Friday, April 23, 2010

“Tuzosubira, Kigutu!”. . .
(See you later, Kigutu!)

This morning I watched as the pink dawn evolved into a spectacular display of cloud formations across Lake Tanganyika over the Congo. I took some deep breaths, soaking in the sights and sounds of Kigutu waking up, enough to last me awhile. It’s my last day in Kigutu. My duffel is packed and I am ready for some travels. I have been progressing through the goodbyes and am now looking ahead to reunions with everyone at home.

Highlights of the week were seeing many of the adorable children who have been discharged from the in-patient malnutrition program, returning for follow up visits. It is EXTREMELY gratifying to witness their progress. The photos tell the story. One 3 year old girl ran up to me with arms outstretched, exclaiming “Mama Muzungu” (“White Mother”)…what more could one ask for?

On Wednesday, Brad and I made a home visit accompanied by Gerard and our steadfast guard Desiree to a 7 year old girl who had been raped by a neighbor last week. She was supposed to return for follow up on Tuesday with her father and we were very concerned. Apparently the man who assaulted her (as well as threatening her with a machete if she screamed for help) believed that having sex with a virgin would cure HIV. Horrific. Amazingly, we found her with her mother and siblings. She seemed to be doing OK and is taking the antiretrovirals as prescribed. The man is in prison and will be brought to trial. Today her father came to VHW to talk and thank us for the home visit since he was not at home when were there. It is gratifying that the family knows that the traumas of the girl’s experience can be counterbalanced with support and concern.

Last night we had the collective April birthday party for people (Peter IT, Mandela, Pascal and me) which was also a combined farewell soiree too. We had a chicken feast, drinks and plenty of dancing to follow with a good dose of tears and laughter too. Now that I am a year older, I figured it was about time for me to kill a chicken, so I did! I will miss my Kigutu “family” very much. It’s an amazing group of talented, dedicated people here and I feel absolutely privileged to have been part of their team.

“See you later, Kigutu and friends”…it’s NOT goodbye, as I feel very committed to the people and the VHW program and certainly hope to return.
Now I am off to Rwanda for a few days.

Helen



















Bukuru and Toyi

Mana at admission

Mana on discharge day

Bea side 25-2-2010

Bea returns for follow up 3kgs. gained!

Fabrice

Fabrice 2

Fabiola

Brad on home visit walk

Chicken ready for the pot...almost

Beheaded chicken

Kigutu friends

Maombi savors chicken

Achel, Ferdinand and Maombi

Frederick and Helen

Dancing

Helen in the misty mountains


Saturday, April 17, 2010

Big week in Kigutu. . .

The past week here in Kigutu has been action packed. The long awaited day for the official opening of the Community Centre was on April 9th. A predawn downpour freshened up the VHW campus and all the hard work done by the landscaping crew and the community women over the past few weeks was pristine. Everything looked vibrant and lovely under the blue skies.

The Kigutu drummers led by Peter and Mandela were spectacular and offset by Claudine’s girls’ singing group. They provided a wonderful backdrop as the VIP guests from Bujumbura arrived. Then per Burundian tradition the community members (perhaps 200) gathered and filed into the driveway and to the Centre in a grand procession singing, dancing and carrying large loads of food and drink wrapped in banana leaves on their heads. It was a sight to behold and certainly very special to feel the energy and excitement.

The morning continued with speeches, more performances and drumming. The youngest drummers (absolutely adorable) who can barely reach the top of the drum, drew much applause. In the cool afternoon breezes and under the shady trees people relaxed on the lawns and soaked up the goodness of all their efforts. Many gathered to watch photos and videos of VHW in the evening to top off the big day.

This week VHW also received a delivery of rice, soya flour and oil from the World Food Programme which will assist with the malnutrition program. Another delivery for the HIV patients will be arriving soon. All these “macro” events are strengthening VHW’s impact considerably.

VHW had a landmark day yesterday when a new state of the art portable CD4 machine was delivered by Felicia Price and her entourage from the Clinton Foundation. Accurate monitoring of CD4+ T lymphocyte levels in HIV-infected individuals is a critical element for the use of anti-retroviral drugs (ARVs) as it guides physicians in determining when to begin drug treatment and is a key measure of the effectiveness of that therapy. Staff members were trained in how to use the machine and we are all thrilled to be on the cutting edge of HIV care here in Burundi.

