I'm home

For those of you who have not been following me on facebook and have just been looking at the blogspot post, I just wanted to let you know that I arrived in Little Rock around 6pm on Friday.

I left Kigali at 20:45.  The guy who checked my bags didn't know how to charge me for an extra bag, so I actually got to fly with that bag for free as opposed to paying $50 for it.  Then, on both the Kigali->Brussels and the Brussels->Chicago flight, I was the only person in my section, so I got to stretch out and get as much sleep as possible on a flight.  Then, when I got to Chicago, I went up to the American Airlines desk to ask to be put on standby for the 4:10 flight to Little Rock, as opposed to the 8pm flight to Little Rock.  Miraculously, I was the only person on the standby list to make it onto the plane.  

I arrived in Little Rock around 6pm, and my dad picked me up from the airport and then took me to a restaurant, where my mom met us.  Then we went back to my house, where I gave them their presents and then left.  It felt good to be home.  My cat obviously missed me.  I took a shower, and as soon as I turned off the water, I could hear her meowing constantly at the bathroom door until I came out.  She slept directly beside me all night long, and woke me up at 6 am with demands for attention.  Apparently, she thinks a month is a bit too long for me to be away.

However, there will be some things that I am going to miss about Rwanda:

1)  the fruit. A whole pineapple costs about 300 francs, or 60 cents US, and it's way better than the ones you buy at the store here.  Mangos are HUGE and taste heavenly and are cheap, also.  Passionfruit is everywhere and cheap as well.

2)  not being able to understand what people around you are saying.  I actually quite enjoy this about foreign countries.  Instead of having to overhear people's gossip, you can just tune out the Kinyarwandan while you're on the bus, the plane, at the store, and do your own thing.  As soon as I got back in the western world and had to hear people complaining about their flights, I had to groan inwardly, especially when I got back to Arkansas and overheard a couple of drunk college guys at the bar in the restaurant.  

3)  the patients.  My patients were awesome, and I could be assured that every 3rd patient was a "what on earth is that!" patient.  Someone would come and grab me every so often, and I'd go into a clinic room only to go "what is eating away that woman's face?  oh, basal cell carcinoma" or "what is wrong with that kid's tongue?  It's so swollen!" or "seriously, is her spleen really that big? it takes up half her abdomen!" or "she's complaining about something coming out of her vagina...oh my, it's her uterus."  Medicine in the US can be more run of the mill:  COPDers, End Stage Liver Disease, Heart Failure, Asthma, Diabetes, etc.  

4)  the weather.  Yes, it was hotter in Kigali than in Shyira, but it was always a sunny day, and it was a pleasant 80-90 degrees.  As compared to Arkansas where I've been freezing the entire time I've been back.

The things I won't miss:  cold water showers, being stared at all the time by the Rwandans, the mosquitos and other bugs, roosters crowing at the crack of dawn in Shyira, the mosque's call to prayer at the crack of dawn in Kigali and Gisenyi, powdered milk, having to filter tap water, and then having to worry about people trying to rip you off at the market.  

So, I think this is going to be my last post, but I plan on editing the other posts and adding more pictures after church, so stay tuned for at least a couple more days!

And I also wanted to thank all the people at St. Mark's and my family and friends for all their support and prayers, and for the Kings for allowing me to come in the first place. Everything went wonderfully well, and I'm so thankful I got to have this experience.  

Amohoro (Peace)!

Bus to Butare

I was slow to wake up this morning, but I got up and made it into town and to the bus station by 9 am.  I was able to finally, after asking a policeman, find the bus to Butare, the former colonial capital in the southwest part of the country.   Butare has recently undergone a name change to Huye, but everyone still calls it Huye.

A bus ticket only cost 2,200 francs, which is about 5 bucks.  I got to enjoy my views of the countryside, and I sat next to a boy who was between 12-14 years old.  He liked to sing along with the songs on the radio, albeit quietly.  Then he fell asleep with his head drifting occasionally to my shoulder, only to wake up somewhere later down the road and decide to do a little dance to the music for a while before chilling out again...or wait, no, actually, I just got off the bus.

