My brother and his wife and their four kids were here over Christmas and we had a fantastic 3-weeks together. It’s the second time we’ve seen them since 2014, the third time since 2010. Yet we feel so close to them. The same day they left our two older kids flew back to Kenya for their second term of school at Rift Valley Academy. Our house suddenly got a lot quieter as we dropped from 12 people to 4. (and to understand fully you would have to know some of those 8 who left)
Once again we have a shift in our family, these bonds that tie us to those closest to us. Two of our kids won’t be home for three months, and I won’t see my brother for who knows how long.
Family relations are an odd thing at the best of times, but being on the other side of the world from parents and siblings, and cousins and everyone else makes these bonds more peculiar.
A few months ago in our team bible study, we were discussing how true community has the same characteristics of a family, including non-selectivity. You don’t choose what family to be born into, you don’t choose what children to have, and even though you chose your spouse, the family that you will end up becoming is not the direct result of precise decisions along the way.
What does it mean to have non-selective compassion, concern, empathy for those around you?
It's is hard.
It is hard in Kibuye, it’s hard in urban Chicago, it's hard in rural Texas, and suburban Edmonton.
While it may look very different, there is nothing unique about God’s call to all who could claim to be his people to love those around them.
There have been many times in my life where I just feel like walking away from someone, or some situation entirely because it seems like the easiest thing to do.
And yes, while it is possible to walk away from family, most everyone has a stronger sense of tie to family than any other relations. Even as a child, you know that you don’t really have a choice. No matter how much your siblings aggravate you, there’s really nothing you can do about it. That’s why as a child the almost mythological option of running away is so huge. How many of us didn’t at least once in our childhood think / dream /threaten/attempt to run away? ( If you say ‘no' - you probably either don’t remember well, had no siblings, or are some kind of freakishly forgiving person)
I guess that’s why there’s a saying "you don’t get to choose your family" (at least I think that’s a saying, if not…it should be)
This is probably why in such independent and individualist societies, we’ve reduced the entire concept of ‘family’ down to it’s smallest possible division. Only your immediate, nuclear family, which have statistically become smaller and smaller. Fine, I’ll love my ‘family’ - but let’s make that word include as few people as possible.
The divorce rates we are all impacted by must be a sign of our refusal to accept this non-selectivity, this non-negotiable set of relationships. If a marriage turns south or gets too hard, we leave because “it’s not what I signed up for”. But isn’t that the whole idea of non-selectivity, that we may get something we didn’t choose?
Our kids will turn out the way they do - and for many parents, that will bring heartache, even disappointment at decisions made. But does that mean you ask them to leave the family? That you decide what they’ve done makes them no longer worthy of being a part of the family?
Non-selectively loving others is hard. It’s hard in extended family, it’s hard in your neighbourhood, it’s hard in all of our jobs, and it’s hard on this team. (Except you Greg - clearly)
Having kids travel two countries away to attend 9th grade seems strange to me, even though we’ve now done it two times. Does that make our family weaker? A few years ago I would have replied with an unqualified ‘yes.’ Now that we’ve experienced it, however, I have a very different viewpoint.
There are (by my count) 21 kids here in Kibuye who call me ‘Uncle George’ on an essentially daily basis - yet some of the children of my biological family really don’t know me that well, some I’ve never met.
I think the problem is made worse by my pathetic communication. There are many people who I care about, and think about often, but never get around to calling or writing.
Family is vitally important. The kind that we immediately think of when we say ‘family’ - our siblings, our parents, our kids. So is extended family. So is community. So is everyone else.
I guess what I’ve come to realize even more clearly regarding these kind of tight communal relations is that they go both ways.
We have to be open to seeing how we can show grace, compassion, kindness to those around us. Reducing ‘family’ down to the smallest possible definition is exactly what the bible scholar who was questioning Jesus was trying to do when Jesus responded with the story we call the Good Samaritan.
“Fine," the man seemed to be saying, "I should love ‘my neighbour’ - but let’s be clear who exactly is in and who is out when we say that. I need a clear line in the sand of how many people I need to be kind to - because it’s hard and I sure to want to show grace to too many people.”
The other thing is that not only do these bonds need to extend out, but we need them to come back towards us.
