Saturdays

     There is nothing I love more than Saturday mornings. I get to attempt to sleep in, which doesn't happen often, but always worth a shot. I can sip my tea unrushed, read a book, and simply relax. Let go of all of the stress from the week and just enjoy my time. There are days that my UT and UVA roomies and I don't do much together simply because we relish days like this. The only thing that makes Saturday morning better? The rain. We are still in long rainy season and I love it. I have been up for hours just listening to the rain fall. It is probably the most soothing thing to wake up to here. 

     I'm beginning to realize that I may not have many more Saturday mornings like this one. Before I know it, the rainy season will be over and not too long after I'll be headed home. But for now, I am here in this stunningly beautiful African nation and I intend to relish this Saturday morning for all it's worth. 

Lesson Learned:

1. Every moment counts. Enjoy them all. 

Off the Grid, Part 1: Mozambique Easter Weekend

     I have been off the grid for the last 11 days and it was absolutely glorious. GLORIOUS. It did leave me with over 400 emails to sift through Monday, which took all day, but it was incredibly worth it. Last week was Genocide Memorial Week. It fell just after Easter this year and having been advised that not much occurs I decided to take vacation.

     Back in the fall a long lost friend from my Bucknell days messaged me on Facebook. Scott was a year behind me so we only went to university together for a year before I transferred to Maryland to pursue nursing. I couldn't tell you the specifics of a single one of our interactions back there, but once a Bucknellian, always a Bucknellian... Scott has been living in Johannesburg, South Africa for the last five and a half years. He first told me about a massive road trip he was planning from Johannesburg to Nairobi in the spring, then he invited me to Thanksgiving dinner.

Bucknell Outing Club Officers 2004-2005
Me to the Right of Jim the Advisor and Scott to the Left (baseball cap)
Taken May 2005

     And thus, the rebirth of a friendship started. I didn't go to Thanksgiving dinner, but happily offered our guest room on his journey. As my time here passed we kept in touch, me essentially providing what little knowledge I have of the region when asked and he completely debunking my ideas for this week vacation and convincing me to do something different. I originally was thinking about going to Cape Town. It's beautiful and I would love to see it and sit on a beach. I can't remember the last time I sat on a warm beach (San Francisco doesn't count). But I was informed very unceremoniously that Cape Town is cold and Easter is not a great time to visit. Why not come to Johannesburg? Because I want to sit on a beach. And yet somehow, about 30 minutes later I'd agreed and bought a ticket. It wasn't very long before Scott's, "I'll take a long weekend trip with you" turned into him taking the entire week off and planning one of the best vacations ever. 

     Not only did I get the beach, but I got great food, zero stress, beautiful scenery, camping with wild animals, and I didn't have to lift a finger and do anything but show up and have fun. Well I dropped the ball a little on my responsibilities. I didn't show up. 

     At least not on time. Delays in Kigali and a forgotten time zone change lead me to miss my connection in Nairobi by twenty minutes. I ran through the entire airport in flipflops and my backpack praying that for the first time everything was running on "african time." For once, things were running on time. I was deflated, sweating, and completely out of breath. Kenya Airways just bought me a two hour wait for my bag (I certainly wasn't trusting them to get it on the right flight the next morning), three hours of sleep in a hotel, and a whole lot of disappointment. (Read Scott's short rendition of the start of our adventure in his blog!)

     But have no fear! On the bright side, I got to see the summit of Mount Kilimanjaro since I was flying in daylight and I finally arrived in Johannesburg, 12 hours late, but in one piece. Scott was exactly where he said he would be, propped against a pillar reading Atlas Shrugged on his Kindle just outside customs. Ten years hadn't changed him much. We loaded the car, he handed me a cold Miller Genuine Draft and a sushi lunch, and we immediately hit the road. I was in heaven. Best. Surprise. Lunch. Ever. Then again, since moving to Africa, the way to my heart is through my stomach, it doesn't take much these days.

