The Rwanda Monologues

2/26/2009

“All at once, as it seemed, something we could have only imagined was upon us – and we could still only imagine it. This is what fascinates me most in existence: the peculiar necessity of imagining what is, in fact, real… The word ‘genocide’ and the images of the nameless and numberless dead left too much to the imagination.”

- We Wish To Inform You That Tomorrow We Will Be Killed With Our Families: Stories from Rwanda by Philip Gourevitch

Today was a hard day. After seven weeks in Rwanda I finally mustered up enough energy (read: emotional strength) to make the trip to the national genocide memorial in Kigali. It’s been a mere 10 minute drive away for the past 49 days and yet it has felt like an impossibly hard trip to make until today. I had finished about half of Philip Gourevitch’s book (quoted above) over the course of about a week in New York but upon arriving in Rwanda, it took me a solid month to finish the other half. After finishing, I put it away and have taken the past couple weeks away from it to try and process all the emotions it brought up. I finally went back to it earlier this week and looked over some of the pages I had marked and was particularly struck by the quotation above. I realized that really, even with all the emotions I’d experienced and conversations I’ve had with people here, I had still only imagined the events of 15 years ago. Suddenly I felt a tremendous guilt for not actively pursuing a more tangible experience earlier in my trip and made the decision to visit the memorial immediately.
Two hours, thousands of haunting images and several mass graves later, I left with the realization that the enormity of it all isn’t really comprehensible and I’m still just left with my imagination. But I’m also left with the faces and heart wrenching last words of 30 children killed in the genocide. And I’m left with a greater understanding of the historical context of not only the Rwandan genocide but others throughout history. So, overall I’m extremely grateful to the creators of the monument for their beautiful memorial to the victims of such {barely} imaginable violence and hatred. While the entire scope of what happened here may only ever be fully captured in one’s imagination, I am honored to have been witness to a few people’s personal stories and to have brought a touch of reality into what has all too easily and commonly been dismissed in history as a far off and intangible concept: genocide.

Please consider contributing to Ageis Trust, the organization that runs the Kigali Memorial Center. They are having a candle lighting ceremony for the 15th anniversary of the genocide this April.
http://www.candlesforrwanda.org/view/10/the-project.html

As a fitting complement to the visit to the genocide memorial this morning, I attended a performance of the “Rwanda Monologues” this evening at Torero Café. The performance was an adaptation of Eve Ensler’s “The Vagina Monologues” and was the first ever performance of any part of The Vagina Monologues in Rwanda (not to mention only the fourth ever production in all of Africa). As a part of the V-DAY 2009 campaign (the "V" stands for valentine, vagina and victory over violence), the proceeds of the performance benefit an organization called Achieving a Better Life which works to prevent gender-based violence in Rwanda.
The theme of V-DAY 2009 is “Stop Raping Our Greatest Resource: Power to the Women and Girls of Democratic Republic of the Congo.” Eve Ensler wrote a monologue called Baptized specifically for this cause after interviewing an eight year old girl, Noella, at Panzi Hospital in eastern DRC. After the interview, Eve tried to hug Noella and she squirmed away. Eve realized then that Noella probably hadn’t been hugged since she was raped by a group of Militia every day for two weeks straight. The rapes had given her a fistula so she was no longer continent. Eve hugged her anyway and held her on her lap and after that, there was no turning back…

Baptized
by Eve Ensler

Look out your window
The dead live everywhere
Think of your luxuries as corpses
Count the bodies

30 hacked children for a new play station

20 tortured women so you can text photos from the party

50 amputated men, waving their missing hands
as sweet Andrew mindlessly bounces his rubber ball

I hold an eight year old girl in my lap
Who had been raped by so many men
She had an extra hole inside her

When she accidentally peed on me
I was baptized

It isn’t over there

The Congo

It’s inside everything you touch and do

Or do not do.

Sosoma and such

2/23/09 – 2/24/09
The past couple of days have been full of frustration and annoyances so I’ve decided not to rehash all the details… Let’s just say that after bringing several quality assurance issues to everyone’s attention so that they could be addressed, it seems that Eugene (the WE-ACTx research coordinator) now has a grudge against me and is making it very difficult for me to actually accomplish anything further with the HPV study. So, I think I’ve done what I can in terms of setting everything up to run smoothly and now it’s time to shift focus.

