I don't have much chance of catching the speaker's conclusions.

We read from Isaiah chapter six.  It's a classic missionary motivation text.  Isaiah has a vision of the glory of God's throne room, and he hears God ask "Whom shall I send, and who will go for us?" and of course, Isaiah says "Here am I!  Send me."

But for the first time, I was struck by what immediately follows:  "Go, and say to this people:  'Keep on hearing, but do not understand; keep on seeing, but do not perceive.'  Make the heart of this people dull, and their ears heavy, and blind their eyes... until cities lie waste without inhabitant, and houses without people, and the land is a desolate waste."

It seems incredibly incongruous.  Was this what he was signing up for?  Why would he do that?  However, if Isaiah was surprised, he gives no indication of being so.  Maybe he had been surprised one too many times already.  Or, maybe he had seen the Lord, and what exactly he was going to be doing was not as important to him as the one that had commissioned him.

Don't misunderstand me.  I believe that God is doing a good work, better than we could dream.  Sometimes I can see it with my own eyes, and sometimes I have to cling to it, remembering evidences of past goodness.  Maybe I even have to cling to it in order to see it with my own eyes.

But I cannot grasp it.  I cannot anticipate it all.  My concepts of what is just and unjust will always continue to move me to action, but I also recognize their limits.

What are we doing?  Where are we going?  God knows.  If that was all we had, it would be enough.

Falls of Beauty, Flash of Terror

By John Cropsey

It was a beautiful Sunday morning after church when our escapade began last weekend.  A group of us from Kibuye decided it would be a perfect day to confirm the existence of a set of hot springs and a mysterious waterfall a few of our teammates had supposedly visited a couple months back an hour south of the southern most source of the Nile.

The journey there was an adventure all in itself as it took us nearly 3.5 hours of searching beautiful hills and valleys in our team 4x4 on two tracks.  Let’s just say the road leading to the falls was a bit difficult to pin down on a map and had some questionable bridges along the way.  The thought did enter my mind that perhaps one of our devious teammates had sent us on a wild goose chase.

After nearly giving up several times, we did finally arrive at our destination.  We decided to head straight for the falls, a 10 minute hike from the hot springs into the mountains by foot.  There was a brief shower we had to wait out and then the sun came beaming through fluffy white clouds and brilliant blue skies. 

Just around a bend in the valley, our eyes were spoiled silly by the sight of a beautiful 300 foot waterfall tucked away in the side of the valley.

It was a perfect day.  I had our three kids with another nine adults pitching in for Jessica’s absence. 

Happy Dad on an adventure with his kiddos.

That’s a better than a 3-1 adult-kid ratio, so what could possibly go wrong?

We enjoyed a picturesque picnic and a polar bear swim down at the foot of the falls.

That’s when our beautiful weather quickly changed.  An impressive tropical thunderstorm rolled over the mountain and we all huddled under the overhanging cliffs at the base of the falls as lightening flashed and the rains came down hard.  The shelter wasn’t great and we were all soaked to the bone by the cold, mountain rain,  but it didn't seem like a good idea to venture back out onto the bare face of the mountain given all the lightening.   As soon as the storm began to let up, one of our stellar interns, Lauren, wisely suggested we get going ASAP.  We agreed and began packing up our drenched picnic as the storm moved south.

Most of the team had now crossed the stream at the base of the waterfall and were headed up the edge of the gorge.  Mrs. Caitlin, Elise (my daughter) and I were still on a big, flat rock in the middle of the stream at the base of the falls where the picnic had taken place.  Caitlin was about to help Elise put her shoes on, and I had just finished closing up the picnic bags which also had our valuables inside (wallet, 4x4 keys, dry clothes for kids etc) when we heard it — a deep rumble like a freight train coming towards us up in the mountains.  We immediately knew our lives were in grave danger.  

I screamed “GET OUT!!!  GET OUT!!!”  As I peered back above my shoulder, I saw a roaring mass of water descending upon us from on high.  I won’t tell you what my next word was.  As there was no option for escape, I felt frozen as my mind futilely analyzed the best course of action.  In reality, it was less than a two second pause per a teammate who was watching this all take place before his eyes from the gorge's edge higher up.  

I snatched up Elise into my arms and jumped off our rock into the stream in what was looking to be a futile attempt to reach high ground before we were crushed by the power of a flash flood coming straight at us off a massive mountain.  I thought it was the end for us.

Waterfall just before storm.

Waterfall shortly after flash flood hit (note people down at stream between trees looking for us)

I’m not really sure when the torrent hit us.  All I remember is my brain telling my legs to sprint as fast as they could to save my daughter’s life, but instead of sprinting, all they did was slip and stumble with Elise’s head going under water again and again as I tried to keep us upright and make progress to the steep bank of the gorge as the flood waters whisked us away.  As Elise first recounted it, "Daddy pushed me off the rock and then kept dunking me under water."

Miraculously, we did make it to the bank.  I threw Elise up into the vegetation as high as I could and yelled at her “CLIMB, CLIMB, CLIMB!!!”  Climb she did, like a mountain goat.  As I attempted to get out myself, she scampered up the steep slope and didn’t stop.  As I crawled/climbed to the footpath via our "shortcut", all I could think about was, “Where are my boys”?  But by now Elise was continuing her rapid summit of the mountain and I had to stop her, so I could search for the boys.  I yelled “STOP ELISE!” over and over until she finally turned around and saw me yelling for her over the deafening roar of the falls.  

As I attempted to gather myself to find the boys, someone shouted to me from further down the path that the boys were safe.  I collapsed face down on the spot.  As I neared passing out with relief that the kids were safe, someone yelled up the path to me to come right away, “Katie is stuck in the river.  We need your help!”  My head was spinning and my hearing was going in and out, but I scrambled to my feet and struggled down the path back to the raging water’s edge.  