     The plan had always been to get on the road the second I landed, Easter weekend means lots of travelers and we were headed to Mozambique. I was going to get my beach fix and finally get to see (and swim) in the Indian Ocean. The queues to cross the border can be insane so we were in for a long drive around Swaziland to the southern most border crossing at Kosi Bay. As we drove I loved how South Africa looks. Parts look very similar to the midwest United States. Then randomly you would see zebras and ostriches fenced in someone's yard and recall that you really are in Africa. Scott had rearranged our schedule and booked a tented lodge just 4 km from the crossing. The staff was lovely. We showed up after eight hours on the road (I was quite impressed that I hadn't fallen asleep) and an hour after dinner was served. The staff stayed and cooked dinner just for the two of us. It was so sweet and delicious. Proper salad, scalloped potatoes and chicken breast without bones. It's the little things in life that mean so much.

     We headed out early nervous that the queue might be extremely long taking our place in line at about 6:45 am... Turns out everyone who wanted to go to Mozambique for the holiday weekend had already crossed. We would have cruised through the crossing if the South African side hadn't attempted to apply common sense to Scott's permanent residency. But once the gates opened at 8 am it only took us an hour to get everything accomplished.

Ever so serious with Atlas Shrugged

I was pretty excited... another stamp in my passport!

     I looked at the road before us... It was sand. Not gritty dirt, but pure sand dunes. I couldn't help but laugh as Scott put his car into four wheel drive and off we went and miraculously never got stuck. 

We drove into Ponta do Ouro, a little beach town with a similar market and a few shops and bars and lots of craft kiosks. At the very end of the road, right on the water was our accommodation. The Whaler, is a reed room dive camp. Did I mention we were going scuba diving?

     I became certified during my freshman year at Bucknell. I had gone diving in the Caribbean during my friends wedding but that was going on seven years ago. I was excited and then nervous as within an hour of our arrival we were on the beach suited up and headed for the water. I'd forgotten what a pain in the butt wet suits can be and it took Scott and his friend Barry hoisting it up and ultimately lifting me off the ground (I felt as though I was in a rugby match) to get the thing on. It was quite comical. In my first six hours in Ponta I did two dives and absolutely loved it. By the time I surfaced on my second dive the wind had kicked up and it was a little rough getting back into the boat. It was at this point that Hilton, one of the owners of The Whaler asked me, "Why didn't that husband of yours come on this dive?" I just about choked on my lollipop. Apparently in approximately 24 hours of seeing each other for the first time in ten years Scott and I were hitched.
     "Not my husband."
     "Oh, so your weekend shag?"
     "We're friends from university." That ended the speculation and the conversation was steered towards what the heck am I doing living in Rwanda and not South Africa (Hilton is South African). By the time I was back everyone else was waking up from their afternoon snooze session and we wandered out into town. The boys went to buy prawns for dinner after they dropped the ladies and I at the craft kiosks. We may or may not have ridden on the runner board of the SUV and jumped off as the boys continued on their quest for food.

Craft Kiosks
Photo Credit: Barry Tanner ©

The group consisted of six of us. Scott and I, Barry and Robyn, and Craig and Theresa. Barry and Robyn are two of Scott's best friends in Johannesburg. Had I attended Thanksgiving I would have met them there. Barry is a freelance photographer (Check out his website at http://barrytannerphotography.com), Robyn and Theresa are both physiotherapists, and I honestly have no idea what Craig does. We never got around to talking about it. Anyway, they were all awesome, sweet, lovely, and didn't mind that my delayed flight had held Barry and Robyn's scuba gear hostage a night. We had a really nice time together. Eventually, after bargaining for some pouffy pants made in Thailand the ladies and I found the boys at a local bar and joined them for the local "famous" drink, R&Rs. To me it tasted like cough syrup, but when in Rome, right? Actually, I waited until Easter Sunday to sample an R&R. After the boys attended dive planning and then disappeared to watch rugby, Robyn, Theresa and I wandered down the beach and shared some loaded chips before returning to find Scott cooking a fabulous meal for all of us. After feasting on prawns, chips, some Easter candy, and listening to Scott's Afrikaans while reading trivial pursuit questions, which required multiple translations at times for anyone to understand the question, we called it an early night so that we would be ready to go on our early morning dive Sunday.

