A Weekend Breather. . .

It’s a rainy Sunday here in Kigutu…sort of a cosy catch up day, even though it’s warm. Another extremely busy week has passed. Two of the nurses were laid low by malaria and another had an eye infection so Brad, Connie and I were working very long hours in the wards. When we are in the midst of morning rounds, the “gates” are opened for the outpatients and it is a bit overwhelming to see the throngs arrive. It seems at least once a day we get a stretcher case that has been carried in and we go into “emergency room” mode. The beds are always full and overflowing. Malaria has been rampant these days (yes, I am taking doxy). Luckily quinine is a pretty quick cure and people are on the mend fairly fast. Before we know it the sun is setting and we have been running all day.

On Friday afternoon Connie and I took a brief interlude up at the water tower to watch the sunset, very revitalizing to step out even for fifteen minutes.
We continue to have a quite a steady stream of patients who see local traditional healers and come here afterwards with infections or bad reactions. A few examples include: a 22 year old male with a significantly botched and infected circumcision; a 5 year old boy who had severe reactions to a potion and several with infections post uvulaectomies. A mother of a malnourished baby told us that the traditional healer said that her child had a “bone disease” and recommended that the baby’s xiphoid process (the lowest portion of the sternum) needed cutting. We all attempted to explain that this bony prominence is normal. Melino is especially passionate about educating the people to avoid the healers. He has seen too many deaths as a result of their work.

Brad and I gave another prenatal class on Wednesday. All women were tested for HIV and all were negative. Nice.

The solar cooker has been officially inaugurated by Connie who baked delicious banana bread. A much appreciated treat for everyone.

It’s great having a bit of a breather today gearing up for another full week ahead.

Helen

Helen and sunset

Melino showing his xiphoid process

Peanut Gallery watching drummers

VHW women

Prenatal class

Mother and babe recovering from traditional healer visit

Aubery

Fabrice

Connie and sunset

Children with malaria

Celestin upon admission to VHW

Celestin after 2 months at VHW

Bazile's breakfast

The Power of Community. . .

Community development requires attention and intention and living in Kigutu is no exception. There are several overlapping ‘sub-communities’ here, including: the community of we ‘muzungus’; the community of our residence comprised of muzungus and the Burundian staff; the complete VHW staff (approximately 60 people); the community of the patients and their families; the community of Kigutu and the community of our whole catchment area which is represented by about 50 community health workers or accompagnateurs. None are mutually exclusive, there is much overlap and observing and participating in the dynamics is interesting to say the least.

It’s been another power packed week full of activity. It has been wonderful working with Brad, Connie and the staff nurses making changes/improvements in the delivery of care which will ultimately benefit the welfare of the patients. We have had meetings with the nurses so we are all ‘on the same page’. We are always making efforts to be sensitive and ensure that we are not, as outsiders, ‘taking over’. The nurses are very grateful that we are here to help as presently there is an acute staffing shortage. Connie has primarily worked in the malnutrition ward while Brad and I have worked together in the hospital ward.

Yesterday the three of us tackled the monumental task of sorting and organizing heaps of medical supplies which had been stashed away in a storeroom for too long. All three of us share the delights of a fairly obsessive organizational behavior, so we were in hog heaven. It is still a work in progress, but we managed to get so much accomplished, which was very satisfying. Brad cranked up the music on his computer and we had patients come and watch the muzungus get into it. It was very fun.

Earlier in the day we participated in the community effort to help fix the road to the clinic which has suffered with the recent heavy rains. We dug drainage and diversion ditches which will hopefully alleviate some of the erosion. It was good to be involved. On Friday the accompagnateurs gathered in the new training center and we did a presentation and training on malaria. Afterwards we distributed the donated LED crank flashlights (thank you, Bob Crane), rain ponchos (Bunnings in Cairns), and tote bags which I had procured while in Australia. They also received new photo ID cards and the original photo.