2/25/2009
Today was the distribution day for the Sosoma nutritional supplement (it gets its name from the three principal ingredients - SOrgho, SOja, et MAis in French which is Sorghum, Soy and Corn) so I spent the afternoon handing out 8kg bags of the mixture along with 2kg bags of sugar to about 120 HIV+ kids and their families. The idea is for the Sosoma to supplement their diet so that they can take antiretroviral drugs without nausea and can avoid malnutrition. Unfortunately many of them continue to lose weight despite the supplement and so my task now is to identify these kids and do home visits to find out why they’re not doing well. I’ve also been in touch with Lisa back in NY and it looks like I will be going back to Kibogora for a week or two to work with the community health workers there in preparation for her maternal/child health program out there. Throw a few weekend trips around Rwanda plus a longer trip to Tanzania/Uganda into the mix and I think I’ll have enough stuff going on to fill the rest of my time here.

When in doubt, pitch it out!

2/21/09
So Diane came this morning and worked with Anita and I for about an hour and a half on Kinyarwanda. Her English pretty good so we got by and I think we’ll try to fit in a lesson with her once a week.
After she left we spent the day cleaning the house – this place has accumulated 4 years worth of people’s junk and we decided no one else was ever going to throw anything out so we made it our project for the day. There is something cathartic about throwing out other people’s junk – it also brought back surprisingly fond memories the days I used to clean out our house when I knew my father wouldn’t be home for a while. Four hours and three huge trash bags later, however, the nostalgia wore off and we left the rest for another day. Now comes the hard part – actually throwing this stuff out. Since I’ve been here I’ve noted that several items have somehow made their way back onto a shelf after being placed in the garbage so I think Josie, Seraphine and Joseph are reluctant to throw things out (understandably given the difficulty and expense of getting a lot of things in Rwanda). Considering that among the items we threw out were expired suppositories and empty ink cartridges for printers that no longer exist, hopefully we can manage to ensure they actually get thrown out. Now “thrown out” is a relative term here since there is no regular garbage collection and as far as I can tell most people just incinerate whatever garbage they create. So who knows what the ultimate fate of those suppositories will be – maybe they would have been better off gathering dust here for four more years! Anyway, we’ve decided to slowly divide the trash over the next few weeks and we’ll see what happens. One huge bonus of our mega cleanup though was the discovery of an electric-mosquito-killing-tennis-racquet-like contraption. We have a real fruit fly problem so I’ve been diligently zapping them which is disturbingly satisfying… I think of Eunice and feel guilty every time I zap something since I know she would have a conniption (she yelled at me every time I killed a mosquito even if it was about to bite me).
Anyway, after calling it quits on the clean up (all we have left is the bookshelf and two bedroom closets) I went for a run (which I’m now going to really try to incorporate into my daily routine) and then Anita and I joined Katie for dinner at Sun & Moon – a new pizza shop in Centre Ville. It still hasn’t ceased to amaze me how dead Kigali is at night and a Saturday night at that! I mean there certainly are hot spots and popular bars/clubs but overwhelmingly this city is NOT nocturnal – quite a switch from NY.

2/22/09
Well today has been my laziest day in Kigali thus far. I went for another run this morning and spent the rest of the day leisurely reading and doing a whole lotta nothin! Anita and I are planning several weekend trips to occupy ourselves and explore as much of Rwanda as possible so I don’t think I’ll have too many more quiet weekends in Kigali… probably a good thing since a little bit of boredom has started to set in this evening.

And then there were two...

2/15/09
We got up early enough today that I was able to see the sunrise – our back yard is really quite beautiful in the morning. We had agreed to leave at 6am but of course Fabreece runs on Rwandan time so he showed up just before 7. In the end it was fine though because it gave me a little time to chat with Mary before we left since she flew back to Chicago this afternoon. It was about a 2 and a half hour drive to Akagera and once we got there we paid the park fees and picked up our guide for the day. We started off seeing zebras and some antelope. Then our guide heard on his radio that the elephants (there’s a herd of about 100 in the park) had been spotted drinking at one of the lakes. So, we turned around and rushed down to the lake since Mary had told us the elephants were elusive (in the 5 times she’s been to Akagera she said she’s only seen them once). Unfortunately by the time we got there they had moved on. We did get to see some buffalo and baboons and then we finished off the day with a giraffe and some more zebras. All in all it was a fun experience but we were tired and hungry by the end of the day… not to mention dirty (the dirt roads had turned my hair red and it almost looked like I had a tan since there was a thin layer of dirt all over me). We all think Fabreece has a crush on Anita and since it hasn’t been reciprocated, he made a point to stop by his “girlfriend’s” house on our way home which was just annoying since we were all so tired. We made it home by about 6 though and after scarfing down some dinner, went to bed.

