This week in Kibuye was our fourth trip in 8 years of cheering from the sideline as our Serge team established an outpost of medical education and care for the poor in rural Burundi. The team has tripled in size, as has the compound of homes, as has the hospital, with new wards, oxygen, a solar electric system, new operating theatres, appropriate-technology locally fabricated incubators for premature babies, specialized ophthalmology equipment and an expanded plant to make nutritional supplements. If you build it they will come, and hundreds of patients present each day, attracted by the competence and compassion. They come in labor to deliver their babies, they come with festering wounds months old, they come with broken bones and traumatic injuries, malarial fevers and twisted bowels.
How does an initial group of medical students find themselves over a decade later staffing a simple hospital, pushing the boundaries to make it a premier teaching center in a very needy place?
Vision, certainly, for investing in a rising generation of local doctors, for hands-on care for the poor with as much excellence as limited resources will allow. Connections, partnership, fundraising, for sure, hundreds of thousands of dollars worth of construction and equipment to just get some space and light and cleanliness, some water and power, nothing fancy. Courage and patience, to live initially in crowded spaces without amenities, to plug through language learning and to see problem after problem beyond any easy solutions. Humor I think, to not let the setbacks swallow you, and community, the kind of friendship that steels one to put their kids and lives on the line as part of something larger.
But mostly, it’s endurance. Being present in a hard place, listening to local partners, voluntarily setting aside the path of quick fixes or domination and working from the ground upward. This visit we stayed in a lovely guest apartment, with hot running water (solar), plenty of electricity, appliances, a comfortable bed. We rounded with the team on patients who had vital signs documented, who were getting IV medications, who were recovering from complicated surgeries. We attended church where the Gospel was powerfully preached, and where the pianist, guitar, and vocalists led with talent and Spirit. It was not always so. Coming in 2019 one might not appreciate the pouring out of life necessary to negotiate, to construct, to organize, to build relationships, to adapt.
As we head towards a decade, the momentum is palpable, but the challenges never cease. In the last week, for instance, the hospital lost several generalist doctors to transfers to the city, entered a period where no medical students (upon whom much of the care falls) will be rotating for the foreseeable future, had one Serge doc leave suddenly for a family funeral and faced a planned week of specialty surgeries thrown into question when another visiting missionary doc got held up by visa issues. It is a resilient community but the prospect of trying to stretch to cover even greater gaps, when already working crazily hard, looks daunting.
Please keep this team in your prayers. Rapid, expanding development stretches the soul, too. They work in three languages, continuously. Caleb our engineer supervises 146 Burundian construction workers, meaning they have a steady meaningful job that provide for their families, but it's a huge weight of responsibility to do that and keep the essential infrastructure intact. We have ten doctors with very little specialty overlap, so everyone is full-on at all times, but even moreso now with the staffing gap. Pray for supernatural patience and quick resolution on hiring more local doctor help. Our docs do much more than patient care; they disciple the chaplains and students, work with the administration on vision and planning, lead Bible studies, travel to Bujumbura to teach medical school classes. Though we have 3 full-time professional teachers for the 18 school-age kids, six other moms (some of whom are trained teachers too) pitch in several class periods per day. Without a school, none of the other work would go forward. And the 15 non-doctor adults not only build buildings and teach school, they work with the malnutrition programs, help with microenterprise, raise funds for the neediest patients, track all the donor spending and administer projects like ward construction, care for wounds, help with the retinoblastoma program, provide lactation consultation for the NICU moms, invest in therapeutic play with admitted kids, run an informal preschool (there are 7 kids too young for school yet!), and spend many hours investing in hospitality. All while living in intensely interdependent community, where the grocery store is hours away and every normal life activity is harder than you thought it should be.
We are hopeful for them, and for Burundi. The first two Burundian specialists (surgery and ophthalmology) have been appointed, both men who were trained with the help of this Serge team. The vision is to raise up a new generation of Burundian young leaders who can help their country overcome the effects of genocide and poverty. It is starting to happen.
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