March 6, 2009
Our previously scheduled clinic has been cancelled. Apparently there is a nurses and directors meeting for all the clinics in Bugesera province. I thought this would be a good time to do a class for many people at once, but apparently it can’t be added onto the schedule. Frustrating- we’ve come all this way.
We had discussed with our friend Vienny a possible side trip to his hospital in Gitwe and arrangements were quickly made for his brother to pick us up in his van. We will meet with the Smile Team, see the hospital and a school built by Gerard, Vienny’s good friend, and then travel back to Butare with the Americans to spend the night and tour the national museum.
It was hard to get back on the road, but we were in good hands with Jean-Paul as our driver. Traveling really makes me exhausted here- the main roads are excellent, but once you turn off you are on deeply rutted, uneven roads. We once again head out, this is the first time Trip has been out of Kigali and he is amazed but the sights. Not only are the people along the road fascinating and beautiful, but the rolling hills of the country side, the sweeping vistas are breathtaking. One of the Americans in Gitwe coined the phrase “Tuscany with Bananas”.
We travel along the main road going to Butare and after about an hour turned off onto the road to Gitwe. This is a typical Rwandan road- red clay, deeply rutted, log bridges over little streams, bumpy. You travel down into the valley and then up the next hill- I would see a small cluster of houses in the distance and pray it would be Gitwe. After about an 1 ½ hours of up and down the mountains and through the rutted roads we turned a corner into the center of a good sized town.
Gitwe has one main thoroughfare with the hospital on it- a beautiful 3 story structure with gardens surrounding, and a few little shops. We met up with our friends Janette and Barry, as well as Gerard (the man who built the hospital and the school) and John, an Ob/Gyn friend of Vienny and Gerard. John is on his 7th visit to Rwanda. He is from New York and helping to establish the new Medical School. Everyone quickly got into the van and we set out back down the road (!) to the community market.
We reached the market and turned a corner to a stretch of about half a mile- packed with people- there must have been 5-10,000 people in this tiny area. Women were sitting on mats with produce or ground sorghum laid out (groups, maybe 1 pound, of carrots were 100rf- about 20 cents US), people were walking about with chickens for sale, there was an electronics section with radios all blasting different stations, an area with plastic washing tubs. People quickly crowded around us and followed us throughout our tour of the market. At some point is became too much and we needed to pack back into the van- it was just too disruptive to have us there.
We then traveled back up the road (ugh) and went to Gerard’s compound. There is a main house and a line of tiny rooms where the cleft palate team – or any other aid workers – can stay. Workers were gathered around 3 clay pots over charcoal and propane preparing lunch for the team.
Vienny took us for a tour of the Adventist school that Gerard started. Apparently in Rwanda there are so few spots for secondary school that it is not unusual to stay in primary school for many additional years waiting to move on. Vienny took 6th grade 4 times. Gerard and some other parents decided to build their own school to alleviate this issue. His school has now grown to 2,000 students from throughout Rwanda. We walked through the campus- it was Friday afternoon so the students were off for the afternoon. Kids were hanging out in clusters, goofing around, playing soccer- just like kids in the US. We walked along the back of the compound and could hear singing wafting through the air. A group of students were practicing hymns in a classroom- the singing resounded off the unadorned walls and it felt like you were somehow sitting inside the music. Other students were at desk with their bibles open, watching the choir. No adults were around to supervise- there is no need. The leader would sing a verse and the choir would join in- it kept building and building- incredibly powerful. We then walked on, turned another corner and were in the lunchroom- long tables, probably 750 kids eating and a slow din of excitement as people noticed us. A young boy came up and said, “Mum, it you have time, I can make you a plate”. It looked like they were eating a vegetable stew with onions and beans and a white doughy porridge of some type. They all were in charge of their own utensils and plates and went to wash them and take them back to their quarters when they were done.
On to the hospital- a lovely open air design with a conference room where report is given in the morning, a small pharmacy (2 or 3 shelves of medications), a tiny lab. Vienny described report as when all of the providers met to discuss changes in patients status as well as what they can do differently, how to be better with delivering care. Maternity was on the 1st floor and consisted of 3 tiled areas- kind of like shower stalls, with beds of laboring women. They do about 5 vaginal births and 3 cesareans every day. The second floor held patients room- postpartum, internal medicine, pediatrics- each room has 3-5 beds. They had just delivered lunch- which is unusual- most hospitals here do not provide food. Each person had a little gladware lidded container. The third floor was isolation for TB, etc, so we did not venture there. Instead of elevators to move patients from floor to floor, there are a series of ramps.
After the tour, we went back to Gerards with a buffet lunch waiting for us. The staff had prepared fresh vegetables, fried potatoes, rice and a stew of eggplant and onions. Then Vienny asked us if we wanted to lay down--- yes! I fell fast asleep for about 2 hours!
The rest of the team returned from their surgical cases and we headed off to Butare. We managed to cram 19 people into Jean-Paul’s van. Thank goodness I had a seat by the window and it was evening and cool. Unfortunately on the main road you will frequently get stuck behind a slow moving diesel truck and the exhaust is stifling. I am uncertain how I didn’t vomit along the way, but I did work up a good migraine. We arrived at our Hotel, Le Petite Prince after about an hour and a half. What an oasis! Granite floors and spotless (sort of) rooms. I regrouped, had a bath and a coke and was thankfully ready to go again. We visited with the other team members and Vienny, and ate a large buffet that was prepared for us. The conversation with the members of the team was insightful- Claire is one of the main coordinators of their many missions. The group has missions all over the world- India, Guatemala, etc, so they have this down to a science. They are also quite fortunate, in my opinion, that they see the immediate results of their surgeries. A simple cleft lip repair may take an hour and 15 minutes to perform, the results are readily seen and the people are so excited about how their lives will change. Amazing.
