New Chaplains and New Chapels

 (from Eric)

When our team returned from the Serge conference last month, we found a new face leading morning chapels at the hospital.  Last year, after decades of faithful service, Pastor Pascal Nyawenda retired from his role as a Kibuye Hospital chaplain.  Now, Pastor Mélance has arrived to fill that void, joining Pastor Silas and Madame Pascaline on the chaplain service dedicated to spiritual care at the hospital.  It has been a joy to see the enthusiasm and energy that a new person has added to the team's work.  We see them praying with inpatients and outpatients, and if you take the time to ask them, they will enthusiastically share stories of healing, repentance, conversion, consolation and faithful presence.

Pastor Mélance, Pastor Silas, and Madame Pascaline

One of the things that I love about our chaplains is that they embrace not only the spiritual care of patients and their family members here at Kibuye, but also the employees and the numerous students that pass through the hospital at different stages of training.

Ever since the beginning of the Covid-19 pandemic, it has been a challenge to decide how to handle the long-standing practice of daily times of morning prayer/singing/devotions from 7:30 to 8:00 each morning.  After trying a number of different models, the hospital leadership restarted this practice a couple months ago.  The response from students and staff has been encouraging with an enthusiastic participation.

The chaplains' response to this was to reflect on how best to use this reinstated time to engage well those that are involved.  They are planning a number of different activities, but one of them is to dedicate one week per month to a thematic message.  The idea is, instead of a different speaker and theme each day, there will be one speaker on a chosen theme who will give four different messages from Monday to Thursday, and then Friday will be dedicated to Q&A.

I had the honor of being the inaugural speaker for a theme week, the chaplains asking me to speak on "Walking with Those who Suffer".  On Monday, I spoke on suffering according to the Bible.  On Tuesday, I spoke on the significance of a God who has suffered and died.  On Wednesday, we talked about consoling the sufferer, and on Thursday, we talked about Finding Hope.  Even this week, it seems that these messages have changed the tenor of some of our conversations about our work in ways that I think are positive and authentic.

I wasn't sure what to expect in the Friday Q&A.  I appreciated what the chaplains were doing by leaving that time for more interactions, but I wasn't sure how people would respond.  After an initial long silence, the questions started to come and had no difficulty filling the time.  They asked about God's redemption of evil and the presence of temptations in their lives.  They asked why prayer matters if God is sovereign.  They asked about the difficulties of caring for the whole person when the work is voluminous and overwhelming, as well as the proper way to talk about the offer of eternal hope with someone who has just receiving hope-shattering news.  In other words, they didn't pull any punches!

Pray for these chaplains in the months to come and for the patients and staff and students that they will impact.

Psalm 77: Following Unseen Footprints

 (from Eric)

This is from a few months ago, and I didn't know it had been posted until now.  I made this short video for our home church in Ann Arbor, Knox Presbyterian Church, which speaks some of the (especially early) 2020 experience for our team along with some thoughts about the way Psalm 77 speaks to that experience.

When the Hits Keep Coming: Psalm 77 and Covid-19

(from Alexis)

It is difficult to have to write another sombre blog post after only a short while has passed since the post about the robbery, but the whole world is experiencing a difficult and sombre time and Kibuye has not been spared that. Like the rest of the world, the repercussions and precautions due to the Covid-19 pandemic have been affecting Kibuye. Fortunately (or unfortunately as it may be), there are as of yet no confirmed cases of Covid-19 in Burundi, however, the concern is that Burundi has not yet confirmed any cases because it has been difficult to get testing set up anywhere in the country (Though we are told testing has officially started).

As such, the team has been bracing for the arrival of the virus by developing and putting into place some new precautionary measures. For example, hand-washing stations have been set up at the gates, only essential personnel are now permitted to go up to the hospital, and Stephanie is heading up an initiative to sew 80+ reusable masks for medical personnel. However, one of the biggest challenges is the same as that which many of you who are reading this post right now are also in the midst of: quarantine, self-isolation, and social distancing measures. Due to potential (but unconfirmed) exposure, several of us have been in quarantine since last Tuesday, required to stay at 6ft away from others at all times and mainly remain in our homes. Even those not specifically quarantined are practicing social distancing measures, staying a fair distance from one another as much as possible. Work has continued for the doctors, but school has been on pause, with a plan to resume next Monday with new social distancing measures in place, but even this feel precarious. These measures, though recommended, have been very hard on everyone, especially in a place like Kibuye where being in community is how we survive.

One of the Gitenge masks that Steph is making

I don't know about you all, but for myself, and as many others on the team have expressed, our lives and communities right now feel as though they are taking hit after hit and there is an expectation surfacing that we are nowhere near the end of this tumultuous season. Before this pandemic took hold, it already felt as though the "ordinary" life of the team had been shattered due to the toll that the robbery took on all of us, but especially for those team members who were directly affected. Now the upheaval from this pandemic has again put "normal" far out of everyone's reach.

