I am a Child of God

(from Eric)

I find myself prone to a lot of ups and downs.  Not in a worrisome way, but it is still troubling.  If I'm at the hospital and my patients are all doing well, then I feel great joy at my life and who I am.  On the other hand, if there is a run of bad outcomes, I can feel quite down.  Then, if I go and have a good conversation with a teammate, I can feel great.  A little while later, someone comes to me with a new problem that wasn't on my radar, and I feel like a failure.  I try to shake it off and remind myself of the bigger picture - that there will always be some problems and that there are good things as well.  And that works.  Sort of.

Up and down.  Up and down.  Sometimes quite rapidly, actually.  I feel free sharing about it because 1) it's undeniably true, and 2) I'm pretty convinced that I'm not alone in this.

What's going on inside of me?  I believe it's a question of where I'm rooting my identity and my worth.  My ups and downs are telling me that I have founded my identity on what I do - on my successes and failures.  Since my life is inevitably a mix of successes and failures, my perception of self-value rises and falls like the tides.  To the extent that my heart embraces the Christian truth that my identity is rooted in the unchanging grace of God, that he has loved me and adopted me as his son for no other reason than his unmerited love, my sense of value finds a firm foundation.

So, my ups and downs mean that I've put my faith in the wrong place, namely in myself.  I know this, and what's more, I've known it for a long time.  So why is it still a struggle?  I think it's because some deep part of me really wants to earn my own value, and thus I rebel against grace.  I know it's a non-starter, but the battle rages on.  Recognizing my reticence to such amazing love gives me further reason to thank God for the unconditional nature of his acceptance of me.

So, pray for me.  In fact, pray for us all.  Our team is passionate about our work, and so I don't think it's a stretch to say that we are all tempted to place our identity in the wrong place.  We need frequent, even constant reminders that we are God's children by his grace.

There is a popular church worship song these days which I have enjoyed on this theme.  A couple of weeks ago in our local French service, Dr. Alliance's wife Cynthia led us in singing this song.  The power at the church was out at the time (but not the hospital!), so I got to enjoy it a cappella with a single drum made out of an ancient 50-gallon shipping drum with a cowhide over it.  Enjoy.

Ultimate Community

by Stephanie 

Sundays, I think they’re pretty great. Church, time with family, time for long walks and at 3pm comes the pinnacle of the week for many on our teammates: ultimate frisbee. 

I had never played ultimate frisbee before coming to Burundi. And for those of you who have never played, this is the gist: There are two teams and one frisbee. The goal of a team is to pass the frisbee person to person down the field into an end zone to score a point. Once a person catches the frisbee they cannot move from the spot where they are standing, they must pass the frisbee to a teammate. The frisbee can move in any direction. The opposing team tries to block passes and intercept the frisbee. The game is fast moving with a lot of running up and down the field following the frisbee. Making the game a little more challenging is the fact that the field we play on is not exactly even, there are many divots and even a gigantic baptismal hole just beyond one end zone.

To be honest, although the rest of my family plays weekly, I still don’t often play. However, you can find me hanging out on the sidelines, cheering on the players and socializing with the spectators. There are always plenty of spectators! 

One Sunday afternoon I took a long walk with some of the ladies on our team. We crossed the main road and then walked up a series of paths to an area where none of us had been before. After quite a ways a teenager started walking with us and practicing his English. When we asked him to point us back towards Kibuye he led us down tiny paths and back to the main road. Then, he shook our hands and said “Goodbye, see you at 3 for frisbee.” I was shocked. This kid lived pretty far from us, and yet since that day I’ve seen him many times on the sidelines of the field watching the game and eager to practice his English.

