March 10, 2009
Clinic at Gashoro
Today Trip accompanied us to the clinic at Gashoro. This was a very basic clinic with no water and very little electricity. Right next to the clinic they are building a new hospital and Dan tell us that the whole project—start to finish is accomplished for about 200,000 US. It looks like it will be a beautiful and modern facility—a main center area with wings spreading out. They are finalizing the roof structure presently and there was a man sitting on the top of the roof welding with a tiny little welding iron- looks like little more than what you would find in a craft store.
We taught 3 nurses and got through the training very quickly. Not really sure how they liked us, they weren’t very expressive, but Trip said he thought they were engaged with the teaching. We taught in a dark, little brick room, with no power. We then toured the facility and the delivery room. There were cobwebs in all the corners of the narrow, dark hallways. The birthing room had an extremely old bed with a bucket underneath it and nothing else—no linens, no tools, etc. There was a tiny little locked cabinet that they told us was for keeping supplies—not much could fit in there for sure. We started cracking up on the way home thinking about the Jacuzzi tubs, birthing balls, tennis balls, chap-stick, aromatherapy, etc, etc that is seemingly necessary to have a baby in the US.
After we left the clinic we asked if we could visit the little school nearby—I had pencils and supplies to hand out. As we began to walk down the dusty road to the school we were soon engulfed in children of all ages. We entered the main courtyard and they were finishing lunch break and lots of kids were playing soccer with one of the leaf and twine soccer balls they make here. There were little heads everywhere- the pictures from that day are amazing!
We walked through the courtyard, trying not to step on the little people gathered around and made our way to the main office to meet with the headmaster. Trip talked with the headmaster, as well as some of the teachers and we gave them supplies and one of the alphabet books made by the kids from Deer Park. It was hard to be in the midst of such a crowd and carry on a conversation—especially with some language difficulty. It turns out there are 1200 students in this little school.. the average class size in Rwanda is about 65! I’ve shown the picture of Grey’s class around a bit and people are shocked at the small class size- which is not small by our standards. Trip loved the time at the school, but we had to move on quickly—we were way too much of a distraction!
Sunday, March 15, 2009
Saturday, March 14, 2009
March 9 Clinic at Mwogo
March 9, 2009
Clinic at Mwogo
Dr Dan took us to clinic at Mwogo today- an easy drive of about 45 minutes. Along the way Dan told us of his many ideas- he never stops thinking! One thing that he thinks would be useful is a mobile clinic- with an x ray, an ultrasound, a portable lab, etc. It is so difficult for people to make the trip to Nyamata for the services that are not available in the health centers. Dan is an amazing person- aside from his work at HDI he also works full time as an ER physician and King Faisal Hospital. Many times he has been with us during the day, then worked his shift, then come back to work with us again.
When we arrived we could see the lines of patients waiting to be seen. There are always so many to be seen and it is hard for the staff to get away from their duties to go to a class. Dr Dan jumped in and started seeing patients- mostly malaria and malnutrition, one fellow had been run over by a cow. He kept a running tab as we saw patients---- that would have been 5 ultrasounds and 4 x rays, etc. The mobile clinic is a great idea! It was heartbreaking when we saw a boy who was 5 years old and weighed 24 pounds… I could have wept so many times. One mother came in with her older child who was ill and I offered to hold her darling infant daughter—then a few tears came… I miss my kiddos so much.
We decided at some point to go outside and have a break- we wondered also if we were slowing the nurses down in their work. The clinic was a pleasant spot with many flowers growing- everything grows so well here (except the people I guess).
Finally we were ready to start teaching. The nurses were quite receptive- they always want more education. Frequently when they have difficult cases they have to refer to Nyamata- this includes the horrific situations like shoulder dystocias- they transfer mid delivery- needless to say the baby is lost. Showing them simple maneuvers to hopefully get them out of a situation is really useful. One nurse, Hyacinthe, really wants to become a midwife… and I said I would try to get her some books to her.