Everyone was excited and pleased to be recognized for their invaluable contributions to the community-at-large. Earlier in the week, five children in the malnutrition ward were transferred to Bururi Hospital for much needed blood transfusions. It was great news to hear that this had been accomplished. Today they will return and everyone is eager to receive them back into the fold. Connie has gone in the ambulance with Elvis, our Translator Extraordinaire, to get them.

Last evening, Will Marsh from Santa Barbara, California, arrived as a volunteer agronomist. (Yes, the inevitable one degree of separation was almost immediately discovered… he knows Grace Bueti!) We are all thrilled with his presence as his expertise will help keep the exceptional food programme on track. We also got the solar cooker Hotpot activated this morning and we are eagerly looking forward to evaluating how it performs here.

Bazile received an early AM phone call on Saturday from his family in Haiti reporting that they were OK. This was the first direct communication he’d had with them since the earthquake. It’s definitely a heart wrench for him to be away from Haiti at this time.

We have had the ongoing steady stream of patients at the clinic, some presenting with interesting pathologies (see the photo of the round worm and also the foot tumours). Each week the amount of patients increase and the distance they travel to come to Village Health Works gets longer. The word is spreading. There is never a dull moment and it’s great to be working hard with such a terrific group of people… lots of love and laughter.

Helen

Melino and Bazile


Insect

Antoine CHW

Alex turns 22 in Kigutu


Trixie hats on Judith and Solange


Helen and Elvis with VHW accomapgnateurs


Helen and Elvis teaching


Connie and Junior Bazile


Will Marsh in the garden


Helen and Will with Solar cooker

After Brad's dance party


Road crew heading off


Road crew finished

Brad and Connie in the middle of the box heap


Foot Tumours

Helen doing dressing on foot

Vomited roundworm sample


Helen, Connie and Brad

“Home” again. . .

A week since my last entry and so much has happened. The globetrotting, jetlag blur already seems long gone…so out of whack with the time, that I am almost “on track”. Yungaburra to Cairns to Sydney to LAX to JFK (the 24 hours layover at the Fingleton’s was wonderful) to Brussels (where Connie and I rendezvoused) to Bujumbura and finally to Kigutu … definitely a long haul.

The trip was book-ended by two interesting events. Driving down the Gillies Range at 3 AM from Yungaburra to Cairns a large tree had just fallen across the road which we were able to drive around….we were lucky we didn’t come around the bend a few minutes sooner. Driving out of Bujumbura to Kigutu we were caught in a blockade involving people who were disputing land issues. Police were present and a feeling of growing hostility and potential conflict was brewing. There were actually shots fired into the air at one point. We managed to retreat and take an alternative inland route (as opposed to along the lake front) into the verdant highlands past the tea plantations. This was lovely and chilly, but took 6 hours as opposed to the usual two from Bujumbura.

The reunions and welcoming from the staff in Buj and Kigutu were very heartwarming. Cory Fisher, a newly hired project coordinator, and Brad Snyder RN are new expat additions since my last trip and I am excited to be working with them. I feel like I have returned to another home and, once again, I have the affirmation that this community is very special. It’s terrific to introduce Connie to everyone and show her around. It’s clear that she will fit in immediately and we have hit the ground running. Our first night here we had a “show and tell” for the staff with all the contents of our duffel bags for VHW….another Christmas. All the staff loved the photos which I had brought for each of them.

Junior Bazile MD, the Clinical Director, is also new since my last trip. He is from Haiti has just gotten a second confirmation today that his family in Port-au-Prince are alive. We will celebrate tonight. He has hardly slept since our arrival, understandably consumed with worry and fear. All of us were sharing this with him and now we are all heaving a collective sigh of relief, yet also feel terrible about the horrific situation in Haiti.

There have been plenty of nursing tasks for us to tackle. The staffing is short and the patient load and acuity is high. Malaria, TB, malnutrition, severe wounds, pneumonia, lung cancer, diabetes are just some of the challenges. Today we had a woman waiting patiently for a few minutes (she had walked here on her own) while we were busy. We then realized she was a full term pregnancy and brought her right in to be examined. She delivered a healthy baby boy on the spot with not even a peep. The people here are so incredibly stoic and contain their emotions remarkably.