2/16/09
Today we started the pilot of the study at Nyacyonga – we set everything up and screened 5 women using both VIA and rapid HPV testing. There were definitely some kinks that need to be worked out – mislabeling of tubes, etc – and Eugene (the research coordinator for WE-ACTx) gave me attitude when I tried to address it with him so it was a frustrating day. I kind of feel like I’m expected to supervise everything but then ultimately I’m not really in a position of authority over anyone so it puts me in this vague middle ground where I identify things that need to be fixed but can’t do anything about it. I guess I should be used to it since that’s the basic job description of a medical student but it doesn’t make it any less frustrating. Oh well, tomorrow is another day! We watched a movie at home after dinner and had a quiet night to unwind.

2/17/09
Well unfortunately today was equally as frustrating as yesterday – we screened 30 women but it took almost the whole day and then we had to stay for 3 more hours for the lab techs to finish the HPV testing. So, the whole “screen and treat” purpose of this study was defeated since we had to send the women home and have them come back tomorrow. We also had the same issue with sample mislabeling and I have serious concerns about one of the nurses’ competence in VIA so overall I just felt really defeated by the end of the day. Add to that the fact that I felt kind of uncomfortable being the only person there to provide quality assurance since I’m far from a gynecologist! For example – I caught two VIA positive lesions that the nurses called negative but there were two others that I think were negative but couldn’t be 100% sure. I guess it’s always better to err on the side of overtreatment since cryotherapy is a fairly benign procedure. There was also a woman that I’m pretty sure had a recto-vaginal fistula that the nurses were ready to let go home but thankfully I convinced them to refer her to the local hospital.
I guess this is why we’re doing a pilot for the study though – to work out all of these kinks. I think we will have to set up a third exam room to ensure that the screening is finished by noon at the latest and that way the HPV testing will be done by 3pm and there will still be time to do cryotherapy on the women that need it. They are also going to be paying an MD to supervise at least 2 days/week so that will help with quality assurance. Thankfully I have a meeting with the pediatrician at the Icyuzuzo clinic tomorrow so I’ll get a break from Nyacyonga for the day and I can go back on Thursday less frustrated hopefully!

2/18/09
This morning I had a meeting with the doctor at Icyuzuzo clinic to identify the kids that are receiving antiretroviral therapy with nutritional supplementation but are still losing weight. The goal is to figure out if their malnutrition is being caused by psychosocial factors or by medical issues and then get them the appropriate support. I’ll also be doing a lot of data analysis for the Sosoma program and will be putting together an annual report for the donors who are funding the supplements. I’m pretty excited for this project since I’ll be doing home visits for those that we identify as at risk and I’ll finally be doing some work with kids!
After the meeting I met up with Felicia for lunch (she’s in town from Bujumbura to present a new protocol for pediatric HIV treatment that the Clinton Foundation is getting ready to roll out). She introduced me to a restaurant in town that has good take-away including some delicious samosas and burritos. Tonight is Alesha and Neeva’s last night in Rwanda so we’re headed down to Republika for a drink to unwind a bit.

2/19/09
Back to Nyacyonga this morning. They set up the third exam room yesterday and so things went a lot better today. They got through 20 patients before lunch and we were able to leave by 4pm which was good since Alesha and Neeva had to head to the airport at 6:30pm. Now it's just me and Anita until the new yoga teacher comes in March.

2/20/09
I met with Eugene this morning to discuss some of our communication issues and hopefully that will make things run more smoothly between us over the next few weeks. The biggest news of the day is that Anita and I ordered bagels and picked them up tonight. The whole process was quite bizarre – Felicia gave me a phone number to call, we placed an order for half a dozen bagels yesterday and were given an address to pick them up this evening. After knocking on the door we were led to a back room where we handed over some cash and they gave us the bagels. The whole thing felt a bit like a drug deal until we realized that it’s an orphanage that makes baked goods as a profit making venture so if they’re any good I think we’ll be ordering again. The bagel place is just down the road from Papyrus (a delicious restaurant) so Anita and I shared some homemade ravioli and then walked home and bought a bottle of wine along the way. There was another full meal waiting for us when we got home and now that everyone else is gone we invited Joseph in for dinner (he usually eats out in the guard house). He’s clearly a really talented artist and if language weren’t such a barrier I think he’d be really fun to talk to. SO, with that in mind, Anita and I are starting Kinyarwanda lessons tomorrow morning. We found an instructor to come to the house for $12/hour so we’ll see how it goes. It would just be really nice to be able to do more than stumble through a generic greeting. We’re thinking we may also look into some French lessons since Kinyarwanda is impossible and French would be equally useful here.

