Things to FEEL GOOD about!

The last few blogs have been difficult to write and I'm sure just as difficult to read.
Even amongst the hardships, sadness, and pain we eventually accept what has happened, learn, cope, and move on- not forget- but just move on.
Together, we help each other heal.

THIS IS WHAT HELPS US TO FEEL GOOD & HEAL!



Thanks to the Clinton Foundation & our dear friend Felicia, we were given a
Portable CD4 Machine-PIMA!
This machine will allow us to determine the correct time to treat patients living with HIV.

HIV treatment is started when the CD4 count (part of our immune system) gets low OR when certain infections appear. NOW we can test people and start them on treatment early instead of waiting for them to get sick.

This is an incredible asset & will change the lives of people in our care!

....................................

Unfortunately Alex left Kigutu to head back to Oregon. We will miss him but his last night here ended in a BANG (and an IV the next morning to help the hang over from local beer).

We keep it classy in Kigutu!
.................................................................................................................

This is a just a little taste of a video we're working on... It's going to be fantastic!
Our friend Amy, a professional documentary filmmaker/ producer came for a visit and helped.
You'll probably have to wait until I get back home to see it (i don't think we can put it on YouTube).

..................................................................................................................

Anna, our lead janitor and STRONG,WOMAN Community Leader!
She has survived a genocide, been a refugee, and now uses her love and wisdom to change people's lives. (you can see the wisdom in her eyes) She never stops smiling...

One day she enlightened us with tips on how to live a good life:

-Respect Yourself-
-Respect Your Partner and Friends-
-Respect Your Elders-
-Take it Slow, Don't Rush--
-Smile-
.....................................................................

There were some days when we didn't have breakfast, don't worry Chipatis are back!
2 4inch triangles of Flour & Water fried in palm oil...Breakfast of Champions.

..................................................................

Home Visits into the Community are a little different than home visits in Baltimore ie, crossing a river with an armed guard (don't worry family and nervous blog readers, it's just standard operating procedures) then hiking 1 hours up a mountain! IT'S GREAT!

Home Visits allow you to run into adorable tiny children eating oranges...

............................................................................................

Doing home visits creates an opportunity to run into past patients like Divin. He was written about in a previous blog. We were certain he wasn't going to make it, due to his host of complications from malaria and malnutrition. But he did make it and as I was leaving the house of a patient I felt a little person squeeze my legs. "how cute," I thought, some child wants a hug. I looked down and Divin looked up and we both got the BIGGEST SMILES on our face! He held my hand as we walked through the town. It's amazing to think that we actually saved his life.
...........................

And we killed another goat to celebrate Alexi's farewell from Kigutu.
I thought I overcame my apprehension the last time I tried to do this but clearly from the look on my face...that is not the case.

.........................................................................................................

Some of the Fam...

........................

Hilarie, our cherished, sole female Burundian nurse, is incredible.
Her intelligence, compassion, humor, and beauty make her one of the most amazing people I know.

..................................................................................

The Laundromat. Will & I always get shit from the mom's in the malnutrition ward because we don't know how to do laundry "Burundian Style." It's too intense so we've created our own 8 step system, it's quite revolutionary.

....................

We really are a family.
Melino & me. "in it together"

...........
ADORABLE KIDS...I mean seriously, do they get any cuter?
This whole "don't bring a kid home" thing is really a lot more difficult than you think.

A new, fun game is asking Will, "ok, which kid is cuter?" To which he replies in a frustrated, confused, and frazzled tone, "WHY DO YOU MAKE ME CHOOSE?!"
sometimes you have to make your own fun in Kigutu.
..................



If you know Bryon Sellman, I'm pretty sure the kid on the right is him when he was 3 yrs old.
............................


Liesse, one of the patients at "Hotel Kigutu" has been here for months and is learning to walk. Everyday we all take turns helping her take steps. She is another child who the team thought was not going to make it...now she cruising around, getting into trouble! ...and we love it.
...................





Hussein & his newly discovered twin Hassein...no words.
Hussein was admitted with malnutrition and comes back regularly with his remarkable grandmother Germaine!

