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.”