Engineering Team Visit

A few weeks ago, Kibuye gratefully welcomed a team from Engineering Ministries International who came to help with the development of thoughtful plans for the expansion of Kibuye Hope Hospital.  

EMI team and KHH staff/administration

This is the third time an EMI team has come to Kibuye.  EMI has been hugely helpful in the past with mapping out strategic and responsible infrastructure growth here by creating a Masterplan for the Kibuye Hospital campus.  As we implement hospital and community development, their expertise has been crucial.

The focus of their time here was the detailed design of a 48 patient ward which we hope to start January 2016.  This will not only create much-needed space for patients, but it will provide a well-lit, well-ventilated, and beautiful hospital environment.  

The team also marked out exact locations for basketball courts and football pitches (soccer fields), worked on large scale electrical and water/sewage developments, and proposed various landscape architecture ideas in order to fully capture the beauty of this place.  And the kids loved watching the surveying part of the work.

Thank you so much to the whole team for your tremendous help here for the future of Kibuye, and thanks also for your gracious attitudes, as welcoming 13 people all at once meant that beds were a bit hard to come by.  Thanks Phil, Dan, Caleb, Tony, John, Stanley, Jonathan, Dave, Matthieu, Kesleigh, Tim, David, and Kevin!

Home Cultures and Misfits

(from Eric)

Today was my last day of work at Kibuye for 2015.  We are headed back to the US in a couple weeks, after a Serge East Africa retreat in Kenya (the preparations for which are probably the reason for the recent radio silence on the blog).  We will return in January.  Our families are waiting for us.  Our nieces and nephew that we've been longing to meet for over 2 years.  Our hearts are full in the waiting.

And there will be also be the joy of entering our "home culture".  Sometimes I wonder to what extent the US is still my "home culture", since, as the years pass, I'm not sure I fit in there the same way I did before.  I forget what normal is.  Glimpses of US life strike me as foreign.  Maybe hanging out with my fellow Serge missionaries in Kenya will be a type of "home culture".

But, a couple days ago, a brief conversation reminded me that yes, the US culture is still very much home.

Rachel said something about the days when she is at home with the kids, that she has to change out of her pajama pants before the Burundian guy that works in our house arrives.  Why is that?  It's not that she is trying to dress up to a certain extent for someone who is not family.  And it's not modesty.  She can wear pants at home here with no one getting offended.  It's because any Burundian is likely to think that it's weird to stay in old pajama pants, when you could spend the day in nicer (and more formal, and less comfortable) clothes.

And we know that.  So, you get out of the pajama pants.

(aside:  many of the more village Burundians don't know pajama pants from normal pants, and thus wear them to church.  But the point stands.)

This is an example of the long-term "strain" of living cross-culturally.  Because, in the US, everyone agrees that it's just nice sometimes to spend the morning relaxing in your pajama pants, and few of us would begrudge that to our neighbor or friend.

In fact (and I think this is the point), the question would never even come up because, living in your home culture means that your values and preferences are those of the culture around you, and therefore you can just glide along with what is already ingrained in you.

And that makes my heart yearn, here at the "32 months since leaving the US" mark.  A yearning for it being easier.  A yearning to not have a subtle, but daily and persistent, tension between what seems "right" to me, and what seems "right" to the culture around me.  I would just like those things to automatically be the same, and so not have to think about it sometimes.

There are probably those in the US that constantly feel like what they want is always at odds with the culture around them.  I think we might call them "misfits".  They don't "fit".  And that must be terribly difficult.  And in a sense, that is what you become when you live cross-culturally.  The good news is that, for the most part, people expect you to be weird, "foreign", or in the best of times "exotic".  But even with that extension of grace, it is still grace extended to the "misfit".  

Wendell Berry writes:

The frog with lichened back and golden thigh

Sits still, almost invisible

On leafed and lichened stem,

Invisibility

Its sign of being at home

There in its given place, and well.

