Surrounded by small children day in and day out can make for some pretty interesting stories (and we don't even have any of our own yet!). Follow our Tucson adventures as Drew navigates his new career as a pediatrician, Emily works to get books into the hands of small kids, and our canine munchkins (Annabelle & Albert) take on the perils of desert living.
Saturday, November 13, 2010
Coming Home
Drew:
This past month was one of the fastest months I've ever experienced. It started out overwhelming and a little scary, but it ended as an amazing experience that I'm so thankful to have been able to do. All three of the settings I worked in were wonderful, and I feel that I learned a ton every day I went to work. Actually, I think one of the biggest things I gained from this experience was confidence. Every resident goes through periods of worry about whether he or she will be ready to practice on their own when they finish. Of course, I am not immune to this problem. When I first was thrown into the work at the hospital, I almost freaked out. I didn't speak the language, I didn't know the diseases, the uses of the medications were a little different, and I had never really worked without supervision. The first few days, and several periodic instances afterward, were frustrating. I was told I would have a "what have I gotten myself into?" moment, and that prediction was correct. However, now that I've completed my month, I think that I did a pretty good job given the limited resources we had. I think I was able to help a bunch of children and families, and I even think I did a little education to some of the health care workers in Rwanda. I'll give a big thank you to my dad and Dr. Elliott for helping me with some infectious disease questions. In the end, I was able to practice pediatrics in an unfamiliar environment, and I felt that first feeling of wanting to be on my own and do things the way I thought they should be done. It was a wonderful feeling of independence, and it makes me even more excited about finishing residency and joining a practice next year.
I also greatly enjoyed working with families and communities that did not have many resources. I've enjoyed this in Tucson, working in a clinic where many families have less money. I've wanted to find a spot in Nashville that works with similar patients, but this experience just confirms my desire. I hope that wherever I end up next year, I will be able to feel this same sense of purpose that I'm feeling right now.
As far as non-medical things go, I've absolutely loved meeting the Rwandan people and immersing myself in their culture a little. Looking back, we could have done so much more, but living in Kibungo has been wonderful. I was really sad when our bus pulled away from the town, and I wish I would have been able to communicate a little better in order to feel more a part of the community. I would definitely love to come back to Africa some day, and I hope that Rwanda can be on that itinerary. I'd love to see how far the country progresses over the next few years, and I hope that it can maintain it's inspiring example of forgiveness and reconciliation.
Now I go back to Tucson, getting ready to work two weeks of nights. I think it will be a little easier adjusting due to the time zone differences, but it's still going to take some time. I hear that reverse culture shock can sometimes be worse than the initial shock of traveling to a foreign land, and I hope that I'm prepared to rejoin the community back in Tucson. It's going to be weird having reliable water, water pressure, and electricity, but I can't wait to enjoy it again. I'm also really looking forward to some food variety, although our diet of potatoes, rice, and beans was quite delicious at times. We'll have to keep making melange with brochettes occasionally.
Emily:
As we sit here in the Brussels airport, it feels like it was just yesterday when we were here waiting to get on a plane to Africa. I remember feeling so excited and extremely nervous all at the same time. Before we had even arrived, I was having the "what have we gotten ourselves into?" moment Drew described above. When we finally landed in Kigali and met our hosts, the nervousness started to subside, as we learned how to navigate the city and met the kind and generous people of Rwanda. Everywhere we went, people wanted to ask questions, practice their English, or just make sure we were on the right bus at the right time. I soon felt safe and secure in this new place and began to settle in.
Over the course of the month, we definitely had our ups and downs, especially as we struggled through the language barriers, but overall the experience was amazing. Like Drew, I look forward to coming back to Africa and Rwanda one day and learning more about the culture and seeing the progress. Yesterday, as we were leaving Kibungo, Drew asked me what my favorite part of the trip was. My initial reaction was my daily interactions with the kids at the orphanage, but as I think more about it, I think it is something more. My favorite thing about our month was seeing a community of people taking care of each other. At the orphanage, people visited the children of deceased neighbors, and the teachers working there had so much love for the children. On the garden projects I helped with, neighbors came together to help prepare the ground and plant. Even for us, when we were in town (despite the stares and calls of "muzungu"), people were ready to help us find the right store or bus, or let us practice our broken kinyarwanda, trying to understand.
