Good morning Good afternoon Goodbye

9 Dec

Back in early September I went into English teaching mode in my community. Perhaps you’re wondering what the entails. I decided that despite failed attempts at organizing English clubs/classes I could make every encounter with folks who need to know English meaningful.

This is a bit harder than it sounds, for the first three months I was so focused on mastery of Kinyarwanda that I squashed any attempts by my coworkers to speak in English, unless I lacked the vocab to communicate in kinya. That pretty much set the course for the rest of my service and now it requires a lot of effort on my part to remember to speak English with people who want to practice. You might call that successful integration.

So my grand plan wasn’t really so grand at all, but it’s had pretty awesome results. Each day on my way to and from work I greet every single student, teacher, shopkeeper, or anyone else I see who needs to know English for professional reasons. When I encounter a pack of students on their way to school I try to make eye contact and greet no more than 2-3 of them at a time. The coworker I walk to work with on a regular basis usually laughs at me as I interrupt the conversation with greater frequency as we near the school.

It seems like a small enough act but after the first month I noticed a real difference. Kids here are sequestered a bit from adult interaction. Most families I visit the kids are kept outside or in a back room, at meal time they eat apart from the adults on a mat on the floor with their hands. There are of course logistical reasons for this I’m sure…. But much of the time it’s got the ‘children are meant to be seen and not heard’ mentality. I mention this because when I first started greeting the kids I got a lot of nervous giggles, lack of eye contact and mumbled responses. As the days of greeting wore on, an increasing number of students would make eye contact and give clear responses.

The responses are rather comical. When I say good morning to a student I’m likely to hear anyone one of these responses:

-Good morning (teacher)

-Teacher

-How are you

-Fine thank you

I’ve explained to people that I don’t care how the students respond, only that they DO respond. The most important thing is that they get used to being greeted by an adult/foreigner and have the confidence to return the greeting however they can.

In semi-related news I’m overjoyed to know the word is about my preferred way for greeting little kids. It’s been a tradition for awhile now that when I come home I greet all the neighborhood kiddos with a hug and a small lift off the ground. It’s good for them and it’s good for me. More recently it’s caught on in my village as well and I’m floored anytime a little one approaches me arms up for a hug. Just this morning I had two little girls race up to hug me this morning then follow me up the hill to work repeating my name over and over. If that’s not a good start to the day tell me what is. A final miracle was when an American visitor and I encountered a liiiiiittle girl and she hugged us both! No fear! A single umuzungu is one thing, two or more is typically enough to make a kiddo shy but not this little girl. It was awesome.

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Kwita Izina

2 Oct

In Rwanda it is tradition to have a baby naming ceremony sometime after the baby is 2 or 3 months old. Up until that time the baby remains nameless and is called perhaps by its father’s name if it is a boy, but most often ‘akabebe’ (small baby) or just bebe. Similarly you can call the parents mama/papa akabebe because calling someone ‘parent of ____’ is a sign of respect in Rwanda.

My friends had their baby naming ceremony on Saturday September 22nd. Since this husband and wife are like brother and sister to me I was asked to come help prepare for the ceremony in addition to making the special dish of macaroni and cheese.

Friday afternoon I headed over to check up on preparations and to visit. They had just finished making banana juice, which would be served to the ‘party crashers’. The neighbors knew that there would be a ceremony the next day and banana juice would be served so quite a few of them stopped by to get some.

I headed over the next morning around 10 after I had done my own weekend chores, cooked the macaroni and cheese, and water for bathing later that afternoon. At first things didn’t look promising. In the village, all cutting of vegetables is done with a super dull knife and a plate on your lap. I should also mention that every girl is taught how this should be done, and there’s only one correct way! As Mama akabebe was running through the list of things that needed to be cut asking me if I ‘knew how’ to each one I had to reply no. The only thing my family let me cut during training was the cabbage. I was handed a thing of carrots and told to slice them, but things weren’t going so well. Then I had an idea so I ran home and grabbed my own fairly sharp knife, and cutting boards and headed back to the house, ready to get down to business. I chopped veggies for 3.5 hours in the sun while chatting with the other folks who had also come to help and explaining that no, the sun would not kill me if I drank plenty of water and wore ‘lotion to protect my skin from the sun’. I sliced carrots and leeks, cut several kilos worth of small eggplants in half, and then when I could no longer avoid the cabbage, I started in on that. It’s very important in Rwandan cuisine that the cabbage is sliced very finely, almost shredded which is a struggle for me. After toiling away at three cabbages and feeling nice and rosey from the sun, I decided to call it quits 30 minutes earlier that I had planned to go home and bathe with two cabbages left for someone else.

