A Day in CHUB

Do you want to know what a good day working at the hospital is like?

Well today, July 21, 2014, was by far one of my favorites! My parts, Sara, and I spent the morning in the capital searching for spare parts for the broken equipment at the hospital. Overall, we bought velcro (to secure temperature probes onto babies in the NICU), power cords, surge protectors, batteries, etc.. then we caught a two hour long bus ride back to Butare, ate a nice lunch at Hotel Ibus, and headed back to the hospital.

We started by finishing up inventory in the ICU and went back to work on a broken CPAP(continuous positive air pressure machine for patients who have trouble breathing) and an incubator. After trouble-shooting for an hour, we determined the problem for the incubator was the motor. But to confirm, we emailed the manufacturer for any other suggestions. As we waited for them to respond, we went to the surgery ward and worked on its inventory.

To enter, we had to have the whole get up, scrubs, face mask, hair net, and rain boots. We found that in two of the operating rooms, many of the wall sockets didn't even receive any power and a couple of the lamps crucial for surgery were out. After making a list of all the functional/dysfunctional equipment, we started talking to one of the orthopedic surgeon volunteers about his next surgery. Apparently, a man who had broken his arm and had it repaired, but the screws and plate used to help the bone realign were too weak and ended up making his injury even worse.

My curiosity got the best of me, so I asked the doctor if I could scrub in during his surgery and he agreed! So there I was front row, watching him cut into the side of this man's arm and watch him pull out nails, unscrew screws, tear out the scar tissue, chip away at the calcification surrounding the bone, and put it all back together.

Before going home for dinner, we decided to do a quick pit stop in the NICU (because we obviously live there), we continued to work on the incubator and a phototherapy lamp that one of the nurses needed for a newborn baby that had just came in. We fortunately found the problem the phototherapy lamp fairly fast, the power supply was being short circuited from the circuit board! The nurse was very, very grateful for it, and it was put to immediate use. :)

Rwanda 101

Transportation
Every corner you turn in the city is filled with moto-taxis, regular car taxis, and buses. Keep in mind the currency exchange is 1 Dollar = 690 Francs. And to each form of transportation, its own!

One bus ride to downtown is around 200 Francs. 

Pros: Cheapest

Cons: Most packed and doesn't drop off exactly where you want to go. 

One moto-taxi ride to downtown is around 700 Francs.

Pros: The most entertaining, the quickest, relatively cheap. 

Cons: crazy drivers, all drivers have one helmet for all passengers, rumor of drivers drinking & driving, most dangerous 

One car taxi ride to downtown is around 4000 Francs. 

Pros: Shelter from the outside, sits multiple people comfortably, delivers right where you want them too

Cons: Expensive

Overall con is that almost no one speaks good English so communicating where to go is relatively hard! EWH(the organization I came with) does not recommend the motos, but they are the funnest! I just know not to ride in the dark nor in the rain! Reducing the risks! 

But regardless of wherever you go, if it is a walk-able distance, you will see people walking! No matter the time of day, the streets are pretty busy!

Food
So a typical Rwandan meal includes:

White rice

beans

cooked banana

cacava

flavorless pasta

Some meat (usually goat or beef, hardly ever chicken)

I tried liver here for the first time! Not my favorite...

African Tea (hot milk and tea) 

and some fruit like papaya, pineapples, or passion fruit

Never fresh veggies!

Overall food is pretty bland, after a week of eating it we decided we needed to explore more! So typically we go to restaurants such as: Meze Fresh(kind of like chipotle), Sole Luna (italian), Chinese restaurant, fancy restaurants near downtown, African Bagel Company (great bagel spot) 

People
No matter where you go, you will always be the center of attention. Little kids run down the streets towards you, yelling "Muzungo" or "Give me money"! At first its pretty amusing, but after awhile its nice to have some peace and quiet.
Women carry their babies wrapped around their backs all day. At our home stay, the mom might be doing chores or just standing around with the little one year old knocked out on her back.
Everyone is usually extra nice to you if you speak kinyarwanda towards them. They really do appreciate you making an effort in learning their language.
After the genocide, the number of handicap people increased drastically and you can see that very

Fashion
On a regular day basis, walking down the street you see half of the women dressed in traditional African cloth and the other half in regular western clothing. Everyday wear is pretty conservative here, you will never see women wearing anything above the knee or exposing shoulders  (no tank tops or shorts). 
Women and men walk around with head wraps to hold whatever they are transporting on their heads, i have seen them carry bananas, jugs of water, mattresses, chairs, etc...