The other day, I accompanied Tom to an English class he was teaching for adults in town, and I ended up "teaching" the Beginners section with Teo (Theophile). Many of the students were nervous to speak English in front of me, or hesitant to talk to me...unsure of this new American teacher. Towards the middle of the lesson, Teo stopped talking about objects around the house, and askd the students to cast aside their fears. He talked about how new things (like speaking English) and new people (like me) can be scary sometimes, but we have to cast our fears aside and embrace the new experiences. He went on to say that he had only met me a couple weeks ago, but had made a new friend, and embraced me in a hug. He described to the students that only by facing our fears can we become better humans that are able to accept and join the world around us and beyond us. Many of the students began nodding and started to participate a little more for the rest of the lesson. His mini-lesson struck me as the perfect summary of my experience over the past month. I was fearful and anxious at times, but I had to throw these fears aside in order to embrace new experiences and new friends. It was a beautiful way to encourage the students, and I was thankful he had put it into words for them. The class will be blessed to have such a teacher for their beginner lessons, and I am blessed to have had such an experience.
Wednesday, November 10, 2010
A Day Trip to Rusumo Gone Awry...
Health Day in Gashanda
We finally had our public health day in Rwanda. Actually, when I first heard about the opportunity in Rwanda, the clinic in Gashanda was where I was supposed to work. Over time, it evolved into a mixture of clinic and hospital work, and I’ve greatly enjoyed my experience. However, it was nice to see the rural setting I had originally envisioned. Here’s some background on the clinic. I’m volunteering for an organization called Humanity for Children, which is based out of the US. They’ve set up two clinics in the area that are eventually to be used as health centers for the rural population. As it stands now, the people in that area have to walk a long way to be seen by a health professional. On of our hosts in Kibungo, Tom, helps to organize community health days whenever a volunteer pediatrician is here. The days are usually attended by a public health nurse, a nutritionist, and several other volunteers who help to run the clinic. The clinics are not open yet due to problems getting final approval from the Rwandan government and a lack of money due to donation shortcomings back in America due to the recent economical situation. Regardless, every time they have done a health day it has been extremely successful and much appreciated by the local population
My first feelings about doing a day like this were filled with apprehension. I would be the only doctor present in a foreign atmosphere. I was just coming to terms with practicing on my own back home, and doing it in Rwanda was very intimidating. Luckily, I’ve learned much since arriving in Kibungo, especially from working in the public health center where I’ve had nurses to help me get used to how things typically run here. The last days leading up to the day found me excited, although I still felt pretty humbled that so much work was being done so that patients could come to see me.
After arriving at the clinic we started getting organized and taking stock of the supplies present. I figured out what few medications we had and made a chart for a quick reference for doses. Yuki, our nutritionist from Japan, set up a counseling station in the waiting room, accompanied by Malea, Anna, and Theophile, who acted as child life specialists to keep the kids entertained during their long wait to be seen. There were no appointments, so some of the kids were waiting for hours. Each kid received a toothbrush and basic information about dental care, and then Yuki evaluated their growth and gave advice on good nutrition. The kids were then funneled into the consultation room, where I was working.
I had two wonderful assistants during the day. The first was an interpreter, which rotated between Lisian and Raymond. Lisian has been with me the entire month, and I think she’s starting to figure out what questions I ask for certain complaints. We’re becoming much more efficient than we were at the beginning. My second helper was Emily, who functioned as a recorder, photographer, and makeshift pharmacist. She also helped to distract the often screaming children while I was examining them. It was nice to work together for the first time since we arrived in Rwanda. I reckon that there are not better handwritten medical records in the entire country.
The day passed by as I saw patient after patient. Every time I looked out in the lobby it seemed that I wasn’t making even a dent in the number of kiddos. We saw diarrhea, colds, weird rashes, asthma, pneumonia, and even some weird liver disease. I tried to help as many of the kids as I could, but with the limited number of medications, I suspect many of the kids will need to go to a health center eventually. Every child that had not been treated for worms in the last 6 months received treatment, and we gave out a ton of zinc to kids with diarrhea. It was one of those times where I felt like I was actually making a difference, and I’m so grateful for the opportunity. By the end of the day, we had seen 55 patients, and the remaining patients we didn’t see received multivitamins and anti-worm medication. Every person at the clinic was extremely helpful in making the day successful, and I thank every one of them.