What is clear is that you can’t thrive without a group of people around you. This life does not work out so well as a solo gig. There are plenty of people who can accomplish certain things without a strong support network (accumulating financial security, personal goals, etc.) -but to really have a full, engaged, rich life like I believe God designed us to have you simply must have people around you who are more than just co-workers, neighbours, or people you spend holidays with because you share some biological bond.
We need each other.
The other needs us.
If being part of this team has taught me anything (and it has taught me A LOT - especially Greg) is that doing life with others in an almost completely integrated way (friends=neighbors=colleagues=church=school=etc) is that it’s hard - but it is such a full, rich way to live.
It is probably the most obvious when there is some acute problem, an emergency of some kind. Someone suddenly finds out a family member has died, someone needs a medical evacuation, someone gets very sick. As a team we've gone through a lot of really hard things over the last few years - deaths of parents, sickness, and many other really, really hard things.
However, that is only the most obvious. When you look closer you see that through all the mundane, the small hurts, the kind words, the grace, the tension, the loss of personal freedom, the gain of communal joy -that this is how God has made us.
To live - in some way - in communion with others.
To be part ofa family,no matter what that looks like.
It just so happened that a Baptist, an ecumenical charismatic, a Christian Reformed, a non-denominationalist, another charismatic, and a Lutheran "randomly" met at a Presbyterian church in Ann Arbor, MI in the early 2000s. This special place called Knox Church became the birthplace of our team so many years ago. And so, it was with great delight that we welcomed three couples from that church to Burundi in May to go through the "Heart & Soul of a Real Marriage" course with our team.
The three team families sent by Knox (first to Kenya in 2009, then Burundi in 2013) with the 3 couples from Knox (Tom & RuthAnn, Steve & Mary, John & Kathy)
They arrived loaded with all kinds of necessities (standardized tests for the kids, math books for next school year, parts for the solar power pack, a replacement for a broken computer monitor) and LOTS of goodies too -- special kits for couples and singles, individualized requests from each family unit (cheese was a popular one!), at-home date night ideas, books & resources, and games/snacks/crafts for the kids. It was like Christmas!
We crammed the first 6 (of 12) lessons from the Heart & Soul program into an already busy work/school week (the May 1st holiday was a big help!). John & Kathy put together an amazing program for the kids while the adults were in "class".
Each visitor also brought along additional gifts and interests to bless our team.
Tom and John busied themselves in the workshop making shelves for the school and the hospital
Mary taught a couple watercolor classes to our kids
She also taught knitting to some of the missionaries as well as some local women
Steve took on juggling and yo-yos!
Kathy helped organize our school library
John taught the kids a lesson about banana trees
We managed to fit in some cultural experiences too -- a trip to the nearby waterfalls, hearing the testimony of a local Burundian couple, a home visit, and a tour of the hospital and its various programs.
Although we had lots of fun together, we also waded through some deep waters -- past wounds that impact our relationships, protective layers that we put up to avoid getting hurt again, God's design for marriage and relationships and how that has been damaged since the Fall, and how the gospel relates to each of these areas. Please pray for each of us as we process and discuss the material that was presented. Pray that our marriages and relationships would grow deeper as a result.
We want to say a big THANK YOU to the many people who worked hard to make this trip happen -- those who helped with logistics, those who traveled to be here & all the preparation that entailed, those who prayed, and those who gave gifts and/or financial support. It was a really great week!
We look forward to welcoming the team back in February 2020 to go through the second half of the course with us!
Our traditional team send-off, the "tunnel of love".
by Ted Disclaimer: These thoughts are based on personal experiences working as a Korean-American surgeon in rural Burundi and do not represent all other Asian Americans serving as missionaries in Africa.
According to the UN Department of Economic and Social Affairs 2015 report on migrant populations, there were an estimated 46 million people living in the US as foreign-born inhabitants. This represents about 15% of the total current population of the US, and about 20% of the world’s foreign-born population.
Not surprisingly, the US is one of the most ethno-cultural linguistically diverse countries in the world. My parents fall in this category of foreign-born inhabitants, as they immigrated from South Korea to the US in the 1980s. I was born and raised in southern California, where there is a non-white majority (not typical for most of the US). My high school had 3000 students, more than half of whom identified as being from an Asian ethnic background. My wife, Eunice, is also Korean-American and also grew up in southern California, though in a different part, and shares a similar growing-up experience. Racial and ethnic diversity was a common subject of discussion in school and college growing up, and while I thought often about my Korean-American identity, it is interesting that living in Burundi brings it to the forefront of my thoughts regularly.
