Book of the Month: Factfulness

by Rachel

It's actually probably been years, but we used to have a blog feature entitled "Book of the Month."  There are a number of books our team has read which have informed our views and thoughts.  You're welcome to check them out here.

So, a few months ago I was reading Melinda Gates's new book, The Moment of Lift.  Excellent book, by the way (even though it's not the focus of this post).  I loved getting to read about the amazing work the Gates Foundation is doing to promote the development and empowering of women around the world.  Each chapter focuses on a different aspect of difficulties that women face, and people/organizations around the world working to ensure that each woman is seen as a life that is valuable; in fact, a life that has equal value to those around her.  Apparently, when the Gateses were forming their organization, they leaned heavily on the advice and wisdom of a man named Hans Rosling, a medical doctor and professor of international health.  He too had written a book....so off I went to check it out.

Hans Rosling was a Swedish doctor who spent years working in Mozambique and the Congo.  He then moved into more public health roles and investigated a number of disease outbreaks (including the 2014 West Africa ebola epidemic).  He passed away in 2017, and the book Factfulness was his last work.  Dr. Rosling's premise is basically that the world is a much better place than we think it is.

He uses a number of actual statistics from the world--infant mortality, life expectancy, kids attending school, average household income, even number of endangered species--to demonstrate that while most people interviewed will guess that things are getting worse, statistics show the opposite: that things have actually been improving over the past several generations.  Not only does he use statistics to demonstrate this, but the book is divided into 10 chapters of WHY he thinks we view the world the way we do.

As an American, coming from one of the most affluent countries in the world, who has now moved to Burundi, one of the most impoverished countries in the world, reading the book was actually surprisingly eye opening.  I tend to think of the world as either the "American" camp or the "Burundian" camp, while in reality there are so many more middle countries than either extremely rich or extremely poor.  You can't put Burundi in the same category as South Africa, or Egypt, or Thailand, or India.  Life expectancy and income are much higher for the average citizen of one of those countries than Burundi or Malawi, for example.  Rosling demonstrates that many of us use an "us and them" mentality when we look at the world, instead of recognizing that there are many different levels of poverty and development, and that the difference between a salary of $1/day and $4/day can have exponential benefits for the individual and society.

One of the lines Rosling uses towards the end of the book is this: The world can be bad, but getting better at the same time.  He's not asking us to pretend that everything everywhere is ok.  It's clearly not, and there are many many problems to overcome and injustices to surmount.  But, we can also celebrate the work and developments that have occurred over the last 100 years, even 10 years, as well.  That knowledge can give us hope that our efforts and the efforts of so many are not in vain.

As an addendum, I'm including some of his data graphics below.  The book is full of them, and it's a book that's fun and easy to read.  You can also compare your knowledge of the world to various Nobel laureates, billionaires, scientists, and chimpanzees...and see how you stack up. ;)

Thesis Whirlwind

by Logan

Whew! In some ways it feels like I can finally come up for air. The specialist doctors at Kibuye have just finished a ridiculously busy time, supervising research, editing papers, and judging the thesis defenses for over 40 medical students in about a month’s time. 

Carlan Wendler, Alliance Niyukuri, George Watts, Greg Sund, and Logan Banks chat in between students' theses

Why this sudden sense of urgency?

Burundi recently changed the way that they authorize doctors to practice medicine in Burundi. In the old system, as soon as a medical student defended their thesis (a final research project that is the final step before finishing medical school) they could apply for a license and start practicing as a physician. There was no pressure to finish before a certain deadline, so the work that this thesis project represents could be spread throughout the year. This also means that the work for the specialist doctors that act as “directors” of the students could be spread out as well. If someone was directing 4 or 5 students, they could do perhaps one a month so that the work wouldn’t be overwhelming.  

But a few months ago, the government said they would only authorize these new physicians once per year. This meant that a large group of medical students were suddenly desperate to finish their final research projects before the end of the year. 

What is it like to direct a thesis project?

The student comes to a specialist and asks them if they would be their director. Depending on their workload, availability, and other factors, the doctor agrees. The director helps the student come up with a research idea, review the research process, edit the paper (several times actually — which is more like a book, with an average length of around 60 pages), and help the student get ready to present the research and answer questions about it in an oral “defense.” This represents several weeks to months of work for the student, and several days to weeks of work for the director. 

When the student is ready to defend their thesis, the director recruits two other specialists to sit on the “jury” with them, and after a 15 minute oral presentation by the student, each person has a chance to make comments about the study and to ask questions to the student. 