I can’t even begin to explain the amount of food that was prepared. They were expecting 100 people to show up, with maybe 30% of those people actual guests. You see party crashing is common practice in Rwanda because culture dictates that you must serve every guest something to eat and drink. With most ceremonies there are two strata of guests, those who get to serve themselves and drink a fanta/beer and those who are served a pre-determined portion and some kind of homebrew, in this case banana juice. The second group usually aren’t served a piece of meat either.

There ceremony was scheduled to start at 3 but didn’t start until 4 or 4:30 which makes sense since they were still cooking frantically when I left at 1:30.

The ceremony started with a procession of the godparents, parents and grandparents. The godmother led the way carrying the baby and all of the guests who were seated sang a song about naming the baby as the procession made their way to the seats up front. Like all Rwandan events there was an MC who started with a prayer. The godfather spoke, welcoming the visitors and offering them igikoma. There was a representative of the dad’s coworkers who made a speech, something about bringing Rwanda porridge as a gift, then a representative of the mother’s coworkers, again the same thing. Then the god father served each of the representatives igikoma aka a bottle of fanta. Oh yea and there was also a speech from the grandfather but what he said was lost on me.

Then it was time to eat. First the family went to the self-service table then the distinguished guests in groups (I was one of them). The bulk of people, villagers were served plates of food and a fanta bottle that had been filled with banana juice. The kids were all lumped together and served a giant platter of rice and fries. It was pretty quiet for awhile as 100 people mawed down on a ridiculous amount of food.

Then it was time for the naming ceremony. It’s tradition that first children come forward and offer names for the baby. I guess often they will say silly things but these kids all offered fairly decent names. There’s a recorder who writes them all down. Then all of the guests take turns offering their suggestions for names. It’s a tradition that if the parents select the name you offer that you’re given some kind of prize, maybe a bag of potatoes, a hoe, or some other valuable house hold thing. However, these days most parents have the name picked out beforehand (as in this case).

After everyone had offered their name ideas (one of my coworkers suggested naming the baby after a Rwandan rapper: J Polly), the dad stood up and gave a speech, thanking everyone and thanking God. Then announced the baby’s name: Gihozo Leo Axcel (not sure how to spell the last name). Which was none of the names suggested, nor did it include an English name like they asked me to help them pick, nor the name of the father as they told me they wanted to use.

After one last prayer most of the guests were off to their homes before night arrived. Remarkably it was only around 5:30 which means that the ceremony was less than two hours. It’s not common for anything, meetings, ceremonies, or church to be less than 2 hours in Rwanda. There was some group picture taking, I was mobbed by all the neighbors/kids to take pictures with my camera and slowly people left.

As the evening wound down, I wasn’t sure what I was supposed to do. There were quite a lot of visitors who were staying the night, and the women were busy working away to cook the evening’s meal. I decided that I’d stay and visit with the family members from outside the area. I always like spending time with peoples’ families because I feel like it reveals so much about them. Plus, there was plenty of opportunity for baby holding. And I got to hang out with my friend’s niece who is one of the cutest, sweetest, intelligent six year olds. She came to stay with my friends for a week while her parents were at a training a couple months ago so I met her then and was happy to hear that she would be coming. She ended up falling asleep on my lap.

The Adventist friends arrive in the evening after the conclusion of their Sabbath. I was flattered when they (indirectly) paid me compliments, explaining to the visitors what a nice girl I was and how I knew ‘ALL Kinyarwanda’.

The young woman who lives in the other house in my compound also arrived in the evening to visit and we made plans to go home together since it was dark and not good to go home alone. I kept asking her if she wanted to go home and kept getting, ‘in a little bit’. I tried once unsuccessfully, and even got as far as saying some goodbyes, but then was told it was almost time to eat (again) and how could I possibly go home before eating? Never mind that I was still stuffed from the large meal I ate just a few hours before. In the end we stayed to eat and finally as it was 9:30 and I was leaving for a meeting at 5 the next morning, I apologized about leaving, but I was tired and had an early morning.

They had borrowed my table to use for the self-service and I discussed with my friend about bringing it on Monday since I was leaving early the next morning and it was late. However, as I was leaving my friend told me he had something to tell me and then along comes two boys carrying my table, which requires some maneuvering to get into my kitchen. All I could do was laugh. So we had two teenage boys escort us home with the table.

