Welcome to my blog! I will be posting information about my mission trip to Burundi Africa for those interested in following what I am doing...

"Beginnings are usually scary and endings are usually sad, but it's everything in between that makes it all worth living." -- Unknown

Thursday, May 9, 2013

My new mission adventure!

I am so glad I didn’t name this blog –Mikel in Burundi --- because now it is the perfect place to share with all of you my next adventure.

Just like the quote here on my blog – this is the beginning of something kind of scary, but I can’t wait to get past the scary part, because I know that it is going to be great!

I am in the process of getting licensed to be a foster parent – with the hopes of adopting through the foster system.   For some of you this may come as a complete shock, and others may wonder why I didn’t do this sooner.

Let me explain to you how I came to this decision:

Ever since I can remember, I have wanted to be a mom.  I used to play “mom” with all my dolls and stuffed animals as a little girl.   As I grew up out of the play stage, I still greatly desired to be a mom.   I have just been waiting for a husband, so that I could start my family.   This year when I turned 34, I had to come to peace with the fact that even if I met someone this year, the odds of being married and being able to start a family would most likely be a couple years out.   That would make me 36 and, at a greater risk for health effects on not only myself if I were to become pregnant, but also risk to the health of the baby.    Add all that to the fact that pretty much all of my friends have struggled with either infertility or miscarriages, or both, and my dreams of having a child of my own are seeming more and more like it might not happen.    When I try to explain this to people, I am often met with, “oh, you are young, you have plenty of time.”  But, the reality is, I am not that young, and I do not have that much time – when talking about fertility anyway.

Over the past several years I have tried to get involved in groups and activities where I could meet someone  -- and I won’t go into all the details here, but if I was willing to listen, I see now that God was clearly closing those doors for me.  Not closed forever, but closed for right now.   Just as clear as those messages were – the message about becoming a foster/adopt parent started to be presented to me.   I had thought about adoption off and on for years, but I always answered the question with, “I do not want to intentionally be a single mom.”  

Fast forward to now ---
It started with someone I hardly know, asking me if I had ever thought about adoption.   A friend giving me a book for my birthday that was about a family that gave up everything to go to Africa to care for orphans.   A long talk in a hot tub with a good friend about how much I wanted to be a mom, and that I was starting to realize being a single mom might not be that bad of an idea.   Something popped up on my FaceBook page about the Spokane Orphan Summit – and that same day my pastors wife mentioned the same orphan summit, and said we should go together.    Recently the front page of the Spokesman review was about Spokane parents that did foster/adoption.  I am taking a class right now about missions, and a recent class started off with the speaker talking about how he became an adoptive parent of 3 girls from China and then helped with an orphanage and getting more children from China adopted.  There have been other things as well, but these are some that have really stuck out to me.   Now, one could look at these things as all coincidences, or it could be like – I just bought a white SUV because I thought it was unique, and now everywhere I go I see them!  The reality of that is that they were always there, but you are just now seeing them.     One could look at this in the same way, but I am choosing to look at this as a clear message of a door that God has not only opened for me, but is nudging me through.

You may wonder why not just adopt, or do invitro fertilization?  Well, I am choosing the go through the foster care system, because of the incredible need.  There are children that are already here, or being born every day that need a home that will protect them and someone to care for them.  I believe that these children deserve to have these basic needs met, and I cannot say no to that.  

Once I decided to pursue this, I can tell you that I cannot remember a time where I have felt so much peace about where my life is going.

Am I scared…of course I am scared.  Do I wonder if I will be able to provide for the child that will be placed in my home…of course I do.  Do I wonder about the health of the child and pray that they will be healthy, but know that even if they are not, I will love them with all my heart…absolutely!   Do I wonder if my friends and family will accept the child and love them as much as I do….of course!   Do I worry about what I will do when they are sick, needy, not sleeping, not eating, crying for no reason…. definitely!     Do I worry about how much time I will have with them, if I will have them for only a few days or for the rest of my life…you bet!     Are these worries really any different from worries that a mom has when she is pregnant with a child?  I don’t think so.   I think these are things that all moms to be worry about, and this is no different.    When I told one of my best friends about what I planned to do – her response was this --- “you will be an amazing mother to whoever your child is, regardless of how they became yours.”   This is the kind of support and acceptance that I pray all of you will have.  If you are willing, this is a journey I would love to share with you, just like any new mom would want to share with their friends and family.    I can assure you that I have thought about all the pieces that go into this.  I know that I am opening myself up to potentially get hurt – but I also know that there are kids out there, that are living a life under circumstances that someone else choose for them, and they deserve better – they deserve a safe, loving, and nurturing place to call home.  If you feel like you really need to give me your opinions, I will listen to them, but know that you are not likely to change my mind.  

If you have known me for very long, you probably know that I have a hard time asking for help.  I think this experience is going to teach me how to ask for help! J  I know that doing this as a single person is going to be challenging, but I am up for the challenge.   Many of you may be wondering what does this mean about going back to Burundi --- because if you know me very well, you also know that I left a piece of my heart there, and I really deeply care about the people there and want to go back.  I don’t see this new journey as putting going back to Burundi off the table; I see it delaying it a bit, but definitely not taking it off the table.  I would love to bring a child to Burundi with me, and expose them to the love and kindness of the people there that I experienced.

Once a foster child is placed with me, I will not be able to give you the details of why they are in foster care, or the details of what is going on with their biological family – so please don’t ask.  I believe I can share pictures with you on facebook, etc., but cannot identify the child as a foster child or use any other identifying information.  I am learning more details about all of that now during my 27 hours of required training while I am going through the licensing process.