In Burundi, according to the same UN report, there are an estimated 250,000 inhabitants who were born in another country, representing 2.5% of the country’s total population. While I don’t have the data to support this hypothesis, I suspect that most of the 2.5% are from other African countries. I mention this only to highlight the homogeneity of the vast majority of the country. If you are not Burundian (or African), you stand out, accentuated all the more when you live outside of Bujumbura.
As far as Asians in Burundi are concerned, there are many Chinese construction workers as well as a handful of Korean family units, almost all of whom are living in Bujumbura. At least to our knowledge, our family is the only one of Asian descent at Kibuye and distinctly the only Korean-American one in the entire country (note: if you are reading this and happen to be a Korean-American living in Burundi, we would love to meet you!).
As you can imagine, there are many moments in my daily life where my Asian-ness is made more apparent and where certain pre-conceived notions are revealed. For example, I am greeted nearly every day on the walk to or from the hospital (or even at the hospital) by a local Burundian with a “ni hao,” which is a greeting in Chinese. Perhaps they are assuming I’m Chinese because if you are Asian in Burundi, you are most likely Chinese. It is usually said in a friendly tone, and I recognize that they are trying to connect with me, albeit under an incorrect assumption. For comparison, in the US, if a stranger came up to me and said the same thing, I would probably be offended. Some days, I will say “ni hao” cheerfully back to them, usually getting them to laugh or giggle, but perhaps also reinforcing the misconception that I am Asian and therefore must speak Chinese. Other days, I might continue walking on, pretending like I didn’t hear them, or if I have the energy, take a moment to explain to them in my broken Kirundi, “No, I am not Chinese. I am Korean.” Or maybe I should be telling them I’m Korean-American. In either case, explaining this to every person that says “ni hao” would be exhausting.
Another question that I get asked from time to time is “Where are you from?” I typically respond with “I am from the US.” More often than not, there will be a puzzled look on their face, with the follow-up question of, “Yes, but where are you REALLY from?” To this, I will usually respond with, “My parents are from South Korea, but I was born and raised in the US.” And that usually brings a cathartic “Ohhh, now I understand.” Not infrequently, I reflect on my reactions and emotions stirred up by these situations, which is usually a mix of amusement, disbelief (ie Did that just happen?), frustration, and/or irritation. Is it because I am being misunderstood or pre-judged based on my appearance? Is it because of racial stereotyping or cultural ignorance? Perhaps it’s an unrealistic expectation that a Burundian (or anyone else, for that matter) know whether I’m Chinese, Filipino, Japanese, or Korean?
Food and cooking bring up other slight differences in our home life. For example, there are certain items that we use regularly in meal preparations, many of which we brought with us from the US: rice cooker, soy sauce, sesame oil, red chili paste (gochujang), ground red chili pepper (gochugaru), soybean paste, nori, roasted seaweed, dried seaweed for soup, curry sauce mix, etc. We don’t eat Korean food every day, but we enjoy it and eat it regularly according to the availability of our limited supply ingredients. Eunice has even figured out a way to make a version of kimchi (spicy pickled cabbage), which is a staple in all Korean homes. With kimchi, we’ve now opened the doors to a whole new world: kimchi stew, kimchi pancake, kimchi fried rice!
Then there is the subject of our boys (ages 4 and 2), who are 3rd generation Korean-Americans living in rural Burundi where Kirundi and French are the two most common spoken languages. I can only imagine the complexity of how their identity is being shaped through experiences that are vastly different from my own.
In conclusion, being a Korean-American in Burundi has some unique challenges, but I believe there are rich blessings found within as well. For example, I’d say that it gives me a slightly different insight into Burundian culture’s importance of group and family over self, which I think is more similar to the Eastern community-centric collectivist mindset of Korean culture than the Western individualism in North America. Furthermore, it affords ample opportunities for self-reflection on who I am, often pointing me back to my primary identity as a follower of Christ. And this is the reason I am here in Burundi, as a follower of Christ, to love and serve the people here in the way that God has uniquely made me.
