December 2006

12/1/06: A day that shall forever live in infamy - I shit myself.  Badly.  First time in my life and it happens in a car-full of people.  I ruin my only pair of pants along with a pair of precious underwear and two socks…all now are decaying at the bottom of the filthiest outhouse in Rwanda: a tiny mud box with it’s door lying on the ground and the smallest of holes gracing an otherwise crap-strewn mud floor.

The trip starts with a stay at a sketchy hotel near Akagera Park.  Only option for our late dinner is the hotel buffet, which in hindsight may have been sitting out for some time.  I eat a lot.  The spaghetti tastes strange.  Laura, Peter, and I spend 15,000 franks each ($30) for the nicest rooms in the place after making the Manager promise that there will be hot shower water in the morning.  Morning arrives there is no hot water or cold water.  My shower doesn’t work at all - welcome to Rwanda.  Rwandans can build walls and roofs but when it comes to plumbing the results I’ve encountered are uniformly disturbing.  The day begins on the wrong foot.

We spend three lovely morning hours in Akagera Park where Giraffes and Zebras amble past the LandCruiser followed by water buffalo, hippos, impalas, and then we halt to view a large flock of vulture-like birds.  One wide-eyed look from Eli and a shriek from Gabby are all that precede a mass of fur that suddenly launches at the vehicle.  For an instant there is a long hairy arm sticking through the open window lifting our bag of croissants before dropping it for our bag of bananas.  Thereafter, a very large baboon proceeds to sit down three feet away from us and consume our fruit, peel and all.  Afterwards, it leaps onto the hood of our truck and sits staring blandly at Dr. Peter and Laura for several minutes.

Everything continues to go rather well until we leave the park and are 30-minutes on our back to Kigali airport where Dr. Peter won’t have much time to catch his departing flight.  It’s at this juncture that someone realizes Jean-Babtist’s wheelchair has been left back at the Akagera Park Office (it was left to clear space in the LandCrusier for animal viewing and we neglected to collect it on our way out…how Jean-Baptiste failed to notice that his main mode of transportation was being left behind is a question best left to Jean-Baptiste).  Laura is on the verge of saying tough toenails and continuing on to the airport…but it’s Jean-Baptiste’s wheelchair – so we turn around and head back for it.

Rather than continue onwards with a detailed account of my ensuing bowel tragedy and the insanity that ensued thereafter I will instead leave this quote:

The door opened onto the street and the smell thereof.  The mosquitoes were competing with the flies and losing.  I lay on the boards, a foot off the floor, and said in the darkness, ‘I wish to die’.
        - Martha Gellhorn (Travels with Myself and Another)

12/2/06: A much needed day of tranquility and mending, I do nothing.  Go to bed, the cat curled up in my armpit with just her little head sticking out onto the side of my chest…adorable little creature.

12/3/06: Back to the Clinic to commence painting.  Day begins in panic as we go to buy a special sort of petrol oil required for the painting (they mix it with paint here) only to discover that everything is closed, it being Sunday and all.  After a good bit of scampering about and back-alley dealing, however, a jerry can of the stuff is procured and we’re off to the clinic.

Painting day.  A big step.  CCHIPS has hired three local ‘professionals’ to supervise several community volunteers.  One of Laura’ coveted rules is that all work funded by CCHIPS must include community-provided-volunteers who are there to assist in the work’s completion.  Sis and Eamonn inspect the progress intermittently all day long and are more than a little critical….but at day’s end Laura is again agog with joyful pleasure at the remarkable transformation that is fast turning these dismal chambers into clean spaces.

Laura and Jacqueline discussed the new patient/ward layout options.  Their conversation is becoming a familiar one – one they’ve now been having for several days.  The plan Laura wishes to enact is to finally separate mothers and newborns from the sick. In the past and presently they are all bedded beside one another in the same room despite the obvious dangers.  Laura wishes to use one of the two ward rooms exclusively as maternity and the other exclusively for the sick.  The conversation is becoming a frustrating one however as they keep seeming to agree on Laura’s plan and yet soon thereafter Jacqueline will add that it is more important to separate men from the women – a plan that would therefore place sick people and babies back together once again.  Laura constantly replies that 95% of the patients here are women and that with so few men coming to the clinic it makes no sense to give them half the clinic’s limited space (there are only two rooms).  Laura says she’ll have a divider made for the sick room to separate the sexes.  Unsure if Jacqueline is fully onboard yet.

A man arrives to check the leaking roof - large wet rotting patches can be seen in the ceiling.        
The old man who was sick here last week, the one who couldn’t be transferred due to a lack of insurance, died yesterday.  I am currently logging footage of him writhing in pain on his bed.  It’s an ethical dilemma to be filming the misery of a dying human being but this problem I think should pale in comparison to the moral question of why the man died the way he did.  No $2 Mutuelle.