I think this story points to the greatest part of Sunday’s ultimate frisbee games, the community it’s brought together. The Burundian doctors and their wives, people who work as guards or making busoma, and students from the local elementary school all join together with our teammates of all ages on the field, eager to play. Another group joins together on the sidelines to chat and cheer them on. There is also usually another group of spectators gathered on the road on rout to or from the hospital and wondering what game is being played.  Frisbee is not a game the Burundians grew up playing, it was introduced to Kibuye by our team and has really taken off. In fact, I’ve recently seen young kids in our community playing frisbee with the lids to oatmeal cans on the dirt paths by their homes. 

For Carlan’s birthday this year he decided to take our ultimate game up a notch and host a tournament.  He even made a trophy for the winners. 

Four teams signed up for the tournament. One of the teams was made up entirely of Burundians, the FC Busoma team. This was the first time that we’d played with one team being just Burundians.  They dominated the field! It was incredible! I was playing for another team and yet I couldn’t help but cheer when they scored because the speed and agility with which they played was astounding. Although we all played hard that day, FC Busoma took home the trophy. Everyone was quite excited about the well deserved win!  

COTW: A Beloved Flower (Guest post from Dan Galat)

(from Eric)

This past week, we hosted a team of orthopedic visitors from Samaritan's Purse.  The two orthopedic surgeons were from Kenya, Drs. Dan and Jomo.  Dan and his family are old friends of our team, and several of us lived across the yard from him back in Kenya.  It was a delight to see them, and they made a significant impact in the lives of lots of families, bringing advanced orthopedics care that would be otherwise inaccessible.

One of the nice things about visitors is getting to see your own familiar context through the eyes of someone else.  With that in mind, here is Dan's blog about a young man that he operated on, which is a great story in and of itself, but also contains some of his glimpses of Kibuye.

(and just for kicks, an ancient blog from 2010 about John and Jason going inter tube rafting in Kenya with Dan's son.  Dan enjoyed reminiscing about this story when he presented last week at Grand Rounds.)

Pi Day

by Jess Cropsey

Our entertainment options are more limited here (which I actually love) -- play outside, watch a movie, ride a bike, read a book, play a game, do an arts/craft project, ...  There are no museums, playgrounds, libraries, shopping malls or amusement/water parks.  In fact, many of the moms and kids can go several months without ever getting into a vehicle.  So, we often go big when it comes to small holiday celebrations.  You know, to spice things up a little bit!

As a math educator, I couldn't pass up the opportunity to celebrate Pi Day on Thursday, March 14th (which also happens to be Albert Einstein's birthday).  My 6th-7th grade math class looked at the frequency in which digits appear in Pi.

My 2nd grade class read Sir Cumference and the Dragon of Pi and then completed an exploration activity similar to the one by the young boy (named Radius) in the story.  They discovered that a little more than 3 pipe cleaners (cut to the size of the diameter of the circle) were needed to go all the way around a circle.

Both classes also contributed to a paper chain representing the first 100 digits of Pi, with each color representing a specific digit.

During the lunch hour, we had a school-wide party.  In groups, kids measured the circumference and diameter of some of the yummy food contributed by the moms (pizzas, a giant circle cookie, quiches, pies) as well as circular objects in the room.  

 

Of course, I made them record their data and do some number crunching to discover the relationship between the circumference and diameter of a variety of circles before they could eat!  Talk about motivation...

Math often gets a bad rap and many people have negative experiences with math class in school, so it was delightful to see all of the kids so excited about Pi Day.  While we were stuffing our faces with "pie", we listened to several students who had worked on memorizing the digits of pi.  The prize-winning student memorized the first 100 digits!  Incredible.

While these kids will never need to know more than the first 3 digits of pi, the lessons learned from setting a goal and seeking to achieve it, exercising their brain power, and wondering at the beauty & order of God's creation (even evident in mathematics) are all life-long.  

It's Electric!

Archimedes may or may not have harnessed the power of the sun to repel a Roman naval assault in 212 B.C., but the utility of solar power certainly has been well known since ancient times. The Romans used solar power to heat their famous baths and later Byzantine emperor Justinian included “sun rights” for particular buildings in the empire’s legal code. The modern harnessing of solar power began in 1839 when French scientist, Edmond Becquerel discovered a photovoltaic effect in an electrolytic cell. The electricity generation of the cell increased when exposed to light. Thankfully, the exploration into solar generated electricity did not end there. 