The Ladies
L to R: Robyn, Theresa, Me

The Boys
L to R: Craig, Scott, Barry

Ten years after the last photo was taken of us... eek!

Chef Scott cooked some fabulous prawns
for dinner our first night in Ponta.

     I woke up a little early on Easter morning so that I could battle my wetsuit. With plastic bags on my feet and I was able to slide into it a little easier than the day before. Scott had to help me remove the bags but not before taking some photo evidence of my 5:30 am struggle.

After a thorough dive briefing and plan we were off. I was more than a little nervous. I have never done a deep dive and here I was about to do my first in the ocean with sharks. Because after all, that's the entire purpose of doing a deep water dive, to see sharks. It was about a 30 minute boat ride out to the reef and before I knew it we were suiting up and Johnny, the skipper, gave the 1-2-3-Go! And I rolled off and descended. My dive buddy was Marlo, the dive master so I made sure to stick close to him. We had reached our second depth marker when I had calmed myself enough to look around and marvel at the amount of deep blue water above me.
     That's when I also noticed one person at the surface and another still way above us. I glanced at the group. Scott and Barry weren't with us. I had to quickly force myself to not worry, which for anyone who knows me, is just about impossible. I worry and over think the dumbest things. But the thing with a deep dive is that you can't worry and you can't surface quickly, so reminding myself that they are both way more experienced divers than I am, I started to focus on what I was seeing as we approached 40 meters. It was a crazy sensation being down that deep. You keep looking down and forget how deep you are. There were some massive fish and a large sea turtle, but no sharks. I was a little disappointed. You can only spend 9 minutes at a depth of 40 meters and we stuck to the dive plan of only staying down there for five. Just as we were at our second safety stop on our way to surface a manta ray swam by and we all started to head back down a little to catch a better look.
     I was keeping a close eye on my oxygen and realized that I shouldn't go any further back down, because I was hitting the low marker indicating I needed to surface. I notified Marlo I was at 50 bar and slowly started up the buoy line to do my final stop and then surface. Apparently, while I was just finishing my final stop and surfacing a hammerhead shark went by the group. I was extremely jealous that I missed it. But on our way back to land we had a couple of dolphins swim beside us briefly, which made up for the lack of shark slightly. Barry and Scott had both had equalizing issues to start, Scott was able to join us, but Barry missed out but was fine. Once back we were wiped. Craig and Theresa were up so we all had breakfast and then split to do our own things. I was done with diving and probably a little dehydrated so I went to take a nap. Our reed room was sweltering so I finally gave up and went out to the beach.

Ponta do Ouro, Mozambique

It was hot but the wind was so fabulous that it felt wonderful to be out there. I swam, read a little, and then went for a walk out to the point. As I was coming back Scott had emerged and we jumped back in the ocean for a bit. Barry and Robin came back from their dive and Craig and Theresa from snorkeling and we all headed into "town" for a late lunch. They took us to Fernando's Bar, which wasn't much more than a hole in the wall and we decided to munch on bread and garlic hot sauce and cook a big dinner.
     After Fernando's we went to negotiate with the fisherman for some lobster or crayfish for supper. It took awhile, but finally Scott and Craig were happy with what they bought and leaving the rock lobster behind, we headed back to have a braai, or in other words, a barbecue.

Negoitiations
Photo Credit: Barry Tanner © 

Rock Lobster
Photo Credit: Barry Tanner © 

First thing first though, we watched the sunset on the beach and had a pre dinner cocktail before eating awesome seafood and fillet. I couldn't get enough of it. I love seafood. I'd be happy to eat it every day of my life no complaints, however, I live in a landlocked country. So this entire vacation I happily ate seafood and lots of well cooked steak, practically every day.

We all chowed down, had many a laugh, and eventually called it a night. It wasn't that late, but I felt as though it was 3 am when we finally hit the sack. I think it was actually closer to 10 or 11 pm but regardless, it was a great Easter Sunday.

