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They live in a small hut without electricity or running water.
To get to their home is physically challenging.
With his illness, he can no longer work in the fields.
The burden, therefore, falls on his wife and children.
In short, life is difficult for them.
“They are an inspiration, though,” said Olivia Butters, a fourth-year medical student at the University of South Alabama College of Medicine. “Many of us would be tempted to be overcome by such circumstances, yet they were joyful and grateful. How incredible that people with so little to offer in the eyes of the world could teach me so much.”
Butters – along with fellow classmates and attending physicians – recently returned from a month-long medical mission trip to Rwanda, Africa, where they directly helped patients in the area and at the same time received hands-on experience.
The group, including 12 USA medical students, one USA physician assistant student, one USA CRNA, and five USA physicians, spent a month working at Kibogora Hospital, a roughly 230-bed self-supported facility in Southwestern Rwanda. They worked alongside Congolese and Rwandan physicians in a variety of fields, including surgery, pediatrics, internal medicine, ophthalmology and obstetrics. They also made home visits – examining patients and offering what they could to help.
Butters said her home visit with a man dying from liver cancer was one of many experiences on the trip that changed her. He was diagnosed three years ago and now has constant pain and difficulty eating. While there, she offered what medications were available in the hopes that his pain would be eased. “I prayed with them, and they praised God for his goodness,” she said. “I have never known suffering as they have. They could choose bitterness – instead they choose joy.”
Butters said she was inspired to participate in the trip because of her responsibility to use the resources, education and abilities that she has been given to help those in need. She enjoyed being an encouragement and helping hand to the permanent staff of Kibogora Hospital. “The hospital is limited by scarcity of resources, personnel and training,” she said. “Supporting the staff encourages their efforts and offers them some relief from their busy, emotionally- and physically-draining service.”
USA surgeon Dr. Lee Grimm, who also visited Rwanda, said mission trips are a vital and necessary part of medical training and practice. “If we don’t exist to serve people like this,” he said, “why are we even physicians?”
Those participating in mission trips learn how patients can still receive excellent care without a fraction of the medical resources we enjoy – and in many instances have become dependent on – in our country. “When you see these patients clustered in a single open ward yet still maintaining a great sense of appreciation and gratitude for their care, it reminds us that we just don’t help heal disease but rather are tasked to help better and empower every aspect of a patient’s life, from the physical to the spiritual,” said Dr. Grimm, who is an assistant professor of surgery at the USA College of Medicine.
Surgical missions have always been of great interest to Dr. Grimm – in fact, one of the things that attracted him to join USA in 2013 was the existence of the surgical mission trip to Rwanda. “USA provided this already established opportunity for me to not only fulfill my desire to help those in vastly underserved areas who suffer from surgically correctable disease, but also to bring students and residents with us to educate them while there and hopefully spark a desire in them to serve similarly in their own future practices.”
Gretchen Vandiver, a fourth-year medical student at USA, split her time between neonatology and pediatric wards while in Rwanda. “I was able to examine so many newborns and children and make my own decisions and plans, which I believe will be beneficial as I begin my residency,” she said.
For many, the biggest challenge of the trip was the language barrier. The people in Rwanda speak a language called Kinyarwanda, which according to Vandiver, is just as difficult to learn as the word itself sounds. The patient charts are in French.
“We learned to rely on histories and physical exams because we didn't have the ability to do most of the tests that we do in the States,” said fourth-year USA medical student Rebekah Frazier. “Getting an accurate history is difficult when you don't speak the language.”
Frazier, like Vandiver, spent most of her time in neonatology and pediatric wards. She said she’s always wanted to use her skills to take medicine to those with fewer resources. “This trip opened my eyes to how extremely blessed we are in the Western world,” she said. “It made me appreciate what we have.”
On the trip, USA surgery resident Dr. Caleb Butts operated on a wide variety of disease processes. Dr. Butts, who earned his medical degree from USA and has been on two previous medical mission trips, said he cannot emphasize enough how much of a difference mission trips make for all medical professionals. “It stretches your abilities and allows you to grow professionally,” he said.
Dr. Butts, who has always been drawn to providing health care on a regular basis in an environment like Rwanda, enjoyed working through challenging cases. One of his favorite moments was treating a burn patient that had failed a skin graft. “Due to the location of the burn, we needed to use a skin flap, which is a rather advanced procedure usually performed by a plastic surgeon,” he said. “Thanks to our combined experience, as well as that of one of our plastic surgeons here in Mobile who we communicated with, we are able to perform the procedure.”
Fourth-year USA medical student Anna Crutchfield went on the trip to learn how other missionary doctors “preach and treat.” “I am called to help people – both medically and spiritually – no matter what their faith, race or background,” she said. Crutchfield said the experience has confirmed her desire to practice medicine in a rural area.
While performing quality control with a group of doctors in a remote area of Rwanda, Crutchfield was involved in resuscitating a child that was born breeched, or bottom first instead of head first.
She entered a room where a 17-year-old girl was in labor, showing signs that she needed a cesarean section. “Before we could finish her transfer papers, the patient's water broke and we were forced to deliver the baby breeched,” Crutchfield said. “We prayed, delivered, and the baby came out blue and floppy, which is the exact opposite of what a newborn should be.”
They immediately began resuscitating the newborn. “Looking back at it, I thought I would've been a bag of nerves, but I wasn't,” she said. “There was a sense of calm and warmth in the room that was not present before. We suctioned, we breathed, and we prayed.”
Minutes later, the baby was pink and crying. “Joy and praises filled the room as the baby was examined and not a single deficit was noted,” Crutchfield said.
“In the States we rely on our resources and knowledge,” she added. “In Rwanda, however, they have little resources – sometimes all they have is prayer.”
Dr. Grimm said he enjoyed working with students and residents in a much more intimate setting and to see the impact they had even in a short trip. “Not only were we able to help patients, but we were also able to work alongside local health care providers and equip them to deliver better care for their patients after we left.”
Now, though the group is back in the United States, Rwanda remains in their hearts. “I will miss Kibogora Hospital and the beauty that Rwanda holds,” Vandiver said. “It is an amazing place with precious people.”
The mission trip is sponsored by the Christian Medical Ministry of South Alabama (CMMSA). To learn more about CMMSA and supporting medical mission trips like these, visit http://cmmsa.org/#/missions.
Click here to view more photos from the trip.
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