Hope for the “Bottom Billion”

By Alyssa Pfister on July 05, 2017

Once again I’m in the unsettled place of straddling two very different worlds. I leave Burundi this month for six months of home assignment in America, and as I finish reading a stack of interesting books, I’m left with two: Margin and Bottom Billion.

I realized the irony the other day as I was alternating between the two books. They might as well be titled “First World Problems” (Margin) and “Third World Problems” (Bottom Billion). As I relate to and identify with both settings, especially as I prepare to leave one for the other, they both certainly apply to me.

One thing I love about Burundi is the margin I have here. Life just moves at a slower pace. I’ve rarely seen a Burundian hurry. There’s always time to stop and chat with friends and neighbors. And, while I certainly wear a lot of hats here and have a lot of responsibilties, for the most part there is margin in my schedule each week for relaxing in my hammock with a good book or sharing a meal or games with friends. I get more sleep here, too, because I can only do so much computer work when the power is out, so I might as well go to bed early!

Even though I’ve done it before, merging into fast-paced American life is intimidating to me. I am American, after all, so I know my tendency to over-schedule my life when given the opportunity.

But lest I paint an unrealistically idyllic picture of Burundian life, remember that the 10 million Burundians fall near the bottom of “The Bottom Billion.” The traps highlighted in the book (landlocked, history of conflict, difficult neighboring countries, etc.) nearly all apply to Burundi. It’s a pretty bleak picture, actually, though it’s easy to forget that on a beautiful morning trek through the hills or while greeting an adorable patient thrilled to be going home today.

One of the recent struggles in Burundi was the fuel crisis. For weeks we couldn’t get any fuel which meant no generator use (and only a couple hours of grid power per day), inability to get needed hospital and construction supplies, and having to lay off construction workers as a result.

We thankfully now have some fuel stocked which we are rationing in case the supply becomes limited again, but, as this crisis hit right in the middle of respiratory infection (bronchiolitis) season, we unfortunately lost quite a few patients due to lack of oxygen.

Another struggle continues to be malnutrition. We saw almost 500 kids in our outpatient malnutrition program last year, many of them walking several hours twice a week just to get a bowl of porridge and a boiled egg. The program brings hope to these families, though, and last week I brought the new medical students up to talk with the mamas.

The new medical students were amazed at how knowledgable these mothers were about nutrition, how commited they were to learning and seeking care for their children, and how thankful they were for the program here.

This is where I see hope for Burundi when I’m tempted to despair in reading statistics — in the face of the students as their perspective is broadened in empathy and respect for those in different circumstances than their own, in the mothers who sacrifice for the health of their children, and in the 11 toddlers receiving the first chemotherapy in Burundi.

The logistics of running a chemo program here seem nearly insurmountable at times, but each month the kids are coming back — some with noticably shrunken tumors and lymph nodes and all with hope that they may actually be the first Burundian kids to survive retinoblastoma (eye cancer).

Please keep praying for them as they all have advanced stage cancer and pray for Krista, Logan, and Parfait as they persevere through the logistical challenges of providing chemo in Burundi. I’ll miss these sweet patients while I’m gone, but I’m looking forward to the many joys of being with family and friends in America instead.

Photo by Scott Myhre.

Alyssa Pfister

About Alyssa Pfister

Alyssa lives and works in Burundi, East Africa, as a medical pediatrics doctor caring for patients as well as teaching and discipling medical students at Kibuye Hope Hospital and Hope Africa University. She loves living in community with her team and serving with the shared vision. You can follow her team at mccropders.blogspot.com. Alyssa is a graduate of Wheaton College and East Tennessee State University.