Our laboratory technician, Euphraim was absent the day we arrived. His wife had delivered their second child in Rumonge Hospital and we got word the next day that the baby had died. Cory asked me to represent the “muzungu” staff at the funeral which I did in Rumonge on Friday afternoon. Once again I was impressed by how much the Burundians contain their emotions. Very interesting to compare cultural rituals too.

Yesterday a few of us went for a “Mountains Beyond Mountains” walk and I delivered photos to families whom I had photographed on the first trip. It was really fun to witness their delight at seeing their images and also their disbelief that I actually followed through with my promise to return someday with their photo. How lucky I am to have the opportunity to do this! One man was so appreciative he offered to donate a goat to Village Health Works.

As I write this, the afternoon sun is blazing through the windows and I am looking out at Lake Tanganyika. Soon the fishermen will be out and there will be a myriad of lanterns glimmering in the night. It’s great to be back!

Helen

View from Kigutu

Helen on 'MBM' walk

Kids along the walk

Helen & Connie on walk

Women and children resting on roadside


Girl tending smokey fire inside

Helen with healthy, happy baby

Pierre & Honore heading uphill
with little guys

Woman with umbrella

Helen with newborn wrapped
in one of Trixie's blankets

January 10, 2010 (egads!)

“Tozosubira”…Yungaburra

“Tozosubira” is a Kirundi word roughly translated “until next time”. . .

It has been a full ten weeks here on home base in Yungaburra. I have been lucky to be able to have this opportunity to recharge and get revitalized before I head off for my second trip (almost 4 months this time) to work at Village Health Works in Kigutu, Burundi. I have had a chance to catch up with family and friends which has been wonderful. It seems as though we get emails every day now from friends, family and acquaintances reporting illness, injury and unfathomable tragedies which makes us count our lucky stars all the more. I am most grateful for my daily swims across Lake Eacham which sustain and nourish my body, mind and spirit.

Helen in Lake Eacham

Since I have been here I have been fortunate to be “far from the maddening crowd”. Yesterday I had to venture to Cairns and into the jaws of the big shopping center for some last minute errands. Oiyveh, what a culture shock…so much obesity and consumer excess, Robert aptly described the scene as “visually toxic”. It is certainly an incredible juxtaposition to life in Kigutu.

During this time I have been able to procure generous donations for Village Health Works. A solar HotPot from Solar Household Energy Inc. www.she-inc.org will help get the concept of solar cooking launched. The community health workers will now be outfitted and equipped with 50 rain ponchos from Bunnings Hardware and 50 mini dynamo hand crank flashlights from C.Crane Company www.ccrane.com. They will also have tote bags from Envirosax www.envirosax.com.au. Diabetic monitoring will now be a reality with 2500 glucostix from NSW Diabetic Association www.diabetesnsw.com.au. Financial contributions have helped purchase three Point One water filter systems to handle 540 gallons per day www.pointonefilter.com. Children and babies in the malnutrition ward will have a new supply of clothes, hats and blankets to help combat hypothermia. Thank you, thank you everyone! My bags are full to the brim!

I’m very excited to be returning to Kigutu where I look forward to reunions with the wonderful staff. This trip will be especially wonderful as I am going to be accompanied by my friend Connie Ghiglieri RN, www.conniegig.blogspot.com, who will be in Kigutu for a month. She lived here in Yungaburra in the 90’s and we haven’t seen each other in 13 years. We’ll rendezvous en route in Brussels and will hit the ground running in Kigutu with all the work that needs to be done.

To keep my luggage weight below the limit I will dress in multi-layers! It should be interesting given all the increased security. The extended forecasts for the airports I will be traveling through reveal clear skies. Given all the potential snafus with travel these days I can only “prepare for the worst and hope for the best”.

There is no word in Kirundi for “goodbye”. I like this, as goodbyes are always very hard for me. I’m not quite sure when I will be returning to Far North Queensland, probably in October 2010. So, it is “Tozosubira” Yungaburra. . .

Helen