Creative Kids Across Cultures

By Michelle Wendler

Back in February we left for California to get a medical test done for our daughter. We packed our bags expecting to only be gone for 3 weeks. Because of COVID, the airport in Burundi closed while we were gone, and remains so these many weeks later. While we bide our time, waiting to return to our team, church, community, and hospital, I’ve been impressed by seeing how the children in our neighborhood in California are finding creative ways to play. During our daily walks, which our daughter Gabrielle lives for, we’ve found all sorts of sidewalk chalk drawings and small little cities created in the dirt along the driveways and yards. 

These were found on and by the sidewalks in Pasadena

It has reminded me of how the kids in Burundi play, finding ways to be creative with what they have. Kids will be kids, whether in Africa or California. I thought I’d share some of the photos I’ve taken over the years of the different hand made toys that I’ve seen in our rural village in Kibuye.

Cardboard and bottle cap pull cars

This little guy was pretty proud of his creation :-)

...or sticks and bottle caps

Bucket lids and sticks make a great game. See how long you can keep the lid rolling!

So precious, both the handmade doll and the cute little girl

A soccer ball that will never deflate! 

Our walks have been such a source of refreshment during these days of lockdown. Even with physical (and geographical) distancing from the ones we love, getting outside, seeing the marks of their creativity somehow connects us to each other and to the God who created from nothing. I'll end with this photo of a little cross on the trail near Kibuye. During these difficult times, know that God knows your suffering. He is at work, both in Burundi and beyond. 

Kibuye during Covid-19

(from Jenn)

Can we talk about the "19" of Covid-19?  Doesn't 2019 seem soooooo long ago!?  Maybe we had problems in 2019, but as we look back we may wish we could have told our 2019-selves "buckle up, the world as you know it is about to change drastically."

Although we spent two months at Kibuye in the summer of 2019 (July-August), I'd say our true missionary career started here mid-January 2020.  It's been a bit bizarre living here these past four months as our world has changed due to the pandemic.   Our lives would look so different if we were in the States right now. As an outpatient pediatrician, I would probably be doing telemedicine there.  As a general surgeon, maybe Michael wouldn't be doing as many elective cases.  Here, it's (almost) life as usual. There have been no big changes mandated by the government except for the fact that the airport has been closed for almost two months and there was a mandatory 2-week quarantine for anyone who flew into Bujumbura. Schools are still running, churches are still gathering, and people are still working.

How do you stop work when a majority of the population earns their daily wage then goes to buy food for dinner? How do you stop schools when there is no online option? How do you tell people to stock up on food when only 9.3% of the population has access to electricity?

At Kibuye, of the remaining seven family-units, five of them contain doctors so most of us are leaving the compound and working at the hospital as per usual (plus face mask usage).  We still have family worship on Saturday afternoons, each family on a blanket on the floor of the outdoor pavilion. The remaining children are still attending school and because there are so few left, social distancing even in a classroom is possible.

We haven't seen a wave of patients severely ill with respiratory disease, at least on the adult side.  In Peds, it's "bronchiolitis season" and therefore we are seeing a lot of respiratory illness, and even subsequent death which unfortunately is not uncommon for this season.  Is it Covid-19? I don't know, and we probably never will because of the limitations in testing for the virus and because of the lack of specificity of symptoms for the disease.  We have heard of some people in Kibuye with anosmia, the loss of sense of smell, which is a more particular symptom.  As not many other things cause that symptom, it could cause one to assume that it is circulating here.  Thus far, however, we are thankful to have avoided any crisis.

This week is also a very big week in Burundi; May 20th is Election Day.  There have been multiple political rallies (even one just outside the hospital), which have been peaceful.  We hear campaign cars driving by at least 2-3 times day giving their information in Kirundi and playing music.   Please pray for peace leading up to and after Election Day.

