Case presentations

To read about two interesting cases from the past week in Kenya and Burundi, click here.

Burundi

Amahoro! (Peace - Kirundi greeting.) We certainly experienced God's "amahoro" last week as we were affirmed in His leading us to Burundi as a team long term. We pray that "amahoro" will continue to reign in Burundi for many years to come. As you can see from the map, we didn't travel too far from Kenya - a short 90 minute flight from Nairobi to the capital of Bujumbura. We certainly noticed some similarities in another East African country but a lot of differences, too, culturally, linguistically, and materially.

Our host, Bishop Buconyori, and his daughter and her husband greeted us warmly at the airport and prayed with us prior to our 2 hour drive up country to Kibuye Hospital. Our team currently includes 8 adults and 6.5 children but only three of us traveled to Burundi this time around.

Kibuye Hospital, new maternity building

Sunday afternoon we enjoyed hiking near the hospital

Behind me down the hill is the hospital

Ariel view of Kibuye

I enjoyed rounding with the medical students each day on the various services (pediatrics, internal medicine, obstetrics). Dr. Marx in the above picture is Hope Africa University faculty and we look forward to working with him in the years to come.

Women and children waiting for immunizations

Medical students Blaise and Isaac with me and a malnourished 2 year old

This child fractured her femur one week ago in a bicycle accident but her mother wasn't able to bring her to the hospital until now. Bicycles are a very common mode of transportation in Burundi.

Busoma for breakfast - a type of nutritious porridge

I so appreciated the opportunity to teach such eager medical students. They desperately need more teachers and thus are forced to learn a lot from outdated textbooks. I found them to be bright, enthusiastic learners who asked insightful questions and learned quickly. It's so much fun to teach students who really want to learn!

Jason, Heather, & I identifying the proposed location of our future houses - quite close to the hospital and to the medical student housing. I didn't know surveying building sites would be part of my missionary job description!

Faders and I outside Kibuye Hospital

Teaching medical student Noel how to do a paracentesis

Rounding with medical student Alliance

The students requested teaching on examining a newborn

Elementary school children. There's not enough space for the kids to go to school all day, so 600 kids attend school in the mornings and 600 in the afternoons. As you can see if you look closely, most of the children have no shoes.

Resuscitating a baby born by C-section without oxygen. There's only one small oxygen concentrator for the operating room and no oxygen on any of the wards. Thankfully the baby was ok. The other surprise was the lack of running water in the hospital - the pipes are there and evidently worked in the past, though, so hopefully the solution won't be too difficult. It was so helpful for Jason and I to work in the hospital so we now know how to prepare. For instance, we will begin looking for an oxygen concentrator to bring with us! And for some advice on setting up the lab (currently only hemoglobin, malaria smear, type and cross, and HIV test is available - no WBC, platelets, coagulation studies, creatinine, electrolytes, CSF cell count, etc.). But I was thankful to discover that care for children under five, pregnant women, and people with HIV or TB is provided by the government free of charge, so I think we'll keep quite busy!

We enjoyed a fun game night with the medical students. This class of 16 students is in their 6th out of 7 years of medical school at Hope Africa University. When more teachers are available at Kibuye Hospital (us!), the students will spend most of their 6th and 7th years at Kibuye. After hanging out with the students last week, I'm really excited to work with them more when we return as well as to mentor and disciple them and enjoy more game nights!

Hope Africa University in Bujumbura. We will likely lecture here at times, but most of our teaching will be clinical up at Kibuye.

View from HAU

Children at a deaf school in Bujumbura we visited saying, "I love you"!

We won't need to learn sign language, but we will need to learn both French and Kirundi fluently. We have new motivation for language study after discovering how necessary both languages are for everyday life. Few of the rural patients spoke any French (only Kirundi) but morning report, interactions with hospital staff, and even customs at the airport was all in French. We plan to study French in Albertville, France for 10 months beginning September 2012 and then to study Kirundi on arrival in Burundi in 2013. It's a long road ahead but we are so thankful for this opportunity to live in this beautiful county and to serve these beautiful people with God's "amahoro".

Village living

I enjoy living in community with other missionaries. Because Tenwek is a large mission hospital with a nursing school, two residency programs, and an internship, more than 50 Americans live and work in this area. The church service at the hospital on Sundays is primarily attended by hospital staff and missionaries and thus is mostly in English with a few Swahili songs. I appreciate being able to worship in English and understand the service. My Kenyan friends and colleagues also speak fluent English and, because they are mostly physicians who have lived in Nairobi, they are quite familiar with Western culture and several have even traveled overseas. These facts have made my cross cultural adjustment a bit easier, but they also mean I'm more removed from the average villager than I would be in another rural setting - and than I likely will be in Burundi. I'm grateful for the opportunity this weekend to experience village life a little more intimately.

Janet invited several of us to her church and to her home. The church recently built this beautiful new building but has yet to finish the roof, windows, or floor, so they are raising funds for this project.

View from the church with traditional Kipsigis homes - round mud structures with grass roofs

For the church offering, people brought produce, sugar cane, and even this chicken. These items were then sold and the money was contributed to the building fund.

View from the outhouse :)

Heather and Anna enjoying their meal of beans and rice

Janet's house

Chicken coop

Janet and Richard with their children Mercy and Emmanuel

In intern Bible study last week, we discussed the story of Isaac blessing Jacob and Esau. This story made a lot more sense to people who come from a similar culture where the oldest son is blessed and meal preparation takes a lot longer as you have to kill the animal first and then cook it. It's interesting to note the similarities between the rural culture here in Kenya and that of Bible times. I look forward to learning more about rural living in the years ahead.

The verse I shared with the congregation during our introduction as guests is relevant no matter where you live, though:
"Mungu kwetu sisi ni kimbilio na nguvu, msaada utakaonekana tele wakati wa mateso." Zaburi 46:1
"God is our refuge and strength, a very present help in trouble." Psalms 46:1