Letter 2

Itʼs Sunday evening at 10:30 PM and we thought weʼd send you an email with an update! Unfortunately
we havenʼt gotten over the jet lag yet! The last couple nights we have stayed up late hoping to avoid the
1-4 AM wake up period. Pray that we can get on this time zone!!
" We arrived in Kibuye on Thursday afternoon. The drive was beautiful as we basically drove up a
mountain to 6,000 feet. The mountain was lined with farms up the sides. There were few cars on the road
as gas costs about $7.50/gallon and the average annual income is about $300. Thus, the driver had to be
cautious with all the bikes and walkers climbing up.
" Kibuye is a small village. We have running water, but I think we are the only ones in town. Even
the hospital gets water brought up from the well. Also, most people donʼt have electricity. We are living in
the poorest area I have ever been to.
" The house is nice with a beautiful garden- both flowers and vegetables and fruit. The workers
take very good care of the area. Itʼs really beautiful- the climate here is perfect for green grass, exotic
flowers, and delicious foods. We stay in the house with Dr. Rusher as well. We eat all our meals together
and usually play a game or two after the boys go to bed.
" I spend the day with the boys- we get into all kinds of mischief! I have been taking them out twice
a day for walks. As soon as we leave the gate we are quickly followed and usually capture the attention of
about 50 people who will just follow us. They laugh at Bentleyʼs glasses and stare at his stroller! I enjoy
getting out and seeing people. I am starting to learn Kirundi. Itʼs a very difficult language! If you want to
say thank you, you say: urukoze. (u-roo-ko-say). I hope to continue to learn to say more than a few
words and form some sentences!
" I was able to go to a church service this morning. It was so great. The building is plain with brick
walls and bench pews. The music was beautiful. They had Dr. Rusher and I sit up front facing everyone- a
place of honor I guess. Of course I felt super awkward, but it was important to them to sit us there! David
wasnʼt able to come because the boys have been a little sick with colds (Clayton was just getting it when
we left- and now it has been passed to us all- and of course Bentley got it a little worse). The pastor
spoke about how we should trust Godʼs will over our own. He used an example about a man who wanted
to get married, but didnʼt want to marry the woman God had chosen… he wanted a woman who was
more beautiful, and I think she ended up leaving him or did something hurtful... Anyway, I started thinking
about Godʼs will in my own life. It has always been a dream to come to Africa- and I am so thankful to be
here…. But I will say itʼs not all butterflies and roses! Itʼs at times 24 hours without water, and unstable
electricity, and extreme poverty, and diseases… itʼs not being able to communicate and at times feeling
like I donʼt have anything to offer-itʼs trusting the Lord daily for the health of our family. I donʼt share these
things because I am unhappy or to complain, I share them to express how God is working in my life. God
gave me a heart for these things… but even though he did that doesnʼt make it easy! I have been learning
how to depend on the Lord more and more. When I wake up and when I go to sleep I seek him in prayerfor
us and for those around us. The slower pace and lack of stuff is slowly ushering me into His presence
and grace. So I guess I am saying, that itʼs not as easy as I thought it would be to follow the Lord here,
but itʼs truly worth it and my faith is growing because of it… and isnʼt that what we desire?
Anyway…
I will let David tell you about the hospital now!
Thursday January 20.
Our first full week in Kibuye came to an end today. I have been really busy in the hospital. There have
been somewhere between 100-120 patients in the hospital since we got here, many of whom had never
been seen by a doctor. We started out seeing patients the nurses thought needed special attention, then
over the last few days we have made our way through the entire hospital census. There are also around
a hundred clinic patients per day that are handled for the most part by nurses. For the first few days Dr.
Rusher and I rounded together, partly so that I could get used to the types of patients here and partly
because we really only ever could find one translator at a time. I wish I could speak Kirundi…or at least
French. Currently there are no Burundian doctors at the hospital every day. Hopefully however there will
be one arriving on Monday.
On Tuesday the medical students from Hope Africa University in Kibuye arrived. There are 16 of them.
They are in their 5th year of medical school out of 7 and are having their first clinical experience now. So
for the last few days, Dr Rusher and I have been rounding separately, each with a group of medical
students. I have been tasked with teaching physical diagnosis to the students, so they will all rotate
through my team. We have teaching time in the morning and then take plenty of time on rounds to teach
various skills as well as medical knowledge about the various diseases we see. It is fun to have a group
of enthusiastic students to work with.
" Here are some of the things that have worked out well…as far as I know I have more ultrasound
training than anyone else in the hospital (not that I have a lot) and that has been really useful. I have
diagnosed a variety of conditions…placenta previa, fetal demise, twin pregnancy, and pericardial effusion.
Pretty much every day there are a few ultrasounds to do after lunch. I also figured out how to tell
estimated gestational age on the machine. We have also been able to find a number of patients who had
not been receiving proper treatment for their conditions. For example, there was a three year old girl who
had been diagnosed with malaria by the triaging nurse and wasnʼt improving on anti-malarial medicine
because she had a pneumonia. So now hopefully she will pull through. There were also a number of
patients who had been in the hospital for more than a month (as many as six months) without any
improvement or change. We have made our way around to all those patients now and are trying to come
up with plans to get them out of the hospital. Today the lab received the materials to test for HIV so now
we can test people we suspect of having it.
" Some frustrating things: No good X-rays. I never appreciated the value of a good X-ray until all I
can get are washed out images that are next to impossible to read. No plaster. In the ward Iʼve been
rounding in there are two adults and one child with tibia fractures and none of them are in casts. One has
been laying in bed for 3 weeks without any immobilization. So Iʼve immobilized them and am waiting for
the plaster which I am told has been ordered. Osteomyelitis…infection of the bone. We have 10-12
patients with chronic osteomyelitis with draining sores and various degrees of bone destruction, and the
only real care they are getting is dressing changes. We donʼt have a lot of good antibiotic choices, but
even if we did, the treatment is surgery and we donʼt have an orthopedic surgeon. The only definitive
treatment is amputation, but it is hard to accept the idea of amputating a limb for most people.
Anyway, Iʼm enjoying myself, and Iʼm learning a lot. Iʼve had to read up on a lot of diseases. I just wish I
had brought more books. I found a 20 year old edition of Harrisonʼs Internal Medicine which is serving
me fairly well.
(Adrienne again!)
Thank you for your prayers we really appreciate them. Please pray for continued health and safety for us.
Pray that I can form a relationship with some of the women medical students who are arriving this week
from Bujumbura- they all speak English and it would be nice to have a friend (other than my 2 little
companions)!!
Love you all!
Amahoro, (peace)
David, Adrienne, Bentley and Clayton