2.5 hours after leaving Kigali, I arrived in Butare.  Besides having the national museum, it is also the educational center of Rwanda.  The medical school, university, and some other schools are located there.  I walked around for a bit, but then went to the national museum.  

In case you've been reading my blog, and haven't figured this out, I'm a big nerd, and I love museums.  So, I spent 99% of my time in Butare in the museum.

In the museum, they have some exhibits showing the natural history as well as the political history of Rwanda.  The coolest part is the section where you walk in and there is a hut in the middle of the room.  You can't go inside (that would be really awesome), but there are some diagrams showing what the inside looked like and what the different rooms functioned as.  

Then there was a ton of stuff on the pottery, weaving, music, dance, etc. of Rwanda.  It reaffirmed for me that if this whole "becoming a doctor" thing doesn't work out, that I should definitely become an anthropologist.  I love this sort of stuff.   

I have to say, I don't think the museum was big enough.  It was only 6 rooms, and I feel like Rwanda's history is a little more extensive than 6 rooms.  

Also, a random thunderstorm (the first one in days, which makes me think that it's truly beginning to be the dry season) came up while I was in the museum, which caused the power to go out.  It kept flickering on and off the entire time I was there.  Thankfully, the museum had enough windows to provide ample light despite the power shortage.  

I then left the museum, and I took another very long bus ride home.  However, I am quite thankful that the Butare-Kigali road has no potholes, as compared to the Kigali Ruhengeri road where it is practically NOTHING but potholes.  

I made it all the way back home, and I met Rebecca at Mawuena's house, and then we walked together to meet Mawuena and Kate at the MTN center, the same place where on my first day I got my phone and my groceries.  There's a Bourbon Coffee there, which is Rwanda's version of Starbucks.  It's a trendy place with free wireless, good coffee, and good food.  It's also the only place where you can trust the ice in the drinks.  They can be a little pricey by Rwandan standards but I can't complain when it offers internet that is fast enough to upload photos on Facebook!

Also, tomorrow, I fly out at 8:45 pm, and I won't be back in Arkansas until 9:55 pm on Friday night.  I do have a 7 hour layover at Chicago-O'Hare, but I'm hoping that American Airlines will be willing to put me on an earlier flight.  If not, expect me to do a lot of blog editing and hopefully picture posting.  It's also a good thing that I'm reading War and Peace...

If I don't post tomorrow, it's because I was too busy packing.  Expect to hear from me in O'Hare, unless American is super sweet and gets me out of there much earlier than expected.

Genocide Memorial

This morning, I basically wasted by blogging, uploading photos from my camera, and then organizing them.  Then Mawuena and I ate lunch before I went to the Genocide Memorial.  

The memorial itself is a white building situated on the northeast side of Kigali, on the side of a hill with a good view of the city to the south.  Around it, there are some very nice gardens.  If you're strolling through the gardens before the rest of the memorial first, however, one might wonder why there are these big concrete slabs without any greenery in the gardens.  That's because they are mass graves, with over 20,000 bodies inside.  

Inside, you walk in a circle, reading about the history of the Hutus and the Tutsis, that really it wasn't a racial differentiation but a movable class differentiation:  tutsis were the upper class cattle owners and hutus were the lower class farmers.  However, should a Hutu acquire more cows, then they became a Tutsi.  There was already a separate clan system based off of families anyway, but when the Belgians came in, they jumped on the Hutu and Tutsi thing.  People who owned more than 10 cows were considered Tutsi, and they were placed in positions of power.  The ever-increasingly powerful Catholic church jumped on this Hamitic theory that the Hutus were descendants of Ham and the Tutsis were descendants of Shem through King Solomon and the Queen of Sheba.  According to Genesis, Ham was made to be a servant to Shem, so that made it sound like an awesome idea to have the Semitic Tutsis be rulers over the Hamitic Hutus.  

Way to go, colonialism.

