Each week, Redeemer Church is going to post 2 blog posts each week from a dear family who has been a part of the Redeemer Church family here in Bellingham for years and moved to Africa to do medical education for 9 months. The Sund Family, Greg, Stephanie, Ella, Biniyam, and Mekdes have lived in Burundi for the last 8 months and we wanted you to be up-to-date on all that they are doing and all that is happening in Africa.

Below is the Sund's blog post in October from Africa called "Reanimation Update". You can find more blogs from there personal blog here > Beyond Our Backdoor

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Yesterday, the first group of 6 medical students finished their Reanimation rotation at Kibuye hospital.  To celebrate, Stephanie and I inivited these 6 students over to our house for dinner last night.  I can't tell you how much I have enjoyed working with these students.  They are bright, hard-working, eager to learn, kind and compassionate with their patients, they all speak between 3 and 5 languages and switch back and forth with great ease, and each of them grew up in a country ravaged by civil war (something they rarely talk about).

Last night, one of the students who is actually from the D.R. Congo began talking about the teaching he has received at Kibuye and how drastically different it is from anything he had ever experienced before.  The students at Kibuye work with doctors who are patient and kind to their students and their patients.  They are doctors who are humble enough to admit when they have made a mistake and also to admit when they don't know the answer to a question.  As this student was talking I thought I sensed his voice beginning to crack a bit, and then he admitted that he gets emotional when he talks about this.  

It occured to me that with all the changes going on at this hospital with this team of American physicians, perhaps the greatest change is that of atmosphere.  This long-term team (and I hope the short-termers like us as well) are modelling for dozens of students each year what it means to be a physician who is humble and patient, and who treats his or her students and patients as human beings created in the image of God.  And these students will then graduate and go on to be leaders in their hospitals and their communities and I believe they will become the kind of doctors that they are studying under now.  Last night was a great reminder to me of why we are here. 

Five of the six students (the sixth was out of town)

I also got this new fancy stamp!  I am told that you are not a real doctor in Burundi until you have your own stamp.  Also, I could not officially graduate this group of students without this stamp.  What does one need to get ones own stamp?  About $25 and a short trip to Gitega.  No need to show any proof that you actually are a physician.  Next week I am thinking of becoming a neurosurgeon!

Each week, Redeemer Church is going to post 2 blog posts each week from a dear family who has been a part of the Redeemer Church family here in Bellingham for years and moved to Africa to do medical education for 9 months. The Sund Family, Greg, Stephanie, Ella, Biniyam, and Mekdes have lived in Burundi for the last 8 months and we wanted you to be up-to-date on all that they are doing and all that is happening in Africa.

Below is the Sund's blog post in October from Africa called "Free Range Children". You can find more blogs from their personal blog here > Beyond Our Backdoor

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I have fond memories of childhood.  The long summer days when I’d jump on my bike and join the other members of the Camouflage Club (previously known as the Clue Club) in the woods near our house to build our fort, climb trees, solve whatever mysteries came our way. We’d be off on our own playing outside until my parents, quite literally, blew a horn signaling it was time to come home. 

I’ve often bemoaned the fact that the world we live in is too different for me to allow our children the same freedoms I had.  When we moved into the our house back in the US I was excited about the woods that lay beyond our fence, “The mysterious beyond” we labeled it and encouraged our kids to go explore.  That is, until we saw the tarp, the sleeping bag, the evidence of a campfire.  We live in a small city, there are many homeless, occasionally they camp just beyond our fence.  Neighborhood kids are fun when home, but often busy with activities, or our kids have activities. If they want to play at a park, I’m there with them.  I don’t want to be a helicopter parent, but in the US it is hard to have free range kids.  

On our first day in Kibuye, Anna, the other 9 year old, asked if the girls could join her for a walk.   “We don’t know, can they? Is it safe?” And so our motto came to be “If Anna’s parents let her do it, then it’s okay, you can too.” And off our girls went with Anna into the woods to walk past tea fields and Burundians hoeing and to find a mound of red earth just beyond the bamboo fence. They spent they next few days shaping the clay into bowls and animals, creating “claytopia”. Ella even had a Burundian boy paint her face with the red clay.  (We like to tease her in saying that we’re pretty sure this means that they are now engaged.) They let Biniyam join them and I unpacked in peace and strange silence. 