As an extension of a history lesson rooted in The Age of Exploration, the Kindergarten through second grade class at Kibuye Hope Academy (KHA), our MK school, was recently asked to pretend that they were explorers to Burundi who needed to report their discoveries. Their goal was to help people like you, our faithful readers, who may never visit Burundi get to know this country they call home and their neighbors.
Ben, 2nd Grade
Burundi looks like it’s carved out of Emerald it’s so green. It’s in the heart of Africa under Rwanda. Burundi has hot springs, forests, water falls, and bumpy roads.
Burundi has lots of cool animals like monkeys, chameleons, and snakes. Something cool about chameleons is, they can look two different ways at once! And, chameleons have long sticky tongues that help them catch flies and grasshoppers.
People who live in Burundi eat beans and rice, goat, and chicken. The food is not the best, but at least it’s food! Also, they eat cow!
The people in Burundi have brown skin. Also they have short brown (or black) hair. Many Burundians (that’s the people who live in Burundi) live in mud houses.
Alma, 2nd Grade
Burundi is a poor country. It’s actually the poorest country in the world. Most of the houses in Burundi are made of mud. I live in Kibuye, a small village outside of Gitega. Our houses are made of brick and concrete.
Our team has a hospital. We have many doctors to take care of everything. So many people get so hurt that they die. Some people get bit by things like a snake or a dog, but most of the time we can fix them up, and they can be sent home. Their family will be very happy.
Zeke, 2nd Grade
Burundi is small and very poor. The houses are made of mud, sticks, leaves, and tin roofs. People grow crops to survive. Growing crops is hard because the country is tiny. Burundi is so small that a couple Burundis can even fit in Missouri.
The most popular food in Burundi is beans and rice. Eating meat is a treat. The most common meat is goat meat. People sometimes make goat brochettes.
The flag of Burundi is a one of a kind. There is no other flag like it. There are three stars that are in a circle. There are four lines coming into the center, forming an X. The top and bottom of the X are red, and the sides of the X are green.
Sam, 1st Grade
Burundi has a lot of trees. Burundi has a lot of animals. Burundi is a poor country.
Seija, 1st Grade
Burundi is very green and brown. There are spiders and grasshoppers, beetles, wild dogs, bunnies, and people. Burundi has lots of cool bugs. I love dogs. I cannot see them because they are always hidden in the forest. But we do see the blue heron. The blue heron is blue and beautiful.
Burundi is a nice place. Come here anytime. This is a fun place. People told me, “Don’t go there.” But we did. Now we live here with my friends, and it is fun to do this.
Clothing from all over the world makes its way to Burundi. This may not be a perfect system (imagine trying to start a textile industry in a country whose markets are flooded by cheap, second-hand clothes), but it does make for some fun randomness. It seems pretty clear that American clothes top the list in Africa. I don't know if this is because A) Americans produce more clothes, B) Americans give more old clothes to Africa, or C) Americans are the mostly likely to fill their shirts with words and logos, and thus make them more noticeable.
Thus, it is not uncommon to be walking around an African city (or village) and to see a shirt from your home state in the US, though the wearer neither knows nor cares about the origin. The fact that the clothes are 100% context-less is part of the humor, like the grown man wearing a bright pink sorority hoodie, or the young woman in the hospital wearing a t-shirt reminding me to "Stay Calm. Kill Zombies." It is, each time, like a little private inside joke between me and the other person. Except that the other person isn't in on the joke.
One of my favorite moments is finding someone with a University of Michigan shirt (or pants, as I saw this morning). It comes up fairly frequently, and I'm convinced that UM apparel is among the most common in the world. Here is one example from 2015. One of John's post-op patients was sporting this shirt, and it matches my residency white coat. So I asked for a picture.
There was one unforgettable time in Kenya, when this 6 foot + Maasai warrior guy was in the lab waiting to donate blood for a family member. He was decked out in traditional garb, with a red blanket wrapped over his shoulder and some nice dilated ear lobes. The only thing that didn't fit (or maybe it fit the best!) was his UM beanie. I was so excited, but at that time, I didn't have a phone with a camera, and by the time I returned after lunch, I couldn't find him.