 

All in all it was a really good day, and I’m happy that I got to visit with so many people. Because I knew most of the people I was even able to understand what was happening during the ceremony for the first time ever.

As I write this I am acutely aware of how my grammar has deteriorated and how I’m constantly wondering if I explain things clearly enough since the things I talk about are all fairly commonplace to me now yet foreign concepts to most of the readers. Haha.

A Day In The Life

2 Oct

After almost a year and a half at site, I’ve finally settled into somewhat of a daily routine and thought it was time to share it.

 

Wake up depending on how I slept and if I’m going to do some morning yoga I wake up between 5:30 and 6:30. Breakfast is first after exercise on the agenda, usually coffee and instant oatmeal with water out of a thermos I heated the night before. Nothing too fancy to the morning routine, a quick wash if needed, brush my teeth, get dressed, fill my water bottle and pack my bag for work (computer, planner, water, umbrella). I’m out the door by 7 am. Sometimes I walk to work with my friend, but a lot of the times he’s late.

 

Walking to work takes 20 minutes and I take the opportunity greet the students on their way to school in English and everyone else in Kinyarwanda.

 

Morning Meeting starts at 7:30 with a church song, then one of my coworkers prays, reads a Bible passage, and delivers a short lesson on the passage. Seldom do I understand the topics, but the songs are growing increasingly familiar. Another coworker prays and we move one to work. The head nurse, second in command, or accountant, whoever is the most senior person at work that day delivers announcements and assigns people to different areas of work. If someone has been to a training they take some time to explain the topic. Then everyone who is not a nurse leaves (including me) and whoever worked the night shift delivers the report from the night.

 

On good days the morning meeting is over in 30-45 minutes. Sometimes though there are a lot of announcements, or discussion and they can go on for an hour or more. Depending on the topic of discussion, I may leave the meeting early if I don’t have anything to contribute.

 

The Migration Folks like to take their sweet time getting down to the business of work, sometimes 30 minutes or more. They greet each other and talk about different things. Typically I’ll great whoever is around, then track down a set of keys to the office I work in so I can get started.

 

Work Most of the work at a health center takes place in the mornings. I make my way to my office in ARV greeting people on the way. Once there, I collect the rendezvous cards from whoever is there to get meds, pull their patient files, and return their cards. While people come and go I check my email/facebook and take care of any business I have online and on the computer while it charges. Things typically slow down, or finish up by 10:30 or 11 am. So then I’ll float around the health center visiting and chatting with my coworkers

 

People break for lunch from 12:30 – 1:30. Since I’m too lazy to make the 40 minute roundtrip I usually just hang out. Sometimes I bring food, or buy a little something something from the cantina. If I’m really hungry I’ll invite myself over to one of my coworkers’ house who lives near the health center for lunch.

Seldom is there anything for me to do at work in the afternoon so around 1:30 or 2, when I know the shopkeeper is back from his lunch break I’ll head into the village. First I greet my market mama and her older sister in English. Depending on how I’m feeling we might just go over basic greetings, but sometimes we chat for an hour or so. Then I go teach the shopkeeper and his friend English for an hour – hour and a half. Then I go visit my other market mama in her shop to greet her and to pick up anything I might need, and soon we’ll start working on English greetings as well.

 

Tuesdays I don’t typically do much teaching because they all have choir practice so it’s usually just quick greetings. Fridays it’s also just quick greetings because it’s market day and they’re busy, not to mention that me teaching them English draws quite the crowd of market goers.

 

I usually head home between 3:30 and 4:30. On my way home I make sure to greet the students in English and when I get to my neighborhood there’s always plenty of kids to greet. They usually come running up to me yelling my name with their arms out for a hug. Every one of the ‘regulars’ gets a hug, and the little ones get picked up. Depending on how demanding the day was, I’ll take some quiet time, maybe read a book or close my eyes for a bit before going back outside with the kids.

 

Evening If the weather is good there are tons of kids coming and going with their jerikans of water. We play ring around the rosie enough times so that every kid can have a turn holding my hand and fly around like air planes. Recently I started teaching them a more useful song, head, shoulders, knees, and toes and their new favorite game is tickle monster. They’re always asking me in Kinyarwanda to tickle them.