Landscape

Northeast = plains (this is where the safari is)

Northwest = volcanoes and mountains 

Southwest = Lake Kivu (the lake that connects the Congo and Rwanda) 

South = Jungle 

But no matter wherever you go, there are hills everywhere. So to travel from one place to another, be prepared to move around the hills. And bring a paperbag, many people get motion sickness. But on the positive side, there are breath taking views wherever you go. 

Weather
I don't miss Texas weather. Its never above 85F nor below 70, every day all day. We have even had rain showers like three times. The only real downside is that the malaria carrying mosquitoes thrive here! But the government gives every single person a mosquito net for free to combat them. Considering malaria is in the top 10 cause of death, the mosquito nets come in to great use! 


Language
So everyone speaks Kinyarwanda, like 35% speak french, and less than 10% speak English. In the past couple of years, the official language went from french to english. Kinyarwanda is tone language, so the way you pronounce things can change what you say. My vocabulary includes how to give directions and how to bargain! Pretty much all you need to know to survive here.

Quick Cheat Sheet: 

Good morning- Waramutse

Good afternoon- Wiriwe

Thank you- Murakoze

How much?- Nangahe

Too much- Ni menshi! 

Here- Hano

Yes- yego

No-ohya

Where? -he he

Slow down- Bohoro

Turn right - kata iburyo

Go ahead- comeza 

So a typical conversation to try to get home on a moto goes as follows: 

Me: Kicukiro? 

Moto: Yego, he he?

Me: ETO (the name of our school)

Moto: Yego (hands me the helmet)

Me: Nangahe? 

Moto: igihumbi (1000)

Me: Ni menshi! Orororo! (Orororo is kind of like saying "ouch that hurts")

Me: Maganarindwi (700)

Moto: *laughs* yego! 

Me: Murakoze! 

If you are curious about anything else, just leave a comment and I will respond! 

Thanks and Gig'Em

Life in Butare

This is the beginning of our fourth week living in Butare, a small historic city in the Southern Province. It has a much slower pace than Kigali, for example the motos don't drive like maniacs! The city is known as the former capital of Butare, during the pre-colonial times, and it is also home to the main campus of the University of Rwanda, a large genocide memorial, kings palace, museum and the only ice cream shop in Rwanda.

We live with the Emmanuel, the head technician at the hospital, his wifi (Celine, an ICU nurse), their a year and half old son, and a house boy and girl. Communicating is rather difficult because the only one that speaks decent english is Celine, so we tend to usually play a game of charades if we want to speak to the house people. Our guard dog is a really nice Labrador mutt, who I trained the first week to jump on my partner everytime she sees her. Every morning we are awaken by the loud clucking of the 6 chickens living outside our window, gospel music playing, and the baby crying. Who needs an alarm right? For dinner the first night, we were fed rabbit and it was delicious! And throughout the days we have ate thus far, goat intestines, liver, kidneys, spleen, and dries up little fishes. We have running water, but no heater, so if we would like to take a running shower, it is best to be prepared to shower with freezing water.

We start our day going into work at 7am, we have a meeting with the ten other technicians in the hospital. The first part of the day is usually inventory, inventory, and more inventory, and we tend to devote the second part of the day, before leaving at 5pm, to working with medical equipment. CHUB, the university teaching hospital in butare, is one of the larger, better equipped hospitals in Rwanda. They have four x-rays and a CT machine, however after working here for three and a half weeks it seems like the place where they need the most help is in the Neonatal ICU. So far we managed to fix infant warmers, incubators, syringe pumps, suction pumps, surgical lamps(in progress, waiting for the bulbs), oxygen concentrators, and dialysis machines. Many of the problems we come across is just poor preventive maintenance, for example: many of the batteries wear out, loose connections, dusty insides, blown fuses, etc...

Even though every department in this hospital has their own technician, it is still very limited by the lack of spare parts, surge protectors, and consumables. So basically all we can do is improvise, or how our professor put it Macgyver it!