That’s it for now… we’ve got a quiet weekend coming up so I may post again tomorrow or Sunday. For now, I uploaded some more pictures from our trip to Akagera – check them out here:

http://www.facebook.com/album.php?aid=2135841&id=2600785&l=ed8bc

Will you be my Valentine?

Well it’s been over week since my last post so get ready for another novel… to those of you who actually read through all of these entries, thanks for your interest in my life! To those of you who don’t, I’m planning on doing some entries just about my observations about life here and what some of my experiences have meant to me instead of just a play by play of events so keep your eyes open for those – I think they’ll be more interesting.

2/5/09
I got a late start today which was nice since my flight wasn’t until 2pm. Rwandair Express is quite an interesting little operation – they don’t actually own any airplanes… they just charter out their flights to a bunch of private carriers so I had a nice little flight on a no-name aircraft. It was only 25 minutes though (compared to about an 8 hour drive) so I can’t complain. I got into Bujumbura and Mary was waiting for me which was a relief since the bank at the airport was closed - it was “National Unity Day” and I didn’t have any Burundian Francs to pay for a taxi with!
We got back to Jeff’s house where he generously offered for me to stay for the weekend. Jeff works for Heartland Alliance – the same organization that Mary and Sean work for – and has been on the ground in Bujumbura for about 7 months setting up their child soldier treatment program. I continue to be amazed with the outstanding international work Heartland is doing! I got a tour of the house including the amazing backyard with every kind of fruit tree you could imagine. His house really feels like a little walled off piece of paradise which is a bit bizarre considering it’s in the middle of a city that has been deep in conflict for decades.
Anyway, Mary and I spent the evening chatting about relationships and life accomplishments over a few glasses of wine. As I said I really think the work that she and her colleagues are doing is phenomenal and it’s had not to feel dwarfed by their achievements. Between Mary’s work with torture victims, Sean’s work with global HIV initiatives and LGBT grassroots organizations in some of the most oppressive nations in the world, Mardge’s activism at Cook County Hospital working for access to healthcare for a highly underserved community, Donna Rae’s work as an activist in the HIV/AIDS movement in the late 80’s and for human rights in Southeast Asia, and Kathy’s work in the Bronx (not to mention the work WE-ACTx is doing in Rwanda), I really feel like I couldn’t possibly have been surrounded by any more accomplished and heroic people. The stories they share and the knowledge and experience they bring to the table have been eye opening and have made me reexamine my own career aspirations and ideas of how to use medicine as a vehicle for social change. I know I am lucky to have met each and every one of them and I have no doubt that my interaction with them has changed my goals for the future (career and otherwise) - I can’t wait to see what opportunities await! It’s totally this kind of inspiration I was hoping to find during my time here and I feel really excited to jump back into school with some new perspectives.
So, after reaching all these conclusions, I went to bed feeling really good but was awoken at 2am either by the sound of Cher’s “Do you believe in life after love” blaring from a bar down the street or by the insect that was in bed with me and had bitten me about 10 times. That’s what I get for sleeping on a mattress on the floor I suppose! Thankfully I had earplugs and cortisone cream and was able to fall back to sleep eventually.

2/6/09
We started the morning off changing money (at a Forex Bureau called “change for peace” which I found rather ironic considering its war torn location). We went and got Mary’s visa extended and then checked out the craft market where I promptly spent all $50 that I changed. There are some good deals to be had on crafts in Bujumbura though so I’m pretty excited about what I got! We also ran into Neelah (the coordinator for the Human Rights Watch in Burundi) twice in the span of about two hours which tells you just how few westerners there are in Bujumbura. It’s really quite sad because the city is about the same size as Kigali and they have just as great if not a greater need for foreign aid yet there’s millions of dollars flowing through Rwanda and basically NO foreign investment in Burundi. We had dinner at a restaurant called BoraBora (which was right on the beach and had a strangely Caribbean feel) and it was with just about every NGO employee in Bujumbura as far as I could tell. I guess I’m exaggerating but everyone at dinner was an NGO employee - Catherine (from Catholic Relief Services), Felicia (from the Clinton Foundation), Michael (from Orphans of Rwanda) and then Jeff and Mary. Felicia has been working on the Clinton Foundation’s new pediatric HIV treatment protocol in Kigali for the past year so we had a great convo about that and she connected me with some good resources in Kigali including a random number to call to order bagels (every kind you could imagine including cinnamon rasin – now if only I could find cream cheese)! Michael was a friend of hers visiting from NY via Kigali and his organization provides full scholarships for graduate level education in Rwanda so yet again I was surrounded by amazing people doing amazing work!
I also got to enjoy an Amstel Bach for the first time which is a delicious beer that I highly recommend. I had enough of it that I slept pretty deeply but woke up in a half dream state to the sound of a large mob of screaming people. I fell back asleep immediately after dismissing it as a dream but found out in the morning that a man had been beaten pretty severely outside of the house – no doubt on his way home from the bar that was blasting Cher the night before. Apparently an off duty police officer was one of the attackers and the mob I heard was actually intervening on the man’s behalf. If the large pool of blood we found in the morning was any indication though I think perhaps they got there a little too late… Jeff assures me this is the first time anything like this has happened but I think it’s fairly indicative of the continuing safety issues after dark in Bujumbura.