I'll skip over the rest of the history and say that some of the more moving parts of the memorial are when you walk into one room, and it's just photos of people who were massacred.  Then, there's another room where they have skulls, femurs, ribs, etc. gathered together, some of them with clear machete marks on them.  

Then there is a special section where they talk about genocides that happened elsewhere, Cambodia, Armenia, the Balkans, the Holocaust...but they also talked about one that I didn't realize had happened in Namibia under German rule in 1904.  

Then, the most moving part, where they show pictures of children and then tell how old they were, a special characteristic about them (daddy's girl, loved animals, good at school), their favorite foods, and then how they died.  Most of them were hacked with machetes, but one girl whose picture showed her with her birthday cake and candle had been stabbed through her eyes and head.  Another very chubby happy baby was smashed against a wall.  

Yeah, I know, this is a debbie-downer post.  Sorry.  I wish I could come up with some sort of deep and spiritually enlightened thing to say about it, but I can't.  I just have to wonder what it takes for an entire society to get up and say, "let's kill off an entire group of people."  I guess I should read "The Path to Collective Madness" so I can perhaps stop wondering.  

But it does also make me wonder what I would do in a similar situation.  Say I wasn't a target/victim, but I was just a member of the populace committing atrocities, would I put my family and myself in danger by helping the victims?  I would like to think so...but then, I've never had my house overrun by men with machetes, saying "give me your cockroaches or we will kill you too."  Let's just hope that's a test no person on earth should ever have to face again.

There was a little section that talked about the different rescuers.  One guy was a Muslim who took 30 or so people in and hid them, quoting a verse from the Talmud and the Quran:  "if you have saved one life it is as if you have saved the world."  Another person had built a series of trenches on his property because he was scared of the Rwandan Patriotic Front, the Tutsi led organization that was trying to overthrow the Hutu Government and establish a democracy in Rwanda.  However, when he noticed that the current government was starting to slay Tutsis, he hid 14 people in the trenches, lay wood over them, then banana leaves, and then quickly planted sweet potatoes on top.  They stayed there for the entire genocide.  His wife and daughter cooked and gave food to the people hidden there.  

Another woman was known to participate in some sort of ancestor-worshipping cult, and she hid people in the cave where the ancestors spirits were honored.  When the Interahamwe (genocidaires) came in to search it, she told them that the spirits would take over the interahamwe if they defiled her cave, so they left her alone and the Tutsis hidden inside survived. 

I thought those stories were just awesome.  I hope that if something like that were to happen, I could be nearly as clever as the last two individuals, and as sincere as the Muslim man.

Travelling To and From Gisenyi

The beach at Bikini Tam-Tam, a favorite local hangout.  Somewhere on the horizon is the DRC.

Our hotel room
The pool and the bar, which charges 6,100 francs (~$12) for a pina colada...just saying, we didn't frequent the bar, just the pool.

We made it back from Gisenyi last night around 7:30 pm.  It's now 8:00 am here, and I'm spending a lazy morning drinking tea and posting on my blog.  To update everyone, Saturday morning, we were supposed to leave at 6 am.  Well, Mawuena, Rebecca, and I had stayed up a little too late the night before, and we were thus shaken awake at at 6:30, only to find all of our stuff already in the car.  (Way to go Kate and Rachel.)  I jumped up, brushed my teeth, and got in the car.  We were on the road by 6:45.

We left at such an early hour because the 4th Saturday of the month is this special public service day, between 8 and 11 am.  Every group of houses is supposed to get together and do something like help clear the road, help build a bridge, etc.  Then they have a meeting afterwards where government spokespeople tell them what all the government is doing for them, and then asks them if they have any specific problems.  For instance, they will note if one family is not on the public health insurance, La Mutuelle, and they will ask why this family hasn't joined.  If people say "they can't pay for it" when it only costs $1.50 or about 750 francs, then the government asks if they are really that poor.  The town can say, "yes, they only have dirt floors, a terrible roof, and all their crops were destroyed last year" and then the government can come in and pay for that family's health insurance.  