 

How hungry I am dictates when I light my charcoal stove. If meal prep for the evening isn’t too involved I’ll light my stove and then use the 20 minutes while the candle burns down to cut veggies/do meal prep. If it’s a little more involved I’ll start meal prep before I light the stove. After the candle has burned down I spend about 10 minutes fanning the charcoal to get it going well. Then I make whatever is on the menu for dinner. Once dinner is finished I put on a pot of water on the stove for breakfast the next day. I usually eat while watching something on my computer, usually in the dark. After 45 minutes the water for breakfast is ready. Twice a week, after all this I heat water to wash my hair/bathe. Otherwise after my thermos is full I lock up my kitchen, anytime between 6:30 and 8 pm, depending on when I started.

 

Most evenings my motivation to do anything vanishes with the sun so I’ll watch a movie or TV episodes until bedtime (9 pm). Sometimes though, I’ll wash dishes, read by candlelight or putz around my room.

 

Because of the market on Fridays, and it being a slow work day in general, I’ll head home early and try to get a jump on the weekend chores, usually sweeping and mopping my two rooms. Friday nights, in an effort to extend the life of my computer battery over the weekend I usually wash my unmentionables.

 

Saturdays I seldom sleep in past 7 am, especially with three little kids in the house. I like to have a slow morning with breakfast and maybe some book reading. Then I get my laundry ready for the umukozi and take care of whatever chores I didn’t do Friday before I head out for a hike between  9 or 10 am. I usually get back around noon, if I don’t end up visiting someone on the way back from my hike and light my stove to make some lunch and bake my cat’s food for the week.

 

Usually at least one day of the weekend I’ll head into the village to visit someone/charge my computer. If I don’t go in Saturday afternoon, I like to bake something or make something involved/delicious for dinner.

 

Sundays I occasionally go to church, but increasingly I like to enjoy the quietness of everyone ELSE being at church. The last couple Sundays I’ve been at site I’ve had visitors at my house so I’ve spent the morning cooking for them. Typically it’s my quiet day and I’ll read quite a bit or write in my journal. Then visit or have visitors in the late afternoon. Usually about once a month I’ll go to church, and I’m trying to visit all the different churches in my community, but it’s difficult when I’m gone a lot on the weekends.

 

Most days no matter what I’m in bed, and often asleep by 9 pm. We’ll see how that changes when the electricity arrives (slated for early 2013).

Rwandan Health Care Structure

24 Sep

Wayyyyy back during PST I remember being impressed with Rwanda’s Health Care Structure. I don’t know anything about other African health care structures so I can’t compare the strengths and weaknesses, or if it is even all that unique. It’s a tiered system which seems to me like a pretty good idea considering the ratio of people to health facilities is pretty disproportional. For example, my health centers catchment area serves 20,000+ people and some serve upwards of 30,000. The only downside is that if you’re in need of serious medical treatment you may have to visit several different facilities for referrals before finally receiving treatment.

At the grass roots level, in the imidugudu (neighborhoods) there are Community Health Workers (CHWs). For each umudugu there are supposed to be four CHWs, a man/woman pair called a binome, a social affairs CHW, and one in charge of maternal and child health. However the actual number and their competency depends on the leadership at the health center. Luckily, in my sector we have dedicated and competent leadership meaning we also have 60+ dedicated and competent CHWs.

The maternal/child CHW weighs all children under 5 in the umudugu on a monthly basis and can make referrals to the health center for malnutrition interventions. CHWs are trained to make simple diagnoses and determine if a referral to the health center is necessary. They can also do rapid diagnostic tests for malaria (since malaria here is like the common cold/flu), they remind people of appointments at the health center etc.

CHWs are average people, there are no educational or language requirements, rather they have good standing in the community. This means that training CHWs to carry out some duties can be a complicated process. For example, a couple of months ago the Ministry of Health started a cell phone based reporting system for CHWs that contained auditory and text elements. There’s no Kinyarwanda language option on the phones here, only French or English neither of which at least half of the CHWs speak. You can imagine the difficulty in teaching people to send a text message on a phone in a language that they have a very basic knowledge of. Despite and difficulties, our CHWs are a tremendous asset to the health center and greater community.

In addition to the cell phone reporting, each month the CHWs compile a detailed report of their work and submit it to the supervisors at the health center. Per government requirements they are also organized into a cooperative so that a portion of the Performance Based Financing they receive is invested into income generating activities.

