Life Lessons for Lexie: Africa Edition: Butare, my new home

It has been a busy couple of days here in Rwanda. Of course when I say busy, I mean African busy, which is really not that busy. As one can imagine, time is quite different here. It's much slower and almost european when you go to eat a meal. Unless you go to a buffet (which is common here) expect at least 2 hours for a meal. Before you know it, your sunlight is gone and you've had a very relaxing day of accomplishing one or two, maybe even three things. Thursday morning Jessie picked Julie and I up in Kigali and drove us to Butare. As I said before, I am replacing Jessie at CHUB (the University Hospital of Butare) in the ICU as clinical educator. She is fantastic. I am so incredibly excited to work with her. During our drive she spoke of the program and the people and her successes and failures and just gave us fantastic advice. She is a font of knowledge. She is originally from Charlottesville, VA and worked at UVA before joining the program in year two. She has had so much success here that my job is going to be a whole lot easier. The drive was beautiful.

Leaving Kigali

Rwanda is not a very large country (roughly the size of Maryland) but it has been highly developed. There is farmland but not woods. They grow rice, corn, beans, melons, and lots of hay for cattle and goats. It’s very mountainous and a little dusty, and overall I was surprised at the development. There are multiple towns that we drove through and here in Butare they are attempting to pave all the main roads (beyond the road to Kigali) before rainy season begins. Jessie indicated that much has changed since she has been gone for a few weeks. She gave us the 25 cent tour (apparently Rwanda has the best coffee in the world and Butare boasts an ice cream shop) before heading to the guest house that the program keeps for short term faculty and newbies looking for housing. I should mention here that every city/town/village in Rwanda has two names. One pre-genocide and one post, with the exception of Kigali. I believe it was an idea to try and start afresh after everything that had happened here. The interesting thing is that Butare is the old name and is also still very commonly used (for instance they didn’t change the hospital name), but the new name for Butare is Huye. It is more commonly acknowledged as the Huye district. I believe that Butare stuck because it was the colonial capital of Rwanda, but I’m not really sure.

Fresh eggs at the store

The rest of Thursday afternoon was spent with Dianne and DeVon Hale, a social worker and Infectious Disease MD and our other roommate Vanessa, a general surgeon from Vancouver/Seattle. The house hunt really was not that exciting and it’s been a little complicated so I’ll explain everything once we move into our new home. The only other really interesting thing was that I ate goat meat for the first time Thursday. Our local guide to housing, Jean-Marie, gave me a piece of the goat meat from his kabob and said try it! SURE! I’m excited to do just about anything once. So when I picked the bite up with my fork I was a little surprised to notice that there were clearly two different pieces… and one was rather textured. It was so textured in fact it reminded me of the sheep tongue I ate in Mrs. Davidson’s Second Grade class at Sparks Elementary (do you remember that day Kathleen & Tori?). So I made the drastic mistake of asking, “Oh! Is that tongue?” “Non, it’s you know… (pointing to stomach area) stomach lining. Intestines.” GREAT… I had to eat it because I had so eagerly accepted it. The goat was fine. I desperately tried not to think about anything else.

Yesterday was exhilarating. Here in the HRH program the United States Institution (USI) faculty have Rwandan counterparts, called our twins. Jessie picked me up and took me to CHUB to meet her old twin and my new twin, Emmanuel. He is darling. So sweet and nice and clearly expressed some ideas he had about what we can continue to work on in the ICU. Last year Jessie thought it would be a great idea to give the ICU nurses weekly lectures on basics since here the nurses are not provided with knowledge the way we are in the USA. What she didn’t realize is how hard it was to prepare lectures and teach particularly when some don’t understand English very well. Whether she realizes it or not, I may be employing Meredith (sister for those who don’t know) to translate some things into French.

The front of CHUB

The hospital looks very small from the front, however it actually has about 500 beds, making it one of the larger hospitals at which I’ve worked. It’s very basic, as one would imagine. The buildings are all connect with breezeways, so you actually can spend a nice portion of the day outside. The ICU has six beds with potential to add another bed if we can get a monitor for it. Jessie was able to procure new beds that allow the staff to raise the head of bed (HOB… I apologize now if I enter nurse zone language skills and forget to spell out an abbreviation) up. Apparently when she arrived last year, all patient’s HOBs were in trendelenburg (or a negative tilt, feet above head), which is not ideal for an entire host of patients. But she has successfully taught them the benefits of keeping the HOBs raised and they have changed their practice. She also was able to get them new monitors, a central monitor, and new EKG machines. It’s awesome. Jessie worked so hard on obtaining equipment and lecturing though that she didn’t have a great implementation process (implementation also occurred in her last two weeks), so that is exactly where I am going to pick up, lots of low hanging fruit to start.

Equipment drying outside at CHUB

I am so excited for work. It’s fantastic that Jessie is still here too because we can really work together with Emmanuel to create a plan for the year. I already know that in June I’m going to need to run a BLS/CPR recertification class because they were able to do that this past June. But the coolest part about my job is that Jessie would like me to help her improve her lectures. Part of the reason why she has moved to Kigali is to do the ICU Specialization Course in CHUK (University Hospital of Kigali). She really would like me to help her teach and perform analysis about the course already done last year. We are both so excited to work together and now that I actually have a clearer picture of my job, it’s just so fabulous. I have the sense that I won’t spend much time with the students, but Jessie said that she would often catch the staff nurses teaching the students the new knowledge they had gained, which is so ideal. I can’t wait to start.

Last night we went to dinner at the Chinese restaurant in town. Yes, that’s right. Butare, on top of boasting an ice cream shop, also has a Chinese restaurant, called, The Chinese Restaurant.

Soon to be my weekly go to

It was awesome. It’s actually owned by a Chinese man who is very nice. Apparently the ex-pats make an appearance weekly for dinner. There was a nice large group of us from HRH who all met there and for $7.25/person we enjoyed so much food and beer it was unbelievable. Back at the house four of us decided to play the card game Phase 10. I’ve never played and actually it was great fun. Perhaps it was more for me because I seriously kicked some butt while winning. We actually did not go to bed early, which impressed me because again I was up with the sun yesterday and today I actually slept in. It was fantastic.

Stacked mattresses at market

We took it easy today, I read, enjoyed the beautiful weather, walked to the market where I found an Orioles baseball cap (though I didn’t buy it) and lots of fun clothing. I am convinced that we need to have an ugly prom dress themed party. There was an entire area of these old American dresses that were hilarious.
This afternoon the electricity went out for the second time for about 3 hours. Previously it had only been for a few minutes at a time. I suspect that as rainy season progresses it will become less reliable. It makes me really wish I had bought one of those battery blocks that you charge and then plug your phone or computer into those. I can probably find one in Kigali next week when there for orientation thought.

Open air market

We also spotted a total of six monkeys on the roof of the house across the street. They were super cute. I had no idea that there were monkeys here. I probably should have read more about Rwanda before I came. Right now we are having our first African thunderstorm and I’m enjoying the cool rain. I am practically a mile above sea level so the rain is nice and cool and it’s always breezy. It’s about time to figure out what we all want to do for dinner and I’m all blogged out. I’ve post more photos to Facebook, but a few here so you can understand everything. Hope all is well stateside.