I don’t know anything about the child that will hopefully be placed in my home.  But I do know that they would be coming to my home out of crisis.  It could be that they were just born to a mom who is addicted to drugs, and so they are going through withdrawals also.   It could be that they have been a victim of abuse, or neglect, or both.   I don’t know their story yet, but I do know that I can provide them a safe and loving and nurturing place to call home, even if it is only for a short time.  The ultimate goal for the foster care system is to reunite the child with their birth parents or blood relatives.   I know this going into it.  However, that will not protect me from not feeling any pain or distress when a child I have been caring for and loving is taken from my home and back into the environment that they came to me out of.   This will definitely be hard, but I am still willing to do it.   Ultimately I will be praying for a child to be placed with me, who will be able to stay with me forever, and I will be able to adopt.   Ultimately, whatever the situation, I know that the time that I will have the child, I will be able to provide them a safe and loving environment and that they will be better off because of that, no matter if I have them for one day, a lifetime or any time in between.

Thanks for reading, and thanks for caring! 

Saturday, August 4, 2012

My last class with my students!!

Today (Thursday) was a very sad day for me!  It was my last class with my students.  I am really going to miss them, and I wish I could stay longer, as I feel like there is still so much I can teach them.   The topic I ended on was Florence Nightingale.  Florence Nightingale is, as you all probably know, famous in nursing for the work she did in the Crimean war, and other things.  Florence was seeing many of the soldiers dying, for things she felt they should not be dying from.  She really focused on cleanliness of the hospital environment and teaching about prevention of diseases.    After we discussed all of the things that Florence did; we engaged in a discussion about how these things could be used in Burundi.  The students were surprised that one could make a big difference, by doing something so simple.   We talked about how change is hard, and is often resisted by many, but it was important for some things to change and keep on improving in order for things to get better.   I assured them that even in the United States we are constantly trying to make improvements in the hospitals when we see that there is a problem.  
Florence believed in two types of nursing.   One was sick nursing, or caring for those that are ill and in the hospital.  The other is health nursing, or teaching and educating people to help prevent disease and illness.   After I explained this to my students, once of them raised their hand and said, “like when we teach the widows?”   YES!!! Yes!!! Yes!!!  I was so happy and excited that they had made this connection on their own.  This may seem like a small feat to most of you reading this, but if you were here and could see all the roadblocks in the way of their learning and understanding, you would see what a big deal this is for me!   Prior to me teaching these students, they had never understood that part of their role as a nurse would be to teach and educate others.   That doesn’t mean that others had not shared that information with them, but for some reason, the message never really sunk in until now. 
Ever since I knew I was coming to Burundi, I have felt really strongly about being able to teach these students some things that they could take out into the communities and hospitals to help save people’s lives and make things a little better for people here.  I realize they cannot change the country overnight, but I really believe that these 70 students I have had the privilege of teaching these 2 months are the future of this country.   I know these are big statements, but I really believe it!
We had a long discussion about good things that exist here in the country for health care, and things that they themselves think are bad and could be improved.  I did not offer any suggestions, as I wanted to see what they thought was good and bad.  It took them a long time to come up with anything they believed was good…but finally they decided that the free care for children, pregnant women and individuals with HIV/AIDS was a good thing, and they would not want to see that change.  That was all they could think of.  I am sure if they were given more time to think about it, they could come up with more things, but on the spot, this is all they could come up with.   We then talked about change and what were things they thought could be changed.  They had many many things they thought could be changed, like:  better training for nurses and doctors, to have clean environments, to have supplies they need to do the care, access to medications and many more.  
Now, here is the part that I really love….. I told them that statistically probably 2-3 of them would actually go out and make any changes ( I made that number up, but it sounded good!!).  Then I asked, who would like to be the ones that go out and make changes?  So many hands shot up in the air, and I said, “oh, these 3 were the first ones with their hands up, so they are the only ones that get to make any changes”    (They knew I was teasing them).  This did not settle well with the students that did not get picked to be the ones to make changes.  They said, “we all want to make things better for our country.”  Yes!!!!  Yes!!! Yes!!!!   I am telling you, this is a motivated group of students, and I really believe that they will make things better for their country.  I am not looking at the situation through rose colored glasses, I realize that not all of them will, but I do believe that if they all start out feeling like they have the power and knowledge to make things better, then they are better equipped to do so, and because of that they are more likely to try.   So, I feel like what I set out to do here, has in a way, been accomplished!  
As part of the last class, I told the students how much I have enjoyed working with them, and how proud of them I am.  I encouraged them to do the best they can in every instance, and that I hoped as they went into their nursing career, they would remember me, and remember some of the things that I had taught them.   Then the class representative gave a small speech that he had prepared on behalf of the entire class. 
He said that they were so thankful that I was able to come to Burundi and teach them, and thanked me for taking the risk of coming to Africa!  He said that there were so many things that they will remember from what I have taught to them, and that they will never forget me, and that they love me! 
I was so touched and told them that made me want to cry.  This made them all laugh J   This truly has been an experience of a lifetime, and I can’t believe that I have been able to be here.
I want to say it again, although I have said it many times before, I am so thankful for all of the support and love and encouragement I have gotten from those of you back in the United States.  I would not be able to be here if it weren’t for all of you.  So, I hope that as I rejoice in the accomplishments that have been made with these nursing students, that you too are rejoicing in it, because you are all a big part of what I am doing here.
The culture here is very focused on relationships.  I am often asked by students or others that I have met, if they could take my greeting to their family, or their church, or others that they know.  I of course, always say yes.  I love this part of their culture, that it is important to them to send and receive greetings from others, and that is makes a big difference in a person’s day.  So, I told my students that there were many of my friends and family at home that were praying for them and that they all send their greetings…this made the class erupt with joy and clapping!  I wish you could have seen it!
I love you all, and although I am very sad to be leaving Burundi, I am looking forward to coming home and seeing all of your lovely faces!  I have missed you all!

