Easter Sunday

He is Risen! Today, believers across the globe celebrate the resurrection of our Lord and Savior, Jesus Christ. Kibogora, Rwanda is no different in that sense; however, the service we were blessed with today was unlike anything most of us have ever experienced. After breakfast, the group traveled down the side of our little mountain to the Lake Kivu (which, ironically, means lake) and journeyed across a small stretch of it, via a small boat - truth be told, it was more of a large motorized canoe. We landed ashore a peninsula, upon which was built a church and school for people in the area. Unfortunately for the ill-equipped and less nimble Americans, the church sat atop yet another hill. With one of the pastors in the lead, we made our undignified scramble up the hill to the church building, an open metal and brick structure brightly decorated for the service. When we arrived, many parishioners had already begun singing the praise and worship with more trickling in as they arrived. We were directed to special pews behind pulpit to sit next to the pastors as honored guess. It was a humbling experience that they would give newcomers such respected seating. The service began in earnest with a series of songs in which almost all of the churchgoers sang and danced to the rapturous music. A good number of us joined in the dancing as well; their enthusiasm in worship was infectious (medicine pun not intended)!
After the first series of songs, choirs from multiple churches sang and praised the Lord, often breaking into bouts of dancing as well. Interspersed among the songs were readings from scripture, the verses translated into English by a local pastor for our benefit. Toward the end of the service, we had several baptisms as well as communion (also known as the Lord's Supper if you're Baptist) and a reenactment of the crucifixion; the entire affair lasted three hours.
Despite the fact that most of the service was in another language, the spirit of worship was unmistakable. God moves through these people in a way that kindles a fierce joy in your heart. What a blessing it would be if we brought back some of that same fierce joy. After the service, the officials of the church invited us to partake in an Easter luncheon. Despite being a poor church, they blessed us with quite a spread: bananas (or plantains, I can never remember which), rice, pasta, cooked greens (we'd probably call them collards if at home), a peanut-infused sauce, and a centerpiece of stewed goat. Meat is such a rarity here, that it spoke volumes about how much they appreciated our coming and worshipping with them. Their spirit of servanthood is truly magnificent.
Our trip back to our houses was more of a scamper than anything else. We tripped and slipped our way back down the hill of the peninsula and into our boat/canoe and began our race with the rain clouds. Most of us were out of the boat and most of the way up the side of the small mountain before the rain came, a blessing seeing as how almost all of us carried some kind of digital camera or cell phone for the same purpose. We each collapsed into our beds, the result of a couple of long hikes and a three hour, joyous Easter service...what a splendid day.
God bless each of you back in the states. May He open our eyes to the magnitude of our sins and simultaneously to the even greater ability of His to love and forgive us of them.
-Daniel

Additional blog on our trip

kjacksonp.blogspot.com

Greetings from Kibogora!

This has been waiting for a few days... every time I have tried to use the internet the past few days, the network here at the hospital has gone down. Finally, it's back online. Carter, Meagan, and I have been working on the Internal Medicine service for the past 2 weeks, and we have seen so many diagnoses we had never seen in the US, including malaria, tuberculosis, typhoid fever, and a possible spinal cord compression/cauda equina syndrome. We have seen patients autonomously, making decisions about each patient on our own. In addition to the infectious diseases of Africa, we have also been able to demonstrate our knowledge treating patients with type 1 diabetes mellitus, congestive heart failure, pneumonia, pyelonephritis, gastroenteritis, and many other diseases. So far, this has been an incredible opportunity to hone our diagnostic skills, building confidence with each patient. We have practiced ultrasound skills on live patients and performed lumbar punctures and other diagnostic procedures. Most importantly, we feel like we have positively contributed to the physical and spiritual health of our patients. We also have learned much from our master orthopedist, Dr. Albertson, who took us on spiritual rounds on Sunday. Dr. Albertson has made this a habit of his career, performing spiritual rounds and praying with patients on Sundays for many years. I find this a wonderful practice that I hope to incorporate into my own practice in the future. Even with the language barrier from English to Kinyarwanda, God’s love can be communicated through service, as well as translated directly by the wonderful nurses here at Kibogora. Further preparation for residency has come to us through the management of emergency patients. Last night, I was awoken at 2:54 am about a patient who was presenting to La Salle D’Urgences (Emergency Room) here with chest pain. Although Drs. Bright and Simmons accompanied me, I was allowed to take the lead on examining and managing the patient. Fortunately, the patient was young and in good health, with no real concern for a myocardial infarction or other major cardiovascular event, and we were able to discharge him without worry. Duane led us in a prayer with the patient and his brother, and we were able to return to sleep with the hope that we had helped another patient and in some way demonstrated God’s love to him.