 

     We slept in, and by that I mean 6:30 am, Monday morning, fixed a great breakfast of leftover fillet sandwiches and then Scott and I hit the road. He had heard stories that it could take up to 10 hours to reach Maputo, the capital of Mozambique, and with the early morning rain, he wasn't going to chance it. Off we went in 4WD over sand, which eventually turned to mud and lots of it. At the end of the day, Scott's white SUV was a lovely shade of tan with at least 4 inches of mud caked on in certain places.

Road to Maputo
Scott needed a cat nap, I needed a stroll.

Hippo in the water!!!

He was not photographing the hippo.
Not quite as excited as I was.

Maputo is a busy city and I was amazed at all sorts of things. For instance, traffic. When Scott scooped me up at the airport we drove immediately out of town and I didn't see Johannesburg at all. The airport is located on the east side of the city and we just kept heading east into the countryside. But Maputo... it's a real city and we were in the middle of it. It was a little overwhelming. Put me in the center of our insane bus station in Kigali and I'm fine. But put me in Maputo and I wanted to snatch Scott's hand and hold on for dear life as we walked a few blocks.

     Fortunately, we didn't have to walk far. We hoppped in a tuk-tuk and headed for dinner. I was on a quest for Thai food because I had read that I could get good Thai food in Maputo. I was sold. Our driver was a little bit of a liar and had no idea where the restaurant was that we named, but eventually we found a Thai restaurant and he spoke to the waiters and arranged for them to call him when we were done dinner to pick us up.

My first ride in a tuk-tuk!

After dinner we crashed. It's amazing how exhausting sitting in a car can be. I Facetimed my mom just to let her know that I was alive and well, got the latest Monkton scoop, ignored 99% of the whatsapps, emails, and texts I had received and crashed. The next morning we were headed back to South Africa for Part 2 of our adventure and we needed to rest up.

     And as always, it's pointless to plan or get upset when things don't go your way because as soon as we left our hotel a little after 6 am we discovered that both side mirrors had been stolen.

One night in Maputo

 Part 2 still to come...

 Lessons Learned:
1) When flying through Nairobi it is best to have a minimum of a 2 hour layover to avoid missed connections.
2) Never underestimate an engineer.
3) Thank goodness for Garmin and third party Africa maps.
4) Remember your past, Live in the present, Hope for the future.

Market
Ponta do Ouro, Mozambique
Photo Credit: Barry Tanner ©

Modern Day Colonialism

    I feel as though the majority of Africa has a history of colonization, essentially a time where Europe believed they ruled all and knew best. The United States is a result of colonization as most of you reading this are well aware (and of course now believe we know best). 

     Anyway, my point being that while technically colonization has long since ended, I seriously wonder if it truly has. I am by no means exempt from what I'm about to discuss so please don't take this as me pointing fingers at others because I think like every ex-pat, I've made mistakes and some of them I'm not even aware. I often find ex-pats, including myself, discussing work and referencing things such as, "my nurses" and "my staff." Where do I get off talking about my colleagues in this manner? I don't own them and yet the very simple quote, "There's an awful lot to own in Africa," rings true. We, as ex-pats and outsiders, sometimes do speak in ways that imply ownership without even realizing it and one of the hardest things to remember in our roles here is that we are guests, we will eventually leave, and we own absolutely nothing. There has been some disagreement among the USI faculty about the ownership of our materials. Who owns the lectures I've written? Me? My US Institution? The Rwandan Ministery of Health? The University of Rwanda? I have no idea, but chances are, it's not me. I'm low woman on the totem pole. 

     I'm not sure why people adopt this form of ownership in their speech. Do I feel entitled to it? Maybe it's just a way we speak in the US and now applying it to a different context and culture I realize how offensive it is. I have no idea really, but I do actively attempt to be more aware of my pattern of speech than I ever was before. 

     Today is our mid year meeting, which has been modified to be a monitoring and evaluation presentation that has been interesting. The first thing they presented was data from last year about the twinning model of the HRH program. The twinning model is rather unique to this program and has many successes and challenges and even failures just as you see in any program global or domestic. 