Sunday, July 29, 2012

The student becomes the teacher!

Teaching and educating others is a big role of the nurse.  Here in Burundi, I see it as the major role of the nurse.  Because of this, I have been working hard with my students to teach them the importance of educating those around them.  It may just be my personal opinion, but I see these 70 bright young minds in front of me here, as the future of Burundi.  The conditions in the hospitals here are horrible.  There may or may not be running water, and electricity is not consistent.  In many of the hospitals there are no doors to shut off the outside world from the patients, and even if there was, I doubt they would close them, because it is so hot, you want the breeze to help keep you cool.  The hospitals are dirty, and most of the people I know, would not even want to sit on one of the beds in the hospital, let alone sleep in one.  Nurses are given too many patients to take care of, and not enough education or information about what they are to do with the patients.  So, they do the minimum.  Not because they do not care, but because they do not know any different.  The family does everything for the patient except medications that have to be given by a shot or through the IV.  When you ask a nurse to check a patients vital signs, the only thing they check is their temperature.  Is this because they do not realize that the other things like pulse, blood pressure, and respirations are not important?  I doubt it.  I think it is because they have never been told any differently.  Hospitals are not where you save lives here, you need to save lives before they ever get to the hospital and teach people how to avoid getting sick in the first place. 
I gave my students an assignment that they needed to find a group of people to teach a health topic to, any health topic.  I didn’t care if it was something I had taught them, or something they had already learned, I just wanted them to get out into the community and teach something.  Little did I know that this would take us into uncharted waters for the university.   The students began working on their project and then told me, that in order to go into the community they would need an official letter from the university president that stated what they would be doing, and basically giving them permission to be out in the community.  It seems that without this, it would be impossible for my students to do the assignment safely, as they were afraid of getting in trouble.  The country has many rules that we would not only not understand, but also not tolerate.  So, when I asked if we could get this permission from the director of the nursing program, he seemed hesitant and didn’t really want to help out…and without his help or buy in, I knew it would never get done.   So, I asked for an alternative, could he help me bring people to the campus that the students could teach.  He thought this idea would be better, and I felt like it would be safer for the students as well.  Eric, the director of the nursing program said he would contact people to help me get them to campus, but it soon became clear to me that this was low on his list of priorities, and he just wasn’t doing it.  I was frustrated, but turned to a few of the people that I do know here and asked for help.
One person was able to help me arrange for the students to teach a group of widows.  The organization of Sister Connection has its office here on campus.  Sister Connection is an organization that helps support widows here in Burundi.  After the war, nearly an entire generation of men/fathers was wiped out.  This left, many women alone to raise their children.  Widows here are seen as “lower than dirt” I was told, and they have a very hard time supporting and providing for their family.  So, sister connection was born, and people can sponsor a widow much like all of the child sponsorship programs.  Only you sponsor a widow instead, and that in turn helps support her whole family.  So, every Wednesday a group of the widows comes to campus for prayer and worship time.  I was able to connect with the director and arrange to have my students teach them while they were already on campus!  Perfect solution!  About half of my students spent a couple hours teaching the widows.  They had prepared to teach them about tuberculosis, diarrhea, HIV/AIDS, hypertension, alcohol, smoking and malaria.  We split the widows up into small groups and each group was taught 4 different topics.   
I was also able to have a friend help me arrange with the church that is right near campus to have the students come and teach people there.  When we arrived that afternoon, they were all ready for us.  They had announced in church on Sunday that nursing students would be at the church teaching if anyone would like to come.  I think about 50 people showed up, it was amazing!
My students did an amazing job!  They took the assignment very seriously and even requested to wear the medical lab coats from the lab so that they would look more professional.   I was so proud of them, I had a hard time holding back the tears.  They taught in Kirundi so I had no idea what they were saying, but they had turned in their teaching plans to me ahead of time so I knew what they were supposed to be saying.  Afterwards the students all said that they felt really good about themselves and felt like they could make a big impact on their country by teaching people around them.  They had never seen teaching and educating others as one of their roles, and now instead of just telling them about how important it was, they were able to live it and see it for themselves.  The people they were teaching were so appreciative to have the information, and were very interested in everything the students were teaching them.  I did have a nurse from the hospital that I had met a few weeks ago come help me on this day so I could have someone there that could understand what they were saying, and she was very impressed with what a good job they were doing.
The pastor at the church said, even though they are so close to the University, they had never had students come over to the church to do anything like this before, and he was so glad we had come.  The widows also said they had never had such education before, and hoped it would continue in the future.  The director of the nursing program I think was a little shocked that I actually was able to pull it off, even though he did not help me at all.  One of the missionaries here said to me, “you have accomplished more in your short time here than some missionaries accomplish in a year here.  You are not afraid to introduce new ideas and you want to see the students succeed and learn.”  I am not telling you all of this to toot my own horn, because it really was not me.  It was the work of a lot of people helping me get this arranged, and it is the students who did all the work.  I just tell you this because I am so proud of the students, and I hope that they continue to remember throughout their careers the impact they can have in their country by teaching and educating.

Friday, July 20, 2012

Things in Burundi are complicated….

Mikel, Fides, Athanase (one of the medical students), and Jacqueline and her baby.

One of my students touching the water at the source of the Nile River.