2/7/09
We woke up at 6am to go to the Parc National de la Rusizi which is about 15km outside of Bujumbura. Two French journalists that Jeff met earlier in the week accompanied us since they had been previously but forgot their cameras. Unfortunately every Saturday morning in Burundi is a national service day – similar to Umuganda in Rwanda that I talked about in an earlier post but instead of the last Saturday of the month, they do it EVERY Saturday from 7-10am. We managed to make it to the park by 7am but almost plowed through a road block on our way there since Jeff wasn’t paying attention! The park was kind of limited but we were able to see a bunch of hippopotami as well as some pretty birds called weavers. It really only took about an hour and a half to hike through the whole park though so by the time we were finished it was about 8:45. Unfortunately the road blocks were up to 10:00 and so when we got in the car and attempted our trip back we encountered a mob of Congolese people who were stopped on their way into Burundi. When the soldiers started to let our car through, two men on bicycles loaded to the brim with goods cut in front of the car and blocked the way. At that point we were surrounded by about 50-100 people all laughing and pointing at the stupid muzungus that thought they could force their way through. Mary and I kind of took the viewpoint that we should just wait it out until 10 when the roads opened up – why should we have any more right to get through than everyone else? Jeff and the French journalists, however, felt that we should be able to get through and so after about 10 minutes of sitting there, the two French journalists got out to talk to the soldiers and I was sent out to protect them from the mob – a lot of good I would have been if things had gone badly! Anyway after a screaming match in French of which all I was able to pick up was “we are human beings too” they were able to convince the bicyclists to move aside. I felt like the whole situation was just wrong and it had the potential to be a real issue. On we went thouth, the privileged muzungus, and we stopped for brunch at the hotel club du lac which felt a bit like adding insult to injury. Mary and I debriefed afterwards and agreed the sense of entitlement was a bit disturbing especially considering these people made a conscious choice to come and work in Burundi ostensibly to make a difference for the very people they pushed their way through. AND we made a choice to squeeze in this leisure activity that morning – it’s not like we had an important meeting or something to go to. Over brunch we agreed to disagree but there was clearly a little tension… Mary and I decided to stay at the beach for a while and the three of them went back into town once 10am passed and the road blocks were down.
The beach was gorgeous with a misty view of the DRC across the lake and cute (but worm infested) dogs running around. We ran into Felicia and Michael there of course – yet again an indication of just how small the ex-pat community is there! On the way out of the resort we walked by a cage with two Chimpanzees inside which I must say was one of the saddest things I’ve seen in Africa (which is saying A LOT). We stopped by t2000 on the way home which is a dollar store full of crappy Chinese goods that is popular in Kigali and I didn’t realize is a chain! For dinner, Jeff, Mary and I met Felicia and Michael at Khanah Khazanah which is THE BEST Indian food I’ve ever had in my life and definitely ranks pretty high in the best food of any kind I’ve ever had. It’s a funny story but basically a very popular restaurant in Kigali called Indian Khazanah was shut down for tax evasion and the same family set up shop in Bujumbura instead. Fingers crossed - the owner promised they would reopen in Kigali in mid April so hopefully I’ll have the chance to go again before I leave!

2/8/09
I woke up early to take a walk down to the soccer fields and watch a troop of Burundian drummers that I had heard practices on Sunday mornings. I guess I got there a bit too early and ultimately headed back because the walk got a little sketchy. I went back at 10:30 with Jeff and Mary and after watching a bit of a soccer match, we saw a troop called Rukinzo Legacy practice for about an hour. Their leader was a magistrate named Posper who introduced himself and the troop to us afterwards. I was hot just watching them – I can’t imagine how hot they must have been. I treated myself to my first Diet Coke (aka coke light) since I’ve been here and we bought them all a round of Fantas. Sean came in the afternoon from Kigali and we went grocery shopping (including purchasing 18 cans of coke zero to feed his addiction) for his trip into the Congo this week. He’s going to Uvira tomorrow to work on establishing a former girl soldier treatment program in southeastern Congo.
We all had dinner at Felicia's – she made delicious eggplant parmesan and Jeff brought over some delicious couscous. All in all my culinary experiences in Burundi were quite impressive!

