Kurira (to cry)

The students here are sponges for information.  They are so hungry for it that they believe everything that they hear.  Unfortunately, they have come to believe the he said she saids that have been passed around their community.   

Fortunately, I was able to provide them with some medical truths that I am optimistic will also be passed along.

I met with the secondary school girls again on Thursday.  We had some serious woman to woman discussions.  In fact, I’m blushing just thinking about some of the words that came out of my mouth.  My presentation included puberty, feminine hygiene, conception, abstinence, and what it means to be in healthy Godly relationships with men.  They had questions on anatomy, abortion, and if you could lose your virginity riding a bicycle or wearing thong underwear.  The day before I promised them I would bring a tampon for them to see and so I did.  None of them had ever seen one – or heard of them.  It was a huge hit.  Lots of giggling and questions. 

(I’m sorry to the men reading this – but Ryan gave fair warning as to the possible content of my blog!)

Then yesterday, Friday, I went back to the school and was available for the girls to meet with me one on one.  Most of them have never met with a doctor before.  Ever.  I spent a couple of hours and met with 10.  Most had similar questions about their anatomy and concerned that they might be sick.  They are actually quite healthy and their problems are all very normal (and not problems at all), but they have never had anyone give them that information.  I think a few were bummed that I couldn’t make it go away.  Oh well, they will have to accept the “joys” of being a woman.

I had a few really tough cases.  One girl really touched my heart.  She was a translator for several of the other girls that came to me, so I was already familiar with her.  Her English is fantastic.  She is so bright.  I’m pretty sure she is the one that answered my question about germs a few days back.  As she told me her story, I just sat across from her and wept with her.  This is the girl that has it all together.  Top of her class.  Beautiful.  Funny.  Strong.  And yet a victim of a string of terrible events.  She has held these haunting memories inside for over 16 years, never having told anyone – until now.  I gave her the medical information she needed to know, promised her I would do some research on local resources for her to use, and gave her my phone number.  I told her I wasn’t trained to do any counseling like she needs, but I would be happy to sit, listen, and cry with her (for the next 2 months anyways…)

Her story is devastating.  In fact, it’s your worst nightmare.  Unfortunately, there are millions with very similar stories.  Our friend Pierre who lives with us has a heartbreaking story behind the singing and whistling he does while he happily serves our helpless selves.  (Hopefully we can learn his story soon.  Right now I can only communicate short sentences like “I can’t unlock the door” and “we go buy water.”)

I wish I could heal their brokenness and make their pains go away.  But I know I can’t, so I will be grateful for the opportunity to cry with them.

On a super happy note – my dad is currently on the flight from Brussels to Kigali.  He will get in late tonight.  Monday we will be heading off to Akagera for a 4-day safari adventure followed by a few days in Ruhegeri to see silverback gorillas and golden monkeys.  Yee-haw.

Inika mu mazi & isabune (soak it in water & soap)

I know I said in my previous post that I was going to be spending some time at the hospital this week.  Well, this is Africa and you have to be able to go with the flow when the flow isn’t going where you thought it was.  Instead of being at the hospital I have been spending some time at the Star School doing public health talks with the secondary school girls. 

Yesterday I met with about 50 girls ages 14-24.  We covered topics such as germs, proper hygiene, and safe drinking water.  These girls are bright.  They are getting one heck of an education.  I started off my talk asking if anyone knew what a germ was.  “A small living organism that can cause harm to your body.”  Said in English.  Just like that.  I couldn’t have answered it better myself – in fact, I wouldn’t have. I then moved to how to bathe, the importance of soap, how to wash clothes (again emphasizing soap), the consequences of not being clean (body odor, infections, disease), and why they should wait for the cooks to boil any water for them to drink rather than the immediate satisfaction of the cold water from the taps outside. 

