Ny toa mzungu

(English translation from Kinyarwanda: My name is foreigner)

As I come to the end of my stay in Rwanda I've been reflecting on being a foreigner or mzungu. It's very interesting being judged on your appearance so profoundly. I'm not even what I would term a real "expat" - I walk a lot of places (and people think I'm crazy for doing so), I cook my own food, wash my own underwear and even ride the public transit. I do get rides to places more than most Rwandans and there's a lady (Vestine) who comes into the apartment twice a week to clean floors and such so I guess I'm living an elevated lifestyle to some degree. Anyway, it is interesting, like I said to be judged on appearance. I often forget how it feels when I'm not in Africa. It's a good reminder for me to not make judgements on externalities.

I really have loved living in Rwanda, there's a real positive energy here that I admire and although it can still be very chaotic, it's a lot of fun. I'm going to miss it. Here are some highlights from the last 3 weeks (I had some internet issues my last couple of weeks so I'm now posting this from Boston)

- A trip up to the north west edge of Rwanda to a town called Gisenyi. This meant a 4 hour bus ride one-way so a bit of a trek just for an overnight trip but still fun. We slept in a hostel, ate brochette (Rwandan-style kebabs - yum) and enjoyed Lake Kivu (a huge lake between Rwanda and the DRC)

Biljana and I on the bus

The crew - waiting for Broschettes

Beautiful Lake Kivu

Lake Kivu

I like to call this one:  The ID doc risking schisto (it's a silly personal joke...)

- data-entry for our project - Hurray!! We didn't think the Ministry was going to let us get on it so quickly! It was great to almost finish all the data entry - even though 10 hours a day is exhausting.

-FESPAD - A Multi-country African Dance Festival/Competition that took place at the national stadium.  We ended up being there 2.5 hours early - we were told it started at 3pm, arrived just before 4pm (adjusting for "African time" or so we thought) and got to sit there until the actual start time of 6:30pm. It was great though, neat dancing from numerous countries around Africa (including Madagascar - reminding me of the time when I and some other sister missionaries won a talent show in Madagascar for our attempt at traditional dancing - Prize: 1 live chicken - donated to a needy family in the congregation after all the ladies in the congregation were horrified when we admitted we had no idea how to kill and pluck a chicken - apparently my mother failed in her duty to teach me such skills)  Anyway, here is a video of the champions (the Kenyan drummers) - I apologize for the sad video skills, this is a new thing for me and obviously I need more practice.

- Saying goodbye to all my friends at church (although this was hard, perhaps not a highlight) - I did love attending church in Rwanda, such great people

The brand new church building in Kigali, Rwanda and branch members milling about after church

 -Eating Rwandan food!  (I couldn't go without a comment on the food of course).  No East African meal is really complete without at least 3 starches and preferably more - here we only have two:  Matoke (non-sweet banana - I totally love this stuff) and potato.  For a real feast we ought to have had sweet potato and/or cassava root plus rice and maybe pasta as well.  Here there's chicken and peas with some sauce but normally there would also be beef or goat and beans as well.  Usually there's also sauce with spinach or isombe (ground up cassava leaves).  

And finally, the finishing touch:  Fanta.  (Most prefer orange, I do not - I prefer "citron").

Close Encounters of the Cockroach Kind

A lowlight (as opposed to a highlight) of living in the tropics - an episode I like to call a close encounter of the cockroach kind: A few days ago, there I was, minding my own business, when I spotted a HUGE cockroach in my bathroom. I must confess, I really don't like them. I've managed to get over my aversion to any vertebrate or spiders or bees/wasps etc. but I still have issues with cockroaches. It's visceral. (It may stem from an experience in Madagascar involving a cupboard in one of our apartments that at first glance had a back wall that moved...enough said)

This cockroach was, no joke, 5 cm long. (U.S. translation = 2 inches) Now, I realize that I am, in fact, 178 cm long, which is considerably larger than this cockroach but remember, 5 cm is long for a roach. This guy/gal had a gimpy leg as well, making him/her pretty slow. Regardless of his/her handicap, I still made a loud sound and Biljana, the other girl living in the apartment, came running. She helped me shove it into a paper sack. We took it outside and our night guard came running to see what the commotion was. He started laughing a fit to kill himself when he found out what the problem was and after getting himself under control he disposed of the bag.