Clinic at Mwogo
Dr Dan took us to clinic at Mwogo today- an easy drive of about 45 minutes. Along the way Dan told us of his many ideas- he never stops thinking! One thing that he thinks would be useful is a mobile clinic- with an x ray, an ultrasound, a portable lab, etc. It is so difficult for people to make the trip to Nyamata for the services that are not available in the health centers. Dan is an amazing person- aside from his work at HDI he also works full time as an ER physician and King Faisal Hospital. Many times he has been with us during the day, then worked his shift, then come back to work with us again.
When we arrived we could see the lines of patients waiting to be seen. There are always so many to be seen and it is hard for the staff to get away from their duties to go to a class. Dr Dan jumped in and started seeing patients- mostly malaria and malnutrition, one fellow had been run over by a cow. He kept a running tab as we saw patients---- that would have been 5 ultrasounds and 4 x rays, etc. The mobile clinic is a great idea! It was heartbreaking when we saw a boy who was 5 years old and weighed 24 pounds… I could have wept so many times. One mother came in with her older child who was ill and I offered to hold her darling infant daughter—then a few tears came… I miss my kiddos so much.
We decided at some point to go outside and have a break- we wondered also if we were slowing the nurses down in their work. The clinic was a pleasant spot with many flowers growing- everything grows so well here (except the people I guess).
Finally we were ready to start teaching. The nurses were quite receptive- they always want more education. Frequently when they have difficult cases they have to refer to Nyamata- this includes the horrific situations like shoulder dystocias- they transfer mid delivery- needless to say the baby is lost. Showing them simple maneuvers to hopefully get them out of a situation is really useful. One nurse, Hyacinthe, really wants to become a midwife… and I said I would try to get her some books to her.
Thursday, March 12, 2009
March 7 Butare and the Dinner
March 7, 2009
Return from Butare/Museum/THE DINNER
This morning we awoke and went for breakfast. Most of the cleft team was already up and the physicians were strategizing about improving their mission operations, I don’t think they ever stop looking for ways to fine tune things and improve. Breakfast was wonderful- a porridge, fresh fruit, toast and jam. We noticed that there were a lot of security personnel about and found out that Madame President was due to arrive at the hotel that morning to attend a meeting. Armed guards were everywhere and large white tents had been set up on the manicured lawns.
Jean-Paul met us and took us to the Rwandan National Museum. The museum was small but comprehensive. It showed the development of Rwanda from the beginning of record keeping- as well as all of the native crafts and handiwork. The highlight was going inside a traditional King’s hut. It was amazingly comfortable- grass padding covered in woven mats, partitions made from the same woven materials. There was a large display showing the types of baskets made her by Rwandans. I have long appreciated the baskets, but had no idea how much work went into them.
To me its amazing to see how self-sufficient most people are and have to be. There are few markets most Rwandans have very little money. The people in the villages live a very resourceful life- some stick huts are still seen, and the more solid homes are made from clay bricks which are formed and dried in the front yard. Grasses are used to make ropes to keep track of the goats or for padding on the floor of a house. Sticks are fashioned into fences and corrals for the cows. Food is everywhere and free- bananas, papayas, and avocados are falling from the trees. You really can survive with very little money.
We made unbelievable time on the return trip from Butare and returned in time to go to the Kimirongo market. This is an amazing place that we visited last year to purchase fabric. The market can be so overwhelming- millions of people and anything you could want to buy. We hired Vincent to help us shop and he assisted us in bargaining and carried our things. Apparently this is a normal job here- we didn’t have a helper last year, but I think we were not receptive to those that asked us. We purchased fabric and baskets and piled our finds onto the moto to get home.
After we returned from the market we showered and prepared for dinner at the British Ambassador’s residence with our friend Alice Cannon. Alice is a Neonatal Nurse Practitioner, previously a Midwife and is currently the head of the NICU at King Faisal Hospital. We became acquainted last year during our trip and she invited us for dinner. Alice was born in Hong Kong and is a fabulous Chinese cook… she served us an “informal dinner” of 7 courses and 3 desserts, with the corresponding wines and cordials naturally. It was nice to discuss the medical system and Rwanda in general with another
outsider. She was candid with us and it was a great evening of conversation and wonderful food, not one I will soon forget.