Concerning the food: Many of you who know me are wondering how I am doing with the food here. We are blessed to have some wonderful ladies preparing our food, and though it is considered a luxury to Rwandans, we have been having meat with almost every meal. While my colleagues here enjoy poking fun at the vegetables lacking in my diet, I assure you, I am eating them on occasion. One or two salads. With pepperoni. That counts, right?

Market day was on Friday this week: It’s like we are celebrities here. The children in the marketplace followed us around the whole time, and many adults crowded around too to see what the Mzungus (“the rich white Americans”) were buying. We seriously had 25-30 kids following us everywhere we went. Some of them even followed us about halfway home (around a mile). Many of us found fabric for dresses (not I; they didn’t have my color), and Laura and Katy bought ingredients for homemade guacamole to go with our delicious dinner of enchaladas. Finally, I want to post a prayer request. Our friend, JC, a surgeon at Nebobongo Hospital in the Congo has visited Kibogora with the group these past 2 years. He is one of the only surgeons in the Congo, and it is 700 km from his hospital to the next nearest surgeon. I ask all of those who read this to pray for JC and Nebobongo Hospital, and if you feel so led, find a way to support his efforts through other action. If you would be interested in finding out more about JC and his work in the Congo, you can ask me (or anyone on the trip), and we can get you more information. We appreciate all of your prayers! More pictures to come!

Joseph

 

A week at Kibogora Hospital

So we've spent a week or so at Kibogora Hospital now, and it's been pretty amazing. Joseph and Meagan and I have been working in the Internal Medicine department with Dr. Telesforo, a Rwandan physician who is at times confused with Dr. Jospin. We've seen a variety of diseases from malaria to lymphoma to hepatitis and everything in between. It's been a great learning experience as well as an eye opener. Despite their suffering, the patients here are so grateful for any and all care that we give. It makes it easy to love on them, and I hope and pray that God continues to bless these patients and our relationships with them even after we're gone.

Anyway, here are some pictures from in and around Kibogora Hospital over the past few days for your viewing pleasure.

Carter

The Canopy Trail

Here are a few pictures from our Saturday adventure. I was the self nominated photographer because heights and snakes are my two greatest fears. I avoided both successfully during this hike through the rain forest. Hallelujah!

I hope you enjoy the pictures!

-Jamie.

Canopy walk

We all over came any fears we had and trekked over the canopy of Nyungwe rain forest. It was a lot of fun but scary at times! We of course represented our school some while we were up there! - laura

Rain forests and hot chocolate

Saturday, we got the chance to visit the Nyungwe (n-YOON-gway) National Forest and hike the Igishigishigi (no-idea) Trail. It being a rainforest and all, guess what? It rained! The entire time! But, being the super-troopers that we are, we pulled on our ponchos, tucked our pants into our socks (oh yes, we were lookin' good!) and had an amazing time!

At the mid-point of our hike, there was a suspension bridge, called the Canopy Trail, where, if you were daring enough, you could dangle untold meters off the rainforest ground to get the view of a lifetime. (Really, though, we couldn't tell how far up we were because we were above the clouds and could no longer see the ground!) Of course, the suspension bridge wasn't as steady as some of us might have preferred, and at one point I may have had to gently and *lovingly* correct our fearless leader, Duane, who thought it would be (ahem) funny to jump up and down on the bridge while we were crossing. But, we all made it out alive(-ish).