I am not that frog.  Because we don't fit, we stand out.  We are always the furthest thing from invisible.  And if invisibility is a "sign of being at home", then we are not at home.

And when you know that there is a place where you could be invisible, where your heart is not a "misfit" in the same way - it's out there, but you just haven't seen it in a very long time - that can be both a comfort and a further challenge.  

Or maybe it's just a good reason to be thankful on the eve of your return.

COTW: Unexpected Birthday "Gift"

by Rachel

Last Wednesday was my 36th birthday.  Somewhere along the way, I guess I started to fall into the trap of thinking that on my birthday, everything is supposed to go “my way.”  It’s my special day, all about me, etc etc.  The kids are supposed to sleep in, I’m not supposed to have to work, other people will cook all my meals for me, and in general I will spend the day with my feet up eating chocolate.  When I write it out, it sounds a bit ridiculous but never the less, those are the subconscious or slightly conscious thoughts rolling around in my head every time a birthday comes up.

Well, things didn’t exactly go “my way” last Wednesday.  For one thing, we were having medical visitors from Buja up for the day and I had agreed not only to meetings but to provide lunch for everyone as well.  I figured it would only make the day slightly more busy.  Ha.  The medical visitors showed up minutes after the power cut out (which was to be a 28 hr outage, something obviously not known at the time).  I pushed away thoughts of my failing crockpot dinner out of my mind and spent some time talking about cervical cancer screening.  Half an hour later, we were ready to head up to the hospital to check out the ultrasound machine when a hospital worker came literally running up to my door.  This is significant, because no one runs here.  There was a lady at the hospital with a ruptured uterus.  She needed help, immediately.  While I was trying to rearrange the visitors’ schedules quickly, I received calls from both Eric and Greg, trying to get ahold of me for this emergency.  Time to go.

I spent the next several hours in the OR, performing a hysterectomy and trying to stop the giant puddle of blood on the floor from growing larger.  The patient was on an adrenaline drip to keep her heart rate up and had actually received SIX units of blood (previously unheard of here).  The rupture had started at the top of her uterus and continued all the way down the left uterine wall and then backwards into her retroperitoneum up towards her renal vein and artery.  Friends, I was WAY out of my league.  I put in stitch after stitch and finally stuck in a bunch of surgicel and started praying that the bleeding would stop.  It did, or at least it stopped enough to close her up.  I had minimal hopes that she would survive, but thanks to great anesthesia care (there’s a reason they call Greg the “Reanimationist” in French) she not only made it through the day, but I’m hoping she will be going home this week.  Miraculous.

The miracle wasn’t exactly the focus of my day, though.  I returned home over an hour late to the lunch I was supposed to be preparing.  The power was out the rest of the day.  The phone networks were down.  The kids were grumpy.  What kind of a birthday was this after all?  Blah.  But now that a few days have passed, I’ve had some time to reflect.  Greg told me that the chance to save a life on my birthday was perhaps the greatest gift possible.  He did say it as a joke, but maybe he was right.  Maybe the chance to focus on something other than “my special day” was really what I needed.

What was it that bothered me so much about the day, the fact that I got to go and help a mother of 5 return home to her family and live a (hopefully) long and healthy life?  Of course not, that’s one of the reasons I’m here.  I think that the problem was that it wasn’t how I PLANNED the day would go.  I wasn’t in control of the situation.  I wanted my day to look a certain way and it didn’t.  But who’s to say it wasn’t a better way to spend the day?  Perhaps the birthday gift was, in the end, a stripping away of my closely held illusions of control.  When are we ever, really, in control of everything around us?  Perhaps the scattered, fragmented, crazy day was a reminder to me of who directs my steps, who holds me in the palm of his hand, and who is ultimately in control of everything around me.  