For myself, this upheaval has gone even further. As international borders close and airports shut down, short-term team members were encouraged to consider whether it would be better for them to return to their home countries while still possible, or whether to stay and wait out what could end up being a much longer term than they had anticipated. Considering that my internship term at Kibuye was scheduled to end in May, and because no one can predict if flights to Burundi will be available at that time, I chose, with a very heavy heart, to return early to Canada. I made that decision less than 48 hours ago and after a flurry of frenzied activity, caught one of the last flights out of the country along with the John family who are returning to the US for home assignment and for Eunice to deliver her new baby. Some members of the team such as Alyssa, the Wendlers, and the CK Faders who were all hoping to return to Kibuye in the next couple months, now have the opposite problem, where they are stuck in the US.

The team making a "tunnel of love" for the van as the Johns and I headed out

As I sit here in the Dubai International Airport awaiting my connecting flight to Toronto, I have been continuing to read through Eric's book Promises in the Dark. I feel there has rarely before in my life been a time when a topic like this one has been as relevant. In his book, Eric explores chapter by chapter the tension between how God's promises are something that we can experience now, but also not yet. He talks about what it looks like to cling to those promises when we can't see the evidence that they are holding true.

Camping out in the Dubai airport for my 17 hour layover, reading Promises in the Dark

A week ago Saturday, Eric spoke at family worship on Psalm 77.  In this psalm, the psalmist earnestly questions the promises of God. This psalm begins as a lament, crying out to God. The psalmist appears to have been taking "hit after hit" in his life (as the team and many of us as individuals have been recently) and he is bringing his sorrow and questions before God, truly asking whether God's steadfast love still remains when he can see no immediate evidence of it. He cries out, and the interesting thing is that, unlike in many other psalms, he is not comforted. He writes, "When I remember God, I moan; when I meditate, my spirit faints". I appreciate this psalmist's perspective because the truth is that sometimes we call out to God and we do not feel immediately comforted. Yet, then in the second half of the psalm, he reminds himself of the deeds of the Lord. He remembers the time that God led his people through the waters of the Red Sea. He remembers that God is massive, beyond our understanding, and that sometimes he leads us through difficult things, not around them, not avoiding them, but heading into them and coming out the other side.

Kayla and I listened to a Tim Keller sermon recently titled "A Prayer of Rest", based on a biblical understanding of Psalm 91, a psalm seemingly about God's promises of peace and security, that helped me to understand this concept. In this message, Keller talked about how Psalm 91 is actually about how God is with us in trouble, not that he keeps us from all trouble, at least not all physical trouble - he does keep us from the everlasting "trouble" and harm of being consumed by our own sins. I would highly recommend giving this message a listen, especially if you are finding yourself with more time at home as many of us are or will be.

This past month, I have been reading through the book of Revelation and just finished the day before I left. I do not claim to understand even a tenth of what is going on in that book though I find it fascinating, but it struck me this time when reading it, that a main theme of the book can more or less be summed up in one half-verse,

"In this world you will have trouble. But take heart! I have overcome the world."
- John 16:33(b)

Reading Revelation reminded me again that, as Christians, our hope is not ultimately in this world. The world as we know it is going to pass away. The promises that Eric describes in his book, and the promises like those described in Psalm 91, are both being fulfilled now, but also not yet.

One of my favourite C.S. Lewis quotes, that I have frequently been reminded of lately, comes from a letter that Lewis wrote to an American woman who was sick in hospital and who thought that she may be dying. Lewis wrote,

"Has this world been so kind to you that you should leave with regret? There are better things ahead than any that we leave behind."

Ironically, this woman pulled through her illness and it was Lewis instead who died three months later. I like this quote because it reminds me that when we experience hardship in this life, we shouldn't be surprised, in fact it should be expected that the world is not "kind" to us...though we live here for now and are called to be present here, our ultimate hope is not in this life, and if some things are not going well for us, that is actually how Jesus said it would be...for now. It reminds us that the ultimate fulfillment of every promise in its truest form will only arrive when the perishable is made imperishable, when heaven and earth are made new. I actually find that a hopeful thought, because it means that I don't need to keep trying to reconcile all of the painful and difficult things that I experience in this life to what I know that God promises. Yet, I also think that we can and do see, in part, ways that God is fulfilling those promises even now, and when we see the goodness of God, we need to keep showing it to one another, reminding one another, and spurring one another on in faith and hope.

Please pray for this community as they brace for the impact that Covid will have in Burundi - in a highly malnourished and immunocompromised population, no one is quite sure what will happen when it comes. Pray for the team for encouragement, grace for one another, wisdom for team and hospital leadership, and capability and resources to face what comes. Pray for them to grow with one another in spiritual maturity, perseverance, and hope. Those are some of the things that I am going to be continuing to pray for them even as I leave. They need your support and prayer as they take up places on the frontlines of where, ultimately, this virus may end up hitting hardest.

(A bit of lovely Alexis artwork her teammates added to this post after she finished it)

Robbery

(from Eric)

We've all been reeling since approximately 7:20 pm on Saturday, February 22nd.  It's a bit hard to share on the blog, but we're sharing it here so that you can pray for us.  So that you can bear our burdens with us.

On Saturday evening, the Watts family (minus Jonah and Matea who are at school in Kenya) were having dinner with Kayla and a visiting nurse Julie who is a missionary in Rwanda.  Four armed men broke into their house with the intent of stealing a bunch of money that they mistakenly thought was somewhere in the house.  All the adults except George were tied up.  George got beaten up quite significantly, stabbed in the thigh, and choked for information as he was forced through different rooms of the house in a search for more money that wasn't there.

