19.10.19

ITEC Video

(By Caleb)

In a blog posted in September of last year we talked about the installation of solar power at Kibuye.  As we had previously struggled with inconsistent power and crippling fuel shortages, the impact of consistent and clean power on Kibuye's ability to provide quality care has been massive.

The system has now been operating for just over 14 months.  In these 14 months we have harvested just shy of 160 MWh of power from the sun.  This is a bit hard to wrap one's head around, but it is roughly equivalent to the average power consumption of 15 US homes over the same period.  

We are very thankful to ITEC for their tireless effort in supporting this installation.

Isaac and Oliver Lewis are brothers who came as volunteers to help with the installation last year.  I was recently made aware of a video they created about this and I wanted to share it with all of you:






14.10.19

Eric's Book Releases Today!


After several years in the cooker which have certainly refined it like a fine vintage, Eric's book Promises in the Dark: Walking with Those in Need without Losing Heart, is available for purchase.  You can buy it from Amazon or from New Growth Press (better deal for bulk purchasing), as well as read a slew of great endorsements on either site.

"Eric, I'm excited about this book!  I'm definitely going to read it myself!  But what can we do to help get it in the hand of other people?"

First of all, let me thank you for such a gracious offer.  Here are a few ideas:

  • Write an Amazon review.  Anyone can do this, and it can be a great resource for others who considering getting the book.  Write about why you think the book is valuable (consider a quote that you enjoyed).  Let the book's content, rather than your connection to the author, be central.
  • Post on social media (Again, consider a quote, using the same advice as above).  Post a picture with your book (or ebook) and tag me in it on Facebook.  We can play the game of "how many people will hold Eric's book before Eric?".  Include the hashtag #promisesinthedark
  • The book includes discussion and reflection questions for each chapter which work great for a small group study.  Consider if there are others in your circles who might benefit from reading it, either alone or together.

“So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day.” - 2 Corinthians 4:16

11.10.19

ZM Part II: Into the Community

by Rachel

At the risk of inundating all of you with more Zigama Mama news (see here for part I), I wanted to continue to share the next part of the story with everyone.  When ZM was set up, part of the program was not just training nurses and doing ultrasounds/scheduling C-sections, but actually going out to each of the 17 health centers in our district to make sure the program was going ok, requirements were being followed, and collecting some data sheets from each center.

I've actually been really excited about this part.  I've come to realize that in my six years here in Burundi, I have become very much a creature of habit.  I used to think of myself as somewhat adventurous, but now I go to the same places and do the same things every day.  I shop in the same one store, I take the same route to Bujumbura, I visit the one tourist destination by us (the waterfalls), I walk the same path to the hospital every day.  Even in Buja, we visit the same restaurant, the same grocery, the same hotel with swimming pool.  Part of this is finding the thing you like and sticking with it, part of it is that there's just not many new places to go or opportunities to go there.  Or that everything starts to look the same, and you wonder if it's worth the effort to keep exploring.  But the health center visit was a chance for me to actually venture off the beaten paths (sometimes literally) and see a totally different aspect of life here.  Months went by with many cancelled trips and I started to despair that these visits were ever going to happen...but as usual here, all of a sudden one day last week the pieces came together and the next day I found myself in the hospital truck with one of my OB nurses and the district health officer and we were off!

We are located in Gitega province, right in the middle of the country.
For those of you who don't know the system, Burundi is divided up into provinces, much like states in the US.  We're right smack in the middle, Gitega province (which is the most populous overall, according to Wikipedia at least).  From a health standpoint, each province is divided up into districts, and each district has its own hospital.  So, we are Kibuye district.  Then, each district is divided up into communes, and there are 4-5 health centers spread across each commune.  We have 4 communes and 17 health centers in our district.  Health centers are mostly like outpatient clinics, except that they will do "small surgeries," occasionally admit patients, and all do basic maternity care--prenatal visits and deliveries.  Each health center will refer their complicated cases to us at Kibuye Hospital, and our ambulance is responsible for going out to each health center to pick up the transfer, no matter what time of day or night.

The first thing that impressed me was the actual travel to each health center.  We were on paved roads for the first 5-10 minutes of the day and then spend another hour on dirt roads, usually smooth but occasionally a bit hairy given the recent rains, before we arrived at the first health center, Mahonda.  So, driving a decent vehicle still took over an hour from the hospital to the health center.  Most patients are not in decent vehicles--they walk, take bicycles or small motorcycle taxis, or sometimes ride in a rickety-looking station wagon-type taxi.  Thankfully, women is labor who need a transfer get to ride in the ambulance, but still...if the transfer is because she needs an emergent C-section or the baby is in distress, there is no quick way to do this.