Congo: Revisiting Hero Bubble Gum

(from Eric)

As some of you very faithful blog readers may remember, in early 2010, we posted this after encountering our first "Yes We Can-dy" in Kenya: Obama Gum.  It remains a favorite phenomenon, and though it is Kenya that has a claim to President Obama, all of Africa feels a certain fascination with the American President.  In fact, as enthusiasm in Kenya has waned a bit (seeing that Obama being President of the US means little for Kenyans), Obama Gum has become harder to find there.  

However, there is a pecking order for these things within Africa, and Kenya's leftovers get sent to...Burundi.  So, we can still find Obama Gum here, though I don't like to think about when it might have been produced.

Obamania in Gum Form: 2010

Last month, visiting DR Congo for the first time with the Eye Team, I was delighted to find that the Hero Gum is, in fact, quite egalitarian.  So, I'm happy to present to you another Hero Gum: Nelson Mandela.

Seeing as though I only found the wrapper, I unfortunately cannot provide you with a side-by-side taste comparison, which (I think we can all agree) would have been absolutely fascinating.

Hero Bubble Gum #2: Nelson Mandela

What this shows us is that, if one day we are able to post a photo of McCropder bubble gum, then all the world will know, with the utmost degree of objectivity, that the mission for which God has prepared us has been, in fact, fulfilled.

Outgrowing the "McCropder" Name

by Jess Cropsey

As you may remember, last year we announced that a new long-term family would be joining our team. We are excited to welcome Caleb & Krista Fader and their son Liam to Burundi sometime this summer. They are completing their cross-cultural training and fundraising and will soon move to Burundi to begin Kirundi language study.  It has also been a huge blessing to have a teacher with us here this year and she has decided to stay for another year.  We are thrilled!  She’s done a fantastic job with the kids and has also had a wonderful ministry with the medical students.    

Over the last few months, we have also officially added two other families to the team. Darrell & Becky Baskin and Logan & Julie Banks have been accepted by Serge and have begun their support raising efforts to join us here in Burundi on a long-term basis. Both families are in the support-raising/training & preparation phase and hope to go to language school in France sometime in the next 12 months.

Darrell Baskin is a retina specialist that completed his fellowship training at Wills Eye in Philadelphia, where he & John met during John’s residency. He is finishing his final year of service with the U.S. Air Force in a few months. John is very excited to have Darrell join the work in the eye clinic. He will bring many complimentary gifts & skills to the clinic and will also be the very first retina surgeon living in the country of Burundi. His amazing wife Becky and their 6 children are excited for this new phase in their lives.  (Family Blog:  www.baskinbrigade.wordpress.com)

We first met Logan & Julie Banks at Tenwek Hospital in Kenya during our 2 years with the Post-Residency Program. Logan was working for 5 months at Tenwek as part of his international fellowship program. He is a family medicine doctor with specialized fellowships in international medicine and obstetrics. For the last several years, he has been involved in the family medicine residency training program in Missouri. He will be a vital part to the work at Kibuye. As we approach 2 years of service in Burundi, our rotations for time spent in the U.S. have begun and we are realizing that having another doctor that can provide coverage for patient care as well as medical education is hugely important. With his training, Logan is qualified to do that in many areas. In addition, his experience in a residency training program will be valuable as we look to start internship and residency programs in the future. Julie is a woman of many talents (that do not currently exist on our team!) and will bring a lot of creative energy and new ideas.  Their two young boys will be great playmates for the McLaughlin & Cropsey boys.  (Family blog:  www.thebanksoffshore.com) 

We are excited to welcome these new families and look forward to what God has in store for our team and Kibuye Hospital in the future. While the “McCropders” can always be a reference to the 3 families that first started out to Kenya together 6 years ago, we recognize that our team is much larger than this now. Conveniently, Alyssa Pfister & Carlan Wendler both fit into the acronym. With the addition of Caleb & Krista Fader, we now have 4 family units sharing the “- er/-der” ending. We (the CROPseys) are living large with 4 whole letters all to ourselves!  So, with joy for God’s blessings in the expansion of our team, we move on from “the McCropders” and embrace the slightly less interesting “Serge Kibuye Team”.  (For now, our team blog will remain the same.)