In the midst of all these grand events for the program, I have been touched by the “micro” events too:

Receiving the very special present of 5 eggs from a patient who had walked far for a rendezvous appointment.


Witnessing previously severely malnourished children be discharged with strength and vigor after 10-14 days of treatment. It’s like watching a slumped over plant receive water and fertilizer, stand straight and begin to grow and flourish. The children literally come to life and become engaged individuals.


Watching another amazing sunset from the water tower with Hilarie.

Giving and receiving a daily hug from Anne, our wise and wonderful head janitor.

Teaching people how to stand on a scale for the first time.

Teaching people how to open a door with a door knob.

These experiences give me profound satisfaction and fulfillment. I will miss Kigutu and hold all these memories closely. Departing next week will certainly be a bittersweet time.

Helen


Community Center on Opening Day

VHW on April 9

Women arriving at Center

Little Drummer Boy

Brad, Gerard, Cory, Celestine
Helen, Will, Elvis on April 9

Peter and Mandela resting

Community women after opening

Claudine's singers

Accompagnateur Daphrose and Helen

Melino drumming at opening

Bazile getting set to perform

CD4 machine arrives in Kigutu

CD4 Training

Will and crew move WFP food

Gift of eggs

Heading home

Hilarie and Helen

Sunset April 14

Alex departs

Helen and Anne

Scale with well worn feet

Eyelash envy



Monday, April 12, 2010

In the grip of igituntu . . .

Marie (not her real name), age 45 weighing 35 kg, is from Rumonge and came to VHW on March 23rd for consultation. She had been experiencing cough, weight loss and dyspnea (shortness of breath) for several months. Dr. Melino suspecting TB (igituntu in Kirundi), referred her to Rumonge Hospital for a chest x-ray and some lab work since VHW does not have these facilities yet.

Today she returned with the x-ray and the lab results. The x-ray is impressive…revealing TB with disseminated “opacities” in all lobes. Miliary TB is apparent in the upper left lobe with pleural effusion. We still await results of sputum tests. She was admitted today, registered in the TB program and began the rifampicin, isoniazid and pyrazinamide treatment regimen.

Seven months ago when her cough became persistent Marie went to the traditional healer in Gatete who specializes in the “uvula disease”. He cut her uvula and epiglottis at that time. Her cough did not subside and now she has to constantly clear her throat since she does not have her epiglottis. She went to the local health center twice where she was told she had malaria both times. After treatment she continued to feel terrible and came to VHW. When asked how she heard of VHW, she replied,” This clinic is known everywhere and many people told me to come.”

Yesterday she walked from Rumonge to Mugara (14 km), spent the night and walked this morning from Mugara to Kigutu (6kms. uphill). Despite it being a Burundian public holiday and arriving at 0900, she was # 57 in the patient queue. After triage assessments she was first in to see Dr. Melino.

Her husband died around 2000 in a war related incident. She has had four children, two who have died at age 6 and age 3. Right now she is concerned because she has left her 12 year old daughter and 10 year old son at home to fend for themselves. She is also worried because her two room mud house (one room for sleeping and one for cooking) just has a grass roof and it will be very vulnerable during these heavy rains. She wants to get her children to VHW as she states her daughter is coughing and has “untreated shoe disease”. Marie realises that taking her to the traditional healer might not be the best choice.

She has “no fear” about being at VHW. Meanwhile we will try to track down her children for screening and assessment. There must also be communication with the traditional healer regarding the dangers of untreated TB.

Helen


Marie with TB

TB lung x-ray


Tuesday, April 6, 2010

Running for Peace. . .

The long distance runner is a special type of person, manifesting extreme dedication with incredible mental fortitude and physical endurance. At Village Health Works (VHW) we have two marathon runners in our midst who have these characteristics. Peter Ndikumana and Nestor “Mandela” Nimbona are currently training hard in the Kigutu “hills” for their first marathon, The International Peace Marathon in Kigali, Rwanda on May 23, 2010.

Peter “IT”, 32, has been employed at VHW since September 2008 and wears several hats. He is involved with information technology (hence the “IT” added to his name), manages inventory control, helps maintain the solar panels and the battery storage. He has been a drummer since childhood and now co-leads the Kigutu Drummers with Mandela. He is eager to fulfill his life-long dream to run in a marathon, as running has always been a passion for him. He loves the challenge of training and wants to see how he “measures up” in a competitive field. He’s excited to run for peace and justice.

