Ruminations of an Asian American in Burundi

by Ted

Disclaimer: These thoughts are based on personal experiences working as a Korean-American surgeon in rural Burundi and do not represent all other Asian Americans serving as missionaries in Africa.

According to the UN Department of Economic and Social Affairs 2015 report on migrant populations, there were an estimated 46 million people living in the US as foreign-born inhabitants. This represents about 15% of the total current population of the US, and about 20% of the world’s foreign-born population.

Not surprisingly, the US is one of the most ethno-cultural linguistically diverse countries in the world. My parents fall in this category of foreign-born inhabitants, as they immigrated from South Korea to the US in the 1980s. I was born and raised in southern California, where there is a non-white majority (not typical for most of the US). My high school had 3000 students, more than half of whom identified as being from an Asian ethnic background. My wife, Eunice, is also Korean-American and also grew up in southern California, though in a different part, and shares a similar growing-up experience. Racial and ethnic diversity was a common subject of discussion in school and college growing up, and while I thought often about my Korean-American identity, it is interesting that living in Burundi brings it to the forefront of my thoughts regularly.

In Burundi, according to the same UN report, there are an estimated 250,000 inhabitants who were born in another country, representing 2.5% of the country’s total population. While I don’t have the data to support this hypothesis, I suspect that most of the 2.5% are from other African countries. I mention this only to highlight the homogeneity of the vast majority of the country. If you are not Burundian (or African), you stand out, accentuated all the more when you live outside of Bujumbura.  

As far as Asians in Burundi are concerned, there are many Chinese construction workers as well as a handful of Korean family units, almost all of whom are living in Bujumbura. At least to our knowledge, our family is the only one of Asian descent at Kibuye and distinctly the only Korean-American one in the entire country (note: if you are reading this and happen to be a Korean-American living in Burundi, we would love to meet you!).

As you can imagine, there are many moments in my daily life where my Asian-ness is made more apparent and where certain pre-conceived notions are revealed. For example, I am greeted nearly every day on the walk to or from the hospital (or even at the hospital) by a local Burundian with a “ni hao,” which is a greeting in Chinese. Perhaps they are assuming I’m Chinese because if you are Asian in Burundi, you are most likely Chinese. It is usually said in a friendly tone, and I recognize that they are trying to connect with me, albeit under an incorrect assumption. For comparison, in the US, if a stranger came up to me and said the same thing, I would probably be offended. Some days, I will say “ni hao” cheerfully back to them, usually getting them to laugh or giggle, but perhaps also reinforcing the misconception that I am Asian and therefore must speak Chinese. Other days, I might continue walking on, pretending like I didn’t hear them, or if I have the energy, take a moment to explain to them in my broken Kirundi, “No, I am not Chinese. I am Korean.” Or maybe I should be telling them I’m Korean-American. In either case, explaining this to every person that says “ni hao” would be exhausting.

Another question that I get asked from time to time is “Where are you from?” I typically respond with “I am from the US.” More often than not, there will be a puzzled look on their face, with the follow-up question of, “Yes, but where are you REALLY from?” To this, I will usually respond with, “My parents are from South Korea, but I was born and raised in the US.” And that usually brings a cathartic “Ohhh, now I understand.” Not infrequently, I reflect on my reactions and emotions stirred up by these situations, which is usually a mix of amusement, disbelief (ie Did that just happen?), frustration, and/or irritation. Is it because I am being misunderstood or pre-judged based on my appearance? Is it because of racial stereotyping or cultural ignorance? Perhaps it’s an unrealistic expectation that a Burundian (or anyone else, for that matter) know whether I’m Chinese, Filipino, Japanese, or Korean?

Food and cooking bring up other slight differences in our home life. For example, there are certain items that we use regularly in meal preparations, many of which we brought with us from the US: rice cooker, soy sauce, sesame oil, red chili paste (gochujang), ground red chili pepper (gochugaru), soybean paste, nori, roasted seaweed, dried seaweed for soup, curry sauce mix, etc. We don’t eat Korean food every day, but we enjoy it and eat it regularly according to the availability of our limited supply ingredients. Eunice has even figured out a way to make a version of kimchi (spicy pickled cabbage), which is a staple in all Korean homes. With kimchi, we’ve now opened the doors to a whole new world: kimchi stew, kimchi pancake, kimchi fried rice!

Then there is the subject of our boys (ages 4 and 2), who are 3rd generation Korean-Americans living in rural Burundi where Kirundi and French are the two most common spoken languages. I can only imagine the complexity of how their identity is being shaped through experiences that are vastly different from my own.