2/9/09
Mary and Jeff had actual work to do today so I entertained myself by walking down to the HUGE central market. I put my money in my shoe since I was forewarned that I would be the only muzungu and indeed I stuck out like a sore thumb. It was a great if not slightly claustrophobic experience and I’m glad I went but it was quite sad since amidst the endless stalls of fabrics and goods, I encountered about 10 amputee and otherwise sick children on display asking for money. I headed back to the house and then packed up my bag and Jeff gave me a ride to the airport.
Arriving in Kigali was actually a really nice experience – despite immediately recognizing just how sanitary and oppressive Kigali can feel compared to other cities in developing countries, I had a sense of homecoming. There are definitely good and bad things about the way things are done in Rwanda but I was really happy to realize that in a lot of ways I already felt at home in this city. There was even a rainbow over the airport when I landed which felt a bit over the top but I went with it and took a picture! I also got a nice welcome from everyone at the house and Donna Rae and Mardge were particularly happy to see me which was really nice. I think I’ve definitely made some lasting connections here!

2/10/09
Back to work this morning… apparently training on Friday went well but one of the machines from Qiagen was broken so things have been a bit delayed. We went out to Nyacyunga for another day of training only to discover power lines were down so we came back to town. I had a package to pick up (thank you again Mama) and so I took a Mutatu (local buses) out to Kaciyru to pick it up at the central post office (iposti in Kinyarwanda) which I am proud to say I figured out how to do all by myself! Anita, Neeva and Alesha came along too and we checked out Top Tower Hotel & Casino which Michael had told me he had fun gambling at. They’re only open at night so we’ll have to check that out another time… We also finally made it over to the Novotel to see the infamous pool where apparently a lot of ex-pats spend their Sundays (the other two hotels with pools are both under construction). We got a buffet lunch at Ma Collines and ran into Savannah & Meredith there – if you haven’t identified a trend yet there’s a lot of running into people here! I had a meeting in the afternoon with Bernadette who works for WE-ACTx to discuss what role I can play in a nutritional supplement program they have for children on anti-retroviral therapy. The cervical cancer study won’t be taking up all of my time after next week so hopefully this Sosoma project will be something else interesting to work on. I also bought Kinyarwanda phrasebook this afternoon since I’ve been lagging in my efforts to learn more words and Anita and I are going to look into possibly taking lessons.

2/11/09
Today was a pretty uneventful day. We went up to Nyacyunga for training in the morning, came back and had lunch at home where we discovered there was a meeting of all the grass roots organizations that work with WE-ACTx (there’s about 20+ of them so it was a full house)! I took a nice nap and after discovering there was no internet we watched Blood Diamond on Anita’s computer and then headed to bed early.

2/12/09
I met Michael (Felicia’s friend from Bujumbura) at the offices for his organization – Orphans Of Rwanda. It’s a scholarship program for graduate students in Rwanda and Michael and I discussed possibly starting an internship program with WE-ACTx for some of their nursing/lab tech students. Then I went to a store called Dancing Pots with Mardge & Donna Rae to check out some Twa (a pygmy people from central Africa) pottery. I also met with Eugene to finalize plans to start the pilot for the study on Monday and I helped Anita set up the machine for her study. Mardge also met with me to discuss another project I can work on while I’m here… they want to start screening all of their pediatric patients for depression and so I’ll be spearheading that along with the two trauma counselors. We had lunch at Ma Collines again with Merideth and when I got home, I discovered Josie had left me a rose from the garden in my room since the one Eunice gave me before I left was dried out… too cute! Mary arrived home from Burundi and it’s Donna Rae’s last night here so there’s more goodbyes coming up.

