July 20th - Muraho Rwanda

The trip back to Dar Es Salaam on Saturday was good, but
packed, hot and dusty. We ended up squishing an old man into the two
seats along with Jeff and I, so it was an akwardish ride, because he
didn't even really acknowledge we were there, even when I offered and
he accepted snacks and ice cream I purchased along the way… weird, but
I guess that can be customary here. He redeemed himself by breaking
out a big smile and "Asante" as he was getting off the bus. Ha, I love
old people. Most of the girls on the trip had considerably younger,
but equally as cute charges, as mothers forced to stand in the aisle
hoisted their children onto open laps. I guess this is also customary,
and I had a lot of fun playing games and drawing pictures of African
animals with the little girl sitting on Lauren and Meredith's lap
behind me. The best part though, was when Jeff gave the little girl
one of his ear buds. Jeff only listens to hard metal… like really
really hard death metal. The kid loved it!

The next morning, all my companions went their separate ways early,
before I needed to be up. I had a relaxed breakfast and chatted with
Anna, the maid/server who was nice enough to teach me a little Swahili
every morning over kahawa, ndizi, mpapai na mayai. It's an odd feeling
going out on my own in Africa… partially because I still can't really
believe that I'm in Africa. The flight was good, but it had an
unexpected (for me) stop in Bujumbura, which is east and south of
Rwanda… I haven't looked it up yet, but I'm guessing in Burundi? There
was a big white UN cargo plane on the ground and a couple choppers.
Neat to see.. I wonder what they were doing there?

The flight into Kigali (the capital city of Rwanda) was great… the
hills of Rwanda are beautiful and the agricultural terracing that
covers many of them makes the approach to the airport almost
breathtaking. Kigali airport is located on top of one of those hills,
to the east of the city centre. I hopped on a bus to take me from the
airport to downtown, much to the mild amusement of everyone around of
course, but the driver and fare collector were very friendly and
helpful.

The city of Kigali is perhaps one of the most beautiful cities I've
been to. Period. Forget fancy architecture or feats of engineering or
thousands of years of history of Europe. What Kigali offers is pure
natural beauty. I hate to keep harping on these hills, but everything
here isn't named "Milles Collines" for nothing… there are a lot of
hills, and they are steep hills, with many houses nestled precariously
on their slopes. The terraced fields are evident even in the city
proper, and the valleys tend to be reserved for rice paddies. The
roads are winding and fun to experience on the bus (in addition to
being surprisingly well maintained!). Not much traffic on a Sunday,
and I got to the bus station without a problem and hopped on the next
mini-bus to Butare, a 2.5 hour drive over and around… you guessed it:
more hills! There was just too much beauty to adequately express in
words what I was seeing. I would have taken pictures, but I'm at a
weird ethical place now, where I'm not sure how I feel about taking
pictures of peoples' lives for tourism's sake, nor flashing my
expensive camera around when many people here will never have the
opportunity to own a digital camera. Sorry. I'll get over myself in a
couple days a take some shots to prove how beautiful it is.

My French has really come in handy here, as many Rwandese do
not speak English, the national language being Kinyarwandan. I'm able
to muddle my way through most conversations with the French I'm
dredging up from my high school years and the people here are
incredibly accommodating with my limited vocabulary and strange
accent. Nonetheless, I've managed to have some great conversations
with students and nurses in the hospital about medicine, cultural
differences, just about anything… except maybe what I'm most
interested in (and perhaps you, reader, are most interested in). I
haven't brought up the genocide with anyone. I don't know that it is
my place as an outsider to bluntly ask. I might take a trip to a
memorial on Friday, in which case I wouldn't have as much of this
worry. The genocide is such a chilling and relatively fresh piece of
this country's history that most of the people walking down the
street, or working behind the hotel desk or coming to the hospital
have experience violence or death from it. How does one even go about
addressing that? The government here seems to have done a fairly good
job, and Rwanda is now one of the calmest countries in Eastern Africa.
I might leave more discussion on the genocide for after my trip to the
memorial.

This is sooo long. The hospital has been great so far. Worked
in ICU on Monday and in the ORs today. The anesthetist staff and
residents here are great and have been very welcoming, if somewhat
amused that I am only staying for one week. Nonetheless, I think it
will be a great learning experience… hopefully both ways. I was able
to offer some suggestions both in the ICU yesterday and in the theatre
today that seemed well received and useful. There are a bunch of new
5th year medical students rotating through anesthesia, and I think
that I have a lot to offer them in terms of clinical anesthesia for
the med student, even with my limited exposure thus far. Unfortunately
none of them have aspirations of anesthesia yet, but maybe I can help
light a spark in them.

Alright, you've been tortured enough, and I'm getting hungry.
I went into town the afternoon to a little bakery, but the samosas and
croissants are wearing off. If you've read this far, congratulations.
If you've checked in just to see what people have commented (you know
who you are), don't worry, that's what I do too.