A few weeks ago, we were out on the frisbee field playing on a Sunday afternoon. The usual crowd was standing around watching. While running by one side of the field, I noticed that a spectator had a UM shirt. Nothing that special in that, but on my second pass, I noticed the words "National Champions." I started to think of the last national championship that UM had won in a sport that would print t-shirts. It seemed a while ago, which piqued my interest. How old was this shirt?
I got close enough to see that it was, in fact, a 2018 NCAA Division 1 basketball championship shirt. Except that UM didn't win that. They went to the finals and went down to Villanova.
Of course, when the buzzer goes off, and the winning team immediately sports their championship apparel, one has to wonder whether the other team's apparel goes. Off to Africa, I suppose.
Well, this got me excited, but once again I didn't have my phone. I went home, hoping that the reason he was out at the frisbee field was that he had some business at the hospital.
As it turns out, he did. The next day, I saw him waiting in line at the cashier. He was waiting with a family member who was hospitalized for an arm fracture. I wasn't going to lose another chance. I asked a friend of mine nearby by to ask him if I could take a picture with him. He seemed amused by it.
I figured I may as well press my luck. I asked him if he happened to like my shirt, and if he wanted to trade. My shirt was from the Gap, a hand-me-down from my brother-in-law, but it fit me a bit snug anyways. He said he liked my shirt very much, and that he'd gladly trade. He had been given that shirt for free.
Everyone was laughing at this point. But how were to make this trade? I told him that I'd come to his hospital bed before I left, and since I had an undershirt, that I'd trade with him.
That's what we did. And for the next week, I'd see him around the hospital wearing my shirt, and this time the inside joke was shared by two.
Hail to the victors. I can't wait to wear this in Ann Arbor. "Where'd you get that?!"
If you've been reading our blog for awhile, you've probably seen a fair number of surgical photos. When we started working at Kibuye, the two ORs had already been in use for probably about 30 years. Those ORs have a lot of stories to tell, many of which happened before our time. In 2013, there was one nurse anesthetist and maybe 50 cases were performed each month, many of which were C-sections. The scrub area was a bucket and a pitcher. Almost all surgeries were done under ketamine (rarely used in the US adult setting). One room had a ceiling mounted surgical light, and the other had a light on a metal stand that we would try to position over the incision. The power went out frequently, and I rarely operated without a head light. Despite limitations, many patients were helped and many lives saved. In fact, many lives entered the world in those rooms! The equipment has slowly been expanded and upgraded, but as the surgical volume has continued to grow these past five years, it became clear to us that it was time for an expansion.
Starting last fall, two new ORs were constructed alongside the old ORs. The noises of hammering, sawing, and welding were frequent accompaniments to the OR music. The first weekend of February, most of the surgical team showed up to help clean and move the equipment from the two old ORs into the new rooms.
Part of our helpful moving staff
Cleaning out the old ORs
The new rooms are so clean and bright! New lights on the ceilings! New scrub sinks! It has been a real pleasure to work in such beautiful spaces. After we moved out of the old ORs, they too were renovated. One opened the week of the visiting ortho team in March. The other is slated to open sometime this month, along with a dedicated room for endoscopies.
With the increased space and number of surgeons, surgical volume has skyrocketed, with close to 300 cases being performed last month. This can be both good and bad--many more people being helped, but an increased strain on our staff, and the need continues to increase. In a country with so few surgeons, the demand will likely always be greater than the supply. Many more staff have needed to be hired to prep patients, set up for cases, circulate, clean and sterilize equipment. It's also been a pleasure to welcome many new anesthetists to work with Greg in order to provide safe anesthesia. They have continued to work long hours in order to help as many patients as possible.
The anesthesia staff, with a visiting RN during ortho week
Please pray with us that these ORs would be a blessing to many. Pray for lives to be changed. But also pray for wisdom for us to steward these spaces well, to have perseverance on the busy difficult days, and to have grace and understanding when we need to say no...so that we can continue to function and provide quality care for many years to come.