Through the courageous intervention of a Burundian friend in charge of security, the perpetrators fled with whatever valuables they had found, dropping most of them on the way.  A pursuit of the perpetrators (by Burundian members of the hospital and surrounding community) followed, resulting in the immediate arrest of some, and the continued pursuit of others.  The rest of our team and other Burundian friends who live in the same area had been informed over text immediately and had sheltered inside our homes until the danger was confirmed to have passed.

The Watts family is now in Kenya receiving some needed support and counseling, as well as being with Jonah and Matea.  George's physical wounds are healing well.  Kayla similarly spent some time in Kenya but has now returned.

As the immediate events have unfolded, we have been greatly encouraged as a team by the outpouring of support from our local community here at Kibuye, up through every level of leadership to the national level.  Additionally, all the resources of Serge were quickly and thoroughly mobilized to care for us all during these events.  So many people have given of their time and effort to demonstrate their solidarity with us and the work of Kibuye Hope Hospital.  We are also involved with a number of leadership levels to redesign our security systems so as to prevent such an episode from ever being attempted again.

***

We're still reeling in many ways.  Our daily lives go on, but it was one of those events that changes the flavor of all that comes afterwards.  Both our hearts inside us as well as the world around us are quite dynamic right now, and we're wondering where we'll land.

There is a sense of feeling violated, and wondering why God allowed this to happen.  There is a simultaneous, intense gratitude for the many ways that we were spared from it being so much worse.  It's truly a strange mix of emotions.

I once heard that we are all looking for people that have scars in the places where we have wounds.  This is true on many levels, and it's part of the reason that our friend Steve, who flew from the States to work with the Watts family and Kayla in Kenya, is such an amazing trauma counselor.  But this fact is never more true than when we look at Jesus.  Our Lord has suffered.  His scars, persistent in his glorified resurrection body, testify of promised healing.  We look to him.

As Kayla wrote afterwards: "In moments when my faith feels weak, I am thankful the object of my faith is not weak.  And in the moments that I don't understand, I am learning to trust His sovereignty."

Please do pray with us.

Eric's Book: Promises in the Dark

(from Eric)

Several years ago, I drafted a series of stories and reflections from my life as a missionary doctor.  The stories center around the theme of "Walking with Those in Need Without Losing Heart".

Jesus calls his followers to enter into the broken places of the world.  That much is clear.  This may be on a personal level, like a family member dealing with a divorce or a chronic illness.  This may be on a vocational level, as a social worker or an inner city teacher or a missionary doctor.

We are called to walk with those in need.  And it takes its toll on us.  How do we avoid burn-out on the one hand and cynicism on the other?  How do we remain faithful in the midst of the tension that is our broken world, where the promises of God are not yet fully realized, and where even their smallest glimpse can be hard to find?

My hope is that this book has something valuable to add to these questions.  I'm excited to say that, after several years of refining, Promises in the Dark: Walking with Those in Need Without Losing Heart will be available October 14, 2019 (less than 8 weeks away!) from New Growth Press.

It's already available for pre-order on Amazon at this link.

Here are a couple endorsements that I've been glad to see:

“Eric McLaughlin brought me to tears with this honest look at the difficulties of the life of a compassionate caregiver. When dealing with this broken world, there are no simple answers. But there can be hope. Promises in the Dark is essential reading for anyone who walks with others through suffering and questions how to keep on going.”
- Dr. Kent Brantly, Ebola survivor; coauthor of Called for Life

“Why do we love lawyer and doctor shows? We know both worlds bear extremity, suffering, and passion, and that is at the core of what intrigues and terrifies us. Eric McLaughlin, a missionary physician, engages the raw and compelling questions of what it means to be human and trust God in the face of a world that is stark and at times cruel. Eric offers no simple answers or trite truisms. Instead, he invites us to engage the questions with the confidence that there is nothing we face that Jesus has not first entered. The song sung in this brilliant book is that death is real and horrible, far more so than our antiseptic Western world can bear, but death never gets the final word. There is something about life and love that lingers far longer than heartache, and it is this story that enables us to enter all other losses with hope. This book will intensify your passion and encourage you to live the best story ever told.”
- Dan B. Allender, Professor of Counseling Psychology and Founding President, The Seattle School of Theology and Psychology

“What does a lived-out faith look like in the throes of an African field hospital? In a world of disease, death, and brokenness—of broken promises—how does one live as a light to the world? The answers to these questions are to be found in the pages of this honest book.”
- Michael Card, Songwriter, Bible teacher

Holiday Giving: the Kibuye Feeding Program

(from Eric)

As we wrap up our time in the United States, several people have asked us about special needs for Kibuye during the holiday season.  Though you can give to many projects and missionaries that can be perused at serge.org (all of which are tax-deductible and will be used to a worthy cause), we'd like to highlight the Kibuye Feeding Program.