Please join us in prayer for these families as they raise support, attend cross-cultural training, pack up their belongings, and begin language study. We understand the unique stresses and challenges of these phases of preparation, but also know how important they are.  

Just in case you were wondering, there are still some specific slots that we’d like to fill on our team.  Stay tuned for more info on folks that we’re looking for (both short-term and long-term)!  

Mama Natalie

by Rachel

I wanted to give everyone an update after the maternal mortality and postpartum hemorrhage blogs.  About six months ago I was over at Alyssa’s house and we were discussing a course she was teaching called “Helping Babies Breathe.”  It’s a pretty awesome way of distilling newborn resuscitation down into a few simple, easy steps that can have a profound impact on short term and long term survival for babies.  A company called Laerdal Global developed the curriculum and sells newborn models (complete with lungs, pulsating umbilical cord, etc) at cost to developing countries with high neonatal mortality rates.  They are called “NeoNatalies,” ha ha.  She was essentially teaching me the course because unlike in the US, the delivering nurse or obstetrician is usually the person who does the newborn resuscitation, not the pediatrician (see previous post about the “Knock at the Door” and response times....).

As I was reviewing the materials, I noticed a line about other products from Laerdal, including something called “MamaNatalie.”  Of course this caught my eye and I went online to learn more.  This company has also developed a low cost model of the uterus and a curriculum entitled, “Helping Mothers Survive.”  It’s essentially a curriculum for lay midwives and community health centers that don’t have physicians, but I figured I could adapt it for our purposes.  So, thanks to some generous donations from you guys, I went ahead and purchased 2 MamaNatalies for our students.  

I am currently in the middle of teaching a 40 hour Obstetrics course to our current 4th yr med students (that translates to their first clinical year).  Every few weeks we’ve taken a break from lectures to do simulations.  The class breaks up into 2 groups (we have an awesome intern here named Molly who is starting med school in the fall and has been helping me with these simulations) and take turns practicing skills like delivering a breech baby, managing a shoulder dystocia (stuck shoulders after normal delivery) and treating postpartum hemorrhage.  I’ve said it before and I’ll say it again, I think that of all the lifesaving interventions our students can learn, managing postpartum hemorrhage (and also, probably even more important, newborn resuscitation) are the most important, highest yield skills that will save the most lives.  So I am super excited that with our MamaNatalies, the students aren’t just learning about this by reading a book or listening to a lecture.  They can actually do hands on training, estimate blood loss, practice essential skills so that when the real thing comes, they’re ready for it.

Thanks to all of you who have contributed to this project!  Hopefully in the future we can expand this training not only to med students, but nurses, nursing students, and midwives as well.  There’s a lot of potential in this country...much change is needed, but we are already starting to see some fruits as well.

Vanity, Resurrection, and Kibuye Triplets

(by Eric)

In mid-December, the first set of triplets was admitted to the new neonatology service at Kibuye. The first two were boys, and a bit smaller girl.  They each weighed between 0.9 and 1.1 kilos (2 and 2.5 pounds).  There was even a bit of fanfare.  Some government guy came and gave the mom several cans of formula (otherwise prohibitively expensive), and then we set to work.

They didn’t do too well at the beginning.  No major problems, but it took about 3 weeks to start gaining weight and about a month to reach their birth weights again.  But then they hit a stride.

Day after day, I would visit them, talk with their dedicated mom, and barter with her about their feeding regimen.  But they gained more and more.  It seemed that their tenure in the hospital would match my tenure as Alyssa’s replacement, and I thought that this would be my legacy as the fill-in pediatrician.

Wednesday, we celebrated.  The oldest boy, named Dieudonné, had reached discharge weight.  We discharged him, and he would wait in the hospital for his siblings to be ready to go home.  We were thankful.