2/13/09
Said goodbye to Donna Rae this morning and I’ve promised to apply to the pediatrics program at UCSF if for no other reason than to go visit her if I get an interview. I met with one of the doctors for the Sosoma (pediatric HIV nutritional supplement) program in the morning... we were supposed to meet with two doctors but the one from Icyuzuzu called to say his brother had been electrocuted so he had to cancel. Things like this are said so casually here that I was strangely not surprised! Anita and I grabbed some coffee at Bourbon (where we ran into Katie) and then back at the clinic I narrowly escaped Bernadette asking me out for Valentines Day… she asked me casually about what I did usually at home for Valentines Day and thankfully I had to leave right before I could tell she was going to ask me to do something tomorrow. I felt bad but at least I avoided the awkwardness of having to make up an excuse why that wouldn’t be such a good idea.
I took a trip out to Remera (a neighborhood near the airport) to visit the Ineza sewing cooperative which is an income generating project for WE-ACTx patients. Two of Lara’s yoga clients (Roy & Sarah) and Meredith joined me. They make beautiful bags and aprons and such there… there will surely be a few gifts coming back to NY from there.
Afterwards we went to a debut concert at the Hill Top Hotel in Remera. It was a concert for a new artist named Eric Sendeli that Bertin (the coordinator of the WE-ACTx children’s program) invited us to. It was supposed to start by 5:00pm but in typical Rwandan fashion it didn’t start until 8pm. We got a few drinks and actually Savannah was randomly at the same concert so we just hung out with her for a while. Bertin gave us “VIP” tickets which basically meant that we had to sit in the front row but considering there were only about 40 people there it was a bit awkward. Despite best attempts to get drunk on uguagua (banana beer), the concert was still not very enjoyable and after about 2 hours of TERRIBLE lip syncing, Alesha and I decided to head home.

2/14/09
Today has been a pretty chill day. Mardge left at around noon. The weather was gorgeous so I sat out in the yard for a little while and then Alesha, Nevea and I took a walk into town so they could check out the craft market here. Candida made a delicious chocolate cake for Valentines Day and we’re heading out to Torero Café tonight to meet up with Amy and check out some live music they’re having there. It will hopefully be an early night since we’re getting up at 6am to drive out East to Akagera National Park which is a savanna reserve with all kinds of animals. Fabreece (one of the lab tech’s we’ve been training) arranged for us to rent a 4-wheel drive vehicle. Should be an interesting day!

Phew, that was long! But now for the most important part… I finally got around to uploading pictures so feel free to take a look – they’re on Facebook but if you don’t have an account then just use the links below. There are three albums so far:

http://www.facebook.com/album.php?aid=2135819&id=2600785&l=0b683

http://www.facebook.com/album.php?aid=2135841&id=2600785&l=63c48

http://www.facebook.com/album.php?aid=2135955&id=2600785&l=54c60

Groundhogs Day in Rwanda

2/2/09
So 6 more weeks of winter, huh? Sucks for you all! I must say though I’m glad I’m not going to have to repeat today over and over again a la Bill Murray – it’s been a kind of frustrating day. It turns out that after all the debate back and forth, today actually was NOT a holiday in Rwanda so we were up at 7:30 with the hopes of getting the 500kg of supplies that Quiagen shipped out of customs and set up so we could start training on Tuesday. While that was being arranged, we met with the lab techs that will be trained and made up a schedule for the coming two weeks that includes 8 hour days since only two techs can be trained at a time and the training is split up into 4 hour modules so there are some long days coming up! Ultimately it became clear that the supplies wouldn’t be getting out of customs any time today since the minister of health hadn’t personally stamped some piece of paper. As soon as we found that out and were about to head home, it started POURING rain so we were stuck waiting around the clinic for another 2 hours until the rain passed. Ultimately we made it home and the only saving grace of the day was that Anita seems to be pretty cool and I think she and I will do some traveling together when there’s down time here. That and I went for my first run in Kigali now that I’m fully healthy again and other than everyone staring at me, it was a really nice and cathartic run. I’m looking forward to making that part of my regular routine here although with all the hills here just walking is a workout!
I also found out that tonight my friend Katie got accosted by some man who tried to steal her cell phone out of her hand. One might not find that so unbelievable but Kigali really is the safest city I’ve ever been in and things like that really just don’t happen here. Thankfully Katie was able to fend off her attacker (after he tried biting her hand so she would let go of her phone) and other than being a bit shaken up she’s fine. The saddest part of the story for me though was the reaction of the two men who came running over to help her. They were extremely apologetic and insisted on walking her all the way home (this is the typical Rwandan hospitality I’ve come to know and love) but Katie said they were clearly shaken up by the attack as well. They wondered if perhaps the man was a member of the interahamwe (the group of Hutus that perpetrated the genocide in 1994). It just made me so sad to think that 15 years later the first thing to come to the minds of these men with even such a petty crime was related to the genocide. I find it’s really easy for me to forget about the atrocities that have happened in this place that I find so peaceful but stories like this one are a reminder of just how much the history is at the forefront of people’s minds here. It’s also a little scary because I have heard grumblings that many people feel the atmosphere in Rwanda right now is eerily similar to the period immediately before the genocide. The DR Congo has recently reached a deal with Rwanda after the arrest of General Nkunda to let several former members of the interahamwe return to Rwanda with amnesty and I think it has really unsettled a lot of people here…

