Already and Not Yet

By: Erica Ause

One of the hardest parts about living in Burundi is learning to hold the hardness of life together with the beauty, joy, and love that is found here. 1 John 3:2 says, "Dear friends, we are already God’s children, but he has not yet shown us what we will be like when Christ appears. But we do know that we will be like him, for we will see him as he really is." Basically, while Christ did come and bring us Heaven after death, we are still waiting for when he comes again and brings the new heaven and new earth that will be without pain and suffering. It is the already, and the not yet and is our reality, whether we see it or not. But in this part of the world, it is unavoidable.

This past year I taught writing to an American boy who lives in Congo, and he expresses it well in a poem he wrote about his country:

Violent, Peaceful
Fleeing, Praying, Helping
Sad and beautiful country

This poem shows the understanding of a child that the world is not good nor bad. It is both at the same time. There is fleeing, praying and helping that exist together. There is sadness and beauty alongside each other. There is violence and peace in the same places. This 10-year-old boy encourages me to follow him in his acceptance that this is how the world is and to see both as equal realities.

A place that our team experiences this dichotomy most acutely is in the Hospital. I want to spend a little time sharing a little of what happens at the hospital where our team serves.

Some Background:
When the team arrived in Kibuye in 2013, there was already an eighty-bed hospital with about ten houses for staff. Now, the hospital has around 350 beds and there are about thirty houses for doctors This is a large change and has created more chances for doctors to be trained, to be given jobs, and for care of patients in and around Burundi. The hospital is connected to a university in Bujumbura, the largest city in Burundi. Therefore, many medical students come to Kibuye to do their internships needed for school. The services include OB GYN, pediatrics, urgent Care, Family medicine, ophthalmology, and surgery, along with food distribution, and courses for medical students taught by the doctors, discipleship and prayer. So far Kibuye has graduated around 310 African doctors since 2014. It is quite a large operation happening!
Below are some pictures of graduation celebrations, our team (+some visitors) moments of teaching and surgery. Everyone hard at work!

I asked several doctors here what the hardest and best parts are about the hospital. Overall, their responses reflected the simultaneous hope and suffering that I have come to understand over my year and a half here. One med student said that the best part is “when I get to see a patient happy because she was able to help them. But the hardest part is to see patients get worse and worse and to be unable to help them.” This is the already and not yet. Yes, there are some amazing things happening here, and people are healed who would never have had a chance without this hospital. And there are still people that die because the world is what it is.

One doctor told me that the best part is "watching a lady hold her first baby after multiple losses" and getting to be a part of that moment. The greatest challenge is seeing a patient whose illness you recognize, whose treatment you know, but also knowing the treatment isn't available in this country, and is too expensive. Yes, there is hope, but often it feels like there isn't enough.

I think the most notable line in the poem Congo is "Fleeing, Praying, Helping". Sometimes, the problems weigh so heavy that I do feel like fleeing, but really the answer is to pray. To pray that God would help us feel the sadness, see the beauty amidst it and move forward to help. This is an exhausting state to live in, but I wouldn't change it, because it reminds me how much I need to depend on God to help me live in the world we have been given.

I will leave you with an illustration. My roommate Jenny was an occupational therapist before she was a teacher. She has used this skill to love and work with the children in the hospital who needed help in that area. One child she worked with was an 8 year old girl who came in for malnutrition. When she arrived she could hardly sit up on her own, was very weak, and seemed to have some sort of mental and physical delay. Many people said that her situation was too hard and unknown, and that there was no way to help her. But God kept putting her on Jenny's heart, and every day she went to pick up this little girl, play with her, stretch and use her muscles, and try to make her laugh. Over the next few weeks, she started to walk on her own, to recognize Jenny, ask when she was coming, and get herself out of bed when she saw her walk into the room. She began to play, smile, and enjoy herself; all things no one ever thought she would be capable of. Jenny said a hard goodbye to this girl she had grown to love as she was releases from the hospital having made some improvements. Months later, this little girl came walking and smiling back into the hospital, all chubby and strutting like she owned the place. How good is our God!!
Telling you this story could go many ways, but what I want to highlight is how this miraculous story is an example of sadness and beauty, of already and not yet. It is representative of the healing that happened on this earth when Jesus brought the kingdom down. And yet, we are still not in the home we were made for. Just as this girl's healing happened in a hospital, which was not her home. We can only continue to pray that little Joy will grow knowing the Lord and eventually find her eternal home with our Lord and Savior.
Joy at the beginning of her stay doing some exercises with Jenny:

Joy when she came to visit a couple months later:

This picture has nothing to do with the hospital, I just love it a lot. These girls were SO EXCITED to have their pictures taken, they just couldn't control their giggles!

(It's also the only picture on this blog that I took, the others were taken by a number of different people in our community).

Please just pray for this place. For the people who live and work here, and for those who come to stay at the hospital! Thank you all for your ongoing support and care. Love to you all.

Press CTL+P to Print

Though the origins of this poem apparently date back to the 13th century, Benjamin Franklin famously quoted it in the preface to Poor Richards Almanack.  He added the line "A little neglect may breed mischief..."  It's an adage that frequently proves true for us.  Never mind the fact that entropy seems to work a little harder here... Machines that are broken often stay that way and projects get stalled all because a single, simple, part is missing.  Amazon Prime hasn't quite made it to our doorstep... and often replacement parts aren't even available or the problem we're facing is such a unique scenario that no affordable commercial solution exists.

Enter the world of additive manufacturing.  

