Underqualified

(by Greg)

Since our return to Burundi, I have been slowly coming to terms with another one of my phobias.  I have a fear of children.  Not all children.  I am not afraid of my children, or really most children.  But as a child is brought into the operating room, my perspective on them changes immediately from “cute and cuddly” to “instrument of terror”.  Why is this?  

For the past 10 years, as an anesthesiologist in private practice in the U.S., I have become quite comfortable taking care of adult patients in the operating room, even very sick ones.  But my time spent taking care of children in the OR has grown more and more sparse.  There is a growing movement in the US to stop taking care of pediatric surgical needs at community hospitals and instead to transfer them to a children’s hospital, where they can be taken care of by a pediatric surgeon, a pediatric anesthesiologist, nurses and techs who take care of children every day.  In fact, research has now demonstrated that children, especially those under the age of 2, have better outcomes at hospitals that specialize in pediatric care.  The result has been that in the US, I rarely anesthetize children, and almost NEVER children under the age of 2.  

It turns out there are a lot of ways you can damage or even kill a very small child during surgery and anesthesia.  These include medication errors, dosing errors, airway mismanagement, even temperature management.  And so you can imagine my, let's just say discomfort upon my return to Kibuye, where I am presented almost daily with children who need to be anesthetized.  There is no pediatric hospital in Burundi.  My suggestion on day one to transfer a sick child to a “tertiary care center” (specialty hospital) was met with stares of confusion and awkward silence.

On Monday this week, I entered the OR to find that we had scheduled a 2 day old, followed by a 3 day old, followed by a 21 day old, all needing emergent bowel surgery under general anesthesia.  Pretty much a full on nightmare from my point of view.  

Some people with whom I have spoken over the past several years have suggested that if you are not qualified to do something in Africa, you should not do it.  I understand their perspective from a theoretical standpoint.  However, from a practical standpoint, if we do not offer surgery to these children at Kibuye, they will most certainly die.  So, when does one go from being “underqualified” to “disqualified”?  Is it simply a numbers game?  If half of your patients are surviving, should you keep going?  I can tell you that this week has led me to seriously consider going back to the US to do a year long fellowship in pediatric anesthesia.  But even that would likely mean hundreds of kids left without an anesthesiologist for a year.  

Thankfully, all three of our tiny patients on Monday survived surgery.  I am not sure they will all recover completely, but for now, they are alive and awake.  Their anesthesia was not perfect, but they survived.  I prayed for each of them.  I can only thank God for the fact that they survived.  For ultimately it is God who holds their lives in His hands, and uses those of us who are far too underqualified.  

A Forest, A Flood, and an Unlikely Star

by Rachel

This month marks the release of Jennifer Myhre’s 3rd book in the Rwendigo Tales chronicles.  Our family has already read and loved the first two books in the series, “A Chameleon, A Boy, and a Quest” and “A Bird, a Girl, and a Rescue”, and I was really excited to read her newest book, “A Forest, A Flood, and an Unlikely Star”, which might be my favorite one yet.  

What do I like about these books?  I think they show a real side of Africa, presented by someone who has lived here and loved the land and the people.  So often, the only side of African life that is presented in the news, books, or movies is broken, desolate, impoverished, and hungry.  And, truthfully, the countries where we live ARE those things.  But those of us who live here know another side of Africa, too.  Incredible beauty, amazing perseverance, community, joy, love.  Jennifer’s stories capture that.  They are set in Uganda, but the language and culture is similar enough that my kids love seeing “their home” in the stories as well.  In this book, a young boy named Kusiima is caring for his grandmother and young sister, who is severely malnourished and developmentally delayed.  His mother has died, his father has abandoned them.  Kusiima gets mixed up into a tale of “forest poachers” and gorillas and has to make difficult choices about what it means to do the right thing, how to love, how to forgive.  There are no talking animals like in other stories, but still an element of the mystical in the friendship Kusiima forms with a homely donkey.