2/3/09
What did I say about being glad I didn’t have to repeat yesterday over and over again??? Well today started off with high hopes of customs clearance and so we headed up to the clinic at 8:00am only to be told nothing would be happening with the shipment until early afternoon, meaning training will be delayed by yet another day. So in order to avoid the frustration of yesterday I just spent the day with Eunice (her last full day in Kigali) and told Eugene to be in touch via cell phone because I couldn’t spend another day filled with “hurry up and wait” moments. So Eunice and I had a really nice day together and we met up with Savannah, Anita, Alesha and Neeva for a buffet lunch (which sadly is not all you can eat here). It was also quite a productive day for me in the end because I decided to go to Bujumbura, Burundi for the weekend and bought my plane ticket… I’m taking a long weekend (Thurs-Mon) and meeting Mary (and hopefully Sean) in Buj to hang out for the weekend. Lake Tanganyika is supposed to have gorgeous white sand beaches and despite being unsafe at night, Bujumbura sounds like a fun city to visit. Mary arranged for me to crash on a colleague’s couch so it should be a pretty low cost trip and I’m really looking forward to it!
The shipment finally got delivered at about 6pm tonight so we’ll be heading up to Nyacyunga to set everything up in the morning and start the training tomorrow afternoon. Once that was all settled I joined Eunice at the Serena Hotel to have a celebratory drink with her on her last night in Kigali. I feel like I’ve said so many goodbyes in my short time here but while each one is sad, ultimately it’s pretty cool to feel like I’m actually rooted here for a while. And Euni and I have plans to reunite in London on my way home in April so hopefully that’ll work out!

2/4/09
After a rainy morning and a delayed departure for Nyacyunga, we finally made it there around 1pm and got all the equipment set up for the training which started by 3pm and went through until 7pm today. We unpacked 19 boxes and 500kg of supplies from Quiagen in this rickety building in the back of a rural health center just outside of Kigali – a scene that attracted quite an audience. We’re training 4 lab techs on how to do the HPV testing and only two of them are proficient in English so it was definitely an interesting day. Alesha and Neeva seem to think it went pretty well though and hopefully by the end of next week they’ll have it down and we can start piloting the study. I’m really looking forward to my trip to Buj tomorrow and I promise once I’m back I’ll upload some pictures! I’ll be out of touch till Monday night probably. Some appropriate Kinyarwanda courtesy of Logan: Uragendo rwiza – safe journey!

Hero's Day aka Y2K Rwanda style.

2/1/09
This morning I went with Alicia and Neva (the Quiagen trainers) to visit the clinic at Nyachunga and figure out the logistics for the HPV training. When we got back we walked up to the Kadafi Mosque where WE-ACTx sponsors a children's program every Sunday. Lara and Eunice do a yoga program there with the kids and the group of donors for Heartland Alliance came to observe that. I made friends with two deaf boys who can't really sign (I can't even imagine how isolated they must be) and we played marbles and one of them had a good time taking pictures with my camera. Neva passed out while we were there from a combination of not eating and altitude issues I think so she went home in a taxi and is doing fine now.
We had a going away dinner for Lara tonight at Soleluna which has excellent pizza and a nice view of the city. I met a few more new people that will hopefully fill the void that Lara and Eunice are leaving once they abandon me here. After that we got a drink with Sean at the Mille Collines and when we got home Anita (a medical student from Downstate) arrived so now the house is really full (but Lara leaves tomorrow so we'll only be at capacity for 1 night).

And now for a little taste of the quirky country that is Rwanda:
So today is a national holiday known as Hero’s Day… it’s somewhat controversial since it basically celebrates the start of the civil war – an odd thing to have a holiday for. Even stranger is the fact that they announced on the news tonight that tomorrow would indeed be a national holiday in observance of Hero’s Day but up until that announcement they hadn’t actually decided. Can you imagine an announcement on the evening news in the US that the next day would be a holiday when up until that point it hadn’t been planned to be?
Anyway, in addition to being Hero’s Day today is also the Rwandan version of Y-2K… they decided to change some of the phone numbers to standardize them and make them all 10 digits so a bunch of people had a 78 added into the middle their number today – talk about confusing. Thankfully my cell number stays the same since it already had 10 digits but the cell network has been busy for most of the day with everyone trying to figure out the new numbers. So between that and the national non-holiday, I’m telling you this country just gets more and more bizarre as the days go on (don’t get me wrong though, I’m loving it).