Got some great film footage at the house today of the surrounding mountains ringed with clouds at sunset…hoping my journey-starting airport fiasco hasn’t fogged my 8mm film stock.

Eamonn makes soup for dinner.  Gabby watches movies endlessly in his room.  I send and answer emails.

12/4/06: We find a boy waiting for us at the clinic with a temperature of 104.  He seems dazed and needs help walking.  His case is severe and he has been referred to Ruhengeri Hospital for treatment.  After the referral was given, however, the boy and his mother continue sitting at the Clinic for half the day waiting for us to arrive.  The ambulance to Ruhengeri hospital is too expensive.  At US$14, the 10.5-mile ambulance ride would likely cost the family more than it earns in a month, quite likely two months.  Eli diplomatically tells Laura about their hope.  Laura is concerned about becoming the local ambulance service but what can you do, we take the sick boy to Ruhengeri hospital.

Next day we learn more.  The sick kid can’t be more than fifteen but the story is that he impregnated a girl younger than himself who, after giving birth, attempted to secretly bury the newborn alive in a field.  Miraculously someone saw her and dug up the still-breathing baby.  All involved are now at the police station or hospital.  

12/7/06: We arrive today to find a boy lying face down and stock-still upon the clinic’s side lawn.  It appears he has been lying like this for some time.  Laura yells for someone to take him to a bed, explaining that the clinic can’t have injured people lying unattended on the front lawn - bad for the image and all that.  A nurse explains the boy has been severely beaten and is lying there waiting for those who beat him to come pay for his hospitalization.  This is how it work here – if you hurt someone you also pay their hospital bill.  

The drive to the clinic consisted of a torturous hour over a bumpy potted stretch of dirt and boulders the month before my arrival.  More recently however things have changed for the smoother.  The Chinese have been hired to build a new road and they are quickly doing precisely that.  The trip to the clinic has been cut to thirty minutes.  However the ongoing construction means the road is often closed and we’re frequently forced on detours that take us through fantastically beautiful stretches of Rwanda countryside and over roads that relentlessly beat the crap out of us and our LandCruiser.  Flat tires are legion.  African Massages rule the roost.

Today we have men come up to do assessments of incinerator & latrines.  At night Nando shows up, a mad Spaniard who is biking around the world and has already been on the road two years.  He has contracted Malaria very recently and we find him in bad shape – but still determined to keep cycling ahead.  His only weapon is a large machete.  He has come today from Goma where a soldier pointed his AK47 at Nando, cocked it, and demanded money.  Nando was hustles away to safety by some locals.  

12/11/06: It’s morning.  Laura, Eli and Jacqueline are sitting around the breakfast table going over the Clinic’s financial figures…which are still a mess but appear to be improving.  The statistics kept under the old manager, Ali, are universally suspect, wrong, even ridiculous.

An old man comes to the clinic today covered in blood.  Someone has thrown a rock and near taken his head off…beginning to suspect that a considerable amount of banana-beer drinking occurs locally.

12/12/06: Last night a man was machine-gunned in the nearby Kisate district, which we drive through each day - shot nine times.  The murderer got away and the countryside is up in arms.  We pass a large military platoon on our way to the clinic and among the standard AK47s I spy an impressive arsenal of mortars, bazookas, and heavy caliber guns.

Vaccination day at the clinic.  Never have I head so many screaming babies…each is made to endure an injection, an oral vaccination, and a blood test… today many babies voice their displeasure with life.

12/13/06: Stayed home today.  Finished the web-page outline with Eamonn.  Tried sending it to Ro & Peter with no success.  Laura and Eamonn currently like www.bebetter.org for our web address name.  I think its sort of a weeney-type name.  Did my usual 40-minute morning jog and ended up racing a little kid who was hauling a 20-liter jerrycan of water.  I barely won.

12/14/06: Gabby went to bed ill and awakes convinced he’s suffering a bout of cerebral malaria – we drop him at the Ruhengeri clinic and continue up to the clinic for a day of upgrade supervision and round-table discussion between Laura, Innocent, Jacqueline, Jean-Pierre, and Eli…  Returning later, we hear the docs could find no Malaria in Gabby – I think he’s dehydrated and suggest a sizeable ingestion of water.  The next day he feels better.

