Life. Death. And everything in between

Mwiriwe! (Good Afternoon)

It's 2:30pm on a foggy Kigutu day, similar to recent days here. I'm settling in nicely, actually looking forward to my next batch of rice & beans!

Working at the clinic has been crazy this week. In the same week in the same room we brought a life into the world and helped another one leave. Such a surreal experience. One day was filled with anticipation and joy and the next was solemn and at times difficult. This spectrum of emotion is a part of life and a part of why I do what I do. Providing care to those in need through the difficulties of labor, the first glimpse at the world, and the last moments here...it's pretty amazing to be able to be a part of it all.

The Baby:
You may have been following the facebook updates on January 8th as I was trying to keep everyone posted on what was happening. We had a woman come in the morning with a few contractions and she was with us through the delivery. Our clinic of 2 doctors and 4 nurses is not designed to deliver babies. At first the only space we had for her was our "isolation room" where one of our HIV/TB patients is living. We had realized that this was probably not the best idea so we used a consultation room which meant we couldn't see as many outpatients. Anyway...After 6 hours of walking, deep breathing, and the infamous search for a washcloth (we REALLY need supplies) a healthy baby girl (name not yet given as I would not allow 'Brad' to be an option) was born! It was incredible to say the least.










"Why is his shirt off?" You may be asking yourself this question. The mom either didn't have or didn't bring any clothes with her and the blankets at the clinic are basically as thick as a paper towel (a cheap paper towel- not Bounty or anything). About 15-20 minutes after being delivered her little fingers and toes started turning pale and blue. I encouraged the mom to put the baby on her chest for warmth...This mom didn't want to do that. Maybe it's a cultural thing. Maybe it's a "I was just in labor for 6 hours thing." I don't know. The point is, the baby was cold and I had a shirt. I swaddled the baby in my shirt and suddenly saw a flash! Melino, one of the docs started taking pictures of me. "Oh Brad! You are crazy. I need to take picture of you!" So he went snapping away.

I handed the baby to her grandmother and she couldn't stop smiling! When we told her it was girl she was ecstatic! What a joyous experience!

Like I said before, our team is small so everyone takes on a side project. One nurse is in charge of the HIV/TB program and malnutrition, the other is in charge of family planning and vaccinations. As we sat around the table and had our meeting it became apparent that I would have to step it up and be in charge of a program. "How about the maternal/newborn health program," Bazile said. "We really need a midwife but since we don't have one...I guess you'll have to learn." So yes ladies and gentleman I am now in charge of the Maternal/Newborn Health Program. I will follow the women and babies from prenatal care through birth and newborn care. Perfect! I'm ready for the challenge.

Maybe you're thinking, "Oh how cute, birth. Are you getting anything more interesting and disgusting?" Well, YES! I give you TUNGIASIS:

This patient presented with lesions covering his feet. They were painful, itchy, and he had them for 1 year. We all thought they were just infected lesions. After closer examination it turned out to be tungiasis. Tungiasis is a rare infection caused by fleas. Basically the fleas enter the feet when people walk barefoot. If a female enters the body she drinks blood and grows to the size of bean. She also has about 200 eggs in her sac which she lays in the feet. These eggs hatch and all the little fleas release into the body and eat away at the flesh. They must each be removed by hand with a scalpel and then the infection must be treated. This disease is extremely rare but fortunately Bazile, one of our docs, is an expert in the field and has published articles about it.

Perhaps that's not bad enough...Perhaps you want more... No problem!

Thank God I paid attention during the wound care lectures (thanks Sonya).
We are not sure what this is but again, the patient had this for over 1 year before seeking treatment. These masses were covered in puss and smelled disgusting! The poor man was in so much pain that he could barely walk. There are two more smaller masses on the other side of his foot and a little baby on his left foot. We aren't exactly sure what it is because we have no lab tests that can help us identify what's going on. We are thinking it might be some sort of HPV (the virus that causes warts) that just got out of control. We are trying to get the infection under control and then we will send him to Bujumbura for surgery.

I've realized that this blog will probably turn into me showing you the most interesting things we are seeing here because to be honest it's either that or landscapes because that's all I have around me! I'll do my best to mix cute and intriguing.


These are my loves! They both came to the malnutrition ward due to severe malnutrition. They have been here for over a month and are doing great! I might add that they love me too! (which is a surprise because most babies here freak out when they see white people). The one in the front, Excel (that's his name), will probably be coming home with me so everyone get ready for a new baby to love!

This is my new Yoga spot. On the edge of a mountain.
It's pretty foggy during the rainy season but still beautiful.



Amahoro N'urukundo (peace & love)