     The point of the twinning model is to provide skills transfer to ensure the sustainability of the knowledge we as USI Faculty are sharing. Capacity building is hard. Practices that I think are important are not necessarily the priorities of the Rwandans and if I don't see the point in some of the practices, they certainly don't see the point in almost all of mine. The results of the survey showed varying levels of satisfaction in the program, but the underlying message is that everyone feels as though we need more time with our twins. I was impressed that the USI Faculty and Rwandans both picked this as an issue. It's almost impossible to find 5 hours during my week with my twin because he has so many responsibilities. 

     The other interesting tidbit was that those USI Faculty who have the least international experience (<1 month) have the highest level of job satisfaction. I have my own theories on why this unexpected result is what it is. Maybe because those who have had more overseas experience perhaps are used to calling more of the shots. This program isn't about USI Faculty coming in and fixing everything to how we want it to be; it's about us helping the Rwandan's determine what they want to change and allowing them to take ownership of these changes. I believe I am here in a supporting role. My twin first said way back at the beginning of my time here, "What are your goals?" And my response was, "Nope! What are your goals? Because my goals are to support yours." Maybe newbies to work of this kind are more motivated and optimistic. Or perhaps the majority of experience abroad is in a less hierarchical  program that gives the control to the ex-pat. I'm not sure. But today has been interesting with all sorts of thoughts running through my head. 

Lessons Learned:

1) Words have different meanings and consequences in different cultures/contexts. 

2) I am far from perfect and should strive everyday to be the best version of myself... Always difficult with my Irish-Italian temper (thank you heritage).

Rough Mornings

       There have been a few rough mornings here at CHUB over the last few weeks. About three weeks ago, I walked into work hoping for an easy morning as Amy and I were on our way north to Musanze for our gorilla adventure in the afternoon. I must have jinxed myself because the morning was anything but easy. I had stayed up late (past midnight) finishing a review lecture on mechanical ventilation that the staff had asked me to give them. It wasn't until midnight that I realized the tedious lecture slides I was making, showing them specifically where to find each setting and measurement on all five of our different ventilators couldn't be completed because I didn't have two screen shots I needed. I resolved to get to work early and finish the lecture at 7 before giving it at 8 am.
     I dashed to ICU, snapped the photos I needed and headed back to the office to get to work. Nothing seemed out of place in the few minutes I was on the unit. I was able to complete the lecture and was back on the unit by 8 am. After setting up my trusty projector and computer I thought I'd check on the patient's while the nurses finished their morning tasks. I was immediately drawn to the incubator that was occupying Bed 2.