Advocacy

By Alyssa 

COVID testing site for persons experiencing homelessness

On the day I was scheduled to fly back to Burundi after home assignment in the US (March 26), I wrote the blog post here about culture and coronavirus. Six weeks later I'm still here and there is still no word on when the Burundi airport might open up again. There have been ups and downs in the past six weeks, but mostly I have been thankful for God's provision. Several of us recently did a distance women's retreat for missionaries and the theme was from Habakkuk 3: Yet I will celebrate. Even though I'm not where I thought I would be at this time, even though the world has been turned upside down, even though I can't even spend extra time with family and friends while I wait due to social distancing, even though the pediatrics team in Burundi is significantly short-staffed..."yet I will celebrate in the Lord. I will rejoice in the God of our salvation. The Lord my Lord is my strength. He makes my feet like those of a deer and enables me to walk on mountain heights." (Habakkuk 3:17-19)

One thing I have been celebrating is how God raises people up around the globe to advocate for those in need (which is all of us at times!) As I looked for ways to help with the COVID efforts as a physician, friends advocated for a position for me in the fray even though I have been out of US medicine for years. And ultimately God provided an ideal part time temporary position for me at the local health department working with vulnerable populations. After 10+ years in under-resourced places in Africa, I now have the opportunity to learn from advocates for the disadvantaged in my passport country. As I've spent many hours in (mostly virtual) meetings, I've been amazed by the enthusiasm and passion of these advocates as they seek to make a difference in their community. We've talked about how to make messages about COVID more accessible to people with hearing impairment and to non-English speakers. We've heard from pastors of congregations at significant risk due to systemic inequality, racism, and chronic health conditions. We've talked about how to test folks who don't have access to transportation and how to protect those in homeless shelters. We've discussed how to ensure access to care for people with mental health needs and disabilities. We've looked at how to address people experiencing new homelessness when the usual resources are unavailable due to shelter-in-place orders. During each discussion, there are people on the call who intimately understands the needs of the at-risk population - people willing to go out to the "highways and byways"and talk to the vulnerable about their needs, to distribute masks, to provide food, to staff crisis hotlines, to work tirelessly writing protocols and educational materials, and to speak up for those at risk of being marginalized and forgotten.

I have learned much from these advocates on how to persevere in both caring for people where they are and also appealing to authorities for change - even if things don't change immediately. The other day I wondered sadly, "What about those around the world who don't have an advocate - who live their lives unseen and who have significant need that no one is addressing?" I think of some of the Burundian mamas in our feeding program who Susan (an amazing advocate!) has discovered have no place to live and no way to earn income to feed or clothe their families. I think of orphans and widows and those with disabilities who don't live in countries with established advocacy organizations. I think of folks in every corner of the globe who have experienced serious trauma or adverse childhood experiences but do not have access to trauma counseling or other resources to help them begin to heal and learn to trust.

Thankfully, we do actually all have an advocate! "If anyone does sin, we have an advocate with the Father, Jesus Christ the righteous." (1 John 2:1b) Jesus Himself is our advocate - for all eternity! And we identify with Him as we advocate for others, too - even when it's hard and there is no visible fruit. We await the ultimate new heavens and new earth with the redemption of all things, but in the meantime we see glimpses of new creation even in the unique passions God gives us for certain people who need advocates around us.

Rural Missionary Life As a DIY Experience

by Jess Cropsey

Living in a rural place with limited resources and personnel, we often find ourselves googling, “How do you…?” And this is not usually because we are trying to save some money or like the idea of figuring out something ourselves. It's because there is no other option.

  

As a simple example, what do you do when your oven's not working? Since the only appliance repair man that you know is almost 100 miles away, you start by trying to figure it out yourself. And what do you do when you discover that the problem is the result of a mouse that has made a home in your oven insulation? Call your neighbor for reinforcements. We have yet to solve the dilemma of getting replacement insulation. 

Want a date night with your spouse? Unless you make a special trip away, your options are the hospital canteen or plan it yourself! Thanks to the genius of a former teammate, some of us buy take-out from a nice Indian restaurant in Bujumbura and freeze it for an easy date night meal. Other teammates have other creative date night ideas (that might be helpful for those of you in quarantine right now!)

Need a haircut and don't have access to a stylist? Pay your stylist a little extra next time you're in the USA so that she can teach your husband how to cut your hair. 

