Julie is originally from Missouri, but has spent about ten years living in Texas and is my University of Texas colleague. She is older, a complete night owl, has a terribly hilarious singing voice, and is game for just about anything. She has also coined our two favorite roommate sayings already... We all "enjoy zesty adult beverages" often and find ourselves saying the very southern "bless her heart, poor dumb thing" when teasing each other. Julie has done a little bit of everything in nursing though her love is oncology. Vanessa is actually Canadian (I'm still trying to figure this out as her mother is Tanzanian and her father is British). She grew up close to Vancouver and just finished her trauma surgery fellowship at Harborview Hospital in Seattle. She has already adopted the role of housemother, which Julie and I were happy to allow. She has spearheaded the house search and is truly a lovely person. Plus, she speaks some Swahili, which is a little bit useful here. Essentially, she keeps Julie and I in line and can drive a manual, which will come in handy.
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| Julie, Vanessa & I at the start of orientation |
Tuesday we all piled into a car and made the drive back to Kigali for orientation. Julie and I were able to attend a nursing meeting Tuesday afternoon, which was lovely. We met many of the USI faculty that are all nurses and were able to share thoughts and a little bit about ourselves. Turns out I am the only Maryland alumna, but that the majority of the nursing faculty is employed by Maryland. Which means that not all but some are also from my home state! Steph is a neonatal/pediatric clinical mentor who grew up in Bel Air and attended Fallston High School. She will also be in Butare and is a second year faculty. I really like her. Several other nurses lived in Laurel and one even worked at Washington. Hospital Center for a few years during my tenure at George Washington Hospital. Another faculty member, Becky White was a professor at Montana State. I must ask my oldest sister if she had Becky for psych class back in the day.
Candid of the Butare Girls
Orientation was busy busy. The first day actually provided a lot of information about Rwanda and their history. They are an incredible nation and have come so far in just 20 years, but still have a long way to go. Their goal by 2020 is to be a middle income country. There are about 12 million Rwandans living in one of the smallest African nations, making it the most densely populated country in Africa. Over 50% of the population lives below the world poverty line of $1.50/day. GDP per capita is approximately $1,500. To put in perspective, when I was in Haiti that the majority lived on less than $4/day and they are the poorest nation in the Western Hemisphere.
The median age is 18 years and only 2.5% of the population is over the age of 65. To put this in perspective, my twin, Emmanuel is 34 years old. He has most likely already lived half his life. The genocide has skewed the population age, although children were far from safe during that time, but more on that later. The WHO recommends that there are 2.3 healthcare workers for every 1,000 people. Currently, Rwanda is at 0.8/1,000 with 6 physicians for every 100,000 and a total of 9,937 nurses/midwives/mental health workers for the entire country. Twenty years ago, there was no academic staff and no one could even tell you how many healthcare workers were left in the country, in fact they basically tell you everyone was killed during the genocide. It's slow progress, but it's progress.
Friday was an incredible day. It started with a surprise guest at orientation (for those of you who follow me on Facebook it won't be a surprise). We were all not looking forward to yet another lecture (I mean our tea and coffee break was suppose to occur) when they announced that Paul Farmer was there. I felt like a groupie. I was in complete awe. He was at the University Hospital in Haiti one day I was working but I never saw him. He spoke for about 30 minutes and answered questions for another 40 or so. It was so fantastic. I was able to voice memo all but the first two minutes of the talk. I really enjoyed it. And after the fact I went right up to him, was first in line to talk to him, shook his hand, introduced myself, and told him how fabulous the Partners in Health (PIH) physicians were in Haiti and I thanked him for a comment or two that really struck me. If I can figure out how to post a voice recording to this blog I will. Or if I can't and you would really like to hear it, let me know and I can email it to you.
Paul Farmer
Friday afternoon we were given the opportunity to go to the Kigali Genocide Memorial. It was incredibly moving. The Rwandans will tell you, "We want you to know our history. It is ours and we own it." It has actually surprised me at how frequently the Genocide comes up in everyday conversation. We were told before our departure that it is not discussed. However, the Rwandans will discuss it minimally. I have not been told anyone's personal experience, but they use the Genocide as a historical marker and often speak of before and after. They will explain why some of their family still live in Uganda, all related to the Genocide. I guess it's pretty impossible to escape the horror of that time. One person did tell me that he didn't feel as though there had been any improvement in the first 5 years after the genocide, that the streets of Kigali were littered with bodies and that it took a very long time to exhume the mass graves and give everyone proper burials.
The entrance of the memorial museum. No photos inside.
According to the museum, they don't believe that they ever found all of the graves. At the end of the museum they did discuss the trials of those involved and it dawned on me that the prisoners I see on the sides of the road working very well may be serving sentences from the Genocide. Here in Rwanda if you are guilty until proven innocent. Those who have been accused wear bright orange scrubs and those convicted wear pink. This is why I left my prized pink Shock Trauma scrubs at home.
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| Off the beaten path |
Saturday was Umuganda. Umuganda occurs on the last Saturday of every month. It is a nationwide community service day. Everything shuts down for the morning; we even got stopped by the police on the way to the community health center where we essentially were a human plough and cleared two small fields. It was fun to drive off the beaten path and wave to the children alongside the dirt road. They were funny and so excited to shout some English words and smile and wave. Finally, when we got back to the hotel/conference center we were greeted with hamburgers and chips (fries) and a lovely traditional dance performance. I will try and post some video of it later if I can. My roommate Julie needs to send it to me!
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| Universal colonial game |
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| All the locals who came to Umuganda |
Because an unexpected nursing meeting came up, we all stayed in Kigali through yesterday. It gave us more time to socialize with the staff and most importantly, do some shopping. We discovered a German Butchery and we stocked up on some good meats to bring back with us to Butare. The variety of food and supplies you can get in Kigali is pretty astounding when compared to other parts of the country. There is very little that you can't get. Apparently General Mills does not import to Rwanda... so I can't get my Cheerios, but Kellogs does so we actually picked up some Rice Krispies today. Have not tried them, but will report if they taste the same.
We are officially moved into our new home as of last night, which means I finally have an address (see below). But there is still a lot of organization to be done. I will post photos once it doesn't look as though a tornado went through it. It felt so good to shower with my own shampoo and conditioner last night. The hot water heater isn't working on my side of the house, so I can't use my shower, but hopefully that will get fixed quickly. Anyhooooo I am blogged out. I will try to be better about blogging more frequently to keep the entries shorter!
Lessons Learned:
1) I really need to learn how to drive a manual transmission.
2) No matter how small, progress is progress.
3) Dream big. You'll never know what you might accomplish in the process.
Address:
Name
Southern Province
Huye District
P.O. Box 137 Huye
Butare, Rwanda
Tel: 0781521965 (if telephone number is placed on letter some place they will call me if it gets lost)
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| Umuganda Before |
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| Umuganda After |
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