I have learned a lot about pediatrics in my time here, but still not enough to feel extremely confident. However, it didn't take me a minute to figure out the child was in distress. I asked the staff who was taking care of the baby. They hadn't decided yet. Glancing at the flowsheet there were no vitals beyond a heart rate that was way to fast and a temperature written down. The baby had pulled it's oxygen mask off and there was no saturation being picked up. His feet were cold. Again, I asked the staff who was the nurse assigned to the patient. After what seemed like hours of debate, which in reality was only a few seconds, one of the newest ICU nurses said he would take care of him. When he came over to the incubator I asked him, "Why am I concerned about this baby?" Fortunately, the nurse had been a good student and was able to rattle off some textbook answers about airway, breathing, and circulation that were pretty close to being accurate. I asked him to find our pediatric blood pressure cuff while I adjusted the oxygen mask and tried to get a saturation reading. No blood pressure cuff to be found. I finally called one of my pediatric colleagues and got a quick response of, "Can I call you back we're in morning report." The newest member of our team didn't know that if I'm calling you during morning report, it's not to chit chat. I explained that I really needed a BP cuff for a neonate and that I was extremely worried about the child. She promised that she would get back to me. I then texted my ICU Senior on that day, which was Claude. He came immediately to the bedside. The IV wasn't working so we started by trying to get a new one. With Claude handling the situation, I dashed off to pediatrics to get the precious BP cuff.
     Use to dealing with adults and in an ICU, I like my numbers. In fact, I learned very quickly in Haiti that I'm too reliant on them when I looked above the cot and discovered there was no monitor there. Natural reaction to an ICU nurse to look for more numbers and data to give us more information. I was told by my colleagues that in a neonate the blood pressure was really the last thing I needed to be monitoring and to simply trend my other vital signs. I was pretty exasperated at this point. "I have a heart rate that is way too high, no saturation, the child is blue, and it's temp is almost 39." It was all I could do to keep the panic out of my voice. I didn't have much to trend, but what I did have I knew was bad. Thankfully, Veronica sensed my panic and came back to the ICU with me. She immediately was concerned too. I was glad I wasn't over exaggerating the situation.
     The nurses had been unable to gain new IV access in my absence but they had finally checked a blood sugar and discovered it was dangerously low. At this point I wanted to throttle the night shift. They have heard me say a million times over, "You cannot document what you did not do" and "It is important to document all that you can to paint a clear picture of the patient" at least a thousand times. And overall they have improved dramatically in their documentation skills, but on this particular night with this particular patient... I was so upset that all my time and energy appeared to have been wasted.
     Was this an overreaction I was having in my head? Probably. But at the end of the day, the baby died. He was five days old. And I know that he died because of poor care. A resident from the pediatric team or surgical team should have checked on him overnight. The ICU resident should have checked on him overnight. And the nurses should have known better. It is so difficult to be understanding here at times. Did I throttle a nurse? No. But I was so extremely upset at the situation. All it would have taken was for a nurse to notice the coloring was off, which would have been reflected in the poor or lack of a saturation reading. I don't know what happened, but it was too late by the time action occurred. I know we can't save them all and there are a lot of hopeless cases here. But this was one that should have survived and he didn't.

     Then last week I received a phone call from Jeff, HRH Internal Medicine Physician, asking who was on for ICU because he was concerned about a patient. In the U.S. easily 75% of the patients in the Internal Medicine ward would be in an ICU. So if you think I have it rough, you should take my situations and multiply them by 20, and that's what Julie is working with. So needless to say, if one of the IM doctors is calling, they're really concerned about a patient. I gave him the information for his resident to contact the ICU General Practitioner but offered to come down to take a look and perhaps speed the process up. The patient in question didn't look that bad and I was happy because sometimes the ICU refuses patients because there simply isn't anything else to be done. But this woman looked as though she would pull through if we got her to ICU. 

     Jeff finished talking the Théogène who in turn agreed to accept the patient. Then of course, it was discovered that there was no portable oxygen. This isn't the first time (or the last) that this has happened. Jeff and I both made the call that we could rush her up to the ICU and she would be fine. She had been sitting in IM without her oxygen on for the 15-20 minutes I had been there anyway. Jeff went with the patient and grab the box of belongings and waited for the family so that they would know where we were going. By the time I got to the ICU, a full minute after Jeff and the patient, they were coding her. Jeff said that she just out of no where gasped about 100 yards from IM and stopped breathing. At the end of the code about 45 minutes later, after time of death had been declared, I told Jeff, "I was not anticipating that." He'd had it worse, apparently she was the eighth patient of his to die in two weeks. Neither one of us saw that happening. Her mother was so upset that she ran away from the staff because she didn't want to hear the bad news. I ended up slamming my office door I was so angry at the situation.

     On Friday of last week I walked into the ICU and the staff told me they had coded our male patient at 5 AM. I took one look at him and knew he was going to die that day. Patients will do something that medical professionals call "guppie breathing." I have never had a patient guppie breathe that was still alive my next shift. What was worse is that we could not for the life of us get this man's oxygenation saturation above 85%. I texted Théogène... "I'm sure at this point he already has anoxic brain injury. How do you do this every day year on end?"

     I knew what I was getting into when I came here. Théogène even warned me multiple times upon my arrival how depressing it can be. And I shrugged it off. I'm use to death in my job. It is my job. Sometimes the only thing keeping someone from completely dying are chest compressions being performed by me (because in reality, if I'm doing chest compressions, the patient is already dead). I've been at this for years... and yet it finally got to me. Sometimes these situations are just so beyond frustrating that I can't even describe them. I didn't wait around last Friday to watch him die, but rather went home and ended up spending the entire weekend in bed or on the couch sick.