Earlier this week I went on a voyage with my students.   However, getting it all accomplished was extremely difficult.  The students wanted to go on a trip to a town called Rutana, that is about a 3-4 hour drive from where we are at in Bujumbura.  At first the campus hostess that is in a sense responsible for me, said the students could go, but that I would not be allowed to go.  She said it was too far, and she was concerned about the roads and having people from the trees jump out and attack us!  What!? I couldn’t imagine that the students would want to take me on a trip with these kinds of conditions, so I pushed a little harder on the reasoning.  In the end, the Bishop decided I could go, but that I would need to go in a university car, with a university driver and someone from the university.  It seems that what he was concerned about what the safety of riding in the bus with the students and wanting someone to be able to explain at all the checkpoints what I was doing with them, etc.  So, we were allowed to go.
We left before the students and took a detour back to Kibuye Hospital for a couple of hours.  While we were there, I discovered that 2 of the patients I had cared for the last time I was at the hospital were still being held their because they could not pay their bill, even though there was no longer any medical reason for them to be there.   Jacqueline had been in the hospital for 6 months, and only needed to be there medically for the first 2 months.  She had an infection in her foot, that has since been treated and cured.  The hospital would not let her leave, so she has been held there, while her bill continues to grow.  I found out that not only did she have 3 small children, but one of them was born while she was being held at the hospital.  I had heard from my parents that there was possibly some people at home that would want to help this patient get out of the hospital and go home.   I had planned to wait to hear back from home, but when I discovered this new information, I knew I needed to help.  I did not have any money with me, but I talked to the finance office.  They trusted me that I would get them the money, and so they agreed to let Jacqueline go home that day! Praise the Lord!   I found her bill was under $300, and that is for a 6 month hospital stay.  The system here is very hard to understand, but it is also hard for them to understand the concept of allowing someone to go home and promise to pay their bill later.  However, I did find it interesting that they just trusted me.  To all the people here, if you are white, it is equal to you having money.   It was so amazing to see the look on her face when she was told that she could go home to her family.  She told me through a translator, that her family lived 6 hours away, and there was no way to get the word to her husband before she would arrive at home.  So, she said he would be so happy to see her arrive at home finally!  I am not sure if he has ever even seen their newest child.   As I was getting ready to leave, I found another patient that was also being held at the hospital for being unable to pay her bill, and her bill was only $76, Fides, is a sweet young girl who is extremely small and thin.  When I was at the hospital before, she was suffering from some kind of stomach problem and had not been able to eat in weeks.  Now, she was feeling better, and had been medically released from the hospital, but was unable to pay her bill.  How could I say No!?  So, about $350 later two very excited young women were released from the hospital.  I was not able to stay to see them actually leave, but I was assured that they would be able to leave with no problems.  Both of them were extremely grateful and happy.  It is hard to imagine living in a world where you are held in the hospital…where your bill increases with each day…and if you didn’t have the money to begin with, you certainly will not have more money later, especially when you are stuck at the hospital and unable to do anything to earn money.  For every Jacqueline and Fides, I am sure there are hundreds of people if not thousands that are in the same situation.  I am thinking of starting an organization at home where people can donate to patients like this in third world countries.  I think if people could see the conditions here, and see the problems that it causes when someone is unable to leave the hospital, they could see that even $5 could go a long way here.   $5 here could pay for someone to have an ultrasound to help diagnose what is ailing them, or it could help pay for basic medications, like antibiotics.   And what do we compare $5 to in the United States?  A large latte from Starbucks?  A bag of chips or candy? I know that a lot of people will not want to help because there are many people in the United States that need help with medical bills as well.  Somehow this situation seems different to me.  In the United States, you are not denied basic care, even if you cannot pay.  I know and understand that there are a lot of people that need help in the United States for so many things.  But, I also know that there are things like shelters and food banks and other resources, here there is nothing.   If we can help people here with the basic things to keep them alive, then they will be better able to take care of the bigger things for themselves and their families.  This is how we help the country develop and get to a point where they can take care of themselves without the help from other countries.  It was not their fault that they were born in a place like this, and I was born where I have never once had to worry about any of those things.