Return from Butare/Museum/THE DINNER
This morning we awoke and went for breakfast. Most of the cleft team was already up and the physicians were strategizing about improving their mission operations, I don’t think they ever stop looking for ways to fine tune things and improve. Breakfast was wonderful- a porridge, fresh fruit, toast and jam. We noticed that there were a lot of security personnel about and found out that Madame President was due to arrive at the hotel that morning to attend a meeting. Armed guards were everywhere and large white tents had been set up on the manicured lawns.
Jean-Paul met us and took us to the Rwandan National Museum. The museum was small but comprehensive. It showed the development of Rwanda from the beginning of record keeping- as well as all of the native crafts and handiwork. The highlight was going inside a traditional King’s hut. It was amazingly comfortable- grass padding covered in woven mats, partitions made from the same woven materials. There was a large display showing the types of baskets made her by Rwandans. I have long appreciated the baskets, but had no idea how much work went into them.
To me its amazing to see how self-sufficient most people are and have to be. There are few markets most Rwandans have very little money. The people in the villages live a very resourceful life- some stick huts are still seen, and the more solid homes are made from clay bricks which are formed and dried in the front yard. Grasses are used to make ropes to keep track of the goats or for padding on the floor of a house. Sticks are fashioned into fences and corrals for the cows. Food is everywhere and free- bananas, papayas, and avocados are falling from the trees. You really can survive with very little money.
We made unbelievable time on the return trip from Butare and returned in time to go to the Kimirongo market. This is an amazing place that we visited last year to purchase fabric. The market can be so overwhelming- millions of people and anything you could want to buy. We hired Vincent to help us shop and he assisted us in bargaining and carried our things. Apparently this is a normal job here- we didn’t have a helper last year, but I think we were not receptive to those that asked us. We purchased fabric and baskets and piled our finds onto the moto to get home.
After we returned from the market we showered and prepared for dinner at the British Ambassador’s residence with our friend Alice Cannon. Alice is a Neonatal Nurse Practitioner, previously a Midwife and is currently the head of the NICU at King Faisal Hospital. We became acquainted last year during our trip and she invited us for dinner. Alice was born in Hong Kong and is a fabulous Chinese cook… she served us an “informal dinner” of 7 courses and 3 desserts, with the corresponding wines and cordials naturally. It was nice to discuss the medical system and Rwanda in general with another
outsider. She was candid with us and it was a great evening of conversation and wonderful food, not one I will soon forget.
Sunday, March 8, 2009
March 6, Travel to Gitwe
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.
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.
March 5, Butare and the Accident
March 5, 2009
Butare
This morning we were scheduled to meet with the Dean of the medical school in Butare, then to visit the national museum and stop at Gitwe on our return trip. Gitwe is where our friend Vienny has his hospital and where the Smile Train folks are doing their work. We start out along the road out of Kigali and see a very different side to this town- the industrial area and slums (for lack of a better word).
In Rwanda everything happens along the roadside, it is the lifeline to getting supplies, it is a smooth place to walk from one village to the next, a place to meet friends and family. On the back side of Kigali, following the road to Butare in was not unusual to see a man carrying 5 mattresses stacked one on top of another- all balanced on his head, tiny children walking alone with jugs to fetch water, someone bringing a goat in to town for slaughter, nicely dressed folks on their way to work in the city.
After we exit the city we begin the journey between villages- it’s rare to go even 200 yards without seeing someone on the road. Its clear that this province has more wealth than Bugesera province where we are doing our teaching. Houses have decorative accents in the stucco or clay, most compounds will have some goats and a cow in the yard, many of the children along the road are dressed in school uniforms and carrying primers.
We drive about 2 hours along this road and at some point begin chatting about the truck in front of us. It is a bank truck and along the bed of the truck it is fitted with seats that look out on either side. Security guards dressed in head to toe black, with black hoods and machine guns on their laps occupy the seats. I discretely take a photo. Suddenly the truck pulls out and to the left, we continue on, then the truck swerves to the right, making a right hand turn onto a road in front of us- collision! Our left wheel and headlight hit their right back panel. We stop and everyone is quite shaken, but no one is hurt. My camera is somewhere in the front seat. A man from the truck runs up and asks Aflodis for his identity card, he takes the card, runs back to the truck and quickly drives away! We slowly begin to exit the car where a crowd is swelling and Aflodis calls the police. Thank god no one is hurt but now what?