At the next level is the health center. There are no doctors on staff at a health center, and at mine there are a surprisingly few number of nurses (eight), the other staff providing medical care are known as ‘travailler’ (eight of them also) French for worker (I think). The health center is run by the ‘head nurse’ or most commonly referred to in French as ‘Titulaire’ who is commonly university educated. Most of the nurses at my health center have an enhanced secondary school education, though many of them study on the weekends to earn a nursing degree. There are three levels of nurses: A0 have studied 4 years of university, A1 three years, and A2 finished all six years of secondary school. The ‘travailler’ only completed the first three of six years of secondary school. Currently, there are no medical schools in Rwanda. If a person wants to go to medical school they must study outside of Rwanda. Pretty much all of the staff who study on the weekends go to university in Congo because it’s close, and much cheaper than studying in Rwanda. Folks who live closer to the Ugandan border typically go there to study. Consequently, most of the doctors in hospitals, at least in my region are Congolese.

Common services at health centers include:
-General Consultation: We have two rooms staffed by nurses where people come with general concerns. While people are waiting to be seen by a nurse, one of the travailler takes their temperature, weight, and records any symptoms they’re having on a sheet of paper.

-Pharmacy: Pretty much every visit to the health center includes a prescription for some kind of medicine. Antibiotics are prescribed a little too frequently for my liking, but I’m sure there are reasons I don’t understand. The pharmacy also gives out things like vitamin C, multi vitamins, and ibuprofen in addition to medicines that actually treat maladies.

The process of seeing a nurse is not a timely one. I’ve often thought that if I had to some to the health center and wait for 30 minutes or more to see a nurse for some ibuprofen just to treat a head ache that I’d be very cranky. However, there are few places to buy over the counter drugs outside of major towns in Rwanda. Not to mention that a significant portion of the population doesn’t understand how to take OTC. Not to mention, by going to the health center they’re able to use their government supplemented health insurance to get the medicine for a small fee.

-Family planning: This service is offered two days a week at my health center. Available methods include; male and female condoms, cycle beads, oral contraception and the implant in the arm. The IUD is also supposed to be an option, but you’d be hard pressed to find a nurse who knows how to insert one. Damaging myths about the various forms of contraception run rampant and may even be believed by the people who work in family planning. Culture is a big barrier to wide spread use of family planning in Rwanda.

-Vaccinations: Every Friday mothers come with their babies to be vaccinated. There’s a national scheduled for various vaccinations: at birth, six weeks, 2.5 months, 3.5 months, 6 months, and 9 months. The vaccine schedule includes BCG, 4 doses or Polio, 3 doses of DTP/Hep B/Hib, 3 doses of Pneumococus, 3 does of rotavirus, and measles.

-Pre natal consultations and PMTCT: Pregnant woman are supposed to come in for 4 visits during their pregnancy. Admittedly I know relatively little about the services provided to pregnant women. I do know that they weigh them and measure their bellies. PMTCT or prevention of mother to child transmission of HIV/AIDS is a separate service, and again one I know relatively little about.

-Delivery: Women are encouraged to deliver at the health center instead of at their homes. For fear of having to witness a birth, again this is a service I know relatively little about. The delivery room is split into two by a divider and each side has a chair. The services the nurses here provide are pretty basic, I know they can administer oxytocin but I know that if things are very complicated the women are transferred by ambulance (which I imagine is a TERRIBLE trip) to the district hospital, where there’s an alarmingly high rate of c-sections. Women are typically left alone during labor and seldom utter a peep during delivery which astounds me.

-Nutrition Services: Once a week parents with malnourished children come to have their children weighed and collect therapeutic food, either a beefed up peanut butter like substance called Plumpy Nut or a blend of sorghum, soy, and corn flour called sosoma which is used to make porridge for the kids. Unfortunately, supplies of the therapeutic foods are unreliable and not always available. Malnutrition (at least diagnosed) is not as prevalent in my area as others, typically there are 6-12 children who are malnourished enough to merit an intervention at the health center.

-Laboratory: In the lab they can test for HIV, measure hemoglobin and blood sugar levels, pregnancy tests, and syphilis. They use microscopes to analyze stool and blood samples for stomach worms, malaria, and possibly other things. My health center is one of a few in the region equipped to analyze tuberculosis samples. Once a week (Wednesdays) early in the morning they draw the blood of a dozen or more ARV patients and then take the blood to the district hospital for a CD4 count. The results take a week to receive.

-ARV: not every health center distributes anti-retro viral drugs to people with HIV/AIDS and I’m not sure what the criteria are. My health center does indeed offer ARV services, in all we have 535 people who come to get some form of medicine. Three days a week we give out medicine and one day a week (Fridays) we give out CD4 results. There are two nurses, a social worker, a data manager, and myself who work in the service. By far, the biggest staff of any service. The social worker helps hand out medicine, but also counsels people and makes home visits to people too sick to come to the health center or fall out of compliance with their regimen. The data manager is in charge of entering patient information into the national database. I just kind of lumped myself into this service after shadowing most of the other services. Before people see the nurses to collect their medicine, they give me their appointment card with an identifying number which I used to pull their chart which records visits and then put them back in numerical order after the data manager has entered the visit into the database.

