Home and Family An Ocean Away

April 16, 2020

Posted by Paula Green, Friend of 20 Liters

Back to the Blog

Fall 2019

Sometimes, it feels surreal that our three kiddos are growing up with a second home and family an ocean away from West Michigan. My family has been traveling to Rwanda since 2009.  We go every year or so for 2-6 months at a time.  My husband, Joel, is a surgeon.  I am a mom.

Each year, we go to the Western Province in the Nyamasheke District in the village of Kibogora.

Getting there consists of 5 nauseating hours driving from Kigali along windy, bumpy, sort-of-paved roads. When we turn off the paved road, we know we are close to Kibogora! We press our faces to the window as we bump along the rutted road, anxious to get out of the vehicle.

We recognize the small market and the bus stop. There is Eric, the shoemaker’s shop and Andre’s duka, where we can always find cold Fanta. We wave back excitedly to Mama Hope and the ladies at the sewing shop. It looks like Gilbert’s printing shop is still up and running. Lake Kivu sparkles just down the hill. The mountains are covered with dusty banana trees; it’s the dry season. Did time stand still over the past year? 

The folks in the Western Province, we are told, have historically been viewed by fellow Rwandans as the “hill people,” the poor, the worthless. When a patient’s healthcare needs advance beyond what the Kibogora doctors are comfortable with, the patient is sent to Kigali to be seen at the larger hospitals. Often, the patient returns to Kibogora days later having given up waiting to be seen by a doc in Kigali. The hill people are overlooked, ignored and sometimes literally pushed to the back corner. 

This is why we go. Kibogora is not forgotten and these dear people are loved. 

Joel’s surgical skills are stretched while he serves here. Preventative care is almost a comical idea. Patients come to the hospital with advanced diseases and wounds that needed care weeks ago; wounds that needed a medical doctor before a witch doctor. Joel’s patience is tested as he tries to understand needs in another language and as he struggles to be understood in a different culture. 

A busy morning in West Michigan for Joel might include rounding on 10-20 patients. Each in their own hospital room with a bathroom, sheets, blankets, and ice chips, among many other comforts.

A typical morning at Kibogora includes rounding on about 90 patients. Each in a bed, often with another patient. The beds are in two large wards – one for men and another for women. The space between beds is barely wide enough for Joel to pass through to see the next patient. Some have a blanket. Their bathroom is a pit toilet outside and their water is unfiltered. There are no ice chips. Patients have food only if their family members prepare food for them.

Kibogora has relied heavily, and usually exclusively, on foreign missionary surgeons to meet the needs of so many people. A few years ago, the Lord sent Dr. Ronald Tubasiime to Kibogora. Dr. Ronald is a Rwandan national and an excellent surgeon. He is the sole full-time surgeon at Kibogora. We are part of a rotating team of surgeons who partner with Dr. Ronald to lighten his heavy surgical load.  Other surgeons who volunteer their time come from Germany, Alabama, Pennsylvania, Australia and England.

Dr. Ronald and his wife, Cissy, have become dear friends of ours over the years. We’ve enjoyed exchanging cultural advice, recipes and laughs together. We’ve stood with Dr. Ronald as he, an outsider to the tight-knit Kibogora community, took on his new role as head surgeon of Kibogora hospital and introduced a new, disciplined, patient-focussed work ethic. We’ve prayed for this couple as they faced criticism from their community for adopting their two sweet children – an unusual event in Rwandan culture. We’ve helped support them as they, with their small income, graciously provide school fees and financial help to many of their extended family. They live in a small, hospital-owned house. Their neighbors are fellow doctors who work at Kibogora hospital. 

Dr. Ronald’s is the only home among them that has a water filter – one we brought to him from the U.S. The water taps only work intermittently and many rely on rain water for daily needs. Each day neighbors bring jerry cans and buckets to Dr. Ronald’s house in order to filter their water.

Education is spreading in Kibogora. More people know that their water needs to be boiled. The logistics of doing is time consuming and shirked by some in favor of taking parasite medicine.

Since we began serving at Kibogora in 2009, Joel has witnessed a noticeable decline in the quantity of patients infected with intestinal worms. For many years, a somewhat common surgery Joel performed was on swollen abdomens. Patients would come in with large bellies, pain, vomiting, and other too-gross-to-mention symptoms. When the abdomen was opened, there would sometimes be, quite literally, buckets of worms inside.

Each dirty water droplet consumed might contain a single worm egg. These worms do not multiply inside the abdomen, but the worms eat the food and nutrition that the person eats. If a person drinks dirty water long enough, and enough worms grow inside them, serious problems occur.

Medicine to kill these worms is now regularly available in schools and hospitals now. Accordingly, these types of surgeries are down, but a need for clean water remains dire. We are thankful to Dr. Ron and Cissy for generously opening their home and offering filtered water to those around them.

But, the community, the churches, the hospital and schools would benefit greatly from more filters and education. 

Whenever the operating room is short on supplies or frustratingly slow or unprepared, Dr. Ronald doesn’t shake his head in anger or yell at anyone. He smiles. “What else can I do?  God is good. Bless God!” He smiles the biggest, most joyful and content smile. He is patient as he serves the people of Kibogora. Our friends in Kibogora are not forgotten. They are loved by our King and Creator and it is our great blessing to be able to walk with them in service too.


From the Field Notes of Paula Green. Paula is a stay-at-home mom to her three kids, ages 9, 11 & 13. Her husband, Joel, is a local surgeon who gives his time and skills to the people in Kibogora. They have taken their family to Rwanda seven times over the past 10 years.  It has been a joy to see how God creates His family of believers across oceans.

You Can Make a Difference.

You can make more stories like this possible by making a gift today.

Donate Now