     I give the Rwandans so much credit. What they experience here is more than I ever have to experience back home. Most of the time it seems their efforts are fruitless so why even bother?

Lessons Learned:

1) Eventually, anger you didn't even realize was there will come creeping out. It may result in slamming of fists into doors, making loud noises with books or doors, and/or having extremely ill thoughts towards others.

2) What matters most though is how you handle this anger... All the above are not going to help the situation. Sometimes it's best to just pause, take a deep breath, repeat yourself a million and a half times more, and encourage the culture change as best as possible.

Gorillas in the Mist

     I haven't been in the mood to write recently despite having so much to tell. Not sure why, perhaps it's because I spend at least 80 hours a week doing work on my computer for my job, or maybe I've just felt like being lazy. The last few weeks have been busy and I have been all over the place and while life is an adventure, sometimes, I just wish I could sleep in past 7 am. Anyway, we last left off with Amy, Julie, and I heading back from Akagera to Butare...
     I really needed to get some work done and unfortunately, it turned out to be a super busy week that Amy visited. So she busied herself with exploring Butare (I will admit not a whole lot) and watching town go by while I worked. She was able to come to the hospital and I was able to give her a grand tour and introduce her to Dr. Thoégène and some of the staff nurses and USI Faculty. She spent much of her time Thursday with our housekeeper Vanessa and Stacey and Sam while I was occupied with assisting in BLS class and I think she really enjoyed herself just soaking up Rwanda.
     Friday of the week she was visiting arrived and I was hoping for an easy morning before enjoying "sports Friday" and heading home at lunch so that she and I could hit the road north. It was anything but, however, that's another story for another time. I got home and Amy was packed and we loaded yet another thankfully borrowed car from friends and off we went. We drove an hour towards Kigali to Muhanga before turning left onto the new road and heading north. I had never driven this road before and it was absolutely stunning. It was by far the most beautiful twisty curvy drive I've done here in Rwanda. Amy and I stopped several times and got out just to look and snap some photos.

     Four hours later we reached the northern town of Musanze and settled into our hotel for the evening. Dinner wasn't anything super spectacular but it got the job done. I had trouble sleeping but was raring to go the next morning. I was really excited to see the mountain gorillas! Along the way to the meeting point we stopped and picked up two of the park rangers who ensured that we would get a good group. We discussed the gorilla "attack" that had occurred a few weeks earlier and they assured us that it was the photographers fault for not listening to the trackers and guides, but no, they wouldn't put us in that group.
     We hung out at the meeting spot enjoying the crisp morning and volcanoes and mist and then I noticed and Orioles baseball cap in the crowd. Sure enough, there was an entire contingent of people from Hopkins doing a 1 week surgical mission at King Faisal. I had to giggle a little. Faisal just has so much more resources than CHUB. I'm sure they came and thought, "how do they do everything they do here with so little?!?" Now imagine having 1/4th of the material and that's my hospital. We get it done with nothing... I like to brag. Regardless, it was super nice to talk to people from home and wish them luck in their week stay here.

DRC/Rwanda/Uganda border on the mountain behind me.

In the mist.

     We were placed in the Titus group with 8 total hikers. I was hoping for more details on the formation of the family, but in my excitement, I actually forgot to ask. But as some of you may know, Titus was the Gorilla King made famous by Dian Fossey and we got to see some of his direct descendants! Titus sadly passed away in 2009 at the age of 35. More surprising, his replacement into the Titus Family was Rano, who died young at the age of 21 last summer. Which meant that our silverback was very young at only 18 years old. Titus Group is a small family with only 7 members. The silverback, 3 females, 1 male juvenile, 1 female youngster (2-3 years old), and 1 baby (3 months). To put it in perspective, some of the families have over 40 members and there are 480 mountain gorillas on the Rwandan side of the Virunga Mountains (Volcanoes National Park) with another 400 in the DRC and Uganda. One of the volcanoes is actually the border where all three countries meet, so not only did Amy get to wave to Tanzania while we were in Akagera, but now she was able to wave to both the DRC and Uganda too.