-Community Health: There are two staff who work in community health. They are in charge of supervising the CHWs, one works part time in nutrition, and the other manages environmental health, which is mostly just visiting homes/public places to make sure they have good hygiene.

-At the health center there are separate wards for women, children, men, and post partum women if they need to stay overnight for observation. The dorms are pretty basic with a mosquito net, a terribly thin and uncomfortable mattress, and bedding. If someone has to stay at the hospital their family is responsible for bringing them food. The small cantina on the premises offers some basic food like bread, amandazi (like fry bread), bananas and pineapple, biscuit, tea, and the popular sorghum porridge.

-Mutuele: This is the national health insurance service. There are four staff who work in Mutuele and are not actually staff of the health center. There’s a head of the service, an accountant, a receptionist in charge of managing patient accounts, and another worker who helps track expenses incurred. Both the health center and Mutuele keep a record of costs and then reconcile with each other each month. The first two people mentioned are responsible for tracking payments for Mutuele (often it’s bought in installments) and writing Mutuele cards in addition to going into the community to mobilize people into buying Mutuele. It’s supposed to be mandatory for every person not otherwise covered in Rwanda, but for subsistence farmers (the majority of the population in my community) finding the money to buy Mutuele on a yearly basis is often a huge barrier.

-Non medical staff: The titulaire has his own office along with the head accountant for the health center. There’s a staff person in charge of tracking the costs for each service provided to charge Mututele. There’s another accountant on staff responsible for minor things, and three janitors who are always cleaning something or other.

-At the next level is the district hospital which has doctors on staff. Despite passing the hospital every time I go to my banking town (at least once a month) I’ve never visited my district hospital. I do know, like many health centers and schools, it was privately built by an organization of churches in England but overseen by the Ministry of Health. There’s a English woman named Sheila who spends most of her time there running the place and because of her presence, there are a lot of foreign doctors who come and work in various specialties for months at a time. I’m not sure if that’s the case at other district hospitals, but I see it as a real blessing considering that we’re so far from specialists in Kigali and to travel there means hours on terrible roads and a lot of money.

The district hospital has a team of what they call ‘Community Supervisors’ who visit health centers on a monthly basis to review monthly reports and offer technical assistance. They also send a doctor on a monthly basis to consult ARV patients.

At the top level, you have Rwanda’s National Reference Hospital King Faisal. I have no idea what happens there, but it’s where all the expats go, and where PCVs go for any tests they might need. I DO know that they don’t have aloe vera.

There you have it, Rwanda’s health care structure.

Gutembera

3 Sep

About a year ago, after some time away from my region (I think it was for my IST) I was on my way home and saw all these new street signs at various places. It would be another couple of months before I found out they were marking Rwanda’s latest tourism effort, the Congo-Nile trail. The trail runs between Gisenyi on the Northern end of Lake Kivu and Kamembe, the city (town?) on the Southern end of Kivu.

Tourists can rent bikes and hire a car to bring things behind them or hire porters and walk the trail in 5 – 10 days. If you’re a Peace Corps Volunteer on break from teaching you can call on your fellow PCVs and bring a tent for those places where there are no volunteers. Living on the trail means that I’ve hosted a couple groups of PCVs who have done the trail.

My PCV neighbor to the South, who happens to be in my same group (RW5H3) and I live about a days’ trek from each other. So after months of talking about how we should make the trek between our houses we set a date, Saturday July 21st.

She arrived Friday late afternoon, spent the night and a little before 8 am we set out. On the way we ran into one of my coworkers (the same one who was worried about me surviving the heat in Bugarama) who, like most of the people I told expressed a lot of concern about our decision to ‘do sport’. Like with all the others I turned it into a game, asking him how many hours he thought we’d use for the walk.

We walked at a comfortable pace, stopping often to take pictures and greet people along the way. I was happy to be able to get some pictures of the rice paddies which are my favorite part of the moto ride to/from site. It was also nice to be able to snap pictures of the scenery a bit removed from my site since strangers aren’t big fans of unexplained cameras. Conversely, sometimes a mob of people wanting their pictures taken breaks out if I start taking pictures.