Unfortunately, we were not able to set up two health days during our stay, as we had initially hoped. Had the original plan to have me work in Gashanda worked out, it would have been an exhausting, but extremely rewarding experience. That said, I’m happy about the way our trip has turned out. It’s been, at times, relaxing and, at other times, stressful. The end result has been a pace that has allowed me to slowly get comfortable with the work I’ve been doing, culminating in a day where I was calling many of the shots. My confidence in my abilities has grown during this trip, and I have no doubt that I will be able to make the transition to being a full pediatrician next year. That said, I’m very aware of the vast amount of knowledge that is still out there for me to learn. My day in Gashanda was something I will always remember and cherish, and I hope to do something like it again some day.
Sunday, November 7, 2010
Gorilla Trekking
Wow! That word seems insignificant, but it is the best word I can think of to describe today. We’re in the northwestern part of Rwanda this weekend going on our Gorilla trekking adventure. Anything I type is going to seem insufficient to portray everything, but I will try my best. Saturday morning we woke up early and took the bus to Kigali. Once there we stopped for a quick bite to eat at CafĂ© Bourbon and Emily satisfied her coffee addiction. I also satisfied my longing for two foods that I had not had in awhile, ham and cheese. After lunch, we hopped on a bus to Ruhengeri. This bus was huge compared to what we’ve been used to, and we each had individual seats. People have been telling us that the area around Kibungo is the “flat” part of Rwanda. We’ve been laughing at this because it’s all hills and mountains similar to the Appalachian Mountains… but with palm and banana trees. After this trip, we understand why they made this distinction. The bus traveled up into huge mountains, with farms going up to the top of most of them. It’s amazing that the Rwandan people do not waste an inch of land. I can’t imagine hiking up those slopes every day to farm, but even the children here seem to have no problem doing it.
Once we arrived in Ruhengeri, we hired a car for the quick drive to Kinigi, which is right next to Volcanoes National Park. Once I saw the volcanoes I had to catch my breath. They are enormous mountains covered in trees that extend up into the mist and clouds. I almost feel like it would be worth it to come to Rwanda and see the park, even if you didn’t see the gorillas. We stayed at the Kinigi Guest House, which is a cozy little place just a short walk from the park office. We grabbed a bite to eat at the restaurant there, where we met several other travelers who were trekking the next day. Emily and I sat next to a lovely couple from South Africa who had spent the previous three days viewing the gorillas and were going to view the Golden Monkeys today. The lady was wheelchair-bound, and they have been hiring porters to carry her and a chair into the jungle so that she can enjoy seeing something that few people in the world get to see. The organization of the people at the park is truly amazing. During dinner, we secured a group to share in the expensive cost of hiring a driver to take us into the park, and then we were quickly off to bed to rest up before the big hike.
I started off today with a luxury that I have not enjoyed in three weeks: a standing shower. Please don’t take reliable hot water, electricity, or water pressure for granted. Being without it is tolerable, but enjoying a nice shower in the morning is awesome. Ok, enough of that… on with the story. After a delicious breakfast, we headed over to the ranger station. There are seven families of gorillas and one group of Golden Monkeys, and each group can have up to eight visitors. The guides quickly divided us all into groups based on their estimate of how fit we were and a few special requests from people who knew a little bit more about the differences than we did. We were just happy to see a gorilla. We ended up with a diverse group, including a couple our age from Australia, a married American and German, and a couple from France. Our guide was hilarious and very informative. We found out we were going to see the Ugenda group, which consists of thirteen gorillas, including three silverback males, several females, and a small bunch of young babies.