This week at our KHA learning experience day we examined the four sources of electricity used in Kibuye as well as other alternative energy sources. To start the day, Caleb led the kids through a tour of Kibuye’s “power plant.” Recently installed solar panels are the first and best option for electricity. You can read a detailed account about the solar project and the ITEC team in Caleb’s blog post from this past September (https://mccropders.blogspot.com/2018/09/solar-power-at-kibuye.html). Next, we looked at the inverters, multicluster, and the second best source of electricity: batteries. The excess electricity generated by the solar panels regularly charges the batteries. Finally, we looked at the last two sources, grid power and a diesel generator. Through the combination of these four sources, Caleb’s work, and ITEC’s technical support the hospital and residential area are supplied with near constant power. 

Upon our return to the school, the students put this power to use by researching other alternative energy sources online. Working in small groups, the students imagined that they were the marketing team for an energy company making a sales pitch to the city council of the new city of Kibuye. Their task was to develop a proposal that included the advantages to using a certain type of energy.  They communicated to the “city council” an understanding of how their type of energy works, as well as both pros and cons to their type of energy. The different types of power proposed included geothermal, biogas, and hydro-electric.

 

The tour of Kibuye’s power plant, researching alternative energy sources, and a reading of The Boy Who Harnessed the Windcombined to ignite the imaginations of our students to the benefits of uncommon solutions. Whether they harness the wind like William Kamkwamba or the power of the sun like Archimedes, we are excited to see how God will use the unconventional in their lives for His glory. 

COTW: Pott's Disease

(by Eric)

Continuity of patient care is a major reason why a lot of doctors choose to join my field of Family Medicine.  It is, on the other hand, a rather poor reason to go into missionary medicine in Africa, since the constraints of travel for most patients mean that they will not come back just for the sake of giving you good news.  Despite these travel constraints, I do have a number of patients that I've been treating now for a couple of years, and it's a great pleasure for them to come back and tell me how much better they are doing.

Yesterday, I saw a young mother that I had first met about a year ago.  She was in the emergency room with a gradual onset of paralysis of both her legs.  It was one of those rare medical moments where I could walk in and make the diagnosis in literally a matter of seconds.  I took a quick look at her back and saw this:

The similar back of a patient from Google.  I didn't get a photo of my lady.

This kind of a bump in your spine in Africa means that you have tuberculosis of the spine.  The bump even has a special name: a gibbus.  One of the vertebrae gets crushed in an angulated way, resulting in a spine that pinches the spinal cord.  It causes a lot of pain, and when it is severe enough, it causes paralysis of everything below that level of the spinal cord.

Tuberculosis of the spine is called Pott's disease.  It's an ancient disease, with old skeletons of Egyptians mummies showing the same deformity.  Percivall Pott was a brilliant British surgeon from the 1700's who lived in the era where the pinnacle of legacy was to have some terrible disease bear your name.  The treatment is standard tuberculosis therapy, which is thankfully available for free to our patients thanks to the government and foreign aid programs, but they need to continue the treatment for a full year instead of the standard six months.

I've been on a bit of a rant recently with my students regarding Pott's disease, because I have seen about six of these cases in the last two months, most of which have gone undiagnosed for a long time, for lack of someone who both looked at their back and understood what that bump means.

We started this lady on this treatment, along with some steroids.  She lives pretty close to Kibuye, so despite her obvious mobility problems, I saw her several more times.  The next time she was walking with a cane, and the next time with no cane, but still with considerable back pain.  We worked through those issues one at a time, and she steadily improved.

Yesterday, she came back for a last time to tell me that she is finishing her year of tuberculosis treatment today.  The bump is still there on her back, but the pain is minimal.  She can farm at her home with no significant difficulty.  There wasn't much to do from a medical standpoint, but I wanted to savor the moment with her.