12/15/06: Went to bed late and woke up in a less than stellar mood…which was lessened still further by the discovery that all three toilets in the house are clogged and out-of-operation.  Laura starts giving me a repeat sermon on not washing toilet-paper down the toilets.  And, rather than point out the non-existence of waste bins in which to dispose of said toilet-paper, I instead turn my back and walk off in a huff.  Later on, still in a shabby mood, I make yogurt using our yogotherm: fresh yogurt the last thing standing between me and insanity.  The milk is delivered each morning still warm from the cow.  Give me two liters of the stuff and I can make the best damn yogurt you ever tasted.

In a poor mood throughout the day, so asked Gabby to teach me to make bread…which he did in a fashion…though we never did get the darn dough to rise…and I felt slightly better for it – dough’s in a bad mood too.  Felt better after christening each loaf with a string of dough in the shape of an S.  Sean Bread I call it.  

12/16/06: Went to bed early and woke early, logged a half-hour jog and then digitized three tapes before 11:30am!  An impressive start to the day.  Laura and Eamonn have left to spend the weekend together in Kigali – they will collect the bio-gas expert, Mike, on their way home Monday evening.

Monster dog is improving somewhat!  Was actually cute for a split second today.  Still thinking about project names for the website….thinking “One Clinic” might be nice – www.oneclinic.org.  Probably taken.  Or perhaps www.risingclinic.com?

12/17/06: Beware of doing favors.  A researcher for the Diane Fossey Fund, Veronica, asks me to dog-sit for her and I end up spending the night looking after two devil dogs while she heads off to have a good time in Kigali.  Damn spoiled dogs have the run of the house…pound their way through the bedroom door, jump through the damn mosquito netting, drag fricken women’s underwear all over the house.  I wake at 6am to let them out and they’ve pissed and shitted EVERYWHERE!  The house is a minefield.  Thankful to exit the next day - the experience is draining.  

12/18/06: Computer is broken again (bastard won’t boot in regular OS X).  Something about a “Kernal Panic” which I read is related to a snafu in the core operating system.  Currently the only access to my desktop is thru “safe mode”, which allows me inside but disables all my toys, aka my FCP video edit system.  Disgusted, I bake more bread today with Gabby…damn dough still refuses to rise!  Maybe the visiting engineer, Mike, will be able to help.  It’s delicious bread but we need to get it upwardly mobile.

Started Paul Farmer’s book “Pathologies of Power”, eye opening, especially given my current position.  He posits questions about mainstream attitudes towards third-world health that compel one to re-examine ones pre-conceptions…unsettling stuff.  

12/19/06: Eli breaks the news that the young female patient, Angelique, has just died.  An attractive girl who, last I saw, was seemingly in the process of regaining her full health.  Eli reports she went to a traditional healer for treatment and was likely poisoned to death by whatever she was given.  Death is not presented as shocking news here.  Poisoning, I am learning, is blamed for a healthy percentage of sickness and death in Rwanda.  Apparently Rwandans are paranoid about being poisoned by their neighbors.

I would like to know what the death rate is here.  I’d also like to spend more time with patients.  I know of three people who have died at the clinic since my arrival: a man, a baby, and now this young woman.

12/20/06: Déjà vu.  Yesterday we rushed out the door because the director of Ruhengeri Hospital called early to report that the Aquasan people were here NOW, a day early, and ready to go up to the clinic this minute!  
We reach Bisate today and drive thru the largest crowd I’ve ever seen up here.  An investigation is underway - a man has reportedly raped a young girl – and now every town member is bearing close witness to the ongoing investigation.  

Internet is maddeningly mind-numbingly slow.

Terrible accident yesterday.  Boscos’ wife and kid were riding in the pack of a pickup truck that flipped; Kid’s undergoing surgery on two broken arms.  Wife’s undergoing surgery on her head.

12/21/06: Had our Christmas Party today up at the clinic.  The goat was selected yesterday and killed this morning, then cut up and boiled in a pot on the ground over an open fire.  Mutzig and Primus flowed like water, a refreshing respite from many days of endless rushing.  Met a great many people…all the Nurses and employees brought wife and kids…Rwandans sure do dress nice…would put to shame us slobs in the Western World.  For the first time it seemed everyone was rather comfortable with each other.

I got hit up to shoot a Rwandan music video by our local wiz-kid environmental health professional/scholar-student, Jean-Pierre…so we’ll see how that goes.

Have been trying to order a new computer over the internet these past two days without any luck – only access is with Laura’s cell phone and the speed is ridiculously slow…so today we stopped at the Diana Fossey office and used their high-speeds to buy a new 17’ powermac ($3,000 with case and apple insurance).

The day concluded with our second flat tire in as many days.

I still feel sick.  Mike the engineer feels sick.  Gabby feels sick.  Whoa is us.

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Death is not presented as shocking news here. Poisoning, I am learning, is blamed for a healthy percentage of sickness and death in Rwanda.
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