Back at the top of the forest, we all dragged our soggy and muddy selves to the Nyungwe Tree Lodge -- a five-star resort in the middle of a tea plantation -- for a spot of tea... and hot cocoa and French-press coffee. And there may have been more than one of these hot and tasty beverages per person. But at this point, we'd definitely earned it!

More pictures to come -- just as soon as we can all dry out our cameras!

-Meagan-

The first week so far

It's amazing how God puts things in perspective for you. The first week in Rwanda has been uplifting, humbling, exhilarating, sobering, and everything in between. There is such a dearth of medical care here, yet the patients and the staff are, almost without fail, content with the position they're in. Part of this is due to the cultural belief that you shouldn't try and rise above your station, but a large part of it is the fact that the people of Rwanda look forward to heaven with such expectancy. These people, because they realize how short their temporal loves are, cling desperately to God's promise of an eternity in paradise. This mind set is so drastically different from the American "rat race" where we act like the goal is to accumulate and attain as much as possible during the seventy or so years we have on this earth. The flip side to their looking toward heaven so fervently is the fact that they have become rather fatalistic: if something bad happens to you, you can't (and they many times don't) do anything about it. As health practitioners from a country where we throw everything and the kitchen sink at a malady to try and cure it, we're often at odds with this mentality.
The patients here often present with problems that we rarely see in the states: massive tumors, traumatic injuries several weeks out from the incident, and diseases we've long since relegated to the tomes of ancient medicine due to the relative eradication in the states. This, while great medical training, poses thought-provoking difficulties regarding the management of the maladies. Tomorrow, Dr. Albertson will surgically address a young boy's elbow which, he thinks, had been previously broken and had healed incorrectly, keeping him from flexing his elbow. Without a CT scan, it's nearly impossible to tell what exactly is happening with the boy's elbow, but if the boy is left as he is, he will probably never be able to use that elbow. It will be a great learning experience for me as a future orthopedist, and I pray that God guides Dr. Albertson's hands as he works to try and heal this boy.
We went on "spiritual rounds" today at the hospital, a tour of the patients with their faith as the main focus as opposed to their bodies. We were able to connect with and pray for almost every patient in the surgical wards. Most of the patients profess the Christian faith, and we hope that this is sincere. The language barrier is most often the challenge, with staff at the hospital more accustomed to medical rather than spiritual English terminology. Please pray that God would transcend the cultural and linguistic differences and touch these peoples' hearts, drawing them closer to Him.
We've been studying Philippians during the mission, and I'd like to leave you with a verse or two from this epistle. In the fourth chapter, verses six and seven, Paul writes "Don't worry about anything; instead pray about everything. Tell God what you need and thank Him for all He has done. If you do this, you will experience God's peace, which is far more wonderful than the human mind can understand. His peace will guard your hearts and minds as you live in Christ Jesus." I hope this is as encouraging to you as it was to me.
- Daniel

Eye Opening

Traveling to foreign countries and participating in different cultures is something that I have come to truly love. Serving people as the hands and feet of Christ is the best part. I am finding no matter how many places you go there will be similarities and differences in every people group.

My travels began in Argentina and have expanded to Guatemala, West Africa, and currently East Africa. Hundreds and thousands of miles separate these countries. Despite the different languages, climates, and over all cultures I have noticed some similarities. One....the people always think Americans are extremely funny when they attempt to speak the language...or maybe they just laugh at me. Who knows? Secondly, they all just want to be loved. We come into these areas to serve these people by providing medical services, vacation bible school, or simply telling them about Jesus. No matter how little they have they take you in as family and offer it all to you. They attempt to serve you and ultimately end up blessing you more than you ever could have blessed them in return.