Burundi is arguably the hungriest country in the world per the Global Hunger Index.  They didn't have data to include Burundi in this year's ranking (though they have recently topped it), but they still note Burundi as the country with the highest rate of kids who don't reach the full height potential due to nutritional "stunting".  We learned early on that malnourished patients don't heal, and thus, in 2015, Kibuye became the 2nd hospital in Burundi to feed their patients, a move which, thanks to dedicated staff and generous donations, transformed our ability to bring health to our population.

Also included in the Feeding Program is a twice-weekly Busoma (the multigrain nutritional porridge manufactured on the hospital campus) distribution program for identified malnourished children in our community.

These programs combined cost about $6500 per month, which purchases about 20,000 patient meals and supports the nutrition of about 250 children and their families at home.  So, please pray for provision for this program and consider giving to it.

You can easily turn this gift into an alternative Christmas present by dedicating a gift to someone.  Here are a couple ways to put the numbers together:

• $8 feeds a hospitalized patient for a month
• $10 feeds a malnourished child in the community for a month
• $56 feeds the pediatric ward (and their moms) for a day (during the busy season)
• $135 feeds all the hospitalized patients and their caregivers for a day
• $312 feeds all the malnourished children with Busoma on a given day who come to the twice-weekly program
• $1700 feeds the pediatric ward (and their moms) for a month
• Be Creative and mix these numbers as you will!

Burundi Feeding Programs three logos: Serge/Hospital/Friends from Radio Friendly on Vimeo.

There and back again

(from Eric):  

A couple months ago, with heavy hearts, the Baskin family, in collaboration with team and Serge leaders, decided that God was calling their family back to the United States for the foreseeable future.  This has meant major transition for their family and significant loss for both Kibuye Hope Hospital and the Serge Kibuye Team.  I am very grateful that they have been willing to share from their hearts during this transition.  Please continue to pray for their family in this new phase, and our team as we feel their absence.

***

(by Darrell)

For I know the plans I have for you.  

In light of the changes my family has seen this summer, I have often reflected on this declaration and on one of its corollaries, namely that Darrell Baskin does not know the plans God has for him. If I had, I might have assailed their logic and questioned their cost. A price precious both in sacrifice and treasure.

After over a year of language training in France and then following nearly a year of learning to live in Burundi, my family returned to the US this summer in order to seek healing in mind and body.  But now we know that it wasn't just for the summer, it's for the foreseeable future.

For I know the plans I have for you, declares the Lord, plans for welfare and not for evil. 

And now I ask, do I trust Him and His plans now that they no longer align with the dream He once instilled in our hearts?  Now that I have returned for a week to pack up our beautiful house in Burundi. Now that my children have wept and sought solace in their pillows upon seeing videos of their friends who remain at Kibuye.  Now that I’ve seen the patients I can no longer care for and the eye staff who have been saddened by my absence. Now that I walk a lonely and poorly understood road few, if any, of my peers have ever traveled.  I find myself asking if this is what welfare should look like.

...to give you a future and a hope. 

My future, for now, is in the US where I see friends, churches and people who supported us, and I respond to them sometimes with joy, sometimes with sorrow, sometimes with shame and grief over this nearly insurmountable loss.  At times, it has been a loss of calling, even identity.

Then you will call upon me and come and pray to me, and I will hear you. You will seek me and find me, when you seek me with all your heart.

In our grief and wrestling, we have turned, over and over, to the Lord. And He has heard us.  He has met us in our place of need. We don't have all, maybe not even a few, of the answers for why we're here now, but we remain steadfast in our belief that He alone brought us to this place.  We never would have chosen this convoluted path on our own. Someone asked me last week how I would proceed if I were to have a chance to do it all over again.  My response then was that I would obey God again and follow His direction even if it seemed counterproductive or confusing or wasteful.

When I was a teenager, my mom once told me that Abraham was obeying God when he took Isaac up the mountain to sacrifice him. And he was obeying God when he sacrificed the ram instead of his son. If Abraham had stubbornly held on to the original plan from the Lord to its final conclusion, he would have actually disobeyed God and missed the whole point of walking with God in a dynamic relationship. Even more, would it have been faith if Abraham knew what was going to ultimately take place?

I can't pretend to know the plans God has in store for us, but I do know the One that has engraved me on the palms of His hands.  I know the One who went with us to France, then to Burundi and now back to Texas.  I am convinced that He will never leave us or forsake us.  And He is enough for me and my family.

In Only Four Months

(By Alyssa)

I recently returned to Burundi after four months HMA in the US. From emails from teammates as well as from missionary training, I expected some things to have changed during my absence. But, wow - I completely underestimated to what extent! When you live in a rural setting and daily struggle with limited resources and "facing African realities", it's easy to think that progress is too slow. Hopefully this blog post will be an encouraging reminder to my teammates as well as to our friends that this corner of the world is indeed developing!

 (Above and below) Burundian physician housing. The above picture is taken from the vantage point of my front yard. McLaughlin's house is just to the right of the picture. In less than four months a site has been chosen next to our houses, funds have been raised, ground broken, and significant construction has been completed including a roof, windows, and walls! We look forward to welcoming our Burundian colleagues to the neighborhood. 