As always, Jennifer is able to weave the story in a realistic but hopeful way—these countries that we love are broken, full of broken people and tragic stories, full of AIDS and war and injustice.  BUT, and this is an important but, there is always redemption.  There is always hope.  These is always God working for His people.  Towards the end of the book, Kusiima is told: 

“All of my struggles and all that you’ve suffered because of me and this broken world, well, they are all a part of our story. They always will be. But they aren’t the end of our story.” 

And because the struggles are not the end of the story, Kusiima can keep going.  He can keep forgiving.  We can keep working.  Those of you who know Jennifer know that she is not just an author whose book I am reviewing—she’s my area director for Serge.  And I’m not just writing a good review for her book because of that.  I can tell you in all honesty that she writes these books from personal experience in multiple hospitals and countries around East Africa.  To her, to us, this is not just a made up story of a fictional child, but this is a story that could represent many people we know.  And, bonus, part of the proceeds from this book go to a fund to benefit kids just like Kusiima, living and working in hope and tragedy, working for a better life and a better world.  If you want to buy a copy, check it out here and here.

Short Term

While we do have many visitors who stay for a few weeks or a few months, in missionary terms 2 years is still considered short term. There was a time when I may have questioned that definition but, now that I'm coming to the end of that term in Kibuye, I affirm it wholeheartedly.  I've heard it said that when living in a new culture you learn 1% of that culture each year. In those terms I'll leave with a 2% comprehension of Burundian culture, which sounds about right.

Over the last 2 years our team has regularly been blessed with new teammates and visitors and each come in with new perspectives and new inquiries that remind me anew how little I truly understand.. I know the general expectations at the hospital and at most events and ceremonies - staff meetings, church services, dowry ceremonies, weddings - but on many occasions realize I have come to accept my limited understanding without questioning. This culture is so different from the one I grew up in that it can generally be expected that any assumptions I make based on my world view will be wrong. How this culture functions on a societal level is completely fascinating and incomprehensible to me.

Here are just a few glimpses into my 2% of understanding:

morning staff devotionals

There are devotional books used on most mornings which involve reading a portion of Scripture, reading an explanatory paragraph, and answering some designated questions.
It took me an embarrassingly long time to understand this process and I still don't understand anything that is being said..
(I shouldn't say nothing, sometimes I'll pick up that someone said the number 6 or some other obviously crucial word)

wedding

I have been to many, many Burundian weddings. It usually involves a choir singing, a sermon, someone to throw confetti at the bride and groom, some sitting/standing/kneeling on a pillow, many amateur photographers (the couple holds their hands in the air when they put the rings on, I assume so everyone can see over the heads of said amateur photographers), paper decorations, and very somber expressions. I follow the basic pattern of when to sit, stand, pray, give the offering, and present gifts but, because of our team guideline of returning to the compound before dark I rarely make it to the reception so there are many more traditions I could be confused about.

women's day celebration

Last year I had the privilege of attending the local celebration of International Women's Day. It involved a parade, signs, singing, speeches and dancing. The only speech that was translated for me seemed to be something about calling women to be perfect but, who knows what was really being said or how it was to be understood. Overall everyone appeared to have a great time. When I asked why our group from the hospital didn't have a sign in the parade they said 'we have you!', it's always nice to feel noticed I guess..

There and back again

(from Eric):  

A couple months ago, with heavy hearts, the Baskin family, in collaboration with team and Serge leaders, decided that God was calling their family back to the United States for the foreseeable future.  This has meant major transition for their family and significant loss for both Kibuye Hope Hospital and the Serge Kibuye Team.  I am very grateful that they have been willing to share from their hearts during this transition.  Please continue to pray for their family in this new phase, and our team as we feel their absence.

***

(by Darrell)

For I know the plans I have for you.  

In light of the changes my family has seen this summer, I have often reflected on this declaration and on one of its corollaries, namely that Darrell Baskin does not know the plans God has for him. If I had, I might have assailed their logic and questioned their cost. A price precious both in sacrifice and treasure.