This journey for me began after a few discussions of last years trip with Dr.Peevy. I wanted the opportunity to go serve people with my medical knowledge. The gift that I felt God had given me. I was amazed as God opened the doors and provided above and beyond what I needed to make this journey. Dr. Peevy attempted to educate me on what NICU life is like here in Rwanda. Needless to say it was still an eye opening experience.

Initially in the NICU I was somewhat frustrated about things I thought needed improvement. The first day of work left me wondering what could be done to "fix" things. I prayed for understanding about the challenges they faced instead of a selfish view of how we could make it better for them. We joke in the states about the fact that in the NICU we have to be creative to make equipment small enough for our special patients. Well...creative does not begin to describe what the women of Kibogora hospital need to be. Adult home CPAP machines provide CPAP to the infants in the NICU here when needed. Actually, ONE adult machine. They also have one old bubble CPAP machine as well. With no compressed gas source ventilation of intubated patients in nearly impossible. A team must be created to manually bag infants around the clock. The list of challenges and how they have overcome things goes on and on. I mention these things because today as I examined a former 28 week infant who survived despite these circumstances I realized that God has blessed this place. There are no state of the art resources, but these men and women who work here are learning to do good things with a whole lot less. The greatest moment though....I got the the privilege of putting this NICU's first heart rate monitor on a baby and show them how to use it. To see the joy on the head nurses face as she realized they had a real monitor was a blessing beyond what I expected.

I pray that I do not return to my NICU as the same person. I hope to return grateful to provide care to the infants at USACW with abundant equipment.

Thank you to all the supporters who provided financially and in prayer. Your investment is going to change my life. God is just getting started in Kibogora.

Jamie

Getting acquainted

Well today is our second day working in the hospital and I think we are all getting a little more into a groove.  We have split up between Pediatrics, Internal Medicine, General Surgery, and Orthopaedics with Sarah getting in some good physical therapy time across disciplines.  We are all seeing some patients with different sorts of problems and pathologies than we are used to seeing in Mobile.  So far though with some prayer and research we have found the answers we need.  Today Mickie and I introduced some children to the Garage Band app and found some avid music and dancing lovers.  They could have played all day long!

We have been trying to educate ourselves on the language and culture here.  When I inquired about how to ask a mother the name of her newborn I was informed that babies are not named here until after 2 weeks of age and never while they are still in the hospital.  This is a practical tradition based on the harsh reality here that it is very common to lose babies prior to this age.  We were also told not to be overly complimentary of any babies because the people here feel this may draw the attention of evil spirits. 

Back at the house no one has cause to complain.  We are in NO danger of starvation-quite the opposite in fact.  Lunch is supposed to be the big meal of the day here but we are all usually just as stuffed after breakfast and dinner!  Our cooks are pretty amazing and we have been treated with french toast, pot roast and mashed potatoes, pork chops with gravy, and hearty vegetable soup-and this is just day 2 and a half!  My favorite is the fruit salad with a delicious mystery fruit we just discovered is passion fruit.  If I can find this back home it will definately become a new staple.  The only thing I could ask for is that the rooster sleep in just a liiiittle later than his 4:15 wake up time!

-Katy

View from our window in Kibogora.

What a beautiful place for healing. We are certainly not roughing it! The hospital is all open air with beautiful views of lake Kivu. Today was our first day at the hospital. Basically just getting organized and meeting people. The smallest things go a long way. Greeting people as you pass them with muramutse (good morning) earns you a smile!

Laura

Our first evening in Kibogora!

The girls' house and the view of Lake Kivu

Lunch stop in Butarie/ Huye

We've made it to Kibogora!

After a long journey through the mountains of Rwanda, we've made it to Kibogora Hospital. I know everybody is glad to be done with the travelling and to have a bed to call their own for the next few weeks. Rwanda really is incredibly beautiful, and I can't wait to explore the area more. Here are some images from the final leg of our journey.

Carter