Need to have a hospital machine fixed? Perhaps you’ll get lucky and there will be a handy visitor around with some free time. But most of the time, you’ll have to take care of it yourself. John spent several hours on Saturday morning trying to fix a microscope in the eye clinic.

Need some PPE (Personal Protective Equipment) in the midst of a pandemic? Stephanie and Lindsay have been working hard to organize mask-making for our hospital employees and patients. Even the kids have participated in the efforts.

Rachel sporting her new mask in the OR

Meanwhile, Greg has been actively working to prepare the hospital for what may be coming. Dubbed, "Captain Covid", he recruited John to help him build a plexiglass intubation box to protect both patients and anesthetists during intubations when viruses can be aerosolized from the airway in large quantities. As you can see, John took this responsibility very seriously.

Greg trying out the finished product

More DIY PPE: 

John purchased transparency sheets in Bujumbura to use as face shields

While it can feel at times that there are too many problems to fix, that we're in way over our heads, or that there just isn't enough time in the day or energy in the body to figure out one more thing, the reality is that we are not alone and that it's not all up to us. We have national partners who are invested in this with us. We have access to a network of professionals, churches, organizations, and individuals from all over the world who are willing to give or offer support in any way they can. 

For example, just a few days ago, John was faced with a really complicated glaucoma case. He e-mailed several glaucoma specialists in the USA asking for advice and quickly received input from the top specialists in the field to help guide surgical care for his patient. 

Most importantly, we have a God who is walking with us every step of the way. We don't need to rely on our own intelligence, capabilities, energy, or ingenuity. He will give us what we need when we need it. And we're thankful for the reminders that He gives of His presence, like this beautiful double rainbow on Sunday.

Post-Graduate Interns: A Major Highlight

(from Eric)

One of the perennially funny things about blogging is how you can look back and notice how you've missed something major.  Such is the case for our post-graduate internship program.

A reform in medical school curriculum back in 2011 set the roadmap for graduates from Burundi to follow medical school with a one-year post-graduating "rotating" internship (meaning that they rotate through several different specialties during this year).  This is what is done in other countries in our region, and what several of us help to supervise when we lived in Kenya.

The program hasn't yet begun on a national level, but many doctors will go somewhere in the country for something similar but less formal, called in French a "stage professionnel".  Many of our graduates have expressed interest in more training after graduation, and we have been eager for several years to take young doctors through a more formal and intensive "stage professionnel", following the model of the internships to come.

After several years in planning, we started this program on May 1, 2019.  We took eight doctors, and later expanded to twelve.  They spend 3 months each on Internal Medicine, Surgery, Pediatrics, and OB-GYN.  They take lots of call, and they see patients in clinic.  They have weekly lectures and reading assignments, and they have been a big part of a weekly doctors' bible study.  Because of their dedication, they have, in many ways, been the heartbeat of the hospital these last several months, and we are so thankful both for them, and for who they are becoming.

Several of the "stage professionnels" with "Papa Banks", their fearless leader

Last night, we all had a dinner ceremony together to celebrate the end of this program for the first five doctors.  Since these five all went to medical school at HAU, we have known them since their very early clinical rotations as a student.  We got to see them progress steadily towards graduation.  Now, we have seen them grow tremendously this year into true colleagues.  It is a delight to think of them going out to truly bless the population of Burundi with their intelligence, their hard work, their practical capacity, and their love for Christ and the people of Burundi.

Congratulations to Dr. Cesarine Nishimwe, Dr. Emmy Prince Ndengeyingoma, Dr. Moïse Niyuhire, Dr. Christian Niyoyitungira, and Dr. Olivier Hakizimana.  Thank you for trusting in a new program and for blazing a trail that many can now follow.  May God bless you and guide you in the days to come.

Some pictures from last night's fête:

Five finishing doctors with their certificates

Eric and Dr. Gilbert (Kibuye's medical director) congratulating Dr. Prince

All but one of the current post-graduate interns

Video messages from those who couldn't be present

Cutting Madame Cynthia's awesome cake

Now we look forward to another year.  We have 6 doctors that are roughly halfway through the curriculum, and another six who began on May 1.