I’ve learned that you can’t say “don’t drink that water, it will make you sick” unless you have a reasonable alternative ready.  All the girls seemed to fully understand the water bit.  They’ve either heard that advice before or have each personally experienced the consequences of the water – or both.  They all laughed and nodded as I rolled around on the floor in the fetal position holding my stomach.  (I had to get pretty silly to get them to come to life.  Rwandans are very reserved – Good thing I’m a goofball.)

Once I had made a big enough fool of myself to get them to open up – they really opened up!  There were tons of great questions.  Tons that made me laugh.  And tons that broke my heart…

Great questions: “What are some of the symptoms of a urinary tract infection?” and “What would happen if you didn’t get it treated?”  “Why is it okay to shower and wash my clothes with the bad water but not okay to drink it?”

Funny questions: “How come when she (points to the girl sitting next to her) takes a shower she still smells bad even right afterwards?”   Talk about a candid group of people!  Could you point to your colleague in a business meeting and announce to everyone that they had terrible body odor?   There were a lot of fingers pointed and names mentioned but no one was hurt by it.  They are a close-knit group and they were looking for answers for each other’s problems.  Still…I couldn’t help but crack up at their frankness.

Many of their questions were so basic that I really had to think about my answers.  I can quickly spout off the major infecting organisms that are found in their tap water, their unique symptoms, and 1^st, 2^nd, 3^rd line treatments for each one…. But that’s not what they want/need to know. 

They wanted to know 1. What temperature the water is supposed to be for their shower. 2. Is it okay to use soap on all body parts when showering.

3. What the yellow stains under the arms of their white shirts are, 4. Why certain parts of your body smell differently than others, and 5. Is it okay to use dish soap to shower with.

1. It doesn’t matter.  2. Yes of course.  3. Sweat stains.  4. They just do.  & 5. No, use Irish Spring, Dial, or Dove. – are the American answers to those questions.  We take for granted a ton of information that we don’t even know that we know.  (And no, they don’t have any of those fancy soaps I just mentioned.  They have one type of body soap.  It’s an odorless brown block of wax and lard.)

In a couple of hours I’m going back to the Star School (rain permitting) and I’m going to have a much more sensitive conversation with these young women.  That’s right.  Yours truly is doing the sex ed, this-is-whats-going-on-with-your-body lecture. 

So hang tight- an even more interesting blog is headed your way soon… 

Finally, a blog about medicine.

It has been almost 3 weeks since we arrived in Kigali and I haven’t posted a single blog about Rwandan medicine.  I had BIG intentions to fly halfway around the world to a developing nation and save all of the suffering people.  Now that I am here, I realize how silly that is.  It’s in my nature to get somewhere and want to do do do, rather than to be.  I’m learning that I should take these months to be close to the Lord in the stillness of my eager hands.

Last week I had the great opportunity to tour King Faisal Hospital.  It’s the fancy-pants hospital of the country and likely one of the best in the entire continent.  Dr. Alex is a senior physician at KFH and gave me a very thorough tour (he’s a pretty big deal).  The first part of the tour was to the nation’s pride and joy – the radiology department.  As it turns out, they have the same equipment that we do in the US.  It’s pretty and shiny and new.  The only difference is that they have 1 MRI machine, 1 CT scan, 1 ultrasound machine, and 1 x-ray machine… for 11 million people.   I expected them to be in constant use, 24 hours a day, with a line of people waiting for their turn for imaging, but they’re not.  That morning there was one person being imaged. The people here just can’t afford the luxury of a plain x-ray, let alone an MRI scan.

Next we went to the other departments: Med/Surg (which was mostly used for patients with malaria or those using one of the 6 hemodialysis machines in the country); NICU (which has a fantastic monitoring system…for one baby); Labor & Delivery; Physical Therapy; ICU; Emergency (which is so quiet compared to the ERs I’ve been in - no monitors beeping or people yelling at each other); & Outpatient (family medicine and pediatrics for people who are willing to spend a couple of dollars to avoid the street clinics).  The only department I didn’t go into was the surgical suite.