We realize that we are surrounded by probably 100 pairs of eyes looking at us. A few people speak maybe 1 or 2 words of English. As the police arrive we start to visit with everyone as best we can. A tiny toddler has a deflated plastic ball and I begin to kick it around, we take photos and show them on the screen- which is a big hit. Most people rarely see themselves so this is a treat. I teach a young kid in a low slung baseball hat to say, “Its coooool” and give a thumbs up – you know , anything I can do to help this society- ha. Eventually the matriarch of this village, Consolee, makes her way forward. She speaks French so I can communicate with her a bit. She visits with us, I show her pictures of the boys and she holds them up for all to see. She is a neat lady- clearly well-respected- and I thoroughly enjoy visiting with her. We exchange contact information before we leave.
The bank truck returns- and tells the police that they have too much money in the car to stop- they need to travel on to Butare. That is why they didn’t stop previously- they had to deliver some of the money to the small bank along the road. At least Aflodis gets his identification back. It looks like the car is drivable after he reshapes the wheel well and we are allowed to continue on to Butare as long as we are back by 2 pm to meet again with the police. So after about an hour we are free to travel on for a bit.
We pile back into the car for our meeting with the Dean. Butare is a beautiful city, small and tidy. We have a very abbreviated meeting with the Dean and he tells us more about how the medical school is operated. It is quite different that they system we are used to. They study 6 years- right out of high school- and when they are done they have a Bachelor’s in Medicine and a Bachelor’s in Surgery. If one wants to specialize they go on for further training.
We are due back at the accident site so we do a quick tour through the national museum and are soon on the side of the road once again. The police encourage the 2 parties to reach a gentleman’s agreement about who is at fault- and truly it’s hard to sort out who was at fault. We purchased biscuits for the kids at the store (a little closet) and I spend more time with Consolee and the crowd. This woman is sharp- she begins asking me about Obama and everyone begins to cheer for Obama. She says he is a good man because he closed the prison and Abu Ghrabe- she is clearly more well informed than most US citizens-- she tells me she listens to the radio all day. I tell her that I want to give her a gift, can we go somewhere so I don’t have to do it in front of everyone? We go into a small room next to the store and I give her an Obama button and my umbrella. She thanks me, we return to the crowd and all eyes are on us. She declares (in French)….. The American…… has given me……. A button of Barack Obama……….. and an umbrella. Everyone nods and says Mmmmmm, as is the custom here (kind of an alternative for saying, OK) -so much for being discreet.
It sounds like the problems caused by the accident will be tough. The police man is asking Aflodis to travel back to Butare at a later date to receive the judgement of fault. This may be a tactic to try to get a bribe. Additionally, the car is borrowed from a driver and he will lose income during the time the repairs are being done. This is a much larger deal than in the US and I feel sick about it. We slowly make our way back to Kigali, we can’t make a tight right turn as the tire rubs, our nerves are frazzled by the time we reach the hotel.
Butare
This morning we were scheduled to meet with the Dean of the medical school in Butare, then to visit the national museum and stop at Gitwe on our return trip. Gitwe is where our friend Vienny has his hospital and where the Smile Train folks are doing their work. We start out along the road out of Kigali and see a very different side to this town- the industrial area and slums (for lack of a better word).
In Rwanda everything happens along the roadside, it is the lifeline to getting supplies, it is a smooth place to walk from one village to the next, a place to meet friends and family. On the back side of Kigali, following the road to Butare in was not unusual to see a man carrying 5 mattresses stacked one on top of another- all balanced on his head, tiny children walking alone with jugs to fetch water, someone bringing a goat in to town for slaughter, nicely dressed folks on their way to work in the city.
After we exit the city we begin the journey between villages- it’s rare to go even 200 yards without seeing someone on the road. Its clear that this province has more wealth than Bugesera province where we are doing our teaching. Houses have decorative accents in the stucco or clay, most compounds will have some goats and a cow in the yard, many of the children along the road are dressed in school uniforms and carrying primers.
