March 6, C.W.

           Acceptance of death in Rwanda is notably different than what I have noticed in America. Last night, a mom lost one of her twins. The umbilical cord was trapped in the birth canal before delivery depriving the infant of oxygen causing severe brain damage. As a result, the infant would not consistently breathe without support and subsequently died.  The baby was removed from the incubator and placed in a box.  The box remained under the incubator all night while the mom continued to care for her living twin.  Some people say there is a different value placed on life here.  I am not sure that I believe this to be true.  I tend to think there might be a greater willingness to let go when the time comes. Here there are no extended services to support occupational and physical therapy or funds to assist the parents.  There are no special education services, assistive technology, or roads conducive to wheelchairs.  I am not sure what the future would have held for this baby had he lived, but perhaps the mom knew.  It is difficult not to view cultures through our own cultural eyes, yet to do so might skew the reality.  It has been a wonderful experience to witness the dedication and commitment demonstrated by the moms here.  They sleep on the floor by their baby’s crib while extended family members bring them any food they might eat.  There are no cafeterias for patients or family members.  It is true that emotion is not displayed in the same manner we show it, but that doesn’t mean that a deep love is not present.  In a country where life expectancy is age 50, perhaps acceptance of death is critical for hope and survival to be present in those who remain.

Richard M. Whitehurst, Jr.

This past couple of weeks has been nothing short of amazing. While I have learned and experienced many new things in the surgery department, the story I would like to relate to you today is my experience on spiritual rounds last weekend. Tommy and I were able to accompany Dr. Albertson on his customary Sunday afternoon spiritual rounds. We visited with about 30 patients in the surgical ICU and on the male surgical floor. Don’t worry, the women weren’t neglected – Mrs. Albertson, Dr. DeLeon, and Stephanie went to their floor. With the help of our interpreter and intern, Leonce we prayed with about 20 patients, all of whom seemed very eager to have us come and visit with them. In fact, when we walked onto the ward, there were several beds empty, and by the time we had finished with the first patient, almost all of the patients had returned and were waiting for us. The eagerness for our patients to receive prayer from us has had a tremendous impact on the way that I view my responsibility as a soon-to-be physician. I believe we have been well-prepared for taking care of a patient’s physical and even emotional needs during our time in medical school, but this experience has prepared me for helping my patients to realize that true healing only comes through having a relationship with God. Through this trip, I feel like I finally know what it means to use medicine to bring glory to God and to reach the lost. Thank you all for your prayers and support.

Ben

Muraho readers!

This post was supposed to go up yesterday, so I apologize for the delay.

Monday marked the start of our last full week working at Kibogora. For many of us, last week was the time we really started to adjust to our roles in the hospital, which hopefully means this week will be a great chance to absorb the experience. On the surgical ward I can say that we're finally getting accustomed to having more of the responsibility falling to the students. A welcome side effect of more responsibility is more direct contact with patients. After hearing everyone's stories from last week, I'm loving the chance to interact with the people here on a more personal level. It's been humbling to see how patient they are with this lost Muzungo, and refreshing to see that a smile can cross language and cultural barriers.

If asked to describe the experience in one word, the only one that would fit is "beautiful". From the breathtaking landscape to the humbling generosity of our hosts, I have never found myself in a situation where I was more struck by the beauty of it all. I hope the pictures and stories we all share do it even a shred of justice.

Lastly, I want to thank you all for your prayers and support. There is no doubt that this trip would not be possible without a strong team back home, and we are endlessly grateful. Hard to believe that in just a couple short weeks we'll be sharing our experiences in person.

Take care, and thank you

TS

Hi to all of our friends and families! I figured everyone loves to look at pictures, so here are some of my favorites so far. Don't worry, I have close to 700 already, so if you want to see more, there are plenty. I'll put a little caption below each one to explain. We miss everyone back home but are having a wonderful, life-changing time over here. The peace and serenity of this beautiful little country is just what the doctor ordered (pun intended).
-Sarah Kelley

Our little fighter. This is the baby that Dr. and Mrs. Whitehurst wrote about in the last blog. 

These pictures are from church today, on a beautiful hill about 20 minutes away. The congregation was so warm and welcoming, and even insisted we stay for lunch and cokes. It was so heart-warming and a provided great worship. 

Sweet Brooklyn enjoying the swing.

 Beautiful Jennifer. (I'm sure this isn't helping David not miss her!)

 Tommy

View from our house. Amazing!

The group on the canopy walk in Nyungwe National Forest.

 Our fearless (patient) tour guide.

Obviously I can't stop taking pictures of the curls.