And speaking of neighborhood, we now have four long term missionary houses completed and occupied. My house (shared with our MK teacher) is the first in the below picture followed by Faders and Cropseys. (McLaughlin's house is just behind the photographer.) The kids are loving running back and forth along the shared backyards - we enjoyed a fabulous game of Capture the Flag together on Saturday! Oh, and that Land Cruiser on the right is also new. Our team now shares three vehicles - a 15 passenger van, a small car, and the Land Cruiser. All the vehicles are white - evidently Jason's preferred color for cars. Actually I think he's oblivious to the aesthetics of the vehicles - just as I'm oblivious to what is under the hood!

So now that everyone lives in their newly constructed houses, the quadplex below is empty. It served us well for over a year and now it will be perfect for hosting visitors. You can see that Carlan & Abraham left some tree saplings behind in apartment 1 to welcome the next inhabitants.  

 And it will be easy for us all to greet new visitors on this newly widened path between our houses and the quadplex.

And below we have the other big change in the neighborhood - the Miller family! We miss the McLaughlins as they begin their HMA in the US, but we are happy that their house and some of their clinical roles are being filled in their absence by Drs. Joel and Janette Miller and kids. The Millers have been missionaries in Burundi longer than we have and have graciously hosted us innumerable times in Bujumbura. And now they are not just sweet friends and colleagues at Hope Africa University but neighbors, co-workers, and MK classmates. We're so thankful for their willingness to fill in at this time.

Happy birthday, Janette! 

Miller family with hospital behind

And speaking of missionary kids, the girls wanted to demonstrate the hard work on their garden (which didn't exist a couple months ago). Burundian friends have confirmed that learning to hoe is actually part of the curriculum of elementary school in Burundi, so Elise, Mekdes, and Ella are right on track! You may remember that one of our first Kirundi phrases learned was "The woman hoes"- maybe not such a useful phrase in English but very relevant in a country where subsistence farming is the primary occupation!

 Significant progress has been made on the new church (on left above, on right below) - including many archways, a bell tower, and trusses for the roof. As I understand it, the construction is primarily being done by church members themselves, one brick at a time. This is the church where we worship on Sundays. 

 And, look! Another new path! So much for our frisbee field. Actually it was prime for ankle spraining so better to use a different field for frisbee, and the landscaping looks great. You can't tell in the picture but it is actually outlining the design of the Burundian flag - pretty creative! 

 New student dorm (above) complete and occupied by approximately 60 medical and nursing students

New building on right above and below - the new Salle de Staff. I'm astounded at how fast this building went up. Ground had not been broken when I left 4 months ago and it has been completed and in use for weeks now. This was a huge need as prior to this there was no space big enough to hold all the hospital employees. While some days it seemed like "there's always room for one more on the bench," that wasn't actually true! All hospital staff and students begin each day here with devotions at 7:30am, and the room is also used for morning report, student lectures, hospital meetings, etc. And now no one has to stand outside or crowd in the doorway straining to hear! 

 (Above and below) The inside of the Salle de Staff

New students. Currently the fourth year medical students are at Kibuye - the first time we've had 4th year students as formerly that was considered a pre-clinical year. The med school program previously was a 7 year curriculum (including undergrad) but has now been decreased to 6 years. The fourth year students are pretty green but they are making progress at the end of their four months at Kibuye. And I'm sure they'll have grown leaps and bounds by the time they graduate in 2 1/2 years.

Porridge for patients! I'm so, so happy to see my patients being fed porridge each morning. Most are chronically malnourished and live in extreme physical poverty so I was never sure if they were being fed in the hospital. Now I'm sure they are eating at least one nutritious meal per day. Thanks to many of you who have made that possible! 

 Above is a 10 year old boy significantly improved after arriving comatose with meningitis. It continues to astound me how God heals these kids who would be hospitalized in intensive care and likely on ventilators elsewhere in the world. This is not new but is an encouraging reminder especially after I spent some time visiting the pediatric cardiovascular ICU in the US and was discouraged thinking of how few resources we have comparatively in Burundi. 

"Lenscrafters" at Kibuye - benefitting the eye patients and the hospital

New paintings with Bible verses throughout the hospital

A new classroom (on left above) at the primary school where Jess teaches English, where Sammy and Micah attend Kirundi school, and now where Elise and Anna attend French class

New water reservoir benefitting the hospital and us - hopefully this will make a big difference in reducing water shortages as the dry season begins in a couple months

New ariel view of the hospital from Kibuye rock with the student dorm (blue roof) visible on the right and the new church (with tower) left of center

Some things don't change. I love these familiar sights of colorfully clad patients and visitors at the hospital (above) and happy kids helping with small siblings (below). 

Thanks for joining me on the tour! 

For Unto Us a Child is Born

(from Eric)

In the last several decades, international health efforts have significantly reduced the number of children under 5 years old who die.  It's quite a victory, though there is a long way to go.  Kids still die in terrible numbers from stupid stuff like malnutrition, diarrhea, and pneumonia.  But they do it a lot less frequently than they used to.

There is, however, one section of this problem which has had a notable lack of progress, and it is the neonatal period, or the first month of life.  If you get sick during this period, your chances of survival aren't nearly so much improved as if you get sick later.  The graph now looks like this:

If you can survive the first day of life, your chance of being a neonatal mortality is cut in half.  If you can survive the first week, it is cut in half again.  In other words, this is a very very high yield time to intervene.