Amidst the challenges there is always light.
Amidst the chaos there is always peace.
Amidst the despair there is always hope.

...remember to create a life to FEEL GOOD about!

no title

It’s surreal. My body still feels numb. I’m trying to digest what I just experienced and it’s going to take some time. As I was running around this morning helping the woman that was carried here by stretcher and then helping to restrain a boy with 40.6 fever while we gave an IV, I barely paid any attention to the 3 people sitting on the bench. I noticed them and did a quick ‘drive by assessment’ and since they all looked okay I prioritized my time. I had no idea who these people were until Helen whispered to me. I froze.

I had to sneak away to the side of the clinic so no one could see my tears as I caught my breath.

After composing myself I went over and greeted them. Bazile came and Helen, Gerrard, and I all went into the consultation with the dad and 7y/o Madeline. She was here on Wednesday for a baseline HIV test and returned today to follow-up. I kept getting that ‘pre-cry’ feeling, where your nose gets a little congested, eyes turn red and start to water but something stops the tears from actually flowing. Maybe it’s innate, maybe it’s me not trying to make them feel more upset. The dad opened up the bottles of anti-retroviral (HIV treatment) medicines and was telling us how he gives them to Madeline. She sat on his lap in her West African patterned, orange and yellow dress, looking around, putting her fingers in her mouth, and trying to not pay attention, or just really didn’t care. Time just froze when I saw ‘anti-retroviral’ on the back of the medication box. This was real, we were treating her this little girl, just in case she does have HIV.

We asked the dad how Madeline was doing with everything, went through some signs and symptoms of post traumatic stress disorder (PTSD), and let them know that we were here to help. The dad explained that she wakes up at night from night terrors and still feels pain but she can tell the story now.

As she sat on his lap, her little mouth opened and I heard the voice of a small child. That soft, kind of high pitched, ‘cute kid’ voice. Her eyes wandered around the room, fingers still in the mouth, and she told us what happened. Gerrard translated her words for us.

“ I tried to run away but he grabbed me. He took me into the house and laid me down. He had a knife. He told me if I didn’t stop screaming he would cut my throat.” She stopped talking. We asked her if she wanted to tell us more. “After the sexual assault (I don’t what words she used because this was translated), he left.”

“How did you feel?” I asked. Silence. She just put her fingers back in her mouth in the space where she lost one of her childhood teeth. “You don’t need to tell us anything you don’t want to,” Bazile chimed in.

The dad told us on Tuesday night they noticed some fluid coming from her vagina and it was swollen. He said he knew the guy that did it. He was a neighbor, someone who Madeline knew as well. The mom and dad were in the fields and Madeline was at the house (not uncommon here as everyone looks after each other’s kids).

When they came to the clinic on Wednesday Melino examined her and noticed trauma and tearing. He asked about the guy that did it and they told him that everyone thinks he is HIV+. Melino asked the dad to bring him to the clinic for an official HIV test, which was supposed to take place today. The man didn’t show up because he was put in jail. Somehow the villagers found out that it was him and took action to get him.

While he is in jail awaiting his trial on Monday, we will begin Madeline on PEP (post exposure prophylaxis) just in case she did become infected from this horrific event. We offered emotional and medical support and encouraged them to come to the clinic regularly to check in. Madeline didn’t seem too overtly traumatized although I did not know her before to compare. She will become a regular visitor and one for the ‘home visit list’ so we can closely monitor her physical and emotional wellbeing.

I am in NO WAY defending what happened here. I am simply trying to understand why someone would perform such an atrocity. I need something to appease my wandering mind because I refuse to accept the response “he just did it.” Here in Burundi, as with many other places, there is a myth that if you have sex with a virgin you will be cured of HIV. Because many of the people who knew this man said that he was HIV+ I’m thinking this might be a reason why he did this. Again, not defending, just trying to understand.

People need education, not just for reading and math but to prevent the spread of disease and halt horrendous acts such as this.

I have never experienced something like this before. I’m still attempting to compartmentalize and cope while still experiencing all the emotions that come with this. For me, it’s important to not suppress anything but rather learn to cope and move on. Love, understanding, support, and time will hopefully help heal Madeline.