After over a year of language training in France and then following nearly a year of learning to live in Burundi, my family returned to the US this summer in order to seek healing in mind and body.  But now we know that it wasn't just for the summer, it's for the foreseeable future.

For I know the plans I have for you, declares the Lord, plans for welfare and not for evil. 

And now I ask, do I trust Him and His plans now that they no longer align with the dream He once instilled in our hearts?  Now that I have returned for a week to pack up our beautiful house in Burundi. Now that my children have wept and sought solace in their pillows upon seeing videos of their friends who remain at Kibuye.  Now that I’ve seen the patients I can no longer care for and the eye staff who have been saddened by my absence. Now that I walk a lonely and poorly understood road few, if any, of my peers have ever traveled.  I find myself asking if this is what welfare should look like.

...to give you a future and a hope. 

My future, for now, is in the US where I see friends, churches and people who supported us, and I respond to them sometimes with joy, sometimes with sorrow, sometimes with shame and grief over this nearly insurmountable loss.  At times, it has been a loss of calling, even identity.

Then you will call upon me and come and pray to me, and I will hear you. You will seek me and find me, when you seek me with all your heart.

In our grief and wrestling, we have turned, over and over, to the Lord. And He has heard us.  He has met us in our place of need. We don't have all, maybe not even a few, of the answers for why we're here now, but we remain steadfast in our belief that He alone brought us to this place.  We never would have chosen this convoluted path on our own. Someone asked me last week how I would proceed if I were to have a chance to do it all over again.  My response then was that I would obey God again and follow His direction even if it seemed counterproductive or confusing or wasteful.

When I was a teenager, my mom once told me that Abraham was obeying God when he took Isaac up the mountain to sacrifice him. And he was obeying God when he sacrificed the ram instead of his son. If Abraham had stubbornly held on to the original plan from the Lord to its final conclusion, he would have actually disobeyed God and missed the whole point of walking with God in a dynamic relationship. Even more, would it have been faith if Abraham knew what was going to ultimately take place?

I can't pretend to know the plans God has in store for us, but I do know the One that has engraved me on the palms of His hands.  I know the One who went with us to France, then to Burundi and now back to Texas.  I am convinced that He will never leave us or forsake us.  And He is enough for me and my family.

Crate Fate

(From Caleb)

It is a significant challenge to utilize every cubic inch inside a 40-foot container destined for Burundi.  Since the initial McCropders arrived in country we have received a total of 5 containers full of medical equipment and supplies, tools for construction, a hammer mill for making Busoma flour, school supplies and many other items essential to the work here.  Of course, we have added some things not so essential to the work exactly, but very helpful for our mental health such as hammocks, motorcycles, and some super-sized jugs of Chipotle Tabasco sauce.

When shipping a 40-foot container the cost is not dependent on the total weight of the container as long as it is under 40,000lbs.  Thus it is the most cost effective to stuff it as full as possible.  One of the most efficient ways of doing this is through the use of crates.  More than 5 years ago, Jason and Heather hosted the first crate building party.  Since then a few similar ‘parties’ have ensued.  The magic of the crate is three-fold: they allow a container to be loaded and unloaded fairly quickly, they protect the items packed inside, and you can pack on top of them thus filling the container to the very brim. 

So what happens to all of this precious dimensional lumber (otherwise not available in Burundi) when the container arrives and the crates are disemboweled? Below are some examples of how these crates will live out their years here at Kibuye:

First Generation Incubators

Eye Unit Operating Tables

Sterile Instrument Storage for ORs

Stand for Vital Signs Monitor

Daily Surgical Line-up Board

Steps for certain 'Vertically-Challenged' Kibuye Surgeons

Stands for positioning a leg during SIGN-Nail Procedures

IT-Closet

Shop Bench

Mega-Desk

Food-Dehydrator 

Lofted Bed with Desk

Baby Bassinet Holder

Baby-Gate