Sarah and William on the canopy walk.

 Hi Alana!

 Actually not as scary as it looks. 200 feet up at the highest point.

The Sarah's take Africa.

Mrs. Connie always laughing.

 Kid looks good on him, no?

Tiara at the gorgeous lodge we stopped at for tea and coffee on the way back from the forest. This place makes American hotels look weak. It was SO nice and had the most spectacular views. Behind her are the lime green tea leaves and further back, the dark green mountains with low-lying clouds. I wouldn't mind spending a night or two there.  

A panoramic of the hotel view. This picture doesn't do it justice.

Amy, Jennifer, and Steph before church.

The local kids LOVE photos, and especially seeing themselves on the screens after we take them.

Local girl. 

The group outside of the hospital, with Julie (far right), a NICU nurse (who basically functions as a neonatologist) who has lived in Kibogora for 6 years. She is our liaison and makes everything happen. Thank you, Julie!

Mean-mugging. This one was just too good to pass up.

The Baxter clan.

Stephanie bossing the boys around. She has done so much hard work in the ortho department. She is essentially acting like a 2nd year resident, taking care of patients pre- and post-op, making major management decisions, and performing big operations virtually unassisted. Get it, girl.

Dr. Gwen

Annie learning from the local doctors on medicine rounds.

Dr. Whitehurst teaching Dr. Ngoy how to perform cranial ultrasounds on newborns. 

Amy doing her thang - solo C-sections left and right.

Sunset at the house.

"Oh hey, girl!" My diva looking so fly in her phototherapy sunglasses.

Caught ya!

Panoramic from the island we rode a boat to in the middle of Lake Kivu yesterday.

March 1, 2014

This beautiful country is filled with many needs, yet we find the people to be gentle and committed in ways that we do not always see in the US.  Last week, I was called to see a baby that arrived from a local health center.  It was around 4:30 am when I reached the NICU.  As I entered the unit, I found mothers curled up on mats next to the crib that held their baby. 

Immediately, it was apparent that the baby I was called to see had a severe case of pneumonia.  Fortunately, the baby was stabilized.  We were able to use an O2 saturation monitor that was donated on this trip.  It dawned on me the same evening that this baby would have had no chance if the staff had not had access to the O2  monitor because the baby arrested a number of times. 

In this case, it was easy to see how God works through many people, over large distances to accomplish his work!  Friday night Julie Yerger made a special effort to come tell the team that the mother had been expecting to sing at her baby’s funeral. Instead she was humming and watching him slowly improve.  Certainly, these moments make it all worthwhile.

On a lighter note, I want to share how the team spent one Saturday exploring this beautiful country.  We hiked over the canopy of a rainforest in Rwanda.  We all had a great time navigating the forest and the suspension bridges.

Richard M. Whitehurst, Jr.

Day 13 of the Odyssey.

Belovèd,

The hour draws late.  You have my promise that this missal will ramble, but I will give my most valiant effort to provide for you a brief account of my perspective of our last two weeks.  Should it wax overly verbose, I beg your indulgence. 
We have been, thus far, blessed. The Scriptures assert that we will be known by our love for one another.  To the extent that I have been able to observe, this has been well-demonstrated.  Yesterday we were deprived of the company of several of our number due to the expiration of their leave from hospital duties in the states.  Their absence stings sharply, save that they removed with them the last remnants of some respiratory plague that I have thus far managed to avoid.  Our forest canopy excursion of last weekend apparently incited the ire of some of our allergies, but I remain relatively booger-free.  If my fortune holds out likewise regarding Kunta Kinte’s revenge, I shall count myself blessed indeed. 
All told, we have eschewed several potential ills.  Traveling mercies have abounded, the fare is, at worst, palatable (with the possible exception of the fried whole-sardines that were served up the other day), our spirits remain healthy, and we are enjoying our work.  As far as that’s concerned, my own experience is somewhat divergent from that of my peers.  While their souls languish in the hospital, I spend my time in the laboratory.  I’ve always had an affinity for laboratories.  Most of the people there are without communicable diseases, there are lots of nifty scientific-looking glass thingies, and I get to see color changes in glass tubes.  The only appreciable difference in this lab is that it is situated at the top of a hill looking out on the Rwandan country side.  The view is truly spectacular. 
They call this place “The Land of a Thousand Hills.”  They undersold themselves. Land of a Thousand-Foot Hills would be more apt.  I am convinced this oversight was intended so as to not intimidate American missionaries.  I find myself gasping for breath half way to breakfast in the morning.  I’m sure it has something to do with the elevation.  Yeah.
At any rate, the people in the lab at the top of the hill (when I finally manage to claw my way up there) are a lot of fun.  A couple of them speak decent English.  They said today that my French was “mediocre.”  I believe that’s because their vocabulary doesn’t include the word ‘abysmal.’  Whatever the case, we have a good time.  They all enjoy laughing, and seem to have a pretty good outlook.  The first day I worked with them I had been there with one of the better English-speakers for about 2.5 hours and I noticed we were alone.  About that time he looked at his watch and said, “We are late for tea.” 
“What?”
“Tea.  At 10:00 we have to go to tea time.” 
Doubting, but not challenging the imperativity of tea time, I followed him up and down a series of inclines to the Kanteen across the street from the hospital where we enjoyed a cup of African tea and some kind of fried biscuit thing.  The African tea was more like tea-twinged milk sweetened with sugar and served at a temperature approaching that of the surface of the sun.  The consistency biscuit thing was reminiscent of various sporting implements with which I have collided in my ill-fated athletic endeavors, but it tasted pretty good too. 
This picture has repeated itself in one way or another daily since our arrival.  In the last couple of days they’ve incorporated me into the lab work, and it’s pretty entertaining.  I find it an interesting indictment of our system that after four years of medical school I’ve had to come to Africa in order to do a Gram stain.  Should I grow tired of the bacteria, there are always birds to photograph.