After a somewhat nauseating drive on a very bumpy gravel/dirt road, we arrived at our hiking point. The ride was tolerable only because the whole road was filled with people, many of whom were children, who all laughed, yelled, and waved at us as we passed. I have no idea what they were saying, but the Rwandan children, as always, are impossible to be around without a smile. The path started out walking through farmland. Before you think that farmland doesn’t sound too bad, remember that I earlier said that the farms went all the way up the mountains. Our path was very steep up a hillside filled with crops and occasional goats, sheep, and cattle. There were children along this path as well, but they may have kept their distance from us because of our two military guards carrying Kalashnikovs. They were our insurance in case we ran into an unfriendly guest, such as an elephant or buffalo. We were also warned not to take any pictures of the soldiers. The hike was somewhat difficult, but we tackled it at a reasonable pace. The view was breathtaking, with the volcanoes rising up out of valleys covered in mist and reaching up into the clouds. I kept telling myself, “Remember this moment.” Before we knew it, we were standing at an old stone fence with a small opening. Beyond it stood a huge forest of bamboo and stinging nettles. We had arrived at the border to Volcanoes National Park.
Journeying into the jungle was pretty surreal. It was hard to believe that the land we were walking on was inhabited by such creatures that I’ve only seen in zoos or on television. We had to watch our step, because the path had been made by a buffalo who seemed to have a case of indigestion. The front part of our group actually saw the animal at one point before it meandered off into the bush. After about ten minutes of hiking, our guide asked us to put down our walking sticks and backpacks, and he told us to try to be quiet… the gorillas were nearby. We were told that this time of year, the hikes are a little shorter than normal. The furthest group can take hours to reach at times, but since this is the rainy season, the bamboo is throwing up new shoots in the lower parts of the mountains, making the hikes much shorter. Our guide asked us to not call it bamboo, however, we called it “gorilla beer.” Apparently the new bamboo shoots have a somewhat intoxicating affect on the gorillas, making them either extremely playful or very lazy. I think it is safe to say that we were hoping for the former.
We carefully crept through some low lying bamboo and suddenly, no more than about twenty feet ahead, there was a huge mass of black fur. Several legs were sticking out of the pile at various angles. One of the mounds of fur had an area of silver and he was identified as the dominant male of the family. There was the one male and about four or five females all grouped together lounging in a small clearing. We could hear the rest of the group moving nearby, and occasionally we’d see a small tree or bamboo shoot get toppled, followed my loud munching. They seemed to be pretty lazy at this time, but even a group of lazy gorillas is fascinating when they’re just a few feet in front of you. Eventually, smaller individuals emerged from the mound of fur, and the babies became more visible. They rolled around and climbed all over the adults. Unfortunately, every time one would look at us, they’d turn away before anyone was able to get a good photo.
After about twenty minutes, the big fella decided he’d had enough of that location, and he suddenly got up and walked out of the clearing, passing our shocked and silent group by only about five feet. The rest of the group followed, with the babies jumping on the backs of the females. It was at this time we spotted the second ranking male. He brought up the rear of the group and kept a close eye on us as we tried to follow them further into the brush. At one point he decided to stop and eat, so we continued on, leaving him somewhere further behind us. I was a curious about putting us in between a big male gorilla and the rest of his pack. I didn’t have to wait long to satisfy this curiosity, however. Our guide suddenly asked us to move quickly. He seemed a little louder and more nervous than usual, and he quickly told us to step aside. It turns out the other male was following us and was literally right behind some of our group. He walked by us seemingly without a care. I could have reached out and pet him if I had wanted, but I am not insane and value my limbs, so I did not.
The remainder of our time was spent following the group and trying to get the best views possible. The main silverback was at the front of the group, so our views of him became pretty limited. Fortunately we were able to get very close to some of the females and the other male, and the picture we obtained were wonderful. They really didn’t seem to care at all that we were there, as long as none of us gave off threatening or surprising impressions. It was one of the most humbling experiences of my life, and I am so fortunate to have been able to do this. Our time was limited to the fastest hour I’ve ever experienced, and we finally had to leave our hosts. After a final glance at the group, we headed back down the mountain.
There is one final thing that our guide asked of us before we left him. I’ll use this blog to partially fulfill that request. He stated that we were now ambassadors for the gorillas and for the country of Rwanda. We may have had many friends or family who warned us not to come here because of the recent violent history. After the experiences we’ve had, I feel that I could suggest Rwanda as a destination to anyone. As you may have guessed from our previous postings, we have received nothing but warm greetings from everyone we’ve met. There’s almost a palpable pride here that the people show in how welcoming they are. Everyone seems to want to put the past behind them and move forward, something which the country seems to be doing better than any other country in Africa. As for being an ambassador for the gorillas, I think reading about our experience and that of others should do the trick. If anyone has the opportunity or privilege to do this, I highly recommend it. There are many other things to do in the national park, and the view alone is worth it.