No 7 year old, nor any human being should have to endure this, but it happens. No person has the skills or experiences to cope with getting raped for the first time. Her world has been turned upside at the age of 7. No one really knows what’s going through her head, which is why we need to listen. We also need to speak up about these situations and make people aware that this is NOT acceptable and this will NOT cure you from HIV.

As usual, I will tap into that human connection that we all have as I try my best to heal Madeline. This connection is something that we all have and I believe all could benefit from ‘tapping into’ a little more as we seek to understand, help, and heal each other. It’s part of why we’re here.

*I debated putting this blog up on the internet. I wrote it for myself to help deal with my emotions, as I do with many stories. But this situation needs to be explained. It needs to be talked about. It needs to end. No change can happen unless we first openly and honestly talk about what is happening.

Was there anything else I could have done?

As I was checking on patients in the hospital I saw a body laying under the blue sheet in bed 9 which was previously vacant. I went over and gently placed my hand on the back and out popped a head. I smiled and he smiled back with a shy expression. He talked and talked to me in Kirundi even though he knew I had no clue what he was saying. I really bonded with this guy for some reason. His name is Epiphaz, young 30s. He walked into the clinic last week complaining of diarrhea for about 1 month. He kept having diarrhea so I would help him walk to the bathroom and then give him medicine, and tuck him in. His fevers were uncontrollably high, up to 40.6 Celsius (over 105 degrees Fahrenheit). There was no clear answer as to what was wrong with him. We did not (and still don’t have) HIV tests at the clinic so he was started on ARVs based on symptoms. He was taking a plethora of antibiotics- Erythromycin, Cipro, Bactrim, and more. He was getting vitamins and paracetamol (for fevers and pain) around the clock but still kept spiking fevers. I would go into the ward and feel his hot body engulfed in the blankets and we’re go through our routine. Taking the blankets off, keeping on only the blue sheet and spraying him down with the water bottle, which he hated at first but later would ask for as his fevers got increasingly higher.


A few days ago I learned that he has a wife and daughter, probably about 4 years old. One of the cutest girls I’ve seen in her peach colored little princess dress-up dress. She would smile at me from a far but when I would get close she would run away and point and shake her finger at me. Everyone in the ward would laugh- her mom and dad included. His wife was sweet. Very attentive to his needs, helping him eat, helping him up to take is medicines and reminding him to keep the blankets off his body.


About the same time the wife and daughter came he grew very weak. He was looking emaciated, frail, and extremely thin. The fevers kept spiking, he got so weak he couldn’t even lift himself up to sit in bed. I had to put the medicine in his mouth and his wife gave him sips of water. He was one of the people I would Reiki on a regular basis. Again, I don’t know what it was about this guy but we immediately connected. I would sit on his bed with him, rubbing his back and holding his hand sometimes in silence, sometimes with him rambling on. I knew he was going down hill because the smiles stopped. The rambling in Kirundi stopped. I would peak under his blue sheet with a big smile and the expression returned was one of misery, and longing to be healed. He was miserable.


We suspected TB as the explanation for the uncontrollable fevers so we sent him to Rumonge Hospital for a chest X-ray. The vehicle wasn’t leaving until about 3 or 4 days after the time we started suspecting TB, so he waited here.


Today the vehicle was leaving and as I was standing outside by the ambulance he was wheeled out of the ward, barely able to sit in the wheelchair due to his weakness and bony frame. He made new holes in his belt because he had lost so much weight his pants would just fall down. It took 3 of us to put him in the ambulance because he had no strength, not even enough to step up into a vehicle. I helped slide him into a comfortable position and gave him a hug. “Turasubira,” I said (see you later). He shook his head no. I explained in my broken Kirundi and gestures that he was coming back after the chest Xray at Rumonge Hospital. I knew he understood but once again, he shook his head no. “Kira,” I said (heal). His wife and daughter slid in the ambulance next to him and I shook there hands, gave the little girl a farewell tickle and again said, “turasubira.” The wife replied with, “ego” (yes).The vehicle drove away and the day went on.