Thursday morning, I was told that Dieudonné had a fever the night before and wasn’t breastfeeding well.  I checked him out.  He didn’t look too bad.  We readmitted him and restarted antibiotics.

Thursday evening he died.

I couldn’t believe it.  Tragic things happen all the time, but to take such a long, steady victory and watch it crash to the ground in such a short time?  I didn’t feel guilty.  Just sad.  And defeated.  It can make you feel like it’s all in vain.  Even his name Dieudonné, meaning “God given”, could almost seem like a mockery, now that he has been taken away.

I went to see the mom, to give her my condolences.  She was crying.  She told me that she is afraid the second son is sick, too.  She speaks for the first time of wanting to take the children home.  I don’t think she will.  She’s not defiant, just in despair.

I had a few minutes before rounds, so I walked home and sat down with my old Book of Common Prayer, praying and searching for some comfort.  I thumbed it’s 150-year old pages, remembering that the health state of the original owners of this book was maybe even worse than my patients.

I turned to the Burial of the Dead and found verses of hope in the midst of sadness:  “I am the resurrection and the life.”  “The Lord gives and the Lord takes away.  Blessed be the name of the Lord.”  “And after my skin has been thus destroyed, yet in my flesh I shall see God.”

And then in 1 Corinthians 15: “Just as we have borne the image of the man of dust, we shall also bear the image of the man of heaven...Behold, I show you a mystery.  We shall not all sleep, but we shall all be changed, in a moment, in the twinkling of an eye, at the last trump...When the perishable puts on the imperishable, and the mortal puts on immortality, then shall come to pass the saying that is written: ‘Death is swallowed up in victory.  O death, where is your victory? O death, where is your sting?’”

And it all ends in a surprising way: “Therefore my beloved brothers, be steadfast, immovable, always abounding in the work of the Lord, knowing that in the Lord, your labor is not in vain.”

Not in vain.  So be steadfast.  I couldn’t tell you how the truth of the resurrection makes the difference for whether or not my work is in vain.  But the promise is there.  It has been spoken to me.  And the one who promises is trustworthy.  And so, even if I don’t understand, maybe I can persevere.

Romains 12:15 - “Partagez les larmes avec ceux qui pleurent.”

(Share the tears with those who weep.)

Chick Fever

by Jess Cropsey

If you remember a post from several months ago, John was given two pigeons by a grateful patient.  After living in the schoolroom bathroom for a week while John constructed them a bamboo palace in our yard, the birds were relocated.  In less than one week in their new abode, they somehow figured out how to squeeze through the bars and within minutes of their escape, one of them was promptly eaten by a crow or hawk.  We found chunks of her feathers all over the ground.  The male was later spotted near the hospital, but who knows if he’s been able to survive the wilds of Kibuye.  Sadly, the bamboo palace now stands empty.

Snow’s passing was a bit traumatic, but the children were able to quickly move on when Biniyam (son of visiting anesthesiologist) received baby chicks for his birthday a few weeks ago.  All the kids ooohed and aaahed over the little balls of feathers and loved to follow them around while they were eating.  The following day, when the children’s eyes were momentarily distracted, an attentive crow swooped down and claimed one of the little feather-balls for a tasty snack.  “Facing African Realities” — this is the motto of Hope Africa University and we continue to understand more clearly what this means! 

If you are a parent, you know the tendency of kids to want the new thing that other said-kid has.  I can’t even begin to imagine what’s the rage these days in the U.S., so I’ll spare myself the embarrassment of hazarding a guess.  Here at Kibuye the latest and greatest fad is baby chicks.  Elise asked for baby chicks for her birthday, so 3 more little ones have just been added to the flock.  I must say, Elise has some natural “mother hen” tendencies, so it’s working out well so far.  We’re hoping they live to see their first birthday, or maybe we should be more realistic and shoot for the 1-month mark!  

The Cropsey chicks -- Cookie, Frodo (also the name of the lost male pigeon - Micah's a big fixated on Lord of the Rings), & Sam (Sam's pretty creative, huh?)