So, why hasn't it changed much?  I don't know.  Maybe people think it's too expensive or technological.  If you walk through an American NICU, you will probably think so.  Maybe the pediatric people saw it as more of a maternal problem than a kid problem, and the maternal health people saw it as more of a pediatric problem.  I don't know.

***

Our time in Kenya gave us a good vision of the possibility of intervening for these little kids, and arriving here, Alyssa was determined to get a little neonatology department going.  The hospital administration graciously gave her a room in the maternity building, and Jason had a few incubators built from local materials.

It was a bit of a rocky start.  Just after the opening of the service, I covered for Alyssa during a one-week absence.  We had a few premature babies.  We weren't reliably weighing them (which is absolutely essential in these cases), and all the moms were saying that they had no milk because they had no food because they were stuck in the hospital with their premature baby who wasn't growing because they had no milk because...  It was enough to be quite discouraged.

But she persevered.  (My single contribution was realizing the inaccurate weight problem was because the nurses and students didn't know how the use the scale.  I wish all solutions were that simple.)

Now that Alyssa is gone, I have gravitated over to Pediatrics, and I found a marvel.  Somehow, in the last few months, this service has transformed itself into something young, simple, but very legitimate.  My first day rounding, I found about a dozen patients on neonatology.  The increase in numbers is expected, since there is absolutely nowhere else to go to get care for these kids, so they get referred to us.  I approached it with a bit of trepidation, but I found reliable records and growing babies.  A few antibiotics, a good feeding regimen, and mother's milk.  And you can save so very many lives.  Lives that will hopefully have many decades in front of them.

That first day I had the privilege of discharging this little baby (seen here in Jason's homemade incubator, modeled after those used at Tenwek in Kenya):

This little one was born around 900 grams (i.e. just a shade under 2 pounds).  900 grams!  Here, in rural Burundi!  In a wooden box made by Jason.  Milk and a few antibiotics.  There are many that size that we lose, and we will continue to lose them.

But not all of them.

Not this one.

Here at Christmastime, we celebrate the coming of a baby.  God didn't skip that step.  It has been said that, in the incarnation, God ennobled the human race, and that we are to treat others with even more dignity because, not only are they made in God's image, but one time for all, God was made in our image.  And so a baby came.  A baby like this one.

Yes' ashimwe. (Jesus be praised)

On Being Rich, Part 2: New Houses and Goat Roasts

(by Eric)

The first of the McCropder families is in a permanent house.  We, the McLaughlins, moved in about 3 weeks ago, and have been loving the space and the sense of settling.  Thanks to all that have made this possible.

Celebrating my 33rd birthday in the new house.  (Yes, that is quite a couch.)

After several years of living in temporary housing (since we left our home in 2009, remember that saga?), the luxury of this nice house all to ourselves weighs on us a bit.  This is certainly added to by the poverty that is all around us.  We've written about these tensions before (and I'm sure we will again), but there is another side to that coin.

A while ago, we decided that, at the end of every major construction project (like a house) we will celebrate in traditional Kirundian fashion:  A Goat Roast.

Everyone takes the afternoon off, and all the workers get to sit down, rest, drink a Fanta, and enjoy a goat-based meal.  And, like every good African ceremony, no one can enjoy themselves unless there are several speeches made (a phenomenon inexplicable to us Americans).  So last Saturday, we hosted the first of these feasts.

Several workers getting the meal ready

Anna helping out, peeling boiled plantains

Five goats were purchased, and several crates of sodas.  The meal was rounded out by boiled and fried plantains topped with a tomatoey sauce.  Roughly 100 guys (and a few ladies) came to enjoy the food, the drinks, and the speeches.  I received a lot of applause for my line of "Nizeye ko, mu misi iza, tuzokwubaka izindi nzu, kandi tuzofungura izindi mpene nyinshi", which translates as "I hope that, in the days to come, we will build more buildings, and we will eat many more goats."

And that's kind of the point.  Not the goats, but the fact that our presence here has been employing over a hundred people steadily, some of them for close to a year now, and with the expansion projects of the hospital, I wanted to encourage them that we hope there will be steady employment for them for quite a while.

There are days that, from a development standpoint, it seems that one of the best things we do is just to live here and be (relatively) wealthy westerners.  There couldn't be a more uncomfortable role for us, but if you look, you can find signs of development.  More builders riding bikes to work instead of walking.  That guy is wearing a nice new shirt.  That other guy got glasses.  And these things weren't gifts.  It was a result of needed, viable employment, and in the process, needed buildings are built, and these guys provide for their families while increasing their skill level and work experience.  Here's the group (it's a bit hard to appreciate how many of them there are here).

So there is a lot to celebrate:  The comfort of a new home, the completion of a long process, the necessary help from a bunch of workers, and the steady employment of the equivalent of a decent sized village.  A good day.

Water Update

Six months ago, this hospital had no running water.  Handwashing was not a routine practice.  Water was carried up the hill by bucket so that surgical instruments could be washed and sterilized.  The water came from a nearby spring which provided about 40,000 L per day for the entire community, including 15 community taps, the hospital, and the hospital staff housing.  Water shortages and outages were a frequent occurrence.  