Road leading to Mahonda health center
Road leading away from Buriza health center
The second thing that impressed me was the actual center and staff.  They have a hard job--located in the middle of "nowhere," seeing sometimes 100 patients a day in a much more resource limited setting than Kibuye, with no doctors to ask advice from.  The nurses need to be able to do suturing, wound care, deliveries, general medicine and pediatrics, and then figure out who needs to be transferred vs what they can handle themselves.  And they know that they can call an ambulance and at minimum, it will be over an hour before the ambulance shows up...if it's not out picking up a patient from a different health center first, or even worse, broken down and out of commission for days or even weeks.

CDS Mahonda staff, along with my OB nurse Moussa and the district health officer, Melance
CDS Buraza, one of the "super" health centers in the center of their commune
CDS Buriza, the newest health center in our district (opened by the president a year ago in August)
Finally, my third observation was just a reminder about how hard it is for my ladies to access care.  Even with free care for pregnant women, and community health centers.  Even with Zigama Mama offering free ultrasounds and consultations.  There are still barriers.  The nurse at Mahonda told me that patients have been refusing to come to Kibuye for a free ultrasound because it still costs 16,000 Fbu in transport costs to even GET to the hospital (reference: around $6 roundtrip.  also reference: for our househelpers, who make more money than the average Burundian, this would be about 4 days' wages).  This is on some level very discouraging--we remove one barrier only to discover that there are so many more still to be surmounted.  But on another level, little by little, barriers ARE being removed.  I was excited to see that each commune has a special, "super" health center being developed, where the government is committed to posting a midwife and improving training protocols and available medications for mothers and newborns.  I am happy to see that, even despite distances and transport cost, over 200 women have decided to make the effort to come in to Kibuye for a free ultrasound and consultation.  I am encouraged to see many nurses and other workers committed to providing health care in challenging places without many resources available to them.  And I hope our program and visits are encouraging to them, too.  To the nurses, to the women--they are seen, they are heard, they are loved.  Someone cares enough to try and make their lives a little bit better.

Thanks to all of your for your support and enthusiasm for our project.  I look forward to seeing its impact continuing to unfold over the next year, and even beyond.

Beautiful terraced hills on the road to Buriza

6.10.19

To Save a Tooth

By Stephanie 

In some ways living in a medical community in rural Burundi can mean minor medical problems get diagnosed much faster then they would in the US. If you see a new rash on your child's arm you can just run over to your neighbor the pediatrician, or if you’re having persistent abdominal pain your teammate, the ER doc, can do an ultrasound on you in the comfort of your own living room. But one area of medical care that we have no resources for here in Burundi is dental care. We have had dentists interested in joining our team, but reality is that routine dental care is beyond the financial ability of the average Burundian. Here in Kibuye when patients have a tooth abscess the medical care that they receive is getting their tooth pulled, usually being unwilling to pay the less than $3 to have the area numbed first. 

In mid September our 10 year old son began complaining of tooth pain. He’s never had a cavity and saw the dentist in the US this summer, so we assumed that his pain was related to a new tooth coming in and pushing on his other teeth. However, as the week progressed so did our son’s pain, to the point that he wasn’t getting any sleep and we had him on ibuprofen and tylenol around the clock. Then he started being lethargic, staying in bed all Saturday while his friends ran around the compound. By evening he had a fever despite the tylenol. We also noticed that one of his adult teeth had become wiggly.

We went to Saturday family worship with our team and asked for prayer. After the service a teammate offered the name of a dentist in the US, Dr. Hank Willis, who has willingly consulted on their dental questions in the past. We e-mailed him right away and immediately received a response. We sent him some pictures and he asked us some questions. Our son didn’t seem to have pain when we pressed above his teeth and in fact we weren’t even exactly sure which tooth was having the problem.  One of the questions Dr Willis asked was about reconstructive work to our son’s teeth. We missed that question at first as we answered others, but then realized that our son had had a chip to his left lateral incisor fixed this summer. Could that be the problem? The chip was the result of a fall 2.5 years ago. Dr Willis told us the tooth was probably necrotic and our son would need a root canal. He was even kind enough to offer to do the root canal for us …. if we wouldn’t mind flying to Idaho.  
                                                                                                                               Dr. Hank Willis

This threw us into high gear. Where could we go in East Africa to get a dental opinion we could trust and the level of care we wanted for our son? We had heard that there was a Canadian dentist who was setting up an office in Kigali, Rwanda. But we weren’t sure if his practice was open yet. Was he in Rwanda or Canada at this time? How do we get in touch with him on a Saturday night in order to arrange to travel ASAP? Well, we turned to another team friend and missionary in Gabon, Dr. Drew Huang. Drew is one of those guys who knows everyone! We gave him a call and sure enough he had the private e-mail address of the Canadian dentist in Rwanda, Dr Jesse Wong. We e-mailed Dr Wong and started our son on oral antibiotics. 