That night I had a nightmare in which I was back in the US.  I was unpacking and Biniyam ran into the room, he said some people brought him home and wanted to talk to me. They were from DSHS and they said they had found my 5 year old wandering around town by himself and why wasn’t I watching him? Once awake I found the dream amusing, pointing to the big reason I don’t allow my children to roam free in Bellingham. I’m afraid of other people, that they will hurt my kids or what hassle they will make for me. I fear people looking at their phones while they drive and not watching for kids crossing the street. I trust my kids, I don’t trust the community at large.

But here they have a controlled area in which to roam, and it’s of a pretty good size.  There is one short road and rarely does a car open the barrier and drive slowly through.  They have multiple houses in which to play (for example, I currently have 3 children playing at my house, none of whom are mine, my children are playing at someone else’s). Before school they will often head out and find friends to play with and after school until dinner they’re with friends.  They spend a lot of time in our “art studio” room drawing their characters for whatever storyline they have going that day and then they head outside to act out their stories. They catch toads and lizards, they climb trees, they play chase, they build forts, they solve mysteries. They don’t complain of boredom, they don’t beg for media time, they fall asleep quickly and sleep through the night. This is my favorite part of our life here in Burundi, watching our kids experience this childhood of freedom and exploration. 

Each week, Redeemer Church is going to post 2 blog posts each week from a dear family who has been a part of the Redeemer Church family here in Bellingham for years moved to Africa to do medical education for 9 months. The Sund Family, Greg, Stephanie, Ella, Biniyam, and Mekdes have lived in Burundi for the last 8 months and we wanted you to be up-to-date on all that they are doing and all that is happening in Africa.

Below is the Sund's blog post in September from Africa called "Making History Can Be Painful". You can find more blogs from there personal blog here > Beyond Our Backdoor 

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The anesthesia students have been very excited this week.  That is because today, we scheduled the very first surgery under general endotracheal anesthesia at Kibuye hospital.  There has been an anesthesia machine in the OR since I arrived, but it had not been set up or used until today.  This week, Jason and I worked on getting it ready to go, connecting an oxygen tank to one port, an air compressor to another and filling it with expired halothane and expired CO2 absorbent.  So what could go wrong?

After discussing the plan with the students, drawing up the medications and preparing the intubation equipment, I handed my ipad to one of the students and asked him if he would take a couple pictures of the intubation to memorialize this historic event.  So, we injected the induction drugs, and this patient turned out to be one of the most difficult intubations I have ever encountered.  The reason for the surgery was to remove a tumor on his neck.  This tumor was apparently distorting his airway, making visualization of his vocal cords almost impossible.  So, what should have been a 15 second induction of anesthesia turned into a 45 minute scene of chaos and mayhem.  At one point I could not ventilate the patient and so his oxygen level dropped to undectable  levels.  The medical student with my ipad continued to take pictures this whole time, 133 photos to be exact.  And I remember thinking at one point that I REALLY wished I had not asked someone to take photos of this historic event.

Alas, by the grace of God, the endotracheal tube finally found its home, the man had his surgery, woke up and appears to be doing fine, and hopefully our next general anesthetic will go a little smoother than this one.  

A few of the less incriminating photos ..... (Photos below are a slide show, click through them)

Each week, Redeemer is going to post 2 blog posts each week from a dear family who has been a part of the Redeemer Church family for years who moved to Africa to do medical education for 9 months. The Sund Family, Greg, Stephanie, Ella, Biniyam, and Mekdes have lived in Burundi for the last 8 months and we wanted you to be up-to-date on all that they are doing and all that is happening in Africa.