We drive about 2 hours along this road and at some point begin chatting about the truck in front of us. It is a bank truck and along the bed of the truck it is fitted with seats that look out on either side. Security guards dressed in head to toe black, with black hoods and machine guns on their laps occupy the seats. I discretely take a photo. Suddenly the truck pulls out and to the left, we continue on, then the truck swerves to the right, making a right hand turn onto a road in front of us- collision! Our left wheel and headlight hit their right back panel. We stop and everyone is quite shaken, but no one is hurt. My camera is somewhere in the front seat. A man from the truck runs up and asks Aflodis for his identity card, he takes the card, runs back to the truck and quickly drives away! We slowly begin to exit the car where a crowd is swelling and Aflodis calls the police. Thank god no one is hurt but now what?
We realize that we are surrounded by probably 100 pairs of eyes looking at us. A few people speak maybe 1 or 2 words of English. As the police arrive we start to visit with everyone as best we can. A tiny toddler has a deflated plastic ball and I begin to kick it around, we take photos and show them on the screen- which is a big hit. Most people rarely see themselves so this is a treat. I teach a young kid in a low slung baseball hat to say, “Its coooool” and give a thumbs up – you know , anything I can do to help this society- ha. Eventually the matriarch of this village, Consolee, makes her way forward. She speaks French so I can communicate with her a bit. She visits with us, I show her pictures of the boys and she holds them up for all to see. She is a neat lady- clearly well-respected- and I thoroughly enjoy visiting with her. We exchange contact information before we leave.
The bank truck returns- and tells the police that they have too much money in the car to stop- they need to travel on to Butare. That is why they didn’t stop previously- they had to deliver some of the money to the small bank along the road. At least Aflodis gets his identification back. It looks like the car is drivable after he reshapes the wheel well and we are allowed to continue on to Butare as long as we are back by 2 pm to meet again with the police. So after about an hour we are free to travel on for a bit.
We pile back into the car for our meeting with the Dean. Butare is a beautiful city, small and tidy. We have a very abbreviated meeting with the Dean and he tells us more about how the medical school is operated. It is quite different that they system we are used to. They study 6 years- right out of high school- and when they are done they have a Bachelor’s in Medicine and a Bachelor’s in Surgery. If one wants to specialize they go on for further training.
We are due back at the accident site so we do a quick tour through the national museum and are soon on the side of the road once again. The police encourage the 2 parties to reach a gentleman’s agreement about who is at fault- and truly it’s hard to sort out who was at fault. We purchased biscuits for the kids at the store (a little closet) and I spend more time with Consolee and the crowd. This woman is sharp- she begins asking me about Obama and everyone begins to cheer for Obama. She says he is a good man because he closed the prison and Abu Ghrabe- she is clearly more well informed than most US citizens-- she tells me she listens to the radio all day. I tell her that I want to give her a gift, can we go somewhere so I don’t have to do it in front of everyone? We go into a small room next to the store and I give her an Obama button and my umbrella. She thanks me, we return to the crowd and all eyes are on us. She declares (in French)….. The American…… has given me……. A button of Barack Obama……….. and an umbrella. Everyone nods and says Mmmmmm, as is the custom here (kind of an alternative for saying, OK) -so much for being discreet.
It sounds like the problems caused by the accident will be tough. The police man is asking Aflodis to travel back to Butare at a later date to receive the judgement of fault. This may be a tactic to try to get a bribe. Additionally, the car is borrowed from a driver and he will lose income during the time the repairs are being done. This is a much larger deal than in the US and I feel sick about it. We slowly make our way back to Kigali, we can’t make a tight right turn as the tire rubs, our nerves are frazzled by the time we reach the hotel.
Wednesday, March 4, 2009
March 4, First Clinic Day
March 4, 2009
This morning we went off for our first clinic and ended up at Gihinga clinic. This was one of the clinics we had visited last year. During the ride to the clinic it was clear that the country is progressing, even in the short time we have been gone. Roads are much improved, houses and buildings are going up rapidly, and improvements are many. All of the beautiful photo opportunities, and a car moving too quickly to capture them. There was a baby on mom’s back, wrapped in a brightly colored pagne with a hand full of bright yellow flowers and of course all of the children running along the road, school kids and village kids, yelling “Mzungu!”. A reminder of how easy we live came around every corner, when you would see a toddler walking alone, a man with a bicycle piled with brush and jerry cans, a mother with a huge sack of grain on her head- a baby wrapped on her back- another holding her hand- and her free hand carrying another bag of stuff.