I asked her how long she had the problem before she was put on treatment.  She had increasing back pain for three years before she was diagnosed.  I asked her if she had thought she would ever walk again.  She covered her mouth with her hand and let out the characteristic "Yooooo!" of Burundians.  Everyone was convinced that she would never walk again.  I told her that she has a lot to thank God for.  She agreed.  I told her that I also have a lot to thank God for, because of her.  And I thanked her for giving me a reason to rejoice.

***

It's not everyday that I get to be a part of a paralyzed person getting to walk again.  The surgeons do this on a fairly regular basis, but less so for me.  In Luke 7, Jesus mentions lame people walking again as a sign to John the Baptist of God's kingdom coming.  It is not the totality of the good news that Jesus brings, but it's part of it, and yesterday we understood together that God has been good to us.

Most of the time, we don't see the end of the story.  I often feel like some kind of Johnny Appleseed, wandering throughout the population scattering seeds, hoping that some of them take root and grow as intended, but not often getting enough chance to retrace my steps to know if it's actually the case.  So yesterday was a good reminder.

Of course, the Bible has lots of good seed imagery as well.  Here's the one that keeps coming to mind:

Those who sow with tears

will reap with songs of joy.

Those who go out weeping,

carrying seed to sow, 

will return with songs of joy,

carrying sheaves with them.

(Psalm 126:5-6)

A Big Deal

(by Greg)

Something happened recently at Kibuye, and it occurs to me that while there has likely been passing mention of it here and there, we have yet to celebrate it here on our blog.  It is a big deal.  Our team settled here in Kibuye with the goal to replace themselves with competent and compassionate African specialists.  In summary, the team goal is to work themselves out of a job.  While this may seem easy enough to a person reading this from the US, it is in fact an enormous challenge.  Burundi has not had in recent years residency programs to train specialists.  This translates into a country with far too few specialist physicians in all fields.  On top of that, for those few specialists, there is a great deal of pressure to remain in the capital, Bujumbura.  A small percentage of our graduating medical students are able to get into residency programs in other African countries.  But the next questions is, would any of them return to to work in rural Burundi?  

A few months ago, two of our former medical students who had gone abroad for specialty training  returned to work full time at Kibuye.  That means that for the first time since this hospital opened in the 1930s, we have hired our very first Burundian specialists.  It has been a great joy to work alongside Dr. Alliance Niyukuri, our newest general surgeon, and Dr. Tony Van Mugisha, our second ophthalmologist.  To take the enormity of this news one step further, Dr. Tony was born at Kibuye!

It is difficult to express in words how important this was for our team, and for the future of the hospital.  Both of these men are outstanding physicians, who are able to connect with our patients in a way that none of us are able to.  They are compassionate, intelligent, diligent and an absolute pleasure to work alongside day after day.  It has also been a joy to welcome Alliance’s family, his wife Cynthia and his two daughters to live alongside our team.  

While we hope and pray that this trend continues, and that in the coming years we are able to welcome more African specialists from various fields, for now we are simply celebrating God’s faithfulness.  He has done and is doing a good work here at Kibuye.  Some days I forget that this is true, but then I look across the drape in the OR and see Alliance operating, and I am reminded of just how good He is.  

 Dr. Alliance

Dr. Tony

Energy & Water Conservation Tips, Fader-Style

by Jess Cropsey

America truly is the land of plenty.  There are so many basic resources that we just take for granted because they’re always there — food, water, electricity, fuel, etc.  In Burundi, we encounter shortages in these areas on a pretty regular basis, and that’s even when we have the financial resources to buy them, a luxury many Burundians do not have.  

In recent weeks, there has been another fuel crisis in the country and we’ve had to restrict travel to essential trips only, coordinate trips with each other more than we already do, and use the most fuel-efficient vehicles for those trips.  While there is certainly inconvenience that comes with these choices, it’s so much easier to be grateful for the resources that we DO have when we see how much others DON’T have.