Below is the Sund's blog post in September from Africa called "Well Sent". You can find more blogs from there personal blog here > Beyond Our Backdoor 

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One thing about our time in Burundi that I don’t feel like we have properly addressed yet is that fact that behind our family coming here are a great number of people back home who sent us.  We were sent in many ways and by many people.  And I am sure many of the people reading this blog are the same people who provided for us with financial donations, prayers and words of encouragement as well as support in many other ways.  Here are some of the ways in which we were “well sent”.

1. Many people donated generous financial gifts to help our family with the cost of airfare, visas, malaria meds and countless other pieces of this trip.  We are deeply grateful for all of your support.
2. My anesthesia group (Bellingham Anesthesia Associates) gave me the nine month sabbatical to make this trip a reality.  Our CEO also worked on many pieces required for this trip to come to fruition, including health insurance, credentialing paperwork and malpractice insurance issues.
3. Our children’s teachers in Bellingham were generous with their time in helping prepare our family for this time and specifically for helping Stephanie prepare to enter the world of homeschooling.
4. My band back in Bellingham “Runaway Truck Ramp” hosted a surprise party/fundraiser for the hospital here in Kibuye.  It was such a wonderful time with friends from work and our local church attending and giving generously toward the Kibuye hospital expansion project (https://www.whm.org/project/details?ID=19170)
5. The staff at the hospital where I work  threw another party two nights before we left for Burundi and took up a collection for our trip.  Again, we felt so deeply loved by the thought and effort that went into these two parties.
6. The hospital where I work also donated many supplies which I was able to bring with me to use in our work here.  We have already started using the ear tubes!
7. Our friend Ethan volunteered his time and skills as a real estate agent to help us rent our house while we are away.
8. As we were driving toward the airport on our way to Burundi, our dear friend Kim stood with her son Harper on the overpass by our house with a giant sign saying “We love you to Burundi and back!”.  
9. My parents have provided much support for us in many ways, one of which was allowing us to move in with them for the six weeks prior to our departure while our house was being rented.  
10. We have received many e-mails, phone calls and other personal messages of support and encouragement in the weeks and months leading up to our departure.
11. The week before we left, the elders of our local church (Redeemer) had a going away party for us.
12. And on our final Sunday in Bellingham, our church family (Redeemer Church) gathered around us, laid their hands on us and prayed for our family and for God’s work in Burundi. (redeemernw.org)

There are many other ways we were blessed by our friends and family and we want to again say, thank you, thank you, thank you.  We truly feel loved.

“By this we know love, that he laid down his life for us, and we ought to lay down our lives for the brothers .... Little children, let us not love in word or talk but in deed and in truth.” (1 John 3:16,18)

Each week, Redeemer is going to post 2 blog posts each week from a dear family who has been a part of the Redeemer Church family for years who moved to Africa to do medical education for 9 months. The Sund Family, Greg, Stephanie, Ella, Biniyam, and Mekdes have lived in Burundi for the last 8 months and we wanted you to be up-to-date on all that they are doing and all that is happening in Africa.

Below is the Sund's blog post in September from Africa called "Réanimation". You can find more blogs from there personal blog here > Beyond Our Backdoor

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Soon after we arrived in Burundi, I was informed by the dean of the medical school that I am a “Réanimationist”.  I am still not sure exactly what a Réanimationist is, but I have to admit, the title is pretty cool.  In fact, I am considering having business cards and T shirts made up.  Greg Sund,Réanimationist, MD.  

As to what the practice of reanimation involves, the answers I have received have been mixed.  As I now understand it, it does NOT involve copying cartoon characters.  And I am not in fact expected to bring dead people back to life.  And after some clarification, it turns out that I am not expected to give the power of vision to children who have gone blind from meningitis (yes, I was asked to consult on a patient for this very reason).  

From what I now understand, it involves a combination of anesthesia and critical care medicine, with an emphasis on resuscitation.  The reason my new title is important is because all medical students in Burundi are required to rotate through one month of “Reanimation”.  Given that the medical school here has no reanimationist, this requirement has gone unable to be fulfilled for many of the medical students (apparently, there are 3 or 4 “Reanimationists” in the country, but they do not have enough availability to get all of the medical students through this rotation).