1) “Home Date” – You feed and put the kids to bed early, dress up, light some candles, turn on some music, and eat dinner and dessert together - just the two of you. I would say this is, by far, the most common form of dating in Kibuye. Even though you have to make the meal yourself, it usually is at least an attempt at something fancy. Personally, I have learned how to make all kinds of different food (albeit, with some serious failures) that I would have never learned how to make if take-out from a restaurant was an option! “Home dates” have definitely helped me to expand my cooking skillZ. Caleb and I have a reoccurring home date every Thursday night where he destroys me in darts.
Watts at home (don't worry, Susan is taking the picture)
Us at Home
Sample Meal #1: Fresh Spring Rolls, Crab(less) Rangoon, Dumplings
Sample Meal #2: Ethiopian: one of our favorites
Sample Meal #3: Vietnamese Banh Mi Sanwiches
Thursday Darts: Bullseye!
Caleb Wins (Again)
2) “Date Run” – I need to include this in here because it is a thing. Even though Jason and Heather are the only ones I’ve ever heard of taking a date run, it does happen – for them. While running might be torture for some of us, these two runners love it! They chat the whole way through a 5K in #beautifulBurundi. Impressive. Also, fun fact: Jason actually proposed to Heather on a run!
Heather and Jason (stock photo) :)
3) “Date Walk” – several couples on our team enjoy this activity, including us. The Sunds actually take one every Sunday, and occasionally they stop at the local village “duka” (shop) for some take-out goat brochettes. Brave.
Goat brochettes, anyone?
4) “Piki Date” – you and your spouse on a single dirt bike exploring #beautifulBurundi together. It’s like the date run, except you don’t have to run. Caleb took me on one of these piki dates for my birthday last year. Breathtakingly beautiful.
5) “Canteen Date” – put the kids down, find a sitter, and walk up to the one and only sit-down restaurant in the area: The Hospital Canteen! Have a Fanta! They also serve delicious rice and beans, chips (French fries) and lenga-lenga (greens). Yum! And you don’t have to cook!
The Hospital Canteen
6) “Wednesday 8pm Team Meeting” – I know this doesn’t sound like a date. But for those of us with little kids at home, there is usually a standing order for a middle-school babysitter to come to your house on Wednesdays at 8pm so that the adults can go to a team meeting. Caleb and I try to sit together at these meetings on the couch. Sometimes we hold hands. No kids!! Woot!
(I don't have a picture of this. Who takes pictures at a team business meeting, anyway?)
7) “Date Night by Elise and Anna” – this is a pretty sweet deal, but it’ll cost you $$. The middle-school youth on our team are trying to earn some money, so for $20 you can get dinner and babysitting. They set up a table for you in one of the empty guest apartments on campus (if there is one available). You go “out” to the “restaurant” and they cater Calzones, salad, brownies and homemade ice cream to you. They also feed your kids at your house and put them to bed. Score!
The beautifully set table - with a tablecloth and everything
Brownies and homemade ice-cream
The chefs AND babysitters
8) “Date Night from the White Elephant Gift Exchange at the Team Christmas Party” – now this is, by far, the most coveted date night of all (babysitting included). Someone else cooks an incredible gourmet meal for you and your spouse at their house. They also cook a second meal for your kids that they take over to your house, where they feed and watch your kids, while you dine out fancy and –ALONE– in their home. It. Is. Awesome. And if you’re lucky enough, your host will be Susan Watts: our Team’s very own Michelin-Star-Equivalent-Chef. We won date night at her house this past Christmas. I don’t think there’s a restaurant in the world that could measure up to that memorable night!
Sunds date night on the Bank's porch
Banks date night at our house
Watts date night at the Bank's house
Our date night at the Watts house
#IWantToGoBack (and, it's just juice, don't worry)
Carrot Cake with homemade Cream Cheese Icing
So, yes. We take dating SERIOUSLY here in Burundi.
It is hard for me to watch people suffering in physical pain. That is not to say that it is easy for others. But as an anesthesiologist, part of our work is to control pain, before, during and after surgery. There are even “pain specialists” now in the US and other countries, anesthesiologists who go on to do further sub-speciality training in pain management. Unfortunately, in most hospitals in low and middle income countries, pain, and especially post-op pain, is often ignored. Most patients with fractured legs or perforated intestines, receive Tylenol, and nothing more.