We were generous with the rest breaks and more than a couple times we were greeted by various moto drivers from my village, tracking our progress and trying to convince us to take a moto. It was fun to hear their exclamations on our progress or the fact that we were resting, yet again. Sometimes though, we took a break to distance ourselves from people we’d rather not share the road with.

Around 1:30 we arrived at a lovely place that is owned by the British lady who runs the regional hospital. She bought some land on a peninsula and built a retreat center. The most magical part of all is that the average Rwandan isn’t allowed since it’s primarily for hospital staff (there are a lot of doctors who come from all over the world). However, if you’re white and know the name of the woman who runs the hospital then you’ll have no problem. The magical thing about this place is that you can eat in public, expose your upper legs and generally do whatever you like without invoking the stares of everyone around you.

By this time my feet were already starting to hurt. We rested for 2 hours, eating the snacks we had brought along and chatting with some of the missionaries who had arrived early for their annual conference of missionaries working in central Africa.

A weird thing happened on the way in. We encountered a group of kids who did the usual asking for candy and money. Then one of them uncharacteristically tried to grab the bottle of water in the outside pocket of my backpack. So I let him know what was up in Kinyarwanda. The kids then became more aggressive and taunting so I did what my coworkers do when kids are flocking us as we go to sport, I picked up a stick and waved it at the a bit. Usually that does the trick, no actually hitting of children necessary. These kids did back off, but they still leered at us. It was really strange because I’ve never encountered kids who actually tried to reach for something (other than the pickpockets at bigger markets). The other PCV I was with thinks it was because of all the small white kids they saw coming and going from the retreat center. Abazungu adults are a common site for Rwandan kids but abazungu kids for some reason rock their world.

We left paradise around 3, feet still hurting and calves REAL tight. As we got closer to where I usually catch a taxi the sky turned dark and the wind picked up. For awhile we wondered if we’d have to call it a day early on account of the rain. After an hour or so we reach the taxi town and stopped for something more substantial to eat and some fanta to raise our blood sugar.

At this point it hurt to sit, to stand and to walk. But the brochettes (meat sticks) and fanta we had did us good. The original plan was to get to K’s site, shower and then go out to a local restaurant. However, she had the foresight to know that we probably wouldn’t be able to leave her house once we got there. With the threat of rain gone we set out once again for the last bit which had the steepest hills, of course.

We arrived a little before 7, about 30 minutes after the last of the sunlight. The good part was that we didn’t have to greet too many people K knows or answer too many questions. Indeed she was right, after we bathed we were not in any kind of shape to go back out. So we ate some of the bread we bought, had a cup of tea and started a movie, which I watched maybe 25 minutes of before I passed out.

The next morning we got up early and hobbled out to catch a taxi to Kamembe where we treated ourselves to the charming atmosphere and deliciousness that is breakfast at La Petite Colline. For $5 you get a thermos of African Tea or coffee, an omlette with 3 pieces of bread and a plate of fruit. It was a nice little energizer before our Camp GLOW meeting. Though because of the blisters on our feet we had to take motos from the bus station to the hotel.

A couple guys at the place we had brochettes estimated that it’s 27 kilometers from my site to K’s. Add another 3 km for the detour to paradise and we walked about 30 kilometers that day. In all it took us 11 hours though about 3 of that was used for resting. Meaning that we walked a total of 8 hours. Considering that my feet started hurting after the first four, and that every step of the last 2.5 or so was painful, I can’t imagine how people do that for 5 or more days at a time without the conveniences of their own homes and sleeping on the ground. I used to think I wanted to get into backpacking in the US, but after this experience I’m rethinking that. Unless you nice folks out there can share your secrets of getting your feet in shape. Needless to say I have no desire to tackle the Congo-Nile trail in its entirety.

Rwanda’s Health Insurance

20 Aug

I’ve been thinking for some time that it’s about time I start writing more informational blogs on Rwanda’s Health Care structure and the like since it really is quite interesting. However, various things have kept me from it.

A fellow PCV’s dad forwarded this NY Times article and I just read it and thought it’d be a good starting place for future efforts to educate about the health system here. Hope you enjoy!

http://opinionator.blogs.nytimes.com/2012/07/03/rwandas-health-care-miracle/

The Sweetest Moment

20 Aug

During training, before my English speaking younger host sister came to stay with us and I knew next to no Kinyarwanda, my older host sister and I communicated primarily in gestures. Our lack of verbal communication didn’t really register with me until one day when I finally heard her speak my name.