So, I was asked if, during my time here, I would lead a monthly Reanimation rotation, with 6 students each month, in the hopes of getting 30 or 40 students through this requirement while I am in Burundi.  I said yes, and this past week, we began.  

Mercifully, they chose 6 of their best English speakers to ease me into this new role.  Our schedule involves 2 lectures each week, mornings in the O.R. learning about anesthesia, then spending 3 afternoons each week rounding on critically ill patients, which we are asked to consult on by various services (Peds, Internal Medicine, Surgery).  To be certain, this afternoon portion is a role I am far removed from back in the U.S.  I did 3 months of critical care rotations during my residency, but since then, the only time I am invited into the ICU is when someone needs to be intubated or needs an invasive line.  So, I am hitting the books, and trying to dredge up all those critical care memories that have been suppressed for years.

The first week has gone surprisingly well.  And I have actually found myself enjoying my time on rounds.  There are plenty of moments that involve me stepping out of my comfort zone (eg. rounding on a patient in isolation with multi-drug resistant tuberculosis).  But the students are wonderful.  They are diligent, and compassionate, and they are learning so much with so few resources (no ipads, no computers, and the only books they read are a handful of medical books in English which are kept at the hospital … then they are required to present all this information in French).  

So, the next time you are feeling less than animated … feel free to call me … Greg Sund, Réanimationist ….. MD.

Each week, Redeemer is going to post 2 blog posts each week from a dear family who has been a part of the Redeemer Church family for years who moved to Africa to do medical education for 9 months. The Sund Family, Greg, Stephanie, Ella, Biniyam, and Mekdes have lived in Burundi for the last 8 months and we wanted you to be up-to-date on all that they are doing and all that is happening in Africa.

Below is the Sund's blog post in September from Africa called "Slow Of Speech". You can find more blogs from there personal blog here > Beyond Our Backdoor

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There is a lot I could write about my work at the hospital, but I suppose I will start with an answer to the question, “what has been the most difficult thing about serving in Burundi?”.  For me, the answer has been language.  The language of Burundi is called Kirundi.  It is in the same group of languages as Swahili.  The language used in business and politics (and healthcare education) is French.  Very few people speak any English at all.  This was not a surprise to me, and I spent a considerable amount of time before we came here preparing for this by studying French independently.  However, while it was easy to find computer based resources for studying French, it proved very difficult to find any native French speakers in Bellingham to practice with.  Add to this my aging 40 year old brain, which is not nearly as spongy as it used to be.    

So, what is it like for me to teach anesthesia to medical students and anesthetists in French?  Imagine teaching a discipline which took 12 years of higher education to learn, but with the vocabulary of a 4 year old.  It is hard.  It is exhausting.  It is often painful.  It is probably even more painful for them to listen to me than it is for me to struggle with every word.  But they have been gracious.  And I am encouraged by the other missionaries I am working with, most of whom spoke little or no French 2 years ago, and now are able to converse with great fluency, using complex medical terminology.  

Compounding this difficulty is the fact that most of the patients speak no French at all, only Kirundi.  As it turns out, there are almost no resources to learn Kirundi outside of Burundi.  So, I came with a handful of greetings and basic words (eg. water, coffee, chicken), but other than that, I’ve got nothing.  Thankfully, we now have a Kirundi language tutor to meet with us once a week to help us get at least a basic framework for communicating with the locals. However, I had my first lesson today, and my tutor’s parting words of encouragement to me were, “with you, I don’t know if I will succeed”.  I am hoping something was lost in translation.

In all this, I am comforted by the biblical account of Moses, who was self-described as “slow of speech and tongue” (Exodus 4:10).  And God’s response?  “go, and I will be with your mouth and teach you what you shall speak”.  I know that I cannot succeed in this based on my own ability to learn French and Kirundi, so, I go with the hope that God is with me and can use me even with my stumbling tongue.