(A bad picture of the cockroach peeking at me from around a bucket)

We thought the excitement over although I did comment (prophetically as it turned out) that cockroaches rarely travel alone. Sure enough, an hour later I was getting into the shower and I went to adjust the shower-head when I noticed ANOTHER 5 cm long cockroach sitting right on the shower-head, wiggling its nasty long antennae at me. I made another loud noise (a loud screaming-type noise if the truth be known) and Biljana came running again. We tried our paper bag exterminator trick again but sadly, THIS cockroach did not have a gimpy leg. She/He/It jumped OUT of the bag and ran somewhere. We screamed really loudly (again) I'm sorry to say.

Unfortunately we never saw where she/he/it went so, consequently, I couldn't shower there and had to bathe in the other bathroom. (Highly pathetic I know, but it just felt icky)

Interim mini-project

It's been a quiet week here in Rwanda. All the data from our study is now at the Ministry of Health awaiting data entry. We're trying to hurry that process along - after all, that's what I'm here for (well, sort of) but these things can be a little political. So instead we found another mini-project for me to do this week. I went out into the field to look at what has been happening in some of the nutrition programs. These programs try to screen for children under 5 who are moderately or severely malnourished so that they can get extra help at the health centre (including extra food supplements for the children and nutritional counselling for the mothers).

(The one on the left isn't a mother, she'd just a neighbor girl who's helping out)

Other highlights:

- sleeping in the guesthouse at Ngoma and discovering that the rooster lived right behind my room. (Why, Why, Why is 3 am an appropriate time to start crowing?!)

- Being told by the entire medical staff (ten of them) of Kibungo hospital (all Chinese expats speaking difficult english, all male, all shorter than I) that I was beautiful and should stay and have drinks with them in the guesthouse restaurant - I gracefully declined (but it made up for the "healthy" comment from last week)

- visiting the Rwanda Genocide Memorial Centre. This was enlightening but emotionally draining as you might imagine.

More next week (and hopefully more pictures, I've tried to load more twice but all it does is suck up my precious megabytes and not post anything!!)

Interviewing is difficult if you don't speak the language...

For those of you who wonder what I've been doing... The program we're evaluating here is one that has community health workers (CHWs) treating children for a few specific diagnoses. There are approximately 60 000 CHWs of them here in Rwanda, one male and one female elected from each village (ostensibly). The diagnoses for the most part are diarrhea, pneumonia and fever, which is usually interpreted as malaria and treated as such rightly or wrongly. The CHWs also are involved in vaccinations and anemia screening (with de-worming medications as needed...your infectious diseases interesting fact of the day: the leading cause of anemia worldwide is hookworm infection - yep, may I point out once again, everything really is infectious diseases - love it!!). For those of you in the Global public health/pediatric fields - it's actually Rwanda's WHO IMCI program. So, the evaluation is to see how the process is working - not so much if it's really impacting the child mortality rate. It consists of interviews with randomly selected CHWs, revision of all their case files, and interviews with all the supervisors in over half of the health districts in Rwanda. (About 1200 interviews in total over the course of one week)

It was somewhat chaotic.

The teams got rearranged at the last minute so suddenly my boss and I were having to supervise a team of people we didn't know in an area that my boss didn't know. Plus there was problems with cash flow (as there often is) in order to arrange transportation and sundry other issues. Such is the fun of on the ground research like this. It's all about going with the flow basically and changing plans about 10 times a day. We pretty much accomplished our goal though. It was tricky as my boss and I could do only a handful of the interviews so we had to make the rest of the team work harder.

Interviews

Community Health Centre in rural Rwanda

The beautiful courtyard of the district hospital in Kibagabaga (which is pronounced exactly as written and is likewise my new favourite word. It sounds like it should belong in Bedrock)>

On our way to/from remote community health centres to do the interviews. I got the front seat because I was "the healthiest" (Rwandan description). A.K.A "the biggest". (This is apparently a huge compliment and I'm trying to take it as such - however, I have been somewhat brainwashed by negative aspects of western culture and had to do some mini-self-cognitive therapy with respect to body image.)

Fun week!! More later.

For all my nieces who want princess beds...come to Africa and you can sleep in a fancy bed just like this one:

Busy...