In February of last year, an Engineering Ministries International assessment team evaluated the water needs and water distribution options.  The team determined that a well the hospital had drilled was capable of pumping about 192,000 L per day, which could meet the expanding needs of the hospital campus and the surrounding community for many years.  A few months later a second team developed a master plan for the long range development of the hospital, including a plan for the water distribution system.  Some generous donors stepped up to meet the financial needs for the water system.

Earlier this year, Gaspard Ndikumana, the project leader for construction of the new water system, arranged for dozens of local men to dig the ditches, construct the well head, and lay the water pipes.

The work was done very well, and the water system now efficiently delivers plenty of water to the hospital and the surrounding area.  We thank the Engineering Ministries International team, the men who implemented the plan, and the people who donated to make it possible.

A Growing Team!

by Jess Cropsey

We are pleased to announce that we have officially increased the size of our team (and no, I am not pregnant)!  A family and a single have recently been approved to join us here in Burundi.  This fall, we are looking forward to welcoming Sherry* who will help with teaching our kiddos at Kibuye Hope Academy.  She is a passionate, energetic, and hard-working young teacher with a heart for evangelism.  We are thankful for her 1-year commitment to our team and praise God for how He answered our prayers for a teacher.  

*Given that she hopes to serve in a sensitive area overseas in the future, she would like to remain anonymous on the blog.

A little further down the road, we will welcome Caleb and Krista Fader.  Yep, you read that right...there are more Faders headed our way!  Yippee!!  Caleb (Jason's brother) is a civil engineer and Krista is a pediatric nurse practitioner.  Both Caleb & Krista are missionary kids who grew up in Kenya and also have experience serving in Africa as adults.  They visited us in February, along with their barely 6-week old firstborn, Liam.  Although they were only here for a week, their visit "just happened" to coincide with an important water project that has significantly improved the availability of water at the hospital.  In the midst of so many projects, we have keenly felt the need for someone with Caleb's skills to work alongside the Burundians on building projects & hospital maintenance.  Also, we hope that Krista will have the opportunity to be involved in nursing education at some point in the future.

Please pray for Sherry & the Faders as they prepare to join us in Burundi.  If you would like to partner with them financially in some way, see the information below. 

Sherry:  Please contact me (jesscropsey@yahoo.com) for details

Caleb & Krista Fader:  http://www.whm.org/give/missionary?ID=51319 

Each of them meet critical needs here and we are eager to have them join us as soon as possible.  A financial gift to help them along their way would really be a gift to all of us on the team. 

In the fall, we will also be welcoming some short-termers.  An anesthesiologist and his family (with 3 kids in our kids' age range) will be joining us for about 10 months.  In addition, we are excited to host a high school graduate whose family is known and loved by all McCropders who have spent time in Ann Arbor.  He plans to be here for about 6 months beginning in October to help with childcare & education for our kids.

I was encouraged and challenged by a quote from C.S. Lewis that Sherry recently sent me.  God has ordained and called each of these individuals to be involved in the life of our team and we look forward to seeing how He will change us and others through each of them!

“In friendship...we think we have chosen our peers. In reality a few years' difference in the dates of our births, a few more miles between certain houses, the choice of one university instead of another...the accident of a topic being raised or not raised at a first meeting--any of these chances might have kept us apart. But, for a Christian, there are, strictly speaking no chances. A secret master of ceremonies has been at work. Christ, who said to the disciples, "Ye have not chosen me, but I have chosen you," can truly say to every group of Christian friends, "Ye have not chosen one another but I have chosen you for one another." The friendship is not a reward for our discriminating and good taste in finding one another out. It is the instrument by which God reveals to each of us the beauties of others.” 

― C.S. Lewis, The Four Loves

New Name for World Harvest Mission

by Jess Cropsey

Just this past week, World Harvest Mission officially announced that it has changed its name and will be continuing as "Serge".  In a recent e-mail (see below), Executive Director Bob Osborne explains the reason behind the name change.  

The vision, mission, and values of the organization remain the same.  Please visit www.serge.org for more information about the name change, answers to frequently asked questions, and several brief videos from leaders in the organization.

First Impressions: Poverty

The blog silence for the last few days is largely a result of us not being sure what to say about beginning work.  Our own processing is so much still in process that it's hard to articulate anything to share.  It's a lot to take in, and one could slice it on any plane.  So I'll pick one aspect, not because it gives a comprehensive perspective, but because it might be adequately bite-size.  The good news is that we're not going anywhere, so if you keep reading the blog long enough, a holistic picture of life at the hospital ought to emerge sooner or later.

Taking care of patients here is hard.  We understand limitations, but we are all hit by a whole new level of limitations.  One of the largest of these is poverty.  This is not new, but it is at a whole new level.  According to GDP, Burundians on average make about 1/3 of what Kenyans take home.

Example:  Rounding on the medical service yesterday, and we see a man in his 50's with urinary obstruction.  We can determine that it's due to his large prostate.  That part doesn't cost anything (ask your neighborhood urologist why).  Jason can take his prostate out.  Great!  We can help this one.  Let's do it!

Problem.  There's a decent chance his urinary obstruction has made his kidneys function poorly enough to be dangerous for his surgery.  And actually hospital policy means he needs a few labs before going to the OR.  OK.  Our lab can check those!  Let's do it!

