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 50^th 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.