Having realized that we are in a part of the world with endemic species of chameleons, I made it my aim to find one.  It didn’t take long.  Walking along a pencil cactus hedge I spotted three of them basking in the sun.  I am convinced that they are the neatest vertebrates extant in Creation.  As if they weren’t adequately fascinating with their independent turret-eyes and lobster hands, they have prehensile tails.  Let us not forget the tongue trick.  These notwithstanding, some species have horns like triceratops.  Top that.  Ok, ok, plants that eat things are pretty awesome too, but I digress.
Nightly we take the opportunity to share time pondering The Word.  We have undertaken to go through II Timothy.  Given our diversity of perspectives it makes for a most edifying discussion, at least by my account. 

Evenings are relatively free, offering the opportunity for much-needed introspection.  It is my hope that my friends have found these times of meditation likewise regenerating. Having been given a sweet—albeit brief--respite from many of the concerns inherent in the eighth semester of a medical education, I find myself pondering questions of Creation and its Author the resolutions of which I have had to defer until such a time as I could muster adequate resources to attempt their cogent incorporation into my meager synthesis of His work.  Words fail me to express the value of the precious hours I have been given to consider these matters.  I can’t really explain this impulsion save that it is inherent in my creation.  I’m far from unique in this regard.  Seeing the same deep-seated passions, though to different ends, among my brethren I am constantly reminded of what it means to be but a member woven into the Body of Christ.  Each of us is such a small part, some more honorable than others, but each so valued by God that He considered it preferable to sacrifice His own Son for our individual and collective redemption than to allow our bearing the full consequences of our transgressions.  It’s a love that I can’t understand.  It’s a love that I cannot get over, and I pray I never shall.  What wondrous love is this, O my soul, O my soul…

Grace in Christ,
--Goose.

Today marks the 6th day out of 14 that we will spend working in the hospital. So far I think I can speak for everyone when I say that this has been a great experience. It is interesting to compare and contrast how medicine is practiced in different parts of the world. In the laboratory here, for instance, we are unable to get some of the most basic of tests such as sodium and potassium levels. The machine that analyzes white blood cell counts was out of commission for several days so we were unable to check WBC on anyone. Although every good physician should determine whether or not a test will alter his patient's management before ordering it, this is done more regularly over here. Not only does the hospital not have access to many tests that we would consider standard, but some of them must be obtained in Kigali which is not only expensive but also time consuming for the patient. My hope is that the exposure to this type of medicine will enlighten us to the way medicine used to be practiced, where sound thinking and a skilled physical exam were used to make the diagnosis and tests and imaging were used to confirm the clinician's diagnosis.

This is the third time I have been to Africa. As I'm sure many others have already mentioned, this is the prettiest country I have been to in Africa and undoubtedly one of the prettiest on the whole continent. We are currently in between the dry and rainy seasons. The soil is rich and the vegetation lush. The rolling hills and tropical rain forest keep the scenery interesting. I discovered that the termites that fly around at night are, in fact, edible. Just ask Goose.

As we move forward I ask for safe travels for the residents and Dr. Simmons as they begin their journey back to the U.S. I also ask for prayer that our focus remain in God and what he has in store for us in the coming weeks.

God Bless
William