The Fader brothers (Jason and Caleb) are masters in the art of using resources wisely.  During a team business meeting, we were discussing the new solar power system at the hospital and how we can make lifestyle adjustments to maximize battery life and deal with power shortages when it’s rainy or nighttime.  As an off-hand comment, Caleb said, “You know, defrost your cheese wheel in the fridge instead of the counter so that the fridge doesn’t have to work as hard to stay cool.”  Two things struck me about this comment.  One, he said this like it was obvious, but I have to admit that I never would have thought of that as an energy-saving move.  Two, I found it interesting that he used cheese instead of meat as his example, but more on that later.  Unfortunately, many of us on the team don’t naturally think like conservationists simply because we’ve never HAD to (until we moved to Africa)!  

The Faders are slowly transforming me into a conservationist, but I still have a long way to go.  Here are some nuggets of conservationist wisdom that I’ve gained from them over the last 10 years.    

• Your fridge and freezer function most efficiently when full (because the already-cold or frozen items keep each other cold or frozen), so use water bottles to fill the space when needed.
• Keep a bucket in your shower to collect run-off and use the excess water to flush the toilets or water your plants.  Jason says that he never flushes the toilet with the handle anymore thanks to this tip.
• Minimize your meat intake.  Per earthsave.org, “it takes 2,500 gallons of water, 12 pounds of grain, 35 pounds of topsoil and the energy equivalent of one gallon of gasoline to produce one pound of feedlot beef”.  Yikes.  
• Pull something relatively “clean” from your dirty clothes pile to blow your (or your kid’s) nose to reduce the amount of toilet paper that you use.
• And of course, something that is now a regular bathroom routine… “If it’s yellow, let it mellow.  If it’s brown, flush it down.”  (We’re still trying to teach our kids that this rule doesn’t apply when you’re visiting someone else’s house in the USA.)    

While thinking about this blog, I thought that surely there must be so many more habits that are so natural to the Faders that they don’t even notice them.  After pressing for more info, this is what I I discovered:

• To conserve cooking gas, Heather never cooks only one thing in her oven.  If she’s going to bake something, she’ll fill it up as much as possible (and yes, cookies are actually the filler sometimes).  She only uses her oven twice a week (and that's not because she's eating out).  
• She sorts laundry not by color, but by dirtiness.  The less dirty load gets a quick wash and the other stuff (like a surgeon’s bloody scrubs or kids’ muddy clothes) gets a normal wash.
• Leftover drinking water after a meal is not poured down the sink, but instead used to soak laundry.
• She admits to still wearing clothes from her high school days.  Of course, not many of us could do that even if we wanted to!  
• She routinely erases post-it notes to re-use them (can’t replace those in Burundi!).

Really, there are so many gems here that I could go on and on, but I think you get the picture.  The Dutch-missionary combo is a pretty good way to ensure maximum thriftiness.  

Thankful for these teammates who have pushed me to think about how my lifestyle choices impact our world.  If you want to see how many planets we’d need if everyone lived like you, check out https://www.footprintnetwork.org.     

The Talking McLaughlins, Here and There

(by Eric)

During our time in the US, we did a good bit of speaking here and there, on various subjects.  Some of those sessions have been posted online (and some will be posted, but not yet).  Here are some links, if you are interested in listening more:

1.  Knox Presbyterian Church:  "The Already But Not Yet Kingdom".  Though I've preached at a lot of African churches, this is the only time to date that I've preached at a US church.  The text is John the Baptist and his doubts while in prison; the theme is our struggle to find hope in first fruits rather than finished work.

2.  StoryPrint.  My friend Wes Burtner runs a podcast about life stories of people in/from the Nashville area.  He interviewed me and the podcast is available here (Episode 003).  This 90-minute interview spans a lot of topics, including vocation.