There are 3 types of patient rooms – private, semiprivate (2 beds, 1 bathroom), and not-private-at-all (10 beds, gender-specific community bathrooms down the hall).

Each bed comes with a mosquito net and a curtain to separate you from your neighbor.  All of the staff speaks English.

I know what I just described to you sounds really nice – and by all African standards it most certainly is - but even the nicest medical center in Rwanda is enough to make any American doe-eyed.  I was invited to spend some time shadowing Dr. Alex at KFH, so I’m going to take a few hours each day this coming week and learn from someone who practices the kind of medicine that isn’t watered down with machines and prescription pads.

(I don't have a picture of the hospital yet, so I've attached one of a hillside of Rwandan homes.)

Yes, please!

On Monday morning, Ryan and I adventurously drove off towards Akagera National Park (the Rwandan safari park) knowing that our map is outdated, not to scale, and in French.  It’s only 3 hours out into the country, down a paved road, and you take a right, and then a left, and then go down a dirt road, and there may or may not be any signs on the way…  My dad is coming to visit in 10 days and we wanted to be sure we knew how to get him there.  I won’t go into too much detail of our trip yet because I know my dad is reading this and I want him to experience the same surprises and excitements that Ryan and I encountered when we showed up to the safari lodge.  The point is it was spectacular, and we didn’t even do the game drive (we’re waiting to do that with him).

The staff at the lodge was so warm and welcoming. It was clear that they had been extensively trained in formal hotel and dining service and were taught a few important phrases in the English language. When we spoke to our waiter, William, it quickly became evident that he didn’t understand us and his responses were recited phrases.  Our favorite response was  “yes, please!”  William would say it as a response of absolute pleasure and confirmation to whatever we ordered from the menu – or to anything we said, really – and he said it with a big smile.  If we ordered a bottle of water, he would say “yes, please!”  If we wanted the club sandwich… “yes please!”  If we asked where the restroom was…“yes, please!” If we thanked him… “yes, please!”  Ryan and I started saying it to each other ALL the time, especially when it didn’t make any sense.  It’s tough to say why that tickled us so much.

So, on our way to the lodge, about an hour away from the entrance, on a terrible dirt road in the absolute middle of no-where African countryside that leads only to the lodge, a pick-up truck blew past us in a hurry.  Tied down in the back of the bed was a 300+ lb pig.  Alive.  It was so crazy to see, especially since we haven’t seen any pigs at all since we’ve been here.  Ryan scrambled to get his camera out while he stepped on the gas and I grabbed the steering wheel.  We got one blurry picture – the truck was going way too fast. 

Anyway, that night we had excellent pork medallions for dinner.

We stayed there for 2 nights, played tennis on clay courts that were on the edge of the mountainside overlooking beautiful valleys, got sun burned, and relaxed.  (We really needed a vacation from our sabbatical...)

Akagera Game Lodge is now one of my favorite places on earth.  The scenery is breathtaking, it’s quiet and peaceful, and there are super-fun fuzzy animals all over the place.

Am I excited to share it with my dad in less than 2 weeks?  Yes, please!

                                                

“I would like you to thank me for eating your dinner.”

Ryan & I had our first dinner guest over last night.  His name is Latimer.  He is a close family friend to Nathan and works as the finance director to his projects.  We’ve been helping him with one of the projects (I’ll get into it in a bit), so we decided to have him over to finish the work and get to know him.  With Latimer’s translation help, we asked Pierre to join us for dinner.  (I’ve tried several times through my broken Kinyarwandan to invite him to our table, but I’m pretty sure he thinks I’m asking him to do the cooking, and then he gets offended when I take the spoon out of his hand and do something totally American -and evidently quite offensive- like put tomato in the beans.  And so he walks out of the kitchen and well, so much for my dinner invitation.)  At the end of the meal, Pierre told Latimer to translate 2 things to me.  

1: to tell me, in whatever the English way is, “thank you for the meal.” 