First Surgical Safari Goes to Congo

by John Cropsey



















Two weeks ago, the Kibuye Eye Team returned from its first-ever surgical safari trip to Eastern Congo. The team included 6 Burundian eye staff, myself, and Eric McLaughlin.  Going into the trip, we were praying that God would make it clear whether or not we should go in light of the ongoing rebel activity in the area.  God seemed to make the way clear for us and reports from the missionaries on the ground said that all was calm, so we moved ahead with the trip.  We drove two vehicles from Kibuye to the Congo border, which was nothing more than a couple little buildings and a rickety one-lane bridge over a swamp.  We were thankful for the Congolese medical director who met us there and helped clear us through customs on the Congolese side without having to pay any major fees or taxes on our expensive equipment.  Upon entering Congo, the roads immediately changed from tarmac to dirt which we followed for the next 3 hours, sandwiched between the mountains and Lake Tanganyika.  We had to ford a few rivers, but only had to pull the team van out once with the 4x4 landcruiser.

When we arrived at Nundu Free Methodist Hospital, a sister hospital of Kibuye, we got right to work setting up our mobile operating room and organizing clinic for the following day. They already had 80+ patients pre-registered, so on the first day we screened those patients and found the ones needing cataract surgery. 

Since this was the first time that eye surgery had ever been offered in this area, many patients were afraid and only two of the surgical candidates were willing to have surgery that afternoon. 

The first two brave patients!

Thankfully, their surgeries went well and on Tuesday morning, everyone waiting in line saw that they had a good result. By the end of the week, we were able to do 50 surgical cases. We worked some really long days, several times operating past midnight. Our hosts, the Matthewsons, kept us well-fed and cared for and are now overseeing post-operative care for the patients.

My most memorable patient was this old man. When I first met him, I asked him how he was doing. Even though he was totally blind in both eyes, he enthusiastically responded “Je suis très bien!” (which means “I am very well!”). After receiving his sight back early in the week, he became the leading champion for the other patients to have surgery. He came back the last day wanting to have surgery on his second eye. Unfortunately we did not have time and he graciously accepted this.

This 10-year-old boy had bilateral cataracts and hadn’t seen since age 3. We successfully removed both of his cataracts using ketamine (intravenous) for anesthesia.  

Nundu is trying to rebuild after chronic civil war in the region. Some of the houses still remain gutted with everything having been taken except for the concrete walls and occasionally the roof.

Most of the Burundian eye staff that joined us on the trip had never been outside of Burundi before. This trip opened their eyes to the differences in culture, language, etc. that exist between their African brothers & sisters. Unlike Burundi, where a large number of patients suffer from something I have dubbed “Kurima Syndrome” (see note below), all of the Congolese patients who came to see us had an actual eye problem. The staff had never seen such a high percentage of actual eye disease!

Dr. Toney Van Mugisha -- my Burundian colleague (a Hope Africa medical grad) who hopes to complete an ophthalmology residency in the future

Elysée -- ophthalmic nurse

Josiane -- ophthalmic nurse

Pastor Emmanuel - vision screener, OR circulator

Pastor Hilaire - cashier, technician

Anosiate -- cleaner, patient attendant (talking to patient with paper in her hand)

Kurima Syndrome:  The word “kurima” means “to hoe” in Kirundi. It was the first verb that we learned and we initially thought that was weird, but shortly realized that it is because subsistence farming with a hoe is how most people make their living. For some reason, when patients have radiating pain in their neck and/or back, headache or chest/stomach pain, it is attributed to a problem with the eyes (as opposed to it being attributed to hoeing all day long or carrying large loads on their heads). So, they come to see me even though they often have no actual complaint with their eyes or vision. Dr. Toney, my Burundian colleague, has become very adept at screening these patients. So, imagine his surprise (and delight) when he realized that this phenomenon doesn’t exist in Congo.