When we arrived at the clinic it was unreal to see nurses and staff with familiar faces- and they actually remembered me- which was amazing. The head of the clinic, Jeremiah, welcomed us warmly and we were ushered into a room set up for teaching- then the people started filing in. Priscilla did her teaching on Neonatal Resuscitation and then we started to do some of our lectures. It was hard to remember how basic the teachings needed to be- and to remember that these people are working with nearly no supplies. They seemed happy to have us and eager to learn. Sometimes, it is hard culturally, and you can’t tell if people are really interested or not. I got my answer when people started asking questions- and they were very on point.
We completed the teaching session and then moved on into the labor room. There were 3 women in labor today. The routine was much the same- they stay in one area until they are 10 centimeters- its hard to believe that more babies are not delivered in transit to the delivery room. We had one birth during our short time there- a smallish baby, soaked in meconium staining. The mother didn’t really look at the baby after he was born and we inquired more about her situation. Apparently this was her 7th baby and this will be only her 2nd living child at home. The other children died at various points after birth. You can sort of understand why she guards her feelings, yet everything we know speaks to how important the mother-infant bonding directly after birth is, and how it impacts the child forever.
After we did the clinical portion of our teaching, the lead nurse brought us into his office. We talked a bit and reviewed some of the concepts we had taught. Then he surprised us with gifts- Rwandan peace baskets, brightly wrapped in wrapping paper. It was very touching.
Dinner tonight in a big group at Sole Luna- wonderful- just as I remembered!
This morning we went off for our first clinic and ended up at Gihinga clinic. This was one of the clinics we had visited last year. During the ride to the clinic it was clear that the country is progressing, even in the short time we have been gone. Roads are much improved, houses and buildings are going up rapidly, and improvements are many. All of the beautiful photo opportunities, and a car moving too quickly to capture them. There was a baby on mom’s back, wrapped in a brightly colored pagne with a hand full of bright yellow flowers and of course all of the children running along the road, school kids and village kids, yelling “Mzungu!”. A reminder of how easy we live came around every corner, when you would see a toddler walking alone, a man with a bicycle piled with brush and jerry cans, a mother with a huge sack of grain on her head- a baby wrapped on her back- another holding her hand- and her free hand carrying another bag of stuff.
When we arrived at the clinic it was unreal to see nurses and staff with familiar faces- and they actually remembered me- which was amazing. The head of the clinic, Jeremiah, welcomed us warmly and we were ushered into a room set up for teaching- then the people started filing in. Priscilla did her teaching on Neonatal Resuscitation and then we started to do some of our lectures. It was hard to remember how basic the teachings needed to be- and to remember that these people are working with nearly no supplies. They seemed happy to have us and eager to learn. Sometimes, it is hard culturally, and you can’t tell if people are really interested or not. I got my answer when people started asking questions- and they were very on point.
We completed the teaching session and then moved on into the labor room. There were 3 women in labor today. The routine was much the same- they stay in one area until they are 10 centimeters- its hard to believe that more babies are not delivered in transit to the delivery room. We had one birth during our short time there- a smallish baby, soaked in meconium staining. The mother didn’t really look at the baby after he was born and we inquired more about her situation. Apparently this was her 7th baby and this will be only her 2nd living child at home. The other children died at various points after birth. You can sort of understand why she guards her feelings, yet everything we know speaks to how important the mother-infant bonding directly after birth is, and how it impacts the child forever.
After we did the clinical portion of our teaching, the lead nurse brought us into his office. We talked a bit and reviewed some of the concepts we had taught. Then he surprised us with gifts- Rwandan peace baskets, brightly wrapped in wrapping paper. It was very touching.
Dinner tonight in a big group at Sole Luna- wonderful- just as I remembered!
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