While it may seem like something out of the future the idea of printing something in 3 dimensions is surprisingly old, dating back to a short story from 1945!  It wasn't until 1987 that the first commercially available printer was manufactured, but the cost ($350k at the time) kept it well outside the range of consumer use.  It wasn't until the 2010's that printers using a plastic filament (Fused Deposition Modeling) started to be produced at more consumer-friendly prices.  Today you can pick one up for under $200, though quality at that price point will definitely suffer.

As a graduation present for finishing my surgical residency my in-laws bought me this printer:

It travelled a long way before finding its resting place here in Burundi.  So how have I been putting it to use?  Well for starters there are some convenience items like this spice rack:

And some fun items like this catapult we printed for technology club:

And then there are the practical things, like the antenna brackets we use to optimize Wi-Fi signals over long distances:

These brackets have been in use for over a year and other than the steadily accumulating dirt and spider webs they're still working great.

While I wish I could say I designed all these things I've only just started dipping my toes into the world of 3d modeling.  Most of the above designs I found on Thingiverse, a collection of freely available 3d models.  More recently though I've had a couple projects where I couldn't find anything that suited my needs:

This little reflector wound up in a custom desk lamp I made.

After setting up the new hospital network, I've transitioned into working on a server which will eventually allow us to access digital x-ray images anywhere in the hospital.  It will also likely service our electronic health record whenever we decide to cross that bridge.  In this process I realized I was missing a bracket for mounting a couple hard drives in the system.

After a little design work and ~7hours of printing:

It's pretty satisfying seeing something go from design to functional product over the course of a couple days!  

While it's not quite as simple as pressing CTL+P to print it's proven super useful at solving some of the unique problems and challenges we face.  I'm already eying my next printer to speed up print times and expand the materials I can use to print.  Now to figure out how to get it here...



New Teammates!

It seems like there are always comings and goings here at Kibuye, with the comings of course being more fun that the goings!  We wanted to take chance to introduce you to some of our new current/upcoming teammates.

First of all, we are really excited that after many years of prayer for an engineer to support Caleb Fader in his many crucial roles at the hospital, we were approached by an awesome couple that has been living in Bujumbura for the past few years.  Craig is a mechanical engineer and Vanessa has a masters degree in sustainable development.  They and their two young children, Wren and Bram, are currently raising support in the US and are hoping to arrive at Kibuye sometime in January.  If you'd like to help support them, click here.

Secondly, as we've posted about many times before, teachers are essential to our team's health and longevity here at Kibuye because they shoulder the majority of the task of our kids' education.  We have absolutely loved having our current three teachers here these past several years, and are thrilled to announce that one of them, Jenny Sorondo, has decided to stay on as a long term teammate and teacher.  She'll be needing extra support as well as she transitions from short term to long term (if you're interested, click here).  

Joining Jenny in fall of 2023 will be a new teacher, Meg Strickland.  Meg is currently teaching elementary school in Georgia and will be coming to work at KHA for two years.  You can support her here.  And finally, speaking of teachers, we are still in need of one more teacher starting in the fall of 2023 for (preferable) middle school ages if you or anyone you know is interested in hanging out with some totally awesome, fun kids (not that I'm biased).

And, while I'm mentioning new teammates, I also wanted to introduce Dr. Selina Thomas.  Selina arrived at Kibuye in June through the Samaritan's Purse Post Residency Program for two years (and hopefully longer!).  While we have had, and even currently now have, post residents serving at Kibuye before, Selina is our first primary care/non-surgeon.  She's residency trained in family practice, which means that she's very versatile.  We've enjoyed getting a chance to have her rotate around on our different services and she has been a great asset.  


Kibuye Pediatrics Video

By Alyssa

Thanks to the incredible work of Serge East Africa Media, we are happy to share this short video with you of the development of Kibuye Pediatrics over the last couple years! I love seeing the before and after shots of our new pediatrics building, and I also love that three languages and multiple Burundian and American voices are included here. Hope these images bring joy and encouragement to you today. Thanks so much to all who contributed to make our new pediatric building a reality! 

Click here to watch the video:

Kibuye Pediatrics Team

Photo credit for all photos in this post: Serge East Africa Media


A Kibuye Sabbath Poem

 (from Eric)

The day spins and the week whirls
and I am drawn again
to wrestle with the cantankerous back door lock
in order to walk out onto the back porch.

To look again on the line of trees
steady and long-suffering, 
though they bend constantly in the wind.
To hear the rustle,
bounding through the upper boughs
until they settle again exactly as they were.
To see the cedar and the bamboo and the hibiscus
planted as saplings by my friend
now reaching overhead and thriving,
rooted for the future.

In the shade of the porch roof,
the concrete is cool
unyielding and refreshing as an anchor.
The half-wall we built as a possible screened-in porch,
still open after many years,
and now a seat
on the edge of shade and sun.

The nearby bird-calls,
constant and so close,
yet I can never seem to find them.
The laughing dove, yes,
but this crescendo-ing call might be a chat or a shrike;
I'm not sure after all these years.
Domesticated mysteries.
Overlook them all your life if you wish,
they stand ready to be a source of wonder
whenever you would be open and quiet.

I return to the porch when the day roils,
to remember that it is,
and that there is something else.

The sunlight alternately dappled and matte
as the clouds move across a heaven so low
compared to the steadfast love of the Lord.

I return to be reminded who I am.
Where I am.
To see again a moment in a story
with a beginning and a flow and an end.
To feel again the warmth of the sun,
the brush of the breeze,
the crackle of grass at the end of the dry season.
To remember the textures, the layers
of unmerited glory that surround me
in the peace and the pain
of this given life.