In conclusion, being a Korean-American in Burundi has some unique challenges, but I believe there are rich blessings found within as well. For example, I’d say that it gives me a slightly different insight into Burundian culture’s importance of group and family over self, which I think is more similar to the Eastern community-centric collectivist mindset of Korean culture than the Western individualism in North America. Furthermore, it affords ample opportunities for self-reflection on who I am, often pointing me back to my primary identity as a follower of Christ. And this is the reason I am here in Burundi, as a follower of Christ, to love and serve the people here in the way that God has uniquely made me.


Little Explorers

As an extension of a history lesson rooted in The Age of Exploration, the Kindergarten through second grade class at Kibuye Hope Academy (KHA), our MK school, was recently asked to pretend that they were explorers to Burundi who needed to report their discoveries. Their goal was to help people like you, our faithful readers, who may never visit Burundi get to know this country they call home and their neighbors.

Ben, 2nd Grade
Burundi looks like it’s carved out of Emerald it’s so green. It’s in the heart of Africa under Rwanda. Burundi has hot springs, forests, water falls, and bumpy roads. 
Burundi has lots of cool animals like monkeys, chameleons, and snakes. Something cool about chameleons is, they can look two different ways at once! And, chameleons have long sticky tongues that help them catch flies and grasshoppers. 
People who live in Burundi eat beans and rice, goat, and chicken. The food is not the best, but at least it’s food! Also, they eat cow!
The people in Burundi have brown skin. Also they have short brown (or black) hair. Many Burundians (that’s the people who live in Burundi) live in mud houses.

Alma, 2nd Grade
Burundi is a poor country. It’s actually the poorest country in the world. Most of the houses in Burundi are made of mud. I live in Kibuye, a small village outside of Gitega. Our houses are made of brick and concrete. 
Our team has a hospital. We have many doctors to take care of everything. So many people get so hurt that they die. Some people get bit by things like a snake or a dog, but most of the time we can fix them up, and they can be sent home. Their family will be very happy. 

Zeke, 2nd Grade
Burundi is small and very poor. The houses are made of mud, sticks, leaves, and tin roofs. People grow crops to survive. Growing crops is hard because the country is tiny. Burundi is so small that a couple Burundis can even fit in Missouri. 
The most popular food in Burundi is beans and rice. Eating meat is a treat. The most common meat is goat meat. People sometimes make goat brochettes.
The flag of Burundi is a one of a kind. There is no other flag like it. There are three stars that are in a circle. There are four lines coming into the center, forming an X. The top and bottom of the X are red, and the sides of the X are green.

Sam, 1st Grade
Burundi has a lot of trees. Burundi has a lot of animals. Burundi is a poor country.

Seija, 1st Grade
Burundi is very green and brown. There are spiders and grasshoppers, beetles, wild dogs, bunnies, and people. Burundi has lots of cool bugs. I love dogs. I cannot see them because they are always hidden in the forest. But we do see the blue heron. The blue heron is blue and beautiful.
Burundi is a nice place. Come here anytime. This is a fun place. People told me, “Don’t go there.” But we did. Now we live here with my friends, and it is fun to do this.  


Trading My Shirt

(from Eric)

Clothing from all over the world makes its way to Burundi.  This may not be a perfect system (imagine trying to start a textile industry in a country whose markets are flooded by cheap, second-hand clothes), but it does make for some fun randomness.  It seems pretty clear that American clothes top the list in Africa.  I don't know if this is because A) Americans produce more clothes, B) Americans give more old clothes to Africa, or C) Americans are the mostly likely to fill their shirts with words and logos, and thus make them more noticeable.

Thus, it is not uncommon to be walking around an African city (or village) and to see a shirt from your home state in the US, though the wearer neither knows nor cares about the origin.  The fact that the clothes are 100% context-less is part of the humor, like the grown man wearing a bright pink sorority hoodie, or the young woman in the hospital wearing a t-shirt reminding me to "Stay Calm.  Kill Zombies."  It is, each time, like a little private inside joke between me and the other person.  Except that the other person isn't in on the joke.

One of my favorite moments is finding someone with a University of Michigan shirt (or pants, as I saw this morning).  It comes up fairly frequently, and I'm convinced that UM apparel is among the most common in the world.  Here is one example from 2015.  One of John's post-op patients was sporting this shirt, and it matches my residency white coat.  So I asked for a picture.