Mandela, 31, a VHW employee for three years, has been working part time in the kitchen as well as being in charge of laundry services. He has been drumming since he was eight years old and has been abroad to France and Japan on tour with a professional Burundian troupe. When his group greeted Nelson Mandela’s plane on a visit to Burundi, Nelson Mandela came up to him and took his imirisho (sticks) and began drumming. Mandela was so impressed and inspired by him, as well as having a similar Christian name (Nelson/Nestor), he decided to take “Mandela” as an additional name.

Both Peter and Mandela are terrific role models for the children of Kigutu, leading and teaching the drumming circles three afternoons a week. When they aren’t working or drumming, they are in the hills of Kigutu preparing for the marathon in Kigali. Everyone from Kigutu and VHW friends from around the world will be cheering them on.

Helen


Peter and Mandela training

Mandela and Peter

Peter drumming

Mandela airborne

Mandela doing laundry

Peter in depot

Mandela and Peter IT

Verdant Kigutu hills

Saturday, April 3, 2010

Gratitude & Renewed Perspectives. . .

Last weekend and early into the week I was all-overish (adj. Feeling an undefined sense of unwell that extends to the whole body) and missed a few meals which meant by the time I returned to the communal table I was definitely avidulous (adj. somewhat greedy). Agerasia (n. a lack of the signs of old age) is a quality that I generally pride myself for, but being horizontal for more time than usual had its agathokakological (adj. composed of good and evil) effects…having some quality time with my Kindle (good) and also feeling older than I really am (”evil”).

I have been immersed in a wide variety of reading (Teddy Kennedy’s memoirs True Compass, Baking Cakes in Kigali, Richard Russo’s That Old Cape Magic and now Reading the OED). I have often thought that if I was imprisoned or stuck someplace for a year and given the choice of one book, I would choose the Oxford English Dictionary. Ammon Shea has taken it upon himself to do just this. I find the book pretty fascinating and as you can see I am trying to include some “As” to expand my vocabulary and exercise the gray matter.

While I was experiencing the “cellular ache” of whatever it was I had, dreaming of luxuriating in a hot bath, I quickly roused myself out of such self-indulgent fantasies and imagined the challenges facing all of the patients who come here to VHW seeking treatment. I was pulled back into my fortunate reality of a cosy bed and a roof over my head as the rain pelted down “hippos and elephants”. I thought of the many people who walk for hours through the pouring rain feeling terrible (and hungry!) often carrying their ill children, doing their best to survive on practically nothing. Everyone has their own sort of pain and suffering, but wow, I felt so spoiled. I came away from my reveries with a renewed sense of perspective and compassion for these significantly impoverished people who I have the privilege to assist on a daily basis.


We delivered one patient home via vehicle last week as she was too weak to make the journey on foot. Her health has deteriorated due to chronic diseases and her possessions were in a small wrapped piece of fabric. Her house was a basic mud house with corrugated tin roof right on the busy tarmac thoroughfare. One could easily think she wouldn’t have any reason in the world to smile, but her delight with her homecoming certainly blew that idea out of the water. She was radiant, despite her emaciation, and just so happy to be HOME with her family! Witnessing the essence of her life, love and family, and receiving her gratitude was very moving.

Despite not speaking Kirundi, I understand more these days, but still feel severely handicapped by not being able to converse directly with all these lovely people.

Walking to “downtown” Kigutu at dusk, I feel quite integrated into this small community on the top of a hill. Listening to the drumming, watching the local soccer game and hanging out a bit at the local boutique greeting VHW staff as they head home. It’s a special place indeed. How lucky I am for these friendships I have made here.

Now I can begin to feel the tide turning as I prepare for reentry into my “other world”. I am really looking forward to the reconnections with family and friends, but also ready to pack a lot into the last three weeks here.


Helen




Homecoming


Helen on home visit


Patient home


Assisting patient for transport from home


Arm

Anna peaking around curtain


Mother with TB with one her
twins who both have malaria


Didace working on huge stump


Bazile

Road to Kigutu


Malnutrition ward

Verdant hills