There was poor Katie, center stream, clinging to a boulder at the brink of being overtaken by the unpredictable torrent.  The pounding mists of the falls lashed at her relentlessly.  She was only about fifteen feet from us, but any attempt to enter the water would have been rewarded with certain disaster.  Gad, her valiant husband, began accosting nearby trees with his bare hands and a rock in order to try to reach her from the bank with a tree trunk.  While he did successfully bludgeon down several, they were not sufficient to attempt a safe rescue.   

We were helpless to save her.  So we prayed.  We prayed the flood waters would let up rather than intensify.  The other ladies maintained eye contact with Katie nearly the entire time and tried to keep us guys from attempting something foolish.  Note, my kids were appropriately "crying their brains out" (per Micah as he initially thought Daddy and Elise had died and now all feared for the life of Mrs. Caitlin).   Thanks to everyone who hugged, consoled and prayed with them as we sought a way to reach Caitlin.

The rains stopped, and we felt time might be on our side for the moment, but we couldn’t know for sure.  We had a contingency plan to attempt a rescue by bending down a branch of an overhanging tree with our body weight if things deteriorated rapidly.  

After thirty minutes of extreme intensity pouring over every possible way to rescue Caitlin, we felt the waters were letting up a bit.  One of our visitors, Hans Peter, convinced us to let him attempt a rescue by fording the stream about thirty feet up-stream from Katie using a vine hanging down from a tree as his safety cord.  It worked and he was able to bring Katie to the bank retracing the same route. 

At this point, everyone was out of immediate danger, but now we had to get to shelter.  That was complicated by the fact that the flash flood now lay between us and our vehicle, and the keys had been swept downstream as I had to let go of the picnic bags in order to have any attempt at survival.  In the mean time, we did successfully get a call out for help.  So the brothers Fader were on their way from Kibuye with warm clothes and the spare set of 4x4 keys.

Given there was a sharp bend in the river downstream in the valley, we decided to send out our two visiting eye docs on a recovery expedition, but with little to no hope.  Long story short, these eagle scouts not only found the 4x4 keys and my wallet, but several other Cropsey articles of clothing strung along bushes at the high water mark including Elise’s “favorite” shirt.

As the waters receded and another storm began to threaten, we successfully forded the once tiny stream using a human chain and booked it to the 4x4.  After being in the cold water, rain and wind, it felt so good to get inside as the rain began to fall again.

There was much rejoicing and thanksgiving as we headed for home and met up with the Fader brothers 15 minutes into the journey.  The adventure didn’t end quite so quick however as our rescuer’s vehicle broke down briefly on the way out and then we came upon the scene of a head-on accident between a motorcycle and a pick-up truck.  

We were so glad to arrive home just 30 minutes after nightfall.  Everyone was alive and well with a few of us nursing some nice cuts and bruises from our ride in the flash flood.  Our prayers had been answered.

  

      

Third Time's a Charm...I Think

by Jess Cropsey

If you are a regular reader of our blog, you’ll know that I’ve made several attempts to intentionally give our kids opportunities to interact with Burundian kids.  This is easier said than done believe it or not and the North American bubble that we often live in can be challenging to burst!  At the beginning of the school year, we tried taking our kids once a week to the local elementary school for a French or Kirundi class.  I wouldn’t say it was a home run success and it certainly didn’t foster relationships with other Burundians like we had hoped (either because interacting was just not part of the class and/or because our kids were all sitting together in the back row).  

Sometime in mid-December I starting mulling around the idea of a bilingual class (English-Kirundi) once a week that was comprised of our “bazungu” kids and Burundian kids.  After some thought and discussion, we decided to drop the weekly visits to the local school and give this a whirl.  We started in mid-January and have had about 6 classes so far.  The Burundian kids were chosen from the local community and I personally know each of their parents.  These kids all live right at Kibuye (with one exception), their parents work for the hospital or the school, and they all attend our local church.  We have roughly equal numbers of bazungu & barundi, with ages and genders matched to some degree.  Here are 6 of the 9 Burundian kids who are part of the class, enjoying a take-home balloon on that particular day.     

The primary purpose of the class is to encourage cross-cultural relationships in an environment that is a little less intimidating [at least for our kids], with some structure, but a limited number of kids.  The secondary purpose is for the kids to soak up as much of the second language as possible (English for the Burundians & Kirundi for our kids).  

I recruited Thérèse, the lady who has been helping teach Kirundi to our kids, to co-teach the class with me.  It’s a great opportunity for all of the kids to function in both a teacher and learner role as they help each other with language.  Here’s Micah & Bryce taking turns giving each other instructions about how to dress the doll.  

Playing a little Twister & Candy Land to practice our colors.

While I feel very unqualified to be doing this, it’s been fun and challenging to plan for this class and so far it has gone pretty well.  Outside the classroom we’ve had some discouraging moments of…

Me:  “Hey, that’s ____.  They’re in your bilingual class, remember?”  

Kid:  “Really?  She looks different here at church.”  

Me:  Sigh.

But we’ve also had some great moments of others seeing a particular kid while they’re out & about and saying, “Hey, that’s so-and-so!” followed by a greeting.  Or, "Hey they're playing that game [with the bricks and ball that we learned together in class]!".  Warms my heart and gives me hope to keep trying.  :)  

While I know there's no perfect solution, perhaps this third attempt is the closest yet in enabling our kids to develop relationships with kids from very different linguistic & cultural backgrounds.  Pray that we'll be able to love these kids well despite our limited ability to communicate and that they'll form a special bond with each other.