There are a multitude of barriers to providing people with effective pain control at Kibuye. For one thing, our patients rarely complain of pain. Africans in general are extremely stoic. On top of this, our physicians are swamped with patients, and so pain evaluation and treatment takes a back seat to things like fluids and oxygen and antibiotics. And I understand all this. But last fall, I decided that perhaps the Lord was calling ME to try to tackle this problem. And so I started with the advice of Atul Gawande, in his book Better, who suggests that one of the steps in becoming a “better” physician is to mesure something … anything. I found two eager medical students who were willing to spend an hour every day for two months, measuring pain scores and vital signs on all of our post-operative patients. I was grateful to have found a facial pain scale that had been translated into Kinyarwanda, and so could be easily understood by our patients who speak Kirundi.
At the end of this 2 month period, I began to do pain rounds everyday with my students, implementing the World Health Organization 3 level pain scale to guide our treatment, and we continued collecting data. This data will now provide the material for the theses presentations of 4 of our medical students. But, what brings me the most joy is that we have been able to prove that providing adequate pain control is possible even in a rural African hospital.
Now I am not one to celebrate victories, much to my shame. And while this all sounds good, on a daily basis I am much more prone to melancholy, frustration that more cannot be done, worry that when I leave for home assignment all of this will come to a halt and wishing I could find a way to put a sustainable system in place to continue this project, which admittedly has become a bit of an obsession for me.
Despite my negative attitude, one evening while at dinner, Jesh sent me a photo. It was of one of the medical students rotating on his surgery service. She was using her phone to show the above mentioned pain scale to a patient. Now this was a student who was not involved in this pain project and who had not yet rotated on my service. But she had heard from others about what we were doing and she took it upon herself to find a copy of this pain scale and start evaluating the pain level of her patients. I am so grateful to Jesh for taking the time to send me this photo, because it was a reminder that God is often doing things that I am completely unaware of. I am completely insufficient for this work. But His grace is made perfect in my weakness, and He is continuing to bring transformation, beyond what we are capable of, for His glory and for His love of people who are suffering. Please pray that this work will continue, even in my absence, and pray for our patients. Please pray for me to have for opportunities to share this work with others. I would love for other hospitals around Burundi and around Africa to invest in this work. But I am confident that God will continue this work, with or without me.
I find myself prone to a lot of ups and downs. Not in a worrisome way, but it is still troubling. If I'm at the hospital and my patients are all doing well, then I feel great joy at my life and who I am. On the other hand, if there is a run of bad outcomes, I can feel quite down. Then, if I go and have a good conversation with a teammate, I can feel great. A little while later, someone comes to me with a new problem that wasn't on my radar, and I feel like a failure. I try to shake it off and remind myself of the bigger picture - that there will always be some problems and that there are good things as well. And that works. Sort of.
Up and down. Up and down. Sometimes quite rapidly, actually. I feel free sharing about it because 1) it's undeniably true, and 2) I'm pretty convinced that I'm not alone in this.
What's going on inside of me? I believe it's a question of where I'm rooting my identity and my worth. My ups and downs are telling me that I have founded my identity on what I do - on my successes and failures. Since my life is inevitably a mix of successes and failures, my perception of self-value rises and falls like the tides. To the extent that my heart embraces the Christian truth that my identity is rooted in the unchanging grace of God, that he has loved me and adopted me as his son for no other reason than his unmerited love, my sense of value finds a firm foundation.
So, my ups and downs mean that I've put my faith in the wrong place, namely in myself. I know this, and what's more, I've known it for a long time. So why is it still a struggle? I think it's because some deep part of me really wants to earn my own value, and thus I rebel against grace. I know it's a non-starter, but the battle rages on. Recognizing my reticence to such amazing love gives me further reason to thank God for the unconditional nature of his acceptance of me.
So, pray for me. In fact, pray for us all. Our team is passionate about our work, and so I don't think it's a stretch to say that we are all tempted to place our identity in the wrong place. We need frequent, even constant reminders that we are God's children by his grace.
There is a popular church worship song these days which I have enjoyed on this theme. A couple of weeks ago in our local French service, Dr. Alliance's wife Cynthia led us in singing this song. The power at the church was out at the time (but not the hospital!), so I got to enjoy it a cappella with a single drum made out of an ancient 50-gallon shipping drum with a cowhide over it. Enjoy.