Tuesday, August 4, 2015

Textbooks for Rwanda

     As many of you know I had a social media campaign for textbooks get slightly out of hand in my first few months here. I had only been here a few weeks when I discovered how much student and staff alike enjoyed textbooks. I had one student ask if I could photocopy an entire book for him. Toying with the idea of coming home at New Years, I thought I'd be able to bring an extra suitcase of textbooks back with me. So I posted on Facebook asking friends to share the post if anyone still had their old books that they wished to give away. 
     Well, by the time I got home at New Years for a brief visit the amount of books was astounding and there was no way I was going to fit them all in a suitcase. Start phase two of the book project... Begging for money to ship the books. Again, I took to social media and email and friends and slowly but surely my family and friends and friends of friends and parents of friends and friends of friends of friends came through and donated just over $4,200 to help me ship the books from Maryland to East Africa. Then it got even better. A neighborhood acquaintance of my parents and good friend of our family friends happens to have a shipping company. He assessed the damage, which was over 40 boxes of nursing, medical, paramedic, and occupational therapy textbooks sprawled down the front hallway and surrounding the edges of the first floor rooms. My mother had started to worry about the foundation of her 130-135 year old home and rightly so. The total weight of the books was just shy of 1 ton coming in at 880 kilos.
     The journey was long. The books were picked up February 19th from my parents home in Monkton. From there they went to downtown Baltimore, to New York, to France, to Tanzania, to  Kigali and finally they arrived in Butare late in the evening of July 14th. When Julie and I walked into our office the next morning it was like Christmas! So many boxes and what fun we had opening them all and organizing them. After that (and the many questioning looks we received by patients, their families, and staff as empty box after empty box came out of our office and into the hallway, we divided over 500 books between the departments. The idea was to create a library for each department so that the staff would actually utilize the books during their everyday practice. Over fifteen departments received books. They are, the ICU, Internal Medicine, Surgery, Pediatrics, Neonatology, Accident and Emergency, Theatre, Nutrition, Physiotherapy, Social Work, the Physicians Center of Excellence, the Pediatric Farm Feeding Project, Orthopedic Surgery, Clinical Training and Research, and the Director of Nursing. Furthermore, we gifted 20-30 books to the In-Charges of the nursing departments as well as some BLS and Research texts to our promising instructors and twins. It was pretty amazing work. 
     The donated money was used to build extremely nice bookshelves to house all of the books as well as customs and transport fees from Kigali to Butare. With the remaining money I purchased materials for the BLS Program that I have worked on here that has been such a success. With still leftover money I made a donation to the Pediatric Farm Feesing Project, which has been a huge undertaking by both Medie and Dr. Emily. Part of the project is to teach mothers better ways to cook (for instance please stop cooking your vegetables for eight hours) and nutritional value of foods. They have hired a cook to prepare food properly and to train mothers who are down in the hospital kitchen. They have also hired nutrition students to teach parents proper nutrition. The $800 donated to the project will go specifically to the students and cooks salaries. I asked that the money be used for educational purposes since that is what the money was originally intended. The remaining $500 donated was left in the capable hands of Dr. Jeff Dixson who will be staying for a second year in the internal medicine wards. Jeff plans on using the money again, for strictly educational purposes like buying white boards and markers for the departments as well as bulletin boards. He has promised to run things by me first, though I completely trust his judgment. I am so thankful to everyone who donated their money, time, books or company. Whether it was $5 or $500, every little bit counted, every book has found a new home and CHUB will continue to grow and improve because of you. I especially want to thank again, Robert Pace and Mainfreight USA for shipping the books. Especially his beyond wonderful manager, Jackie Long, who tirelessly and effortlessly answered my 5 million questions over a five month period. They are both saints. In addition, I'd also like to thank the friends who used their own money to mail their books to me in Rwanda themselves and those who mailed or drove books from all over the country to my parents. Finally, I'd like to say thank you for all the funny things I found tucked in the books... From my babysitters price slip from her lower school, to a photo of my friend Sonya whom I worked with in Haiti, which marked the page of how to deal with unruly patients, to a motivational notecard to my longest friend in the world from her big sister about passing the boards, to $5 for a study break while studying for the boards, and finally my mothers Christmas present from my sister-in-law that somehow got mixed in (don't worry mom, I'll bring it home), they provided me with some great laughs and smiles. 
     I cannot say thank you enough and neither can the hospital. I am thrilled. They are thrilled. 
Thank you. 