Problem.  It's too expensive.  It's probably at least $8 to get all those lab tests and he doesn't have the money.  His family is coming tomorrow.  Maybe they will have something…

This is an illustration.  In most other cases, the problem of the grinding poverty here comes into play right at the beginning, so they wouldn't make a very interesting illustration.

Poverty calls everything into question.  "Standards of Care" are almost always income-dependent.  Everything we know of such standards is therefore subject to drastic reevaluation.  This test for this problem.  This medicine for this benefit.  Is it worth it?  Well, what does this cost mean to you?  There is often no straight answer to this question, so it gives us a great sense of "shooting in the dark".  Was that the right decision?  I think so, but how can I know?

And this, of course, is humbling.  Or maybe humiliating.  Sometimes the difference is hard to tell.  And maybe not all that important in the end.  Humility (or maybe humiliation) seems to be one of the hallmarks of our clinical beginning here in Burundi, as it has been throughout our time of language learning.

It's not a new thing.  It's certainly not a bad thing.  But it's hard.  Pray for us as we go.

A Trip Back to Tenwek

(from Eric)
  
There is nothing like banana trees to make you feel like you've been gone awhile.  It's due to their capacity to grow so quickly.  Behind the apartment building where we all lived for our two years in Kenya, we had a shamba where we grew lots of produce, and we had transplanted a few banana saplings there in the first six months or so.  Towards the end of our term there, we took this picture.  You can see a few banana trees in the background, spindly and a bit solitary.

Several months ago, someone sent us this picture of the same plot, now with a veritable forêt of trees.  Wow, I guess has time has passed.  And when I look at the picture of Maggie above, I must admit that small children have the same effect as banana trees.

The end of our time here in France is within 3 months.  Some of our team members will have need to travel back to the states afterwards (weddings and such), and so we set a month hiatus before we are all due in Burundi at the beginning of August for the next phase of this journey.

What to do?  After some deliberation, it was decided that my family and Jason will be spending the majority of that time at Tenwek Hospital.

We look forward to a time of getting back into medicine, seeing old friends, renewing contacts, showing off the interim growth of our family, hiking down to the waterfall, and of course, checking out the banana trees.  We will even be staying in our same apartment, which happens to be vacant at the time.

Maybe it's the time that has passed, or maybe it's the end of an alpine winter, or the lack of medical practice for a while now, but it seems that the nostalgia of our lives at Tenwek is at an all-time high.  When we think about visiting so many colleagues and friends, sharing a mug of chai, waking up at precisely 6:15 to a cacophony of birds, it's enough to send us into the third heaven.

Our time there was a time of great joy.  And yet we know (and if you have been reading this blog, we hope you know as well) that, as life always is, it was so much more multi-dimensional than that.  It was joy and sorrow.  It was routine and frustration.  It was smooth and so very very difficult.

So, what to do with all this nostalgia?  Ride the wave until you crash on the rocks of reality, i.e. when you remember all the other dimensions?  Stifle it down to avoid the disappointment?

Because living cross-culturally involves such cycles of emotions with regards to one's host culture, I think the question is an important one.  And it strikes me that such nostalgia has at least a chance of being a time of great gain.  A time of truly loving and enjoying the blessings of a place and its people, while letting the frustrations roll of one's back a little more lightly.  Maybe something that can linger, or even last.

We'll let you know.  But for now, we're excited to shake a million hands, greet people in Swahili, keep a warm chapati in one hand and a bottle of Stoney Tangawizi in the other, and enjoy our trip back to Kenya.

Tobias Timothée McLaughlin

Over four months ago, Rachel told me that the ideal date for our baby to be born would be April 1.  She didn't want another March birthday (she and Ben are in March), but she didn't want to wait any longer than necessary, and that way, true to McCropder tradition, the baby could share a birthday with Sarah.

Never mind that it was 8 days prior to her due date, and thus 15 days prior to her French due date (they use 41 weeks for some reason).

Yet, lo and behold, months later, more or less during Sarah's birthday celebration, the contractions kicked up in earnest.  Several hours later, Tobias Timothée McLaughlin was born at the Albertville hospital.  All has been well.  Rachel will provide her take on being a patient in the French system later on.

It may be remembered that Ben has two middle names:  "Kenneth Kipruto", the first being Rachel's dad's name, and the second being his Kenyan name, meaning "boy born while traveling".  Timothée (pronounced Teem-o-tay) is in fact the French spelling of my father's name, thus keeping the same pattern, but combining both elements into one.

Questions from the peanut gallery:

• Was he a chunker like the others?  8lbs 9oz, in between the others
• Does Tobias has a really cool-looking French birth certificate?  No, it is in fact the most underwhelming legal document I have ever seen.
• Is he eligible for French citizenship?  No, you must have a French parent to be eligible for citizenship.
• Could he be president of the United States?  This was actually the first question he asked me after being born.  It's funny how the answer to this doesn't seem to be straightforward, but the most reliable answer I've been given is that, since he acquires citizenship at birth (by virtue of being born to American citizens), that he could be president.

Thanks to all of you who have been praying for us.  Please continue.

Psalm 126:3 - "The Lord has done great things for us, and we are filled with joy."