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.