Lessons Learned:
1) There is so much good in this world. 

A Goat Roast

        If you may recall my first experience with goat in Rwanda did not go over so well. (Life Lesson #1- if you accept food, don't ask what it is until you've swallowed it and there's no chance of it making another appearance at the table). Fast forward 11 months and I was on my way to Medie and Robbin's for a goat roast. I was less apprehensive of this meat mainly because this time around, it wasn't going to be wrapped in intestine and everything Medie and Robbin make is absolutely delicious. Two HRH colleagues, Claire and Isobelle came down from Kigali with Simone, a visiting Community Health Nursing Student from University of Maryland. We arrived about 4:30 pm and low and behold, the goat was indeed roasting away over the pit.

     I was excited. Medie has been working in Rwanda longer than the majority of us and loves doing this type of thing. Robbin had bought the goat that morning and had it slaughtered in their own back yard. Someone then skinned it and Robbin stuff it with lemon and rosemary. It smelled incredible when  we showed up.
Zingalo Appetizers
We started to mingle with the crowd a mix of mzungus and Medie's friends from the neighborhood and hospital. It wasn't long before Adolf, the grillmaster came around with appetizers. Having just told Isobelle the story of my first goat/intestine encounter, I was not going to ask what exactly he was offering. But Isobelle did. Zingalo as it turns out is not only the intestines but also the stomach of the goat. I'm not going to lie, I took one piece of the skewer and ate it all. Rather chewy as it turns out and not the best plan. Since I find it extremely difficult to waste food, the second piece I ate I attacked differently. This time instead of eating the entire thing I nibbled the intestine slowly unraveling it until I was left with what I assume was a piece of stomach. MUCH better. My sisters and I have always been texture freaks (I couldn't stand tomatoes for the longest time) so this was the much better approach to zingalo. It was pretty tasty actually.
Robbin and his goat
Yes, that is hair on the tail of said goat
Finally, after about 8 hours of roasting the goat was ready! Medie had sterilized some banana leaves and spread them on the table and the men lifted the bamboo poles and got to work carving the meat off the bones. It was quite a site to be seen. We ended up making goat tacos with asian cabbage salad on the side. It was so delicious.
Claire holding the bamboo poles as the goat
is removed for serving
After dinner the fire was built up and Medie's friends played guitar and sang. The women who play traditional drums joined in too. The women are part of the group Ingoma Nshya (A New Drum), an all female drum troupe based in Butare. Playing the drums is traditionally done by men here in Rwanda as it is a symbol of authority. I can say that this was the first time I'd witnessed women openly playing. The group formed after the genocide as a way for women to express their emotions and is open to survivors of both sides of the genocide. It was great to see them playing and singing with the guitar players and afterwards having some of the young men ask the women to show them how to properly beat a drum.

     If you want to learn more about the troupe, watch the documentary "Sweet Dreams." I have yet to be able to watch it but it tells the story of the troupe and probably gives a great background (at least a better one than I can give). One of the troupes partners is our local ice cream shop, Inzozi Nziza (Sweet Dreams). The shop provides education and business to the women in the troupe and is still the best ice cream in all of Rwanda (and just one of Butare's claims to fame).
     After hours of fun with old friends and new Claire and I called it quits and came back to my home to crash. It had been one of the coolest Rwandan experiences of my time here.

Lessons Learned:
1) It's good to get out of your comfort zone, whether that's mingling with new people or tasting new foods.
2) There's just something about a bonfire that brings people together.