Jason Fader, Alliance Niyukuri, and Ted John sit on a jury

The whole process from start to finish takes over an hour. Then the grade is given, and the student immediately takes the “Serment de Genève”, the French equivalent to the Hippocratic Oath.  

Just some of the 41 medical students as they take their "Oath" after successfully defending their theses.

This process was then repeated over 40 times between December 6th and January 11th. 

Greg Sund, Rachel McLaughlin, and Logan Banks celebrate with the new doctor Abel Nzoto after he successfully defended his thesis.

As you can imagine, this was an incredibly busy time for all the doctors at Kibuye. There are 10 specialists doctors currently at Kibuye. 41 students x 3 doctors per jury = roughly 123 times that a combination of 3 doctors sat on a jury. Some days there were 5 theses in the same day. That is nearly 8 hours of defenses. Sometimes one doctor would sit on 3 juries in the same day, reading and critiquing research in French for 5 hours. During this month-long period, one doctor actually sat on 26 juries, 9 of which as the director. 

This also meant that all the other doctors at Kibuye (the Burundian generalists and interns in the Stage Professionnel program) all had to pitch in to help the hospital services continue to run smoothly during this time. There were days that I was supposed to be rounding on Pediatrics that I could hardly make it over to the ward. I am so thankful (and I know all of us are) to the other doctors on our services that helped keep things going during this hectic time. Carlan even organized a “Thank You” dessert for our Burundian colleagues.

"Thank you! Thank you! Dear Colleagues!"

We are so thankful for the help from all the doctors at Kibuye. We are so thankful for all of these new doctors that just finished their theses. These 41 new doctors represent so much more than the work that went into the past month. They represent years of hard work -- on their part, and on the part of all the professors that taught them (whether in the classroom or on the wards) how to care for their patients in a compassionate, Christ-like way. 

Forty-one new doctors to help care for patients in Burundi (and beyond). What an answer to prayer!  That makes all this craziness worth it. 

But for the moment at least, I know that we are all ready for a nice long break from any more theses.  

Introducing the Harlings!

Michael, Jennifer, Amelia (4), Madelyn (2) and Mark (3 months)

Hello! We are the Harlings! Michael and I met in residency orientation in Greenville, SC, in 2012, and on our second date, Michael told me that he was planning on going to Africa to be a medical missionary.  Here we are, married and three children later, moving to Burundi to be a part of this wonderful team! 

 Engagement Pictures (January 2013)

Some of the few moments we were able to see each other in the hospital during our training! (2013)

The road to where we are today has been somewhat of a tortuous one, but we have seen God's hand and have felt peace that passes all understanding throughout this whole process.  God is awesome.  When I look back at the past two years preparing for the work we are just now starting, I truly can say I am in awe of who He is, and how He has transformed us in this process. 

I graduated from my pediatric residency training in June 2015, and Michael still had two more years to finish his surgical residency.  The plan was for him to finish in June 2017, for us to raise our financial support and finish our pre-field training during the end of 2017 and early 2018, moving to Cameroon in early spring 2018.  Cameroon visas, check.  Immunizations for Cameroon, check.  Purchases made specifically for a house and home we were planning to build in Cameroon, check.  With essentially all of our goodbyes said and the moving company coming the next day, we received an email saying Cameroon was too unsafe for us to move.  So many questions - Why, God, have you allowed us to come this far only to allow this trajectory to come to a screeching halt? 

Our “staging area” – things to get packed into our container destined for Cameroon. 

Because of this stop, our family had the opportunity to live in Paris for a year to learn French which was such an amazing year of spiritual/emotional/marital growth. We met some lifelong friends while attending language school, and we now speak French which has opened a ton of opportunities in Africa.  We learned about this tiny country called Burundi.  We learned about our identity in Christ. We learned (and learned again and learned again and learned again) how to be flexible and to hold onto our plans loosely. We learned intensely about God's sovereignty and how deeply He loves us and how He has perfect plans for us. 

The Eiffel Tower! 

We are thankful for the stop, but we do mourn the loss of what we thought would be.  The people we were planning to work with in Cameroon are good friends of ours.  I would have been able to serve a large pediatric population and Michael would have part of a flourishing PAACS program there.  

After finishing language school in June, we moved to Burundi for a "vision trip" for two months, then returned to the US in September for the birth of our third child, Mark.  We return to Burundi in just two weeks! 

We are so excited to join this team and further grow the friendships that started during our two months at Kibuye in the summer.   We are thankful for this great opportunity to serve God at Kibuye Hope Hospital! 

-Jenn