Monday, March 31, 2008

End of week two

March 29, 20008
Goats, sheep and chickens live in the yard of ARC’s house in the rural village of Nyabiheke. They are the pets of the camp manager. He does not eat or sell the animals, so the other staff tells him he needs to start family planning as is being done in a major effort at the camp. The village is not on the electrical grid, so all electricity comes from generators. The water supply is unpredictable and must be heated on the stove for baths.The internet is unreliable. The roads are mud with large rocks and Toyota Land Cruisers are the vehicle of choice. Only two families in the village and or of course refugees have vehicles. Bicycles are used for transporting three big bags of grain, building materials and people. All of the field work is done by hand. I have not seen any garden tillers, horses or oxen in the fields. This area is at a lower elevation and is warmer though due to the rainy season not hot. The highest temperature has been about 85 F. The food is rice with meat sauce(beef or goat), potatoes and cooked vegetables. The cooks know I like cooked greens. The meat is chewy, therefore I floss at least twice a day.

Thursday a teenager died suddenly in the infirmary after sudden onset of abdominal pain and vomiting. The nurses and family think he was poisoned. No autopsy or investigation will be done as far as I understand. This happened 45 minutes before I arrived at the clinic and per routine the nurses did not call me. Of course there is nothing that I could have done. There are many things needed in the clinic and infirmary includeding thermometers as measurement of temperatures the past two days has not been done, baby scale and especially running water in a convenient place for washing between patients. I am making plans and gathering information for subjects to teach to the nurses, who provide 90% of diagnostic and therapeutic decision making and direct care.

This weekend, as last, I am working at a camp and none of the managers are at the house, so it is a bit lonely. The housekeepers come in daily to clean and cook and there are guards outside, so I’m not alone. Next weekend I will probably go to Kigali.. After that I expect to have a work plan and schedule. April seventh is a holiday to mark the genocide of 1994. I may visit the genocide museum next weekend.

Friday, March 21, 2008

more pictures





1st week photos








First week in Rwanda

After delays nnd a free trip to the Brundi airport, Louise, another volunteer met me at the airport. We met the staff at the Kigali office and Barry Wheeler, the country director explained that I am to observe and work at two camps the first two weeks and then meet with several people th decide how my skills may be most helpful. All the staff have been helpful with tasks such as recovering a lost bag, taking me to a wedding and solving computer problems. You may see the office at www.arc.org.rw.
I have been near the camp Gihembe(18,000 residents) for five days now. The refugees are from Congo and have been here 10-12 years. They are not supposed to work in the Rwandan economy according to law and have minimal space to garden. There is little for adults to do. The children attend schools.
The diseases we've seen include malaria, typhoid, pneumonia,HIV, probable early AIDS, previous spinal cord trauma with papaplegia, measals, chickenpox and rectal prolapse in a 3 yr old. Communication in French is difficult for me and there are few good english speakers. I hope to improve French and find more English speakers. I will probably give presentations on some diseases like diabetes and use of equipment like oto and ophthalmoscopes which they don't have. Allina gave me two of each to bring. Also I will discuss uses of the reflex hammer.
Everyone here says it is very safe and I have felt no concerns. Many say Rwanda is one of the most organized, safe, clean and law abiding countries in Africa. I am staying in a house about a mile from the camp in a walled compound with full time watchman.
I am posting a photo of a woman holding her medical record that she carries with her. The clinic has a log book with one line of information about her visit listed by date with all of the other patients who vivited that day.
Acess to the internet is varriable and always slow. I'll try to add photos now.
John