Anyway…I digress.  The point of this blog was to tell you about the journey I went on with my students!
So, we arrived at Rutana before the bus full of students, and standing on the corner was one of the students who was waiting for us to arrive.  She waived us down, got into the car with us and took us to her aunt’s house.  Here we were welcomed into a lovely home and fed a snack of French fries, omelet’s and fanta!  I was excited, because since I have been here those are 3 of things that I can consistently eat!  As we were waiting for the other students to arrive, I received a text message from one of them, he stated that they were running late, because their driver had been arrested for a short time, but to “let the worry out”, I guess meaning, do not worry.    It turns out he was not really arrested, but only stopped by the police and there was a problem with some of the paper work for the bus, but they allowed them to continue on.  There are police at many places along the road, and if they motion for you to stop, you must stop and answer their questions.  Most of the time, when they saw that there was a white person in the car at these checkpoints, they just waved us on through.
I was so impressed by the students and how organized they were.  They took myself and the other instructor that was with us to the hotel they had booked for us.  They had me go in and check out the room and approve that it would be okay, before they confirmed that we would stay there.  They had us at a separate hotel from the students.  Most of the hotels here are small, there are only about 10 rooms for each place, so there would not be room for all of us at one place, and I think they wanted me to be at a nicer place.  The aunt’s house that we were at for the snack, also fixed us a huge lunch and a huge dinner and breakfast the next morning.  She fed all of us, 27 students and 4 others, and did not ask for any money for any of it.  She said that she has been blessed with her home and other means, and was happy to pass it along to all of us.    
The first day we went to the source of the Nile River.  I have to admit I was expecting a large river or something really large.  After my students argued with the guards about the price, it was determined I go see the source of the Nile, if I payed, 5,000 Burundi Francs (only a few dollars in U.S. money), the students were free since they were African, (I say African and not Burundian, because not all of my students are from Burundi…I have some from Kenya, Rwanda, Chad, and the Congo).  As we walk down the stone steps, I see what is the source of the Nile…it is a small pipe coming out of the side of mountain, that is draining a small flow of water.  I actually laughed at myself a little bit, that I had been thinking it would be something with a lot of water, and running into a river or other body of water.  But, it was still very exciting to see.  I have since learned that many African countries also have a source of the Nile location to visit, but the one in Burundi is supposed to be the southernmost source.  It was really fun to see how excited the students were about this.  They had only heard of this place, and none of them had ever visited it, and I felt privileged to be a part of the experience. 
The following day we started out on our journey at 7am and did not arrive back in Bujumbura until around 8pm.  I asked the driver, Emery, how much of the country we had seen that day, and he said, “more than half.”  That gives you an idea of how small the country is.  We went to a place where there were 3 waterfalls to hike to.  Most of the students had never seen a waterfall either.  Getting to the waterfall was a bit complicated however!  We drove down a long dirt, bumpy and at times terrifying road up into the hills.  When we arrived into a small village, we were summoned to stop by the village guard.  The students got out of the bus and argued with the man, they showed him official papers from the University proving that we were from Hope Africa University and had permission to be there.  Pretty soon the guard gets in the car with us, and we drive to the house of the village mayor.  The students once again get out and argue with the mayor.  It is pretty clear at this point, that they also want money because they have white people with them.  So the students come back and tell me, I have to pay a little bit of money to see the waterfall.  Not a problem.  In the U.S. at these kinds of sites we would expect to have some kind of fee to pay, but here it is all negotiated and argued about, not a set price per person.  When we finally are allowed to drive into the hills a bit further to get to the waterfall, I notice that several military men have gotten on the bus with the students.  I was not sure at this point if having them with us made me feel safe, or scared!   We finally arrived to the first waterfall, and it was beautiful and large!  The students were so happy to be there, and so excited, it was really fun to experience with them.  Everyone wanted their picture in front of the waterfall with their muzungu (white) teacher.    We then took off on a long hike to the next waterfall.  At the end we had to go down some very steep stone “steps” to get to the waterfall…and unfortunately I was in a skirt and sandals.  This made going both down and then back up difficult.  The students were wonderful, on the steep steps they would hold my hand to make sure I didn’t fall, and one of them even exchanged walking sticks with me because he thought the one I had was not as good.  They are so wonderful and caring. 
Once we were done enjoying the waterfalls we started the drive out, and when we came to the entrance, the “gate” (a rope with fabric tied to it) was up again.    The other teacher in the car jokingly said, “we probably have to pay to get out of here too.”  The student in the car with us said, no, that would not happen…but after much arguing and dirty looks from the guard, that is exactly what happened…we had to pay to leave!
We were now back on our journey and headed to a hot springs.  Another a long, but beautiful drive on bumpy, dirt and terrifying roads, we arrived at a bridge with some water below.  We all got out, and I was thinking this was the hot springs.  As we walked up to the bridge I was thankful that we were not crossing the bridge because it was a few logs and some metal planks.  The bridge was very narrow, and there were large spaces between the logs and metal planks.  So, when the bus pulled right up to the bridge (with no students on it), and was getting the tires lined up to cross, I actually thought it was a joke…I took a picture as he was starting to cross and the tire is not even fully on the bridge, one inch or two in one direction, and the bus would likely fall off into the water.  I couldn’t watch the rest of it, and had to look away.  The whole village was there watching and cheering on the bus driver, along with all of the students.  Then Emery was next, the driver of our car, and I couldn’t watch that either.  But, they both safely made it across the bridge with no problems.  I asked Emery if he was scared, and he said, “Yes!!”  So, I quickly realized that this was not the hot springs and we must continue on our journey to reach it.  Once we arrived, we found the hot springs in the middle of a small village.  We walked to the entry, and to my surprise I did not have to pay!  They had an area for men and an area for women.  We walked down and found the source of water that made a nice natural pool.  Many of the women and children from the village were bathing in the water and just enjoying the warmth.  The water was very warm, and all the students went to put their feet in the water.  It was so fun for me to watch them all experiencing this wonder of nature for the first time.  I tried to explain to them that in the United States at many of the hot springs, we had the water coming into a pool where people would swim, but it was not a natural pool, it was like a swimming pool.  This was difficult for them to understand why we would not just leave it natural.  We drove to second hot springs, but I choose to not climb down to it, as it was down a steep slippery hill, with no stone steps, and I was afraid I would fall!
The day of this journey also happened to be my sisters’ birthday.  She would have turned 35 if she was still alive.  I thought about her most of the day, not only because it was her birthday, but because of all the crazy adventures I was on that day…she would have LOVED every minute of it!  She never would have been scared, and she would have been one of the people cheering on the bus and car as they crossed the scary bridge.  I miss her so much, but I hope that in some way I am making her proud of what I am doing here in Burundi.  I wish she could have been here with me experiencing all of this with me, but I know that she is smiling down watching all that is going on and she is always with me in spirit.

Monday, July 2, 2012

Home from the Upcountry

Some of the kids from the school.
This is an example of the heavy loads they carry on their bicycles!  And, this is going uphill.
I am “home” from the upcountry, and I am back in Bujumbura.  Just in time for the 50th anniversary celebration of the country’s independence.   This is a big deal for the country, and they have been celebrating for a few weeks already.  I will be celebrating by staying home and writing an exam for my students J  I would really love to see what the celebrations are all about, but we have been advised to stay in the campus compound, as the city will be filling with people to take part in the celebrations, and could quickly go from a fun event to a dangerous event.  I don’t need to be warned twice! 