4 hours later I was listening to music taking a pseudo nap when I woke to Elvis saying, “that guy we sent to Rumonge died.” I sprung up with a “what guy?” “The one from bed 9, he just died on the x-ray table at Rumonge, he collapsed.”
I was in disbelief. His wife, his 4 year old daughter in her peach dress. No one was expecting this to happen, except for maybe him. Maybe he knew it was the end and that’s why when I said “see you later” he replied with a “no.” Do people know when their going to die?


Moments like this remind me that death can happen at any time. I’m glad I sat with him, rubbed his back, held his hand, and brought him smiles. He in term lit up my day when I would peak under the blue sheet and see his shy smile looking at me. I’m still in shock, I was certain we would help him regain strength and send him on his way. I guess there were other plans for him. Now we need his wife and daughter to get tested for HIV as soon as we get the supplies in the lab.



Even though in my heart I know I am not responsible, my head still asks, “was there anything else I could have done?”

Meet Marie: “I do not fear”

Marie came to our clinic a few days ago, she got here at 9:00am and was patient number 57. She was complaining of dyspnea (trouble breathing), weight loss, and cough for 7 months. She is one of those patients who just ‘looked sick.’ When she noticed that she was not improving Marie went to the Mupfumu (traditional healer) who told her that she has the “shoe disease.” Many traditional healers tell their patients they have a shoe in their throat and the treatment is a uvulectomy (cutting the uvula, hangy ball in the back of the throat) and/or a epiglotectomy (cutting the epiglottis which protects the windpipe). Marie had both procedures done. With no improvement she went to her local health center in Rumonge twice and she was treated for malaria.

Marie decided to come to VHW even though it took her 2 days to get here. She explained that, “this clinic is known everywhere.” With TB suspected, a chest X-ray which was horrible, confirmed the diagnosis. TB is spread through coughing and since she has no epiglottis to protect her lungs she is constantly coughing and potentially spreading TB to others. She is currently in our “isolation” room, which is a large room with 2 TB patients. In the U.S. TB patients have specialized rooms with airflow control, negative pressure systems, and filtration. Here we open windows.

She shared her story with us and explained that she has 2 children (10 & 12) who are now living at home alone while she is here. Her husband was killed about 9-10 years ago during the genocide. Marie is worried about her children being home alone and caring for themselves. She is also concerned because it is the rainy season (which means torrential downpours) and her mud hut with a grass roof could collapse or wash away at any moment. Her daughter is coughing at home so we want them to come to the clinic for treatment, she does not want them to go to a traditional healer after her terrible experience. After Melino explained the situation and about TB, Marie told us that she is glad to be here getting treatment at our clinic and ended saying: “I do not fear.”

Her story hit my heart. This story seems unique but it is not uncommon. So many of the people face these challenges everyday. Can you imagine living with constant food insecurity, risk of your house collapsing in the rain, lack of sanitation, and poor access clean water? These struggles are everyday life here.

"I love this clinic like I love my own heart"

"I love this clinic like I love my own heart."- Anna
She is our lead janitor and community leader. Her friend Madeline in the back was admitted due to an infected wound. These women light up my life.


Immaculate, a TB patient, was discharged! We drove her to her house and she was aglow after being here for about 3 weeks. It's rewarding to see people healed.

..............
A visit to Melino's house was incredibly beautiful. I road in the back of the truck during the 2 hour voyage up the mountain into Vyanda. Breathtaking. The wind in my face, driving through evergreen trees, fog, eucalyptus trees, and vast open fields. We arrived to his house which reminded me of a New England bed & breakfast- a quaint stone house surrounded by avocado trees, eucalyptus trees, rolling green hills, and corn hanging around the outside of the house drying. Melino's prized possession is his cows! He LOVES them. I wanted to snap a picture of one little guy licking Melino's face (apparently it's their thing).


Mama Melino (that's one way to address mother's here) was adorable. She gave us fresh milk which I had never had- delicious! Milk is a big deal here, it's cherished.

......


When supplies are limited or unavailable- we make do with what we have.
Melino teaching his mom how to use a makeshift spacer for her asthma medication.