In the beginning it felt like my rather private host family and I were engaged in an awkward dance neither of us could get the hang of. There was a lot of coexisting and observation with a pinch of interaction here and there. When my sister spoke my name it marked a change in things, we (my family and I) had found the same rhythm and started to sync up.

Heidi can be rather tricky to pronounce for Rwandans. I get a lot of Hiriye and Hiliyes. So when my supervisor gave me my Kinyarwanda name during site visit I never really turned back. If you came to my village and asked for Heidi few people would have any idea who you were looking for (except for the fact that I’m the only American in the village). Ask for Mahoro from the hospital though and you’re in business.

A couple months ago the teenage girl working as the umukozi (housekeeper) was called home and one of the ladies who was around the house regularly stepped in and came to live with us. She also brought her two kids, one of whom is my favorite neighbor boy. The other, a little slip of a girl who would often cry at the site of me. Since coming to live with us, the kids eat a lot better and the girl’s temperament has improved. One day, it seemed overnight she started talking (later than most kids her mom says because of a problem with her palate I think) and sweetest moment number two happened when she started saying my Kinya name. She’s still getting the hang of speech so usually ‘Mahoro’ sounds more like ‘MA-ho’. Now whenever I’m outside every five minutes or so it’s ‘MA-ho book!’ ‘MA-ho sweet potato!’ ‘MA-ho Helena!’or whatever it is she sees. If you think baby talk is difficult to understand, imagine trying to decipher it in a language you only have some semblance of a grasp on. Her mom often has to play translator hahaha.

On my moto ride to get ready for camp last Friday I was seized by an overwhelming amount of gratitude. Sometimes it’s kind of a bummer that there’s no one in my village to have a beer with from time to time. Conversely, that means that on market day (Friday in my village) I don’t have to smell the moto drivers’ breath to see if they’re drunk, something they told us during training was important to do. In a lot of other places this is not the case. I was at one of the training sites on a market day and saw 3 or 4 moto drivers knocking back Mutzig. Alcoholism runs rampant in many parts of Rwanda, particularly the out of the way, hard to reach places, but it’s homebrew made from bananas or sorghum that they drink. Alcoholism certainly exists in my village, but the folks with a propensity for over imbibing tend to be the minority. Most of my coworkers don’t even drink.

I was also grateful that I could think of at least five of my friends/coworkers who I know would help me no questions asked if I really needed it and that there were probably as many more I didn’t think of who also would. Both the times I had money stolen my coworkers always made sure I had money to buy food.

I’m so late in writing about it, but my ‘new’ house is so awesome and I feel so blessed to live there. Mama wachu (our mom) is an amazing and kind woman with a lot of influence. It came up in a conversation with her early on that I don’t like being called an umuzungu, she reiterated that to all the kids within earshot, that I was to be called Mahoro only and from that day I’ve not been called umuzungu at my home by any of the dozens of people who come to fetch water. Nor do I get asked for money or food from people when Mama Wachu is at the house. She does a lot of business in Kigali and Kamembe so she’s frequently gone for a couple days at a time and occasionally the women will feel brave and ask me to give them something.

Since my work at the health center is seldom very fulfilling, it is definitely my relationships with people here that keep me going. My friends are always asking me when I’ll be returning back to America, will we keep in touch, will I tell them when I get married, and how much they will miss me. Not being very fond of goodbyes (just ask anyone I avoided saying goodbye to before I came here), I don’t like these conversations. My heart feels pulled in two directions, there’s home in America with family and friends who share the same culture, where I have anonymity and don’t belong to the ‘not fully human uuzungu’ class. Then there’s my home in Rwanda, where I have been warmly received, loved and supported in so many ways despite my American oddities. I have a love/hate relationship with Rwanda depending on the day, my emotional stability, and the number of people who have asked me to give them something. My relationship is further complicated by the fact that I’m half decent at navigating life here. Coming home after being away at GLOW camp, greeting and catching up with everyone feels so good. I have this sinking feeling that saying goodbye and leaving Rwanda is going to be much more difficult than I imagine.

When I said goodbye before I came here I knew that Peace Corps service is 27 months and that I’d be home after that, no questions. When I leave Rwanda, there’s no certainty in when I’ll be able to return. But I can’t imagine not coming back to see when the paved road finally reaches my village, how things will change and develop after the electricity finally comes, or how the babies I know now grow into kiddos. Keeping in touch with people will be reliant on them not changing their phone numbers, finding ways to check email, and not moving away or falling out of contact with the people I keep in contact with.

I’m so blessed to have people on TWO continents who love me so I suppose I ought to just quit complaining about it.