However, it being a public service day, we were intent on leaving Kigali before it started so we wouldn't be told to wait until it was 11:00 am before we left.  We made it.  However, we were stopped by police officers several times on the way to Gisenyi.  Since we are all 20-something-year-old Muzungus and then Mawuena, we just played that up.  The police officers would ask where we were going, and we'd look up through our sunglasses and say, "Gisenyi?"  Rachel had even learned how to say, "I want to go to Gisenyi" in Kinyarwandan, which made the police officers smile as we tried to say it.  They always let us go on.

To get to Gisenyi, we drove the same twisty and potholed road to Ruhengeri.  This time, we were in a Toyota Corolla, which is definitely not the same experience as a a Toyota Land Cruiser.  We had to slow down quite a bit for each new set of potholes, and Kate did an amazing job maneuvering around them. Rwanda is not the place to be in the backseat if you are prone to carsickness.  After Ruhengeri, however, the road is amazingly smooth, as some Germans recently came in and built the road themselves.  It still has fresh paint markings and there are more signs showing town names.  And one can clearly see all of the volcanos along the road.

There are 2 things that I had not previously noticed on my earlier travels:  billboards advertising condoms and genoside memorial signs.

There are these billboards, which tend to be a gold background with some famous person painted on them, wearing dark clothes.  The celebrities are holding a condom, and giving a strange stare at all passersby as if to say, "this is serious, use a condom.  I do."  However, from the backseat of a car going 60 km/hr, the condom looks like it's just a coin until someone points it out to you.  And then once that happens, you can't believe you didn't notice beforehand since there is a billboard every 1/4 of a mile.

Also along the way, it seems as though every little village has a white wooden sign, with paragraphs of Kinyarwandan stenciled on them.  The one word that stands out, of course, is JENOSIDE, which is painted in red as opposed to the other words which are in blue or black.  I finally asked about it, and someone told me that it marks a sight where a massacre happened, and will tell how many people were murdered.  As I said, I think there is one in every village.  I even noticed one up on Jumba, the hill towering over Shyira.  Insanity.

Once in Gisenyi, we checked into the Stipphotel, which is a nice little affair, directly across the road from the lake, with a swimming pool, all you can eat breakfast, and a bunch of cranes that graze the property.  We spent most of our time by the pool or at a local beach on the lake and I am only slightly sunburned on the back of my arms and my shoulders.  The fact that I am only slightly sunburned with my skin tone and being under the equatorial sun from 10 am to 4 pm each day is a small miracle.  I reapplied sunscreen every hour, and especially after getting out of the pool, and I took 30 minute shade reprisals. 

View from the Hotel Room, looking on Lac Kivu 

And apparently, while I was doing all my sunbathing, it was sleeting and snowing in Arkansas.  I'm glad I missed that.

The lake is huge, and we were able to see the one active volcano, Nyiragongo (see photo above) near the neighboring city of Goma, in the DRC.  We were probably less than 2km away from the border with the Democratic Republic of the Congo, the country where more than 5 million lives have been lost since 1998 in the Second Congo War.  http://en.wikipedia.org/wiki/Second_Congo_War 

  It's also where most of the fugitive genocidaires have been living.  Needless to say, we didn't pay the $30 fee to cross the border to go into Goma, even if the town itself is a bit of a safe haven due to all the numerous UN and NGO organizations headquartered there at the moment.  

But hey, I'm cheap and I didn't want to spend $30 to go into another city in a debatable war zone for just a couple of hours.  Mom and Dad, breathe a sigh or relief, you did raise me to have some common sense. 

That's really all there is to say about my time in Gisenyi:  it's a beautiful little village on an enormous lake that is remarkable for Africa for not having schistosomiasis (at least not in the bathing areas of Gisenyi) with nice hotels neighboring people's brick and plaster one room houses.  There's an active volcano and a war zone just a few kilometers down the road.  I spent most of my time in the chlorinated pool.

Plans this week for Kigali:  the market, the genoside memorial, and a day trip to Butare (the national museum) and Nyanza (the former royal palace).  I fly out in approximately 60 hours...too soon.

