Thursday, 26 November 2009

A glimpse into our local hospital

November 25th

A very busy day today. This may well have turned out to be my last “working day” in any normal sense of the word. Into the office well before seven. No sign of Claude or the modem. Valérian is there, and I have some files to put on his computer for him. There’s no other work to do; Soraya has a few trainings left but they tend to be at weekends and I can’t share them with her.

At the post office there are a couple of packets for April, one of which contains her new iPod to replace the one which was stolen just after she arrived. Not only that, but she can use the iPod for a lot of her audiology work, so it’s very much one of the tools of her trade and certainly not just an entertainment device.

And there’s more news from the post office. They have installed a new batch of outside post boxes, including ours. This means that we have to fit a lock to it, but when the lock is operational we can access our mail at any hour of day and night. I have a combination padlock on loan to Becky; that will be the ideal one to use. (With so many volunteers using the box, we can’t use keys and we will have to use a combination lock). I take the opportunity to say farewell to the post ladies and explain that Tom is taking over as the “titulaire” for the box. So BP146 will remain the muzungu mail address for the Gitarama gang, especially all the VSOs.

Next I go to the FHI office where I have some artefacts waiting to be picked up to use as presents back home. Tom’s there and I’m able to quickly check my emails on his laptop. In doing so I discover there’s a volunteer coming to Ngororero, the next district over from me in the West of Rwanda, and I’ll send her some info. She’s going to feel very isolated to begin with in Ngororero, and we will be her nearest fellow volunteers.

Back up through the town to one of the little clinics which have sprung up. Here comes the highpoint of my day. I deposit a little pot with a poo sample and wait a few minutes while they analyse it to see what manner of nasties I’m carrying inside me. I’ve convinced myself that I’m going to need deworming, or at least that I’ll have vestiges of amoebae crawling through my guts and multiplying.

To my considerable surprise the technician tells me that he can’t find any evidence of worms, or of amoebae. Apparently my bacteria count is high, but that’s nothing serious and it should adjust itself back to normal when I return home. So my immediate reaction is not one of relief, but rather of doubt – does he know what he’s looking for; has he been thorough? I think a bit more deeply and conclude that I’m just being irrational. He seems to have all the kit; I’ve explained to him exactly what I want him to check for and I’ve no reason to doubt his competence. Certainly it means that I can’t be badly infested with anything nasty or he’d have seen it.

A bit of shopping on the way back to the flat; then it’s about turn and off to Kigali. I’m not staying long in Kigali but I need to draw out money to finish the water tank at Nyarusange. Moira’s in on the project with me, too. I celebrate both getting the money and being “clean” with lunch at BCK, the first time since my family came out last summer. Club sandwich and “thé africain” – how’s that for fusion food? Kigali is hot and stuffy as usual and there’s a storm brewing. I get straight back home, all the way to Kabgayi to see J.

J is in the hospital at Kabgayi and will be there several more days. The details are not for a public blog, but she’s going to need all the support we can muster, and I’m cursing the fact that this has happened just when I’m about to leave. The timing couldn’t possibly be worse in so many ways. She’s become a very close friend and it really hurts to be on the point of leaving when a friend is damaged and needing support.

What depresses me further is how bleak the hospital is. Tom explains to me that they are desperately short of money – the volume of patients is so great, and the amount of funding they get to buy drugs and equipment is so low, that conditions are appalling. P has just come back from Uganda and apparently had to smuggle quantities of drugs into Rwanda just to keep the hospital going. They have used up all their credit with local pharmacies, who will no longer supply the hospital without cash up front. It’s a desperate situation. There’s no catering in the hospital; if you are an inpatient it is expected that your family will effectively camp at the place and bring a charcoal stove to cook all your meals. Doctors and nurses are in short supply, overworked, and can’t cope with complicated cases. For specialist care you have to transfer to the King Faisal hospital in Kigali, but that is very expensive and way beyond the means of almost any Rwandans. Honestly, before any English person reading this ever criticises our NHS again, they ought to come and spend a day at Kabgayi.

Back at the flat I write up some notes from yesterday’s Global Links meeting and I’m just about to go shopping when the heavens open and it pours for an hour. By then its dark and Tom’s home, soaked through.

All day long there has been trouble in the market. I don’t know what’s happening; perhaps there has been a major fight between stallholders. The police have weighed in and closed the market down, but all that means is that the women have set up stalls all along the side of the main road. They’re not going anywhere until they’ve sold their produce. It’s absolute chaos trying to get through the town. All late afternoon there seem to be gangs of men hanging around in groups; there’s lots of shouting and you get the feeling that it wouldn’t take much to start a riot. None of the tension is directed against muzungus and we’re safe unless we’re unlucky enough to get caught in crossfire, but it’s unsettling.

Because of this we decide to cook a meal from left overs, and as usual we dine in style. It’s my turn to cook tomorrow and by then I’m sure the market will be back to usual.

It’s been a busy day. Best thing – discovering that I’m in good health after two whole years of living in equatorial Africa and doing a lot of eating out.

Worst thing – J is in a desperate place both physically and psychologically. The physical side is short term; she will come home by the time I leave unless there are major complications. The emotional side is going to take years to heal and will need lots of love from everyone around her. Life in Rwanda is harsh; early deaths are common and if they threaten someone close to you it hits you like a thunderbolt. (Fortunately J seems to be getting stronger each day, but the sooner she’s out og Kabgayi and back home, the better).

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