In addition to all the warmth, peace, and joy that was felt I was able to take a picture of a baby goat, kitten, and puppy all playing together! I mean, I basically died from cuteness.
..........
In Other News:
The clinic has been bustling with some very high acuity patients. Heart failure, TB, malaria, life threatening high blood pressure in a 17 year old, malnutrition and more.

This woman Yvonne has heart failure which causes her abdomen to fill with fluid because her heart isn't strong enough to pump the blood effectively. This is terribly uncomfortable, impairs her mobility, and causes her to have trouble breathing. Helen and I did a home visit and determined that she needed to come into the clinic. Her house is situated farm back from the dirt road so we had to carry her to the ambulance which was waiting in the road.

The power of community...

......................................................................................

When she arrived we decided that in addition to medication she needed a peracentesis to drain the fluid from her abdomen. I did the procedure which was pretty cool- something I wouldn't be able to do in the U.S. (even though it's fairly straightforward).
........
Lots of TB floating around here.


Rainy Season!
April or Ndamukiza means "greet them for me" because it rains so much that people cannot visit each other.

.................
We have introduced the Family Planning Beads! They are a HIT! The women love them. Hilarie has taken this project to her heart and is doing an incredible job educating the women. Family planning is tricky here because most people's religious beliefs forbid the use of contraception. The women love natural family planning and want to use the beads and educate others...this has the potential to change the future of Burundi! Farmer Will and I have been teaching women in tandem about nutrition and family planning.
Smaller, healthier families means more opportunities for growth, development, and poverty eradication. I'm VERY excited about this project! Look at our logo below.

.....
Here you go: CUTE CHILDREN!

.....................................................................................................................

"The most important thing in the world is giving and receiving love"

Make a Difference!

Feeling inspired?
Want to touch some lives?

Here's how YOU can help

1. donate

-Supplies:
Clothes & Shoes- baby, kid, adult
Baby/Newborn Blankets
Baby/Newborn Caps
Washcloths
Twin Sheets & Blankets
Crayons/Art Supplies/Chalk
Stimulation activities for children
Towels- all sizes
Plastic cloth diaper covers
Plastic,reusable Cups
Soap
Laundry Detergent (washed by hand)
Dry Erase Boards & Markers (for patient updates)
Hand Sanitzer...Lots
Pens...Lots
AA & AAA & C Batteries (rechareable is a plus) for equipment

-Money:
Many of our patients needs surgery, tests, and procedures that we can't do here. most don't have the money to pay so we try cover what we can. unfortunately, our funding is not so hot right now which means patients are not getting treated. you can make a donation to help pay for some patients.

*Contact me if you want to make a monetary donation: bradleytsnyder@gmail.com

2. inspire
start a fundraising/collection drive at your school, work, community center, ANYWHERE!

host a party! have people make donations of supplies or money while they party with you. Cocktail party, African themed party, cookout, change the world, dinner, WHATEVER!

tell these people's stories to anyone who will listen. give a presentation at your local library, school, meeting etc.

3. support a project
here's what we're working on:
Natural Family Planning: Because 1 out of 9 women in Burundi will die during pregnancy and childbirth and most family's religious beliefs forbid the use of contraception, we are introducing for natural family planning!Urudede Ngeramvyaro or birth control beads will allow women to track their cycles naturally. The women will make the beads and give them away to those who can't afford them and sell them in markets to those who can.

Want to help buy some beads and change the future while you're at it?

Home Gardens & Miranga: 80% of people in Burundi are malnourished. Help us make healthier families. Miranga is a miracle plant that provides essential nutrients, protein, and an answer to the malnutrition crisis. Donate to buy seeds so we can teach people new techniques and provide them with food diversity to help fight malnutrition!

Want to help combat malnutrition and provide hope for the future?


* let me help
you want pictures? I got 'em!
you want stories? No problem!
you want ideas? Let's chat!

Email me, tell me what you're thinkin' about: bradleytsnyder@gmail.com

Mail stuff HERE:

Village Health Works
c/o Brad Snyder
110 East 42nd St
Suite 1419
NY NY 10017

These are real people with real stories.
Most of the people here live in extreme poverty (less than $1/day).
1 out of 5 children will die before their 5th birthday.

Help us bring health & hope...it's part of the reason we're all here.