Man picking flowers on our hike up.
Not sure for what they're used.

All of our trackers

Our Ranger/Guide

     Our hike was moderate, a little steep in places, and mud up to our ankles but it was only about an hour and a half long. We crossed back into the park (we drove about 30 minutes from the meeting point to the hike start) and within ten minutes we were told to leave everything but our cameras in a spot because we were going to get our hour with the gorillas. And man was it quite the experience. The family was spread out over a small, incredibly densely forested area. So dense that all of our trackers had machetes to get through the brush. The first gorilla we saw was the silverback. He was hanging out eating some plants, roughly 200 kilos, and he hit me.

Yep. You heard me. I got whacked by a 200 kilo silverback gorilla in Rwanda. According to our guide it was a playful movement, but it sure as hell felt like a ton of bricks went into my thigh. Everything was fine initially. The website and the guides all say that you are to stay 7 meters away from the gorillas. But we were much closer than that and the guide and trackers seemed ok about itt. I was about 6 feet away from this guy (as was the rest of the group). He was fascinating to watch and roughly 10 minutes into observing him I crouched down to get a photo of him at eye level. As I was looking at the camera I realized this silverback was staring right at me. The guides told us it was ok to look them in the eye so I wasn't worried. Then he batted the plant stalk directly in front of him to get a better look at me. I slowly stood back up and glanced towards the guide and Amy about five feet to my left.

Last zoomed photo before he whacked me... the brach to the
left is the one he batted down before approaching me.

     My attention was immediately drawn back to the silverback as he stood up and came to all fours. Now when gorillas stand up they naturally come forward onto their extremely long arms, thus closing the distance between him and me by 2 feet. Then he started to walk towards me. He made no noises, he wasn't running, it was as if he was just done with the spotlight. He was within a foot of me when he veered slightly to my left to pass and then it happened. WHACK! His left arm went out intentionally and he walloped me in the thigh. It almost knocked me over. Then he decided to climb the tree behind me and continue with his day. Since he didn't charge me or make any noises the guides said it was friendly play behaviors that he exhibited. I wasn't so sure, but I figure if he wanted to, the gorilla could have done some serious damage. And after all of that... I didn't even get a bruise. I have no idea how because I bump my legs into things and bruise easily and yet, nothing. It was sore for several days, but nothing to prove it. It was incredibly disappointing, I'm not going to lie.

Then he decided to climb a tree

And eat some more

     We next found one of the mothers with her 2 year old again, just hanging out and eating. Beyond them in the trees were two more, mother and child. And finally, the mother with her 3 month baby. It was utterly fascinating. Gorilla's DNA is 97% similar to our own.

Much closer than 7 meters

Sure they look different and their arms are long and they don't speak our language... but wow. They are freakishly similar to us. It was one of the most thrilling hours of my life to just observe them.

The infant's head almost gave the impression of a full head of human hair, particularly with his little ears sticking out. The gorillas reproduce very similar to humans, however we were told that up to 60% of the babies die due to hypothermia. I was not expecting that when residing 200 miles from the equator. But our guide indicated that during rainy season it can get quite cold in the mountains, which I certainly believe. I sometimes think I didn't pack enough warm clothes for Rwanda, but I never translated my feelings of cold to what it might do to the animals. Eight hundred, eighty gorillas might sound like a lot, but when they are only located in this region... that's all the mountain gorillas in the world. The guides told use they were due for another census of the gorillas soon, the 880 number is from 2012, so hopefully, the numbers will be higher.

Hiking down

     All in all it was a fabulous trip that Amy had and I'm glad I got to experience both Akagera and Volcanos Parks with her. It was very good to have a piece of home with me despite it being such a short time.

Lessons Learned:

1) Gorillas aren't very warm and fuzzy no matter what your roommates say (Me: So I just got whacked by a 200 kilo silverback. Vanessa: Awww he was just hitting on you!)

2) Near or far your friends will always be your friends, but having them closer is always better.