Don't Worry...

I am leaving at 6 am in the morning to go to Gisenyi, and I've made the executive decision to leave my computer at Mawuena's house so I don't have to worry about it being stolen in my hotel room.  Not that I'm going to a shady hotel, it's just something I worry about when I stay at any hotel...

So I probably won't post again until I get back from Gisenyi on Monday.  

Happy weekend everyone!

A Full Day In Kigali

Kigali from Mawuena's house

Allright, so last night, I went with Mawuena, her Australian friend Rebecca, and Mawuena's roommates, Rachel and Katie to Chez Lando, a hotel & restaurant to watch the Ghana versus Nigeria game. Mawuena chose Chez Lando because they apparently have the best brochettes--kabobs in French--in town. After eating 2 fish kabobs, some veggies and fries, I was thoroughly content. We chatted and caught up on the past 4 years and watched Ghana win, 1 to 0.

We were home by 8:30, and I took a very nice hot shower before going to bed at 9:30 and sleeping until 7. I slept so hard and so throughly it was ridiculous. Then it took me forever to wake up today. We finally left the house around 12 to go eat lunch, then Mawuena and Rebecca took me into town. Mawuena had to go into work, but Rebecca and I went shopping for souvenirs and then stopped for some coffee at Bourbon Coffee before going to her house. I saw that an African Coffee, with chocolate and ginger, was listed on the menu so I tried that, as I love chocolate, ginger, and coffee. The three together were an interesting combination, but I'm not so sure I'd order it again.

We took a taxi back to Rebecca's house, which is AMAZING. Rebecca's an Australian nurse who is working for this NGO that is focusing on maternal and child health. Somehow, she's living for free in the house of the guy who's the director of the Rwandan Development Board (or maybe it's the Development Bank. I'm not sure which). He's an American multimillionaire and the house is ridiculously beautiful. I wish I could have a house like it in the US. It's built in a half-circle around this garden, with the dining room, living room and all the bedrooms having full length glass walls and doors looking out onto it. There are also tons of little lofts tucked in over bedrooms and the living room. Also, there's an outdoor bar area with a firepit.

And two streets away, are the slums. That's Africa for you.

Well, I'm going to wish my brother an early happy birthday on Skype, and then Rebecca and I are going to go to eat at Sol le Luna, and perhaps Richard will come and join us.

Sayahshkah and King Faisal

Last night, I think I only got 2 hours of sleep since I was a little nervous about going to Kigali.  I couldn't complain about the free ride, other than the fact that we left at 5:26 in the morning.  

Since I am the overprivileged Muzungu, I got to ride in the front passenger seat.  It was still dark, and Apollinaire, the patient, her "guarde de malade," Anastasie the Francophone nurse, Phocus the pharmacist, and Leonard the chaffeur piled in.  It took us 20 minutes to get down the mountain in the dark.  We made it to the paved road to Ruhengeri at 6:26, then it was 9:00 before we hit Kigali.  

We went straight to CHK, where we first were taken to the Salle d'Urgence, then to Internal Medicine, and then finally Ward 5, where the one doctor who could do a bone marrow aspirate would come by later.  All along, everyone was staring at me since I was the only Muzungu, and I was carrying a huge backpacker's backpack on my back, and a regular backpack with a computer on it in front, like I was pregnant with an iMac and the Oxford Handbook of Tropical Medicine.

When we got to Ward 5, a nurse went to look for him, so we waited in a conference room for 2 hours.  I, thinking ahead, brought War and Peace with me and started reading it, and promptly dozed off.  Finally, around 11:00, someone came in, and Anastasie grabbed me.  I go into a procedure room, and there is a man in a white coat sit and waiting expectantly.  He has me sit down, and so I start in French to tell him about my patient.  I have a nicely typed summary in my hand, and he then starts speaking in English.  "Does she have any lymphadenopathy?"  No.  "Has she been having fevers?"  No.  "Well, we don't quite have the right needle, but we can try anyway.  The only thing is, we don't have a pathologist here who could read it."