2: to tell me that in Rwanda, I am to thank him for eating the meal I have prepared for him. 

…you’re welcome?  …thank you?

As it turns out, the thank you comes from women standing over the cook fires preparing the meals for the men who are out in the fields.  The women are privileged to work in a place of warmth, light, and safety, so they must thank the men for that. 

Usually, I thank Ryan for eating my first-year-of-marriage-experimental-meals… but I have never thanked him for allowing me the privilege of cooking for him. 

So, Latimer’s current project is to find sponsors for 18 children to board and attend the Star School.  It’s essentially like one of those commercials you see on TV that “for less than $3 a day you can change a child’s life.”  I know.  You’re rolling your eyes.  But really.  For less than $3 a day, a child will be boarded on the school grounds, fed 3 meals a day, provided with safe drinking water, and will receive an education that would rival most American schools.

Once you meet the kids on those commercials, you don’t roll your eyes anymore. Ryan and I got to meet and take pictures of 18 children that are currently waiting for sponsorship through the World Help program (one of Nathan’s US partners).  Three of the children, sisters, are victims of a scenario far too common out here:  Both parents died of AIDS.  Their mother’s entire family (entire = mom, dad, brothers, sisters, aunts, uncles, cousins, second cousins, etc.) was killed in the genocide. Only her youngest sister survived. The youngest sister had to quit her job to move to Kigali in order to take care of the girls.  Now she has no job and 3 nieces to house, feed, and make sure they get an education (which is required by national law). Nathan had heard about her family’s trouble and chased her down, convincing her to bring those girls to his school and he would find a way to help them.

My heart is breaking in ways that I’ve never experienced.  The people of Rwanda are incredibly stoic.  I’m learning heavy lessons from the least of God’s people.  I should be thanking them for more than just eating my dinners.

Inyama (Goat)

Yesterday Ryan and I had the day to our selves. We got up and went for a jog.  We ran half a mile…  Don’t judge us; this altitude is killer!  Maybe tomorrow we can do a whole mile?  Please.  Who am I kidding?  We get winded walking across the street.

We then set off to find the Blessed Mango Tree Church to take pictures of the roof being put up.  We ended up in Bugasera – which if you look at a map, you realize we definitely took a wrong turn somewhere.  It happened to be exactly the right wrong turn for me.  We drove about an hour into the countryside and boy is it beautiful.   It’s exactly what I pictured Rwanda to be: Vibrant green hillsides covered in banana trees.  A winding river through the valleys.  The lushest scenery you could ever imagine.  And tons of goats.  Okay, I didn’t actually picture all the goats, but it was nice to finally see a fuzzy face.  (We miss our dog.)

Once I had decided we had gone far enough (once my anxiety couldn’t take it any longer) we turned around and guess who drove us all the way home?  Yup.  Me!  WooWoo!  This place is the PERFECT place for woman drivers.  You get to do whatever you want whenever you want.  You can honk the horn, flash your headlights, wave your hands frantically, and drive in the oncoming traffic lane if you want to as long as you avoid hitting pedestrians – it’s a lot harder than it sounds, but so far so good.

I have been praying for some answers as to why I was here and asking Him to show me what I should be doing.  Lord, if only there was someone with whom I could effectively communicate with and who understands my profession…

Last night, our landlord called and asked if he could come by, meanwhile honking to be let into our gate.  (Hey, at least he called, right?)  He brought over a doctor friend of his, a Rwandan who studied medicine in the UK and worked there for 15+ years.  He’s an internist who specializes in diabetes, speaks perfect English, understands the Western thought process, and knows what a PA is!!!  He invited me to tour King Fasial Hospital with him on Friday morning.   

Murakoze Imana! (Thank you God!)

It smells like fish...

Ryan & I went to the Remera market today and loaded up on fresh fruits and veggies.   But instead of reading about it, click on the like below titled "At The Market"and watch our experience:

At The Market