Mikel, Dr. McGee, Alice and Randy Matthewson

Ouch!  I can't believe she has all these pots on her head.
A child from the pediatric ward

With Joyeous, one of the nurses from the hospital.

With Marvin, one of the medical students at the hospital.
 I cannot imagine this already overcrowded city being filled with more people.  The sites in the city are similar to what you would see in a huge, busy city in other parts of the world.     In other parts of the developed world, you might have a city with hundreds of people walking on the sidewalks, and when the crosswalk on the busy street lights up with the “walk” sign, swarms of people cross the street.  It is exactly like that here.  Only take away the sidewalks, and replace them with store fronts, right on the side of the street, and tarps lying on the ground covered with dried beans for sale. There are no stop lights, stop signs or crosswalks.  The way this is set up leaves very little room for people to walk, or cars to park, so the people, cars, motorcycles and bicycles are all sharing the same space on the road.  This provides for a very dangerous street for all involved.  Take the periodic homeless person on the street in a developed city, and you might see them dressed in shoes and pants and shirt (although not clean and in need of repair) asking for money.  It is exactly like that here, only replace the homeless person with multiple, truly starving men women and children who rarely have on shoes, and are considered lucky if they have pants and a shirt to wear.  The clothes they are wearing are not only dirty, but look as if they might disintegrate if they were to be put in water.   Their bodies are very dirty and you often can see evidence of disease as well.  There are no homeless shelters or places to go for food or a place to sleep.  Back in a developed city, you will have streets occupied by taxis, cars, trucks and SUV’s, motorcycles and bicycles.  It is exactly like that here; only the bicycle and motorcycle are the most common form of a taxi. The bicycles all have small little grates across the back tire that in a developed city you might see a bag attached to, or something else that is small.  It is exactly like that here; only the bicycles are old, rusty and look as if they could fall apart any minute, and on the back of the bicycle you will see a man, or a child or two, or a mother with her baby tied to her back getting a ride home.  These same bicycles also function as wheelbarrows, hand-trucks, and all around transport vehicle.    A bicycle here is a prized possession of many families.  The bicycle will help them get their produce or lumber that they are selling to the city to try and sell.   They carry 2-3 large bags full of cabbage, the bags are the size of an army duffle bag and they are packed so tight, nothing else would fit inside.  They carry 5-6 plastic containers that each contains 24 bottles of coke.  They carry huge branches from the banana trees off each side of the bike, each branch containing probably 50 or more bananas.  They carry large bundles of branches and leaves, 10-12 pieces of cut lumbar that are at least 20 feet long if not longer.  I am still in awe every time I see someone peddling with one of these loads, or balancing the load on the bike while they push it through town or up a steep hill.  The others here are so used to seeing it, that it doesn’t even faze them, but every time I see something like this I just can’t stop watching, and feeling so bad for the person.  Especially when I see the women walking with loads of clothes, food, brick, pots etc on their heads.  Yesterday on the way home from the upcountry I saw a woman carrying 6 pots on her head.  I snapped a quick picture, and will try to attach it to this blog to show you….it is something you probably would never believe if you didn’t see it with your own eyes!

Anyway…back to my experience in the upcountry at Kibuye Hope Hospital.  I loved my time there.  This was probably the best experience so far.  I loved the people, and I loved being in the hospital with the patients.   I stayed in the missionary house with a missionary couple, Alice and Randy Matthewson, and Dr.McGee.   Alice and Randy are long time missionaries here Africa, and have spent most of their time in the Congo.  They were here during the war, and had to leave for a period of time, but continue to come back each year for part of the year to work with and minister to the people in the Congo.  They have done amazing work there!  Dr. McGee is also amazing.  He travels to several hospitals similar to the one at Kibuye and donates his time and talents to do surgeries and teach the medical students and current staff and doctors.  He also led chapel each morning before the day started for the staff and students.
At Kibuye I felt like I had so much more freedom to walk around and be outside.  It was also much cooler there as it is up in the mountains so it was comfortable to be outside in the sun.  On the way from the missionary house to the hospital you must walk by a primary school, also started by missionaries.  Being up in the mountains the children especially have seen very few white people, so I got a lot of attention!  The kids would run to the edge of the school yard when I would pass by, and would say, “Good morning, how are you?”  This must be the only English they know, because they would say this over and over and over again, and would say it morning, noon and night.  They were so cute.  It was hard to tell at times if they were intrigued by me or terrified of me.  Some of them would only come so close, and then they would run away screaming.  One little girl ran up to me touched my arm and then ran away screaming.  I can only imagine what she was thinking…possibly, “I touched her and I didn’t die!”  Most of the kids however, want to shake your hand and hold your hand and walk with you and stare at you.

The hospital is a special place.  It is filled with very sick people and limited staff who do the best with the tools and education they have, but they know that it is not enough.  Dr.McGee warned me that the first time he walked through a bush hospital, he went outside and cried.  I knew he was preparing me for the worst of the worst and wanted to let me know that it was okay to be touched by it let it affect me.   It will certainly be hard to complain about any conditions that we have in the hospitals in the United States after working here at this hospital.  I was able to spend time in all the areas of the hospital, and then at the end of the week I had a class with some of the nurses to give them some extra education.  When I asked them at the class what they saw as problems at their hospital they mentioned things like; we only have one oxygen machine, we have no incubator for babies, and we need more help. 