This trip was a dream come true for me as God has given me the vision to bring eye care to hard-to-reach places in this region of Africa. We hope to return to Nundu on a regular basis. Thanks to all of you who prayed for us and this trip. Please continue to remember these patients in your prayers and pray that the seed of the Gospel that has been planted would grow in their hearts and lives. 

COTW: Fullness of Redemption

(from Eric)

Several weeks ago, a 7 year old girl came into the ER.  She was in a coma with a high fever, her neck arched back and drooling.  She had gotten sick a couple days prior, and fallen into this coma that morning.

We unfortunately see this kind of thing not uncommonly.  Most of the cases are cerebral malaria.  Some of them are bacterial meningitis.  A few of them are TB meningitis, but they don't usually get sick that fast.  Her malarial test was negative, but given the severity of her illness, she was started on both meningitis and malaria treatment.

Often these kids get better.  Sometimes they don't.  The next day this little girl still had a fever and looked no better.  We tried to think of anything else we could do for her, but came up empty.  Same thing the next day.  We prayed often for her with her family.

Around day 4 in the hospital, she had a break-out of red lesions around her mouth.  They looked like herpes.  Now the ideas changed.  Rarely, herpes (either the sexually-transmitted kind or the oral-transmitted "cold sore" kind) can develop into a brain infection.  And this would explain what she wasn't getting any better.

Herpes can be treated with acyclovir.  It's cheap, old, and effective.  So much so that in the US, it is often replaced with a newer, more expensive, and slightly more effective (maybe) version.

But we don't have that.  In fact, we have nothing at all to treat herpes.  So we're just watching her.  Praying.  Giving her IV fluids, and oxygen after she got worse.

Day 6, I look at her pupils, and one is definitely bigger than the other and not responding to light.  In short, this is a sign of impending brain death.  You can't really get worse than this and still be alive.

Her mom knows she isn't getting better and wants to take her home.  "To pray" she says, which I think means "to die", but who am I to question that?  I tell her that we have been praying for her, and we will continue to pray for her, but I don't think that she will succeed in getting her home, and even if we cannot guarantee that she will make it, I don't think that going home is the right thing to do.

She assents and asks me to pray.  So we pray.  (Witnessing this conversation, about 5 other patients in the room ask me to pray with them prior to finishing rounds in that room.)

The next day, she is a bit better.  Mom is satisfied.  Each day, she is a bit better.  She stops having trouble breathing.  She is able to eat a bit.  Mom never lets me pass her by without stopping to pray with her.  Eventually she goes home.

Her pupil is still big.  She doesn't talk.  She can sit up only with great assistance.  And there is a good chance that she will stay that way, but who knows?  If we keep praying, what could be gained?  I don't know what this girl was like before, but if I think of a young healthy Burundian girl, in the first couple years of walking to school with her friends, and compare her with the girl I now know, it's hard.

She's alive, and I thought she would die.

But she still needs so much healing.

And it's like that, a lot of the time.

***

In the hymn "Take the World, but Give me Jesus", there is a short phrase:  The Fullness of Redemption.

This girl is alive, now, with her family, at home, and I expected her to die.  That is redemption.  It is goodness, and for it I and her mom are thankful.

But it's not "fullness of redemption".  Not by a long shot.  And my heart yearns for Fullness of Redemption.  Sometimes we get to see it, in a particular place and time, but most of the time, it is something that falls short.  The malnourished kid gets over the pneumonia, but the family still doesn't have enough food.    Jason puts the femur back together, but the roads are just as dangerous as ever.  A father survives a stroke, but he can't afford his blood pressure medicines, so there's likely another coming soon.

But there is a promise.  A promise for fullness.  For completion.  Even for perfection, of a type that we probably won't have anticipated when it comes.  Something that almost always seems out of reach, even of our imaginations.  But it persists.  A quiet, insistent, pulsing promise:  

"I am making all things new."

Come, Lord Jesus.