3.  Louisville GMHC:  Rachel and I moderated the Marriage & Missions panel, including the Kims, the Chupps, and the Vaughans.  Our friends had some great perspectives to share.  There are pauses for small group discussion periods, but it should be easy enough to skip over those parts.

4.  Louisville GMHC:  I did a different breakout session entitled Walking With Those in Need Without Losing Heart.  The material for this talk was culled from four chapters of my upcoming book (more on that later!).

Refrigerators and Doors

by Rachel

A long time ago, before any of us moved to Burundi, we packed a container of "essential things" for life here.  Because we were unsure of what sorts of things would be available here, it was deemed a good idea to order appliances in the US that were wired for 220 volt electricity, so that we could have high quality appliances that would last for a long time, but that would also work well in our new environment.  Stoves, fridges, washing machines, and microwaves were loaded up in the container that arrived here December of 2013, several months before our houses were completed.

Where do you want your light switches?

Building a house was an adventure that was...occasionally...somewhat fun.  But mostly overwhelming and confusing.  Our house was the first to be built.  From almost day one, there were unanticipated issues.  Eric and I will never forget standing on a slope looking down at our newly poured foundations, then looking at the "blueprints," and then looking back at the foundations, wondering if there were perhaps new plans for our house that we didn't know about.  In fact, there were not, but every room except two had been mis-measured (by up to 2 meters).  We rolled with it.  We would occasionally get asked what kind of trusses we wanted (I didn't know what a truss was) or where we wanted our windows, and then Eric would rush off to figured out where to put windows and the workers would remove rows of already laid bricks in order to accommodate said requests.  So, yes.  An adventure to be sure, and we are so grateful that for the past 4 years, our teammate Caleb has helped the process run a little smoother every time.

The kitchen under construction

So, the day came in 2014 to move in our appliances in preparation for our move in, how exciting!  Sadly, there was an issue.  We had already been asked as to the width of our doorframes (um, standard size please?) and when the refrigerator was brought to the kitchen door, the fridge was about 10cm too wide.  Apparently Burundi standard size doors are not large enough to accommodate American "standard size" appliances.  Even after removing the kitchen door from the frame and the fridge door.  Finally, the security bars on the kitchen window were sawed off, the fridge was hauled in, and the bars were re-welded on.  We vowed to never remove the fridge again.

Trying to repair the fridge for the first time

I won't go into all the details, but the fridge has had a lot of issues.  It was repaired (while remaining in the kitchen) at least twice, and then we got an email on Christmas Day saying it seemed to have died for good.  Bummer.  Surprisingly, there is a Canadian Muslim refrigerator repair man now living in Bujumbura, who came up recently to try and repair the fridge.  Although he was not successful, he thinks that he will be able to fix it in his workshop in Bujumbura.  

We tossed around the idea of sawing the bars off the window again, but this time, Caleb came up with a new idea: why not widen the doorframe permanently?  I must admit, I was a bit skeptical.  The walls are solid brick and concrete.  I envisioned sledgehammers and half of my kitchen wall crumbling down.  But Caleb was very confident in our new plan.  So, on Wednesday, three very competent Burundian workers showed up at my front doorstep.  They promptly got to work with their little chisels and hammers (no sledgehammers, though) and removed 15 cm of wall.  Wouldn't you know it, the fridge fit out perfectly!  By the end of the day, a new frame was fitted, the concrete was poured, and other than the lack of paint, you could hardly tell work had been done at all.

It fits!

Now our fridge is on its way down to Bujumbura, hopefully to be repaired, and when it returns, I look forward to sliding it right in the kitchen door, with no chisels, saws, or hammer required.

Farewell, fridge...

As I was typing this up, Eric reminded me that actually we have had similar problems in America, so as "exotic" as this problem seems, we did have to move a queen box spring into our bedroom in Ypsilanti MI through the window...because it wouldn't fit up the stairs.  All's well that ends well....

The box spring in the Ypsi upstairs bedroom