When I walked through the hospital, it was some of the same experience I had as walking past the school.  There was a lot of people staring and pointing, and wanting to shake my hand.  The smell at the hospital was the first thing I had to overcome.  It was a combination of urine, blood, body odor and food; it was awful, but after the first day, I became used to it and it didn’t bother me anymore.    At this hospital there is no such thing as a private room, and the toilets are in another building that you need to walk to.  There are small rooms filled with beds, and nothing to separate one bed from the other, so everyone sees everyone…there is no privacy.  The family stays with the patient and cares for them.  They must cook them food outside, sleep in the bed with them, wash their sheets and clothes, help them to the bathroom, and give them their medicine.  If there is something that they need help with, they must find the nurse and ask for help.  The nurse gives the injections and medications that go in the IV, but the other medicine the family is responsible for.  If you cannot pay for a service at the hospital, you will not receive it.  Things I saw not being completed because of this were; x-rays, ultrasounds, dressing changes, medications, blood tests, and many more.  In fact, at this hospital if you cannot pay your hospital bill, you are not allowed to leave.  For example, Jacqueline, she came to the hospital 6 months ago with an infection in her foot.  The infection was treated and she able to be released 4 months ago, but she cannot pay her bill, so she is not allowed to leave.  This system is very common in places like this, and seems so backwards to all of us, but that is the way they do it here.  She continues to accrue charges for each day she is at the hospital, and is not allowed to leave.  It seems like a simple answer, and as you read this you are probably thinking…if she was allowed to go home she could be earning money to pay her bill.  However, the system here of owing money and paying a bill is very foreign to them.  There are many cases in the hospital just like Jacqueline.  Please pray for her and the others like her that are being kept at the hospital until able to pay their bills. 

During my time at the hospital I even helped deliver a baby!  This was a great experience.  I met this woman who was in labor, and was dilated to 8 cm.  You never would have known it by looking at her and listening to her though.  She was soooo quiet!  Didn’t make a moan or groan or anything!  I asked the nurses if this was normal for women here, and they said yes, that they are very quiet.  I explained to them that women in the United States often yell and scream when having a baby, and they all laughed!  They thought that was the silliest thing.  So, as this woman was pushing and pushing to try and deliver her baby, she was struggling to get her out.  I noticed that she was lying flat on her back and asked if it would be okay to help her sit up and push on her next contraction.  She agreed, and with the next contraction I helped her to sit up, and the baby was born!  Everyone in the room looked at me with surprise, and the medical student in the room said, “I have never seen anyone deliver like that before, but it works.  You have taught us something new, and we thank you.”  It felt great to be part of this, and to feel like I was being helpful.  After the baby was born, they wrapped her up and placed her on the baby scale while they tended to the mother who was continuing to bleed quite heavily.   I was concerned about the baby and really wanted to pick her up and calm her down but wasn’t sure if there was some cultural reason for what they were doing.  So, I asked permission to pick her up.  With permission, I picked up the newborn baby girl and swaddled her and rocked her to calm her down.  She was healthy and happy and beautiful, with lots of black curly hair.  What a great experience to be part of.  

Throughout my time at the hospital I was able to watch a couple surgeries with Dr. McGee, spend time in the Emergency room of the hospital, internal medicine, pediatrics, and maternity.  I loved every minute of it!  I am hoping to be able to make it back there during my time here.  I enjoy teaching the nursing students in the classroom, but I really loved being at the hospital with the patients and the staff and medical students.

