I've gone for a few runs on the same main street and have found that children like to run with me as well. I sometimes try to make them sing "CH-RIS KUMBAYA" like the congolese children did for Muhammad Ali, but it hasn't caught on yet. I usually start daydreaming of my own Rumble in the Jungle though and often beat up at least one of George Foreman's children (all of whom are named either "George Foreman" or "Georgina Foreman") so it still sort of counts in my books. Also, his children are fully grown so it's not weird.
I am, of course, growing my moustache for Movember this year. I have convinced the Rwanda anesthesia residents that they should also grow theirs (just their upper 'Mos). However, trying to explain the concept of "raising money" for other people doesn't make much sense to them as they are so unbelievably poor. Perhaps it's because we're raising money for prostate cancer, which very few of their population will acquire because so few live that long. HOWEVER, they are still growing their 'Mos, mostly because I told them that it would be a fun picture to take at the end of the month and it might provoke some people back home in Canada to give some of their comparative wealth to a worthy cause - hint hint - http://ca.movember.com/
This weekend we are taking off and mostly relaxing. No real sightseeing other than strolling around. Everything is so unbelievably different here. People are sooooo poor. But everyone manages to live the only life they've ever known. They wear their clothes and shoes until they are absolutely non-functional. Every piece of equipment is used well beyond when it is safe to keep doing so. Special safety devices prevent the wrong tanks from being inserted to the wrong places in Canada (eg you can't fit the oxygen hose on the nitrous oxide tank), but they've found ways to defeat that here, because it would cost too much to have all those separate parts. All the farming is done by hand, and often up the side of steep hills. Basically everyone works from sun up to sun down - in the city. In the fields, women wake up at midnight to start gathering their wares and begin their long march to the market, occasionally several (sometimes > 10) kilometres away. They work as children, when they are pregnant, with a child strapped to their backs and well into their old age (if they live that long). Elderly people are looked at with the utmost respect and admiration - there is a good reason they've lived that long and people respect that and draw upon their wisdom.
People eat the same food every day, everywhere in the country. I thought that the lunch in Butare would be a welcome change to the plate of rice, potato, beans, spinach, and beef that is the only option in the hospital cafeteria every day. I was somewhat shocked to find the exact same food in the exact same serving dishes. Nor do I think this is only constrained to the hospitals. I thought this particularly odd until Bill, the staff guy I'm here with (from Saskatchewan), said that he knows of people in Canada who eat the same thing for breakfast every day. Can you imagine that? In my ignorance of analyzing this country, I had forgotten that, besides a day or two here and there, it has been more than 15 years since I've eaten anything other than eggs and toast for breakfast and even my lunch is nearly identical day to day in Canada.
Rwanda is very forward thinking. Friday afternoon has been pronounced "day of activity" by the ministry of health here. No one from the health care field is supposed to work on Friday afternoons (barring emergencies of course) and is supposed to spend it doing a sport or exercise. Plastic bags are not allowed in the country. Smoking is banned in all public places and outside as well. At least 33% of parliament has to be female (there is widespread knowledge that the genocide likely would not have happened had more women been in power). At the moment, it has >50% female politicians, the highest in the world.
Prisoners are allowed to work outside of the jails and their pay goes to them or their families. If they are genocidaires, some of their pay goes to organizations that are used to help survivors of the genocide. These prisoners are dressed in pink to identify them. Perpetrators from the genocide are still being tried, some go to jail, others have to spend a minimum of 6 months in an institution that is supposed to help them try to re-integrate into society. I think it is like a gigantic alcoholics anonymous gathering where they are encouraged to re-tell their stories, admit what they did, provide names of others, as a means of both understanding and identifying others involved. It's supposed to work well.
NO ONE in Rwanda refers to themselves as a Hutu or Tutsi any more, and it is severely frowned upon to ask anyone. I can't believe that so many people have been able to move on from that devastation. Last weekend, we stopped at the genocide memorial in Kigali and spent a few hours in and around the monument, museum and mass graves. There are horrific stories and some pictures that are difficult to see, but I think it's important to be exposed to, lest we be part of the injustice by ignoring, or forgetting what has happened here. Unfortunately, this is often all that one knows of Rwanda, but it has become an impressive, and very safe, place during these last fifteen years and seems headed on the right path.
On a lighter note, I saw some mountain gorillas last weekend, around ten of them - two silverbacks, one infant and a variety of others. They are such amazing creatures to see and you can get around 5-10 feet from them sometimes. The silverbacks weigh nearly 200kg and are big porkers - they eat bamboo all day and have huge beer bellies. However, their arms are capable of easily lifting all 200 kg into a tree and even when being gentle have been known to crush the bones in the human wrist by accident of their strength. Some of the younger ones were curious of us and stared right into our eyes - such an incredible experience as these are some of the closest relatives we have. The older ones didn't bother much about us and went about their business of eating and pooping. Usually in the afternoon there is a little more activity as this is when the dominant silverback may mete out punishment to any of the others who have crossed him (eg mated behind his back). As you can imagine, I was very careful to keep my chest hair covered up, lest a Silverback confuse me with one of his own. Although the male Silverbacks mostly ignored me, I'm pretty sure my moustache got some admiring looks from some of the females, no big deal.
Last weekend, we stayed in a "resort town" on Lake Kivu, right on the border of Congo. Saw a live football game that was very exciting as the whole town was around. Their navy was playing the police from Kigali and it got really heated, but fun. I couldn't believe that little, landlocked Rwanda had a navy. There is no ocean and only one big lake! However, this lake borders on Congo and there is always concern that their rebels might decide to head over to peaceful Rwanda.
This is the exact half way point of my time here. I am missing Martha and our little growing baby a whole lot while I'm here. Babies mean a lot anywhere, but perhaps even more here. I am constantly asked how many children I have and when they find out that my first one is on the way, they get so... I can't think of the right word, it's not just excited, but there's something else and it makes me feel quite proud. They all tell me that it'll be a girl because "all anesthesiologists have a girl first" - something about the gas we breathe all day (I'm trying to fix that for them - connecting a bunch of tubing so that the waste gas goes from the machine out the window rather than polluting the whole room. Maybe I'm changing things for the worse though, as more males will be born in the future!).
These past two weeks have been both frustrating and rewarding, as I imagine the next two will be. The operating rooms are both impressive and annoying. They have some modern machines and a lot more drugs and equipment than I'd thought. A lot of it doesn't work or doesn't work well though, which can be both annoying and dangerous, especially if it is a little baby on the operating table. I am quite surprised and impressed with the type of surgery that they do here and also saddened by some of the things I have seen. A lot of babies will not survive here because they can not make it through the neonatal period without at least a little time on a ventilator. There are no ventilators capable of supporting a neonate so someone would have to hand ventilate them - something that is possibly only for a few hours at most before the decision is made to withdraw.
All right, I'm all typed out. I hope you are all doing well. The internet access is pretty good here, so feel free to write me back if you want, or check out my Movember webpage!
Chris