So now we’re relaxing in the guest house, enjoying some peace before we have to make the long journey back across the country. We’ve swapped e-mail addresses with several of the group members, so I’m sure the best pictures from our group will be shared. We’ll make sure to post the videos and photos once we’re back home with a faster internet, but I think we’re going to try to upload one to Facebook today. So we now go off into our final week in Rwanda. The public health day is coming soon, and then we pack up to go back to Arizona. This week is going to fly by.
Friday, November 5, 2010
Rainy afternoon in Kibungo...
Wednesday, November 3, 2010
The Great Turkey Adventure
I hope everyone had an excellent Halloween. We definitely missed having kids come to our house and giving out candy, then eating all the candy that was left over. Unfortunately, Rwandans don’t celebrate Halloween, and we got a very strange look every time we tried to describe the holiday. Honestly, try to describe the purpose of Halloween… it’s really an odd celebration. Despite all of this, we did not pass the weekend without celebration. Tom and Malea invited several other Peace Corps volunteers to the house for the weekend, and we had a group that reached about 15 members. The question then arises, how do you feed so many guests? And that’s how our recent adventure began.
One of the first things we heard about when we got here was Tom’s famous (infamous?) goat roasts. You can go to the market and buy a goat, which is later led to your house… alive. There, he’s had Timo or Jean Claude (our guards) slaughter and butcher the thing, and he’s roasted it over charcoal in the backyard. Tom’s done this twice since he’s been here, and both occurrences have been great successes. He wanted to change things up a bit this year, however. He wants to roast a turkey for Thanksgiving, and he deemed this past weekend as an excellent time for practice. I know what you’re thinking… turkeys in Rwanda? Yes, we’ve seen, and heard, several turkeys since arriving here. Most of the locals laugh when you ask them about “dendo,” but there are a few people who raise and sell the birds.
Tom made arrangements to get a turkey last week, and we asked one of our friends, Teo, to pick it up for us. Unfortunately, when he got there, the guy had sold it to his son, despite our reservation, and Teo had to go to a different town to find a bird. He brought it back to the house and it sat in our backyard for the evening making occasional pitiful noises. If you’ve never seen a turkey up close, they’re actually quite ugly, but our bird was immediately dubbed “cute.” I’ll admit, I did bond with the very American bird, and I felt a connection to home with it. We even named it Turkems. Timo wanted to name it Indestructible, but that name would have been sadly inappropriate. Unfortunately for the bird, several hungry guests were coming to the house, so no amount of bonding was going to save it.
We awoke the next morning to hear Turkems making quite a ruckus. Tom later came to my room and said, “the turkey flew over the wall, we have to go catch it.” So, Tom, Emmett, Timo, and I walked around the block to our neighbor’s house to recapture the escapee. Our neighbors have a bunch of chickens. They formerly had a rooster, which I’m guessing met an early demise due to its tendency to crow every 30 seconds in the morning, starting at about 5:00. None of us were sad to see, I mean hear, that thing go. As we approached the house, there was no mistaking which yard was the hiding spot. There were kids running around in the street and yard yelling, “Mizungo!” which means “white people.” They all thought it was hilarious, and I immediately thought of several movies where some city slicker tries to catch a turkey and ends up in the mud. I brought my video camera, but I think Turkems desire for escape had faded, and we easily captured her without much of a fuss.
The rest of the morning was pretty routine. By routine I mean that a large bird was decapitated in the yard, drained of its blood, boiled in a pot, defeathered, then roasted on an open charcoal pit for a couple hours. The dinner was a great success, and the stuffing and baked beans were delicious. The turkey, while it’s always nice to have meat, was a little tough and “gamey.” The turkeys here are the wild variety, and not the white birds that are farmed back in the US. Despite that, the whole experience was quite exciting, albeit tragic. I’d just like to say, “Turkems, your sacrifice was greatly appreciated, and we will always remember you.” Again, I promise to have tons of pictures of this story, and all of our other ones, uploaded when we get back.