Saturday, June 23, 2012

Burundi Realities

Burundi Realities ---
Yesterday while teaching my students about tuberculosis, I learned several things about Burundi realities. First of all, they knew very little about tuberculosis.  They knew that it made people cough, but not much more than that.  As we began talking about tuberculosis and what causes it, how to treat it and how to prevent it; I learned some things about this country that are incredibly sad.  Things we probably all know, and have heard before, but if you are like me, you just say, “Oh, yeah, that is too bad, and go on about your day.”  
Tuberculosis (TB) is transferred from person to person through the air, from things like coughing or sneezing.  In the U.S., if someone is in the hospital with TB they are automatically put in a special room.  The room has a double door system and negative air pressure so that the air in the room with the patient is never circulated though the rest of the hospital.  Anyone going into a patient room of someone who has TB or is suspected of having TB must wear a mask and gloves and a gown to make sure that they do not inhale any droplets that may contain the disease.   This is one of the ways we keep people safe and help stop the transmission of TB. 
Here in Burundi, I learned that nurses are forbidden to wear masks!  I realize that they do not have the money to have the fancy negative pressure rooms that we have, but something as simple as wearing a mask…and it is forbidden!  I felt so sad for this class of 70 future nurses, knowing that when they come into contact with a person who has TB, there is little they can do to protect themselves.     The students told me, here for a nurse to wear a mask is forbidden because it is considered to be rude.  Rude because you would be portraying that there is something wrong with the patient, and it would make the patient uncomfortable.  How does one change the culture of an entire country to allow nurses and doctors to wear masks when caring for patients?
Being malnourished is a huge risk factor for contracting TB, especially in children.  We were discussing this is class and talking about how do we keep children in better health so they are less likely to get diseases like TB.  The students said, well, if the family has no money for food, then there is nothing we can do.   Sad, and in some cases true!  However, I happen to know that in several areas in this small country there are feeding programs set up for children by different organizations…I know the group I am here working with has one, and world vision has one, as does world relief, and many others. 
The sad part to me was, these students had NEVER heard of such a thing!  Never!  I had to explain to them what a feeding program was, and tell them where the ones were that I knew about.  So, if the people that are educated and going to be the future of the health of this country, don’t even know about these programs, that is a huge problem.  How can they tell the parents of the starving children they are caring for where to find nutritious food for free, if they have never been told about it?
These students had never been told about the teaching role that a nurse plays.  Here in Burundi, I see their role as mostly teaching and educating.  After we talked about tuberculosis I put some numbers on the board showing them how if each of them taught 5 people in their community about tuberculosis;  how to prevent it, what symptoms to look for so you can go to the hospital, and how it is treated..How many people that would impact.  Then if each of those 5 people told 5 people and so on…eventually their knowledge could reach thousands of people.  Just like TB is killing hundreds of thousands of people here every year.  I told them, this is how you change the health of your country.  You change the health of each of your communities, by teaching them how to stay healthy and when to seek care.   I had them work in groups to come up with a plan of how they would teach people in their community about tuberculosis.  Once they understood what I was talking about, and how important it was, they took the assignment very seriously!  I wish you all could have seen the light bulbs turn on over their heads when they realized that they could in fact help save their country.  What a great feeling…we are doing a great thing here!  I say we…. because I would not be able to be here doing this if it weren’t for all of you, and to that I am forever grateful!
I have seen that many people look at these students, and at many of the people in the country as lower class citizens, and do not treat them as intellectual equals.  I am here to tell you, that these students are very bright!  All of them know 3 languages, and many of them know more.  They are learning how to be a nurse in a language that many of them just started to learn 2 years ago.  I barely survived nursing school in my own language; there is no way I could do it in a foreign language!  These students are here because they want to change the health of their country and they want to save and change lives.  When you ask nursing students at a university in the U.S.; why do you want to be a nurse?, you get many canned answers like, “because I love people,”  and others will say, “because it pays well, and I will always have a job.”   Many students in the U.S.  have deeper reasons why they want to be a nurse as well, but the motivation is rarely at the level of what I am about to share with you from the students here.  When I asked my students here to write down why they wanted to be a nurse, the answers were painfully different!  Here are some direct quotes, broken English and all:
 “because in 2009, a nurse save my life.  I saw that the best place to save someone is to be a nurse and I decide to come to study in the nursing department.”
“because I want to treat the patients and help those who are suffering by whatever diseases.  And more than, I love so much to rescue someone who is miserable in his daily life.”
“because I need to protect the patient by the death.”
“because health and living conditions in my country is poor.  I choose to be nurse to improve health in my country.”
“because conditions of life here are bad, people need help in health promotion.  That is why I choose to be their promoter and helper.”

Friday, June 22, 2012

I am a cow...and it was meant in a nice way??

A some of the students working on a group assignment.

Another group of students.   I had to split the students into 3 rooms for the group assignment so they would have enough room.  Both groups above are working on writing out a plan for what they will teach the people in their community about tuberculosis.  Once they understood what I wanted them to do, they did a great job! 

Yesterday I was called a cow ----
Yesterday I was visiting with one of local teachers at the University.  He mentioned that he had recently returned from Korea where he obtained his masters degree.  Knowing that he also spoke French and Kirundi, the local languages here, and was talking to me in English, I asked him how many languages he spoke.  He responded with 5,  I laughed and said, “oh, I only speak one.” He then laughed and said, “oh, you are a cow.”  The other person in the room and I both stopped for a minute, not sure whether to laugh or what.  Then he continued on, “we call people that only speak one language a cow, because cow’s can only say, ‘moo, moo’.”  He continued on to say, that this was not an insult, and in fact, cows are very highly thought of here.   Later while visiting with some of the other missionaries on campus, we all had a good laugh about the fact that I am a cow!   I am trying to not be a cow.  I have learned a few words in French, Kirundi and Swahili! 

The mosquitoes here are huge and there are so many of them!  If I go outside at night for even just 5 minutes, I am sure to get 5 bites.  It gets dark here very early, I get out of class at 530pm, and I have less than an hour of daylight before I need to be shut inside away from the mosquitoes!  I am so thankful to have the mosquito net to sleep under at night!  There was one hanging here, when I got here, but it sure felt great to put up the new one I brought with me, knowing it was fresh and clean! (Thanks Nicole!!)

My class is continuing to go well.  I think they understand more of what I am saying, and they are getting used to my teaching style.  They are not used to doing group work, and every time they get in a group to do something they assume they are going to get points for it.  They are very driven my points here.  They operate under the Belgian system of schooling, which is very strict…they take attendance at every class, and if you are absent for more than 25% of the classes, then you fail the course.  There is a lot of fear in the students about failing.  You can tell that their experiences with teachers who work with them to succeed has been limited.  I am enjoying working with them and learning along side of them.    Many of the students have very good questions, and we are learning together how to adapt some of the things that would be common in the U.S., to what they have available here.   I was teaching yesterday about patients with respiratory problems, and when we were talking about patients who have a hard time breathing if they lie flat on their backs, I said it would be important to make sure they can sit up some in bed.  One student asked, how will we do that?  So, we talked together about what they could do…and came up with asking the family to bring pillows or blankets from home to put underneath the mattress to raise it up some.  Here in Burundi, as with many of the countries here, the family must provide these types of things for the patients; pillows, blankets, and they also must feed the patient, and take care of most of their daily needs.  I explained to them that in the U.S.  our beds are electric and we can lift them up to the height we need.  This made them all laugh, and they asked if people had beds like that even in their homes!   The students have been a lot of fun to work with, and I am really enjoying being a part of their education journey.

Next week I will be going to the upcountry for a week, to the Kibuye hospital.  I am really looking forward to getting out of the city.  In the city, I am stuck on campus most of the time, because it is not safe to just go wander around by yourself.  The campus is not that big, so I am looking forward to having some more space to be in and see a different part of the country.  I think it is a several hour car ride on very poor bump roads.