Early the next morning we received an e-mail back from Dr. Wong. He was indeed in Rwanda and could see us at 8am Tuesday morning. We booked airline tickets for two, a hotel, arranged transport, then borrowed Rwandan money and SIM cards from teammates. We also hunted down our passports which were in the capitol for visa renewal.  As we arranged all this our son was back out playing with friends, only occasionally complaining of pain. Had we not consulted Dr. Willis we probably would have believed that the antibiotics were taking care of the issue and stayed put in Kibuye. 

Monday we began our journey to the dentist with a 3 hour car ride to the capitol where we were able to find the correct office, wait for someone to arrive, and pick up our passports. We then flew to Kigali. And as is typical with African travel, the airport visa line was long, our hotel driver was not there to pick us up, our SIM card did not work…. but we sorted things out and got to our hotel.


Tuesday morning we went to the office of Dr. Wong at DMC Dental. The clinic was 
clean and modern, even having a TV mounted in the ceiling for our son to watch as they worked on his tooth. Dr. Wong was quick to see the issue on x-ray, a large infection above the tooth that had been chipped in the fall years ago. The infection was so large that Dr. Wong left the hole in the tooth open to drain overnight. Our poor boy spent the rest of the day spitting out draining puss and watching The Peanuts Movie in our hotel room. On Wednesday morning we returned to DMC Dental where Dr. Wong cleaned out the tooth again. He really wanted to finish the root canal for us then, but there was still too much drainage from the infection. He put medication in the tooth and we will return to Rwanda in November to assess the infection and hopefully finish the root canal.
  


During this episode our son asked us “What would have happened if I were a Burundian?” So we talked about the lack of pain control that would have been available to an average Burundian boy, the delay in diagnosis because of the cost of a medical consult, and how his adult tooth probably would have been pulled.  Medical care is improving in Burundi, but there is still a long way to go. Events like this make us feel our privilege in being able to access the best medical and dental care for our kids, even if it means traveling to another country. 

2.10.19

What Goes Around, Comes Around: An Ear for an Ear

by Jess Cropsey

In 2010 at Tenwek Hospital in Kenya, John fixed the earlobe of a patient who came in for cataract surgery. The patient seemed more happy about his ear than having his sight restored. Almost 9 years to the day later, John found himself in need of a similar favor.  



We were just wrapping up a heated game of Dutch Blitz with the Fader family on Saturday evening when some of the kids decided it would be a great idea to play a trick on Uncle Jason (who chose to spare us all from a humiliating defeat and change the oil in the van instead). The weapons of choice (water balloons) were switfly loaded and plans were made. John, Heather, kids and I stealthily crept out to the “man cave” where Jason was busy at work. Unfortunately, he was underneath the vehicle, surrounded by lots of items that really shouldn’t get soaked. So, the kids left, disappointed that their plans were foiled.  However they quickly perked up when I suggested that we switch targets to John. We waited for him outside while he talked to Jason.  And we waited.  And we waited some more.  Seriously, how much is there to say at 9PM?  At one point, we even knocked over an empty crate thinking the noise might cause him to come out to investigate.  Alas, no.  After more waiting, John finally emerged, but the noise had made him suspicious. He spotted us right away and made a mad dash for the house.  We were on his heels and had him surrounded when he said, “I think I ripped my ear.”  Not sure whether he was fibbing to get out of his predicament, we paused … and wondered whether it was okay to pelt him with a water balloon even if he was actually hurt.

A quick glance proved he had indeed torn his ear on a branch, but it wasn’t bad enough to stop him from grabbing a balloon from one of the kids and smacking me in center of the back.  My aim was right on too though.  Our ammo was quickly exhausted and we took a closer look at the injury to analyze the extent of the damage.  I wasn’t about to touch it (just writing about it gives me the shivers), so I took a picture for him to look at.


It was decided that a few stitches would be required to repair it properly.  Fortunately, Darrell Baskin, former teammate & retina specialist who happened to be around for a 2-week visit, was up to the task.

Patient being prepped for surgery

Cleaning of the surgical site

Surgery commences, and micro-surgery for that matter!

Viewing for Micah & Sam made possible by the surgical camera

Post-op


Happy patient & surgeon!

The offending branch was cut down the next day to prevent future injury.


For more stories about times we've had to treat each other, visit these links.  Not surprisingly, this isn't the first time John has had to have a teammate stitch him up.