Thankfully, Louise had told me that she wanted to make sure an extra slide was done anyway that I could take back to the US because it turns out that they know a pathologist in Little Rock who has volunteered to read it.  I just said, "that's okay.  I will take it with me to the US next week."  

"Okay," he said.  

While we were waiting for Apollinaire to come in and undress, he asked me how medical training was set up in the US.  I told him how we did 4 years at university, then 4 years of medical school, and so on.  He then asked about the 4 years of university.  And I said, well, one can go to university, study anything you want, from chemistry to biology to literature to music.  One has to make sure that they take the basic sciences required for medical school, but after that, they teach you everything you need to know in medical school.

This doctor couldn't stop laughing when I told him that.  "Maybe, if we could study music and then medicine, then we would have less depressed doctors."

Then, the patient is there, he preps the patient, and decides to do a sternal bone marrow aspirate, with only a little bit of local anesthesia.  Poor Apollinaire.  After she is prepped, the local is injected, and he begins to drill the hole into her breastbone, the thought suddenly occured to me that to an illiterate peasant, this could very easily appear to be the same practice as the traditonal healers with their herbs, tonsillar swabs, and cuttings.  I'm not sure how much she understood about her disease, its diagnosis, or its treatment, and suddenly we are drilling a hole into her sternum and taking some bloody stuff out.  

I felt terrible for her....terrible.  I would have switched places with her in a heartbeat, if my bone marrow would have given us her diagnosis.  There's nothing worse than bad things happening to you and you don't know why.   

After we finally finished with that, I talked to Louise and she said to take a biopsy to King Faisal, the nice private hospital in Kigali.  So we get in the ambulance, kept driving around for a long time, and then suddenly, I realized that we had just passed the restaurant that is next to my friend's apartment.  The restaurant, Sol de Luna, is no where near King Faisal.  I'm good with maps and directions, so I look this stuff up.  I theorize that we are lost.  I test that theory by asking, "Ou est King Faisal?"  

"King Faisal, c'est....j'en sais pas."  Theory reinforced.  I pulled out my Bradt's Rwanda guidebook.  

"Ah, elle a une carte!" I quickly figure out where we are (by the Egyptian embassy), but before I can find out where we are supposed to go, they stop for directions.  A very nice lady tells us, "turn around, and go to the Hotel Novotel, then turn immediately after that."  Boom, I locate it immediately on the map.  We turn around, get to the hotel novotel, and I'm saying "Gauche!  Gauche!" and then there it is right in front of us.  

Anastasie and I go inside, and we talk to the laboratory receptionist.  A pathologist? or maybe he's just a lab tech, comes out, and then he says, "you don't have a request form.  You ought to know that the standard is to have a request."  I'm sorry, dude, but I haven't even had time to get a request form.  I can fill one out in no time though.  I finally get one and fill it out, while he's looking at the slides, being a jerk, shaking his head, saying, "you have to have a request form, and you ought to know that."  Eventually, he says, "this is not a bone marrow aspirate.  This is just blood.  And there is not enough on the slides.  It should not be this faint."  

So I only gave him one slide and I'm hoping that the people, whoever Caleb and Louise know in Arkansas, will be able to get something more off of it if he's such a pessimist.  

Afterwards, the ambulance took me to Sol de Luna, which I was able to direct us to without any problem (back to the roundabout, take it for 270 degrees, and then keep going up the hill until you see the sign), and then got out at the restaurant.  It was 3 minutes of me waiting on the sidewalk when Mawuena came up...my long lost travel buddy from grad school.  She had to laugh at me carrying two bags that were about the same size as me, and then she took me to her house where I have just crashed for the past 3 hours.  We are going to a restaurant to watch the Ghana v. Nigeria African Cup match with some of her friends.  Mawuena's parents immigrated from Ghana, so that is who we will be rooting for.  

I may finally get some food in my stomach and just crash.  Mawuena will have to wake me up with the game is over.  

Genius.