There was one unforgettable time in Kenya, when this 6 foot + Maasai warrior guy was in the lab waiting to donate blood for a family member.  He was decked out in traditional garb, with a red blanket wrapped over his shoulder and some nice dilated ear lobes.  The only thing that didn't fit (or maybe it fit the best!) was his UM beanie.  I was so excited, but at that time, I didn't have a phone with a camera, and by the time I returned after lunch, I couldn't find him.

A few weeks ago, we were out on the frisbee field playing on a Sunday afternoon.  The usual crowd was standing around watching.  While running by one side of the field, I noticed that a spectator had a UM shirt.  Nothing that special in that, but on my second pass, I noticed the words "National Champions."  I started to think of the last national championship that UM had won in a sport that would print t-shirts.  It seemed a while ago, which piqued my interest.  How old was this shirt?

I got close enough to see that it was, in fact, a 2018 NCAA Division 1 basketball championship shirt. Except that UM didn't win that.  They went to the finals and went down to Villanova.

Of course, when the buzzer goes off, and the winning team immediately sports their championship apparel, one has to wonder whether the other team's apparel goes.  Off to Africa, I suppose.  

Well, this got me excited, but once again I didn't have my phone.  I went home, hoping that the reason he was out at the frisbee field was that he had some business at the hospital.

As it turns out, he did.  The next day, I saw him waiting in line at the cashier.  He was waiting with a family member who was hospitalized for an arm fracture.  I wasn't going to lose another chance.  I asked a friend of mine nearby by to ask him if I could take a picture with him.  He seemed amused by it.

I figured I may as well press my luck.  I asked him if he happened to like my shirt, and if he wanted to trade.  My shirt was from the Gap, a hand-me-down from my brother-in-law, but it fit me a bit snug anyways.  He said he liked my shirt very much, and that he'd gladly trade.  He had been given that shirt for free.

Everyone was laughing at this point.  But how were to make this trade?  I told him that I'd come to his hospital bed before I left, and since I had an undershirt, that I'd trade with him.  

That's what we did.  And for the next week, I'd see him around the hospital wearing my shirt, and this time the inside joke was shared by two.

Hail to the victors.  I can't wait to wear this in Ann Arbor.  "Where'd you get that?!"  

"Burundi, of course."


Brand New ORs

by Rachel

 If you've been reading our blog for awhile, you've probably seen a fair number of surgical photos.  When we started working at Kibuye, the two ORs had already been in use for probably about 30 years.  Those ORs have a lot of stories to tell, many of which happened before our time.  In 2013, there was one nurse anesthetist and maybe 50 cases were performed each month, many of which were C-sections.  The scrub area was a bucket and a pitcher.  Almost all surgeries were done under ketamine (rarely used in the US adult setting).  One room had a ceiling mounted surgical light, and the other had a light on a metal stand that we would try to position over the incision.  The power went out frequently, and I rarely operated without a head light.  Despite limitations, many patients were helped and many lives saved.  In fact, many lives entered the world in those rooms!  The equipment has slowly been expanded and upgraded, but as the surgical volume has continued to grow these past five years, it became clear to us that it was time for an expansion.

Starting last fall, two new ORs were constructed alongside the old ORs.  The noises of hammering, sawing, and welding were frequent accompaniments to the OR music.  The first weekend of February, most of the surgical team showed up to help clean and move the equipment from the two old ORs into the new rooms.
Part of our helpful moving staff

Cleaning out the old ORs
The new rooms are so clean and bright!  New lights on the ceilings!  New scrub sinks!  It has been a real pleasure to work in such beautiful spaces.  After we moved out of the old ORs, they too were renovated.  One opened the week of the visiting ortho team in March.  The other is slated to open sometime this month, along with a dedicated room for endoscopies.

With the increased space and number of surgeons, surgical volume has skyrocketed, with close to 300 cases being performed last month.  This can be both good and bad--many more people being helped, but an increased strain on our staff, and the need continues to increase.  In a country with so few surgeons, the demand will likely always be greater than the supply.  Many more staff have needed to be hired to prep patients, set up for cases, circulate, clean and sterilize equipment.  It's also been a pleasure to welcome many new anesthetists to work with Greg in order to provide safe anesthesia.  They have continued to work long hours in order to help as many patients as possible.
The anesthesia staff, with a visiting RN during ortho week
Please pray with us that these ORs would be a blessing to many.  Pray for lives to be changed.  But also pray for wisdom for us to steward these spaces well, to have perseverance on the busy difficult days, and to have grace and understanding when we need to say no...so that we can continue to function and provide quality care for many years to come.