My first week in Rwanda has really flown by. After arriving late last Saturday night I spent Sunday settling in because Monday morning we (meaning my boss and I) left bright and early to drive up north to Musanze (previously know as Ruhengeri – name changed because of some political reason that no one seems to know or want to tell me: “It’s political”). This is coincidentally the same place that I visited in Rwanda the last time I was here as it’s the staging point for all the trips to see the gorillas (see previous post: "Uganda 5: Gorillas in the Mist"). This time I didn’t see the gorillas, or actually much of anything – in fact I didn’t leave the hotel grounds the whole 3 days I was there. We were too busy.

The Ifema Hotel is a very nice hotel if you ever happen to be in Musanze…

The reason for this visit was a training program for all the people that are administering the survey on which our evaluation is based. We had to talk about sampling and such as well as reviewing all the documents that they’d be using. It was tricky because of the language issue. The survey will be done in Kinyarwanda, the local language, so had to be translated. Kinyarwanda, like all the Bantu languages is apparently extremely complicated grammatically, and so there were numerous discussions about the language. Unfortunately mostly in Kinyarwanda so neither I, nor my boss, could follow them. We persevered however and organized logistics and actually did the random sampling. Busy, but fun - if you’re into that kind of thing, which surprisingly I am.

I did see some wildlife - in the garden beside the hotel…

The rest of the week was spent back in Kigali at the office working on more organizational stuff. We’re trying to computerize the data entry aspect somewhat so we’re going to trial a program on Pocket PC Creations, we’ll see how it goes. This next week is the actual survey week so we’ll do some trial data entry then as well. A lot of public health work is office stuff so not so exciting to blog about; in fact, here you can see my boring little office…
Yep, not very exciting but the whole point of this evaluation is to make sure that the program really is making a difference in the lives of Rwandan children – and I think that’s the really exciting part.

Saturday was spent wandering about the main part of Kigali and trying to find places to shop besides the big expatriate shopping centre. Due to the huge influx in development and aid money to Rwanda as well as the associated influx of large numbers of expat aid workers in the last several years, things are hugely expensive. Food, both at expat-type restaurants and at the expat shopping centre is as expensive or more expensive than in Boston. My roommate (another girl who’s working for the same organization) and I are finding alternative options.

Today, Sunday I went to church, which turns out to be about a 40-minute walk from my house. Well, in the interest of honesty, it was 40 minutes one way but on the way home I tried to take a shortcut, which turned into a very long and hot walk. It’s alright, probably the best way to learn the city is to get lost and then find your way home a few times. (It’s the only way I’ve ever learned my way around cities that don’t really have maps).

Rwanda introduction...for mom especially

Greetings from the land of a thousand hills! Many of you know that I'm here in Rwanda doing a public health internship for a few weeks. I'm here helping with a monitoring and evaluation project of a program that uses Community Health Workers (translation: lay health workers or those who have received only very limited health care training) for implementing a series of protocols to treat children (less than 5 years) for the most common childhood illness - and the ones that kill the vast majority of children worldwide. I'll leave it at that for now as I'll likely be talking a whole lot more about it later.

I flew into Kigali on Saturday evening and I just want to assure my mother (and father) that all is well. Really, I have this really nice apartment and things are fabulous. Here are some pictures to show you...

My bedroom with fabulous sleek fuschia bedspread

Bathroom - no hot water but it's always quite temperate so no problem

Living area - I haven't actually tried the TV, although I'm fairly certain the only thing on right now is World Cup games and World Cup related broadcast

Kitchen (the fridge is almost, but not quite as small as our fridge in Boston Cami)

The Laundry room

And this is my favourite part!! Looking out from my room this is what I see!!

View from the balcony - looking out over the valley towards the main centre of the city (Rwanda is basically hills and hills)

I've been up north over the last three days helping out at the training meeting for the people who are actually doing the survey for the evaluation - more next time!!

Nothing for months - and now a turkey!!!

Apologies to all of you who thought I was really going to blog something about my actual life. I have the best of intentions all of the time but by the time I get around to blogging things, it all seems so over and done with. I made a promise however, to a certain small friend of mine that I would prove to her via photographs that I do have real, live, wild turkey living in the ravine in the back of my house. This is for you Anya!!

P.S. He is really much bigger than you