The Green Corner

I need to write about a restaurant that sustained me 4 years ago in Rwanda and that too my shame and regret I only visited this week (twice).

I speak of the Green Corner.

4 years ago on our first day here, dazed and confused we realized after dark that we had no groceries and knew of no local restaurant.  The volunteer guide said that they had heard that the Green Corner was okay and I found it on a map in the Bradt Guide and figured I could navigate us there, which I did by the long way staying on light busy streets.

Arriving there reminded me of the scene in Animal House where the gang go to see Otis Day and the Nights.  Nevertheless we were shown to a table.  I asked for a menu in French and was told "Poulet or Poisson".  I figured poisson was safe and order three along with beer and frites.  About 10 minutes later someone explained to me in broken English that the the Poisson was way to big for us to eat three and suggested we get only 2.

It took a while to arrive during which we drank beer.  The Green Corner is a typical Rwandan restaurant, painted plaster, concrete floors and resin chairs.  After about an hour, a man arrive with the kettle of warm water and a bar of soap and we were directed to wash our hands.  When the food arrived, we learned why, there was no cutlery.  They did give us fork when we asked.  The poisson was the best I had even tasted or have tasted since.  Cooked over a wood fire, exquisitely spiced.  I would kill for the spice mix, I suspect the only way they would give it to me would be if they killed me after.

We ate their 4 more times, eating the equally good poulet, sometimes both.  We took the residents there for our last teaching session.  We stopped using cutlery and tore the meat off with our clean hands  We started taking the short cut through the unpaved unlite streets.

What was interesting was that after the initial suspicion of our first visit, by the fifth visit we were welcomed as old friends.

It took me until my fourth week here to venture over there.  It had changed, bigger with TVs now.  Still the same excellent food and I took Simon my colleague there the next night to demolish a chicken and poissson.    They do have a menu now albeit just written on a white board.

Still the best place I have eaten in Rwanda maybe in the top 10 world wide.  Not in Trip Advisor.  Pity.

Mazunga

Being a Canadian of British heritage, I have never been subject to an ethnic  nickname.  True Canuck was a derogatory term for Canadian, however Canuck now is just an under-achieving hockey team with very fickle fans.

During my last visit to Rwanda I learned that white folk like me were referred to as "mazungas".   This term is used throughout East Africa  This either means "wandering person" as I am sure Africans couldn't figure why these people left their homes to live in a land where the Africans were eking out an existence.  Someone else told me that it means someone with money and that black Africans are eligible for mazungahood.  Whatever.

I had a most embarrassing encounter today.

I love the little bananas they have here more than life and generally eat them for breakfast.  The quality of the bananas in our local market or street vendors is pretty poor possibly due to the season or maybe I am being offered mazunga-grade bananas.   I usually walk home but on taking a taxi which because of one way streets had to use  road parallel to the NR, I noticed some excellent fruit markets along that street.  For that reason I made a detour to buy some bananas today.  I actually bought them off a lady's head and probably paid too much but proceeded uneventfully along the remaining 2 km carrying my bunch of bananas in my hand.

That was until 1700 when a rather large school got let out.  School in Rwanda goes until 1700 although I think they get a long lunch break.

Suddenly a group of pubescent school uniformed girls  followed me, giggling and yelling "give us your banana Mazunga".  Okay it was getting close to supper and maybe they were hungry but somehow I don't think that was what they meant.  Rwanda is a very conservative country where men and women rarely even hold hands in public and I was a little shocked (and really embarrassed).  Anyway eventually I slunk onto a side street and they fortunately didn't follow me.

Last weekend I was at Nyungwe.  I had always noticed that when we passed groups of children they would always yell and wave and act like our driving past at that moment  was the best thing that ever happened to them.  This time I actually listened to them and they were chanting "money Mazunga" because that is apparently what we have.

I don't blame Africans for distrusting whites.  Aside from colonizing them (I still resent the British); there are all the stupid things we made them do post colonization, all the kleptocratic dictators we propped up, all the weapons we sold them and all the money currently stashed in Mazunga banks.

I have now spent 7+ weeks in Rwanda.  I can walk the streets safely (it would be nice if they learned sidewalk etiquette) , people treat me like a prince and the only Rwandan who has taken advantage of me is an ex-patriot Rwandan who lives in Canada most of the time (our landlord).

I can take the odd name calling and the odd embarassment.

Butare and Nyungwe

Tuesday we left for Butare.  Kigali was getting very old and I was ready for a change of scene.  In true Rwandan fashion we had to wait until Monday afternoon to find out if somebody was actually going to pay for our little trip there but it came thru and Tuesday morning we got picked up outside our apartment.

It is a two hour drive from Kigali to Butare.  We swung west along the river but after a few km climbed up.  As in most of Rwanda the whole area was cultivated as far as the eye can see.  The roads were crowded with people walking and riding bicycles and we could see people working in the fields. We passed through 2 moderate sized towns before entering Butare.  We checked in to the Credo Hotel were I stayed last time.  Not really much has changed.  We then went to the hospital to present ourselves to the administrator who was quite pleasant and were then directed to the OR to meet Isaac one of the anaesthesiologists.  This was a bit of a reunion as Isaac was a junior resident the last time I was in Butare.  Isaac showed us around the hospital.  Currently Isaac is the only staff anaesthesiologists.  Dr. Theo the department head is in Sweden doing a post-graduate degree and another anaesthesiologist is in India doing ICU training.  Yet another staff anaesthesiologist is working as an administrator at the hospital.  Isaac seemed to be taking being the only staff anaesthesiologist quite well.

After we walked back to our hotel stopping for a coffee and a light lunch.  As has become usual when given the opportunity, I had a nap followed by a dip in the Credo's rather large pool which actually has a deep end and a diving board.  After a beer on the terrace overlooking the street Simon and I walked up to the Ibis hotel which is really the only good place to eat in Butare.

We worked in the OR the next two days trying to teach two brand new first year residents and one second resident.  Fortunately the anaesthetic techs are extremely good in Butare and I admired their patience in dealing with the junior staff.  Aside from there being fewer staff anaesthesiologists, things have improved a great deal in Butare.  When I was last there, they had a variety of older machines some with drawover vapourizers but in the past 4 years all the machines are new, donated as I learned by HRH an American organization funded by the state department.  On the last day we met an American surgeon who was spending a year there funded by HRH.  He was an interesting character, a retired cardiac surgeon now doing general surgery and had also done a lot of MSF work.  As cardiac surgeons are the uber-princesses of the OR it was interesting to see how he could work in what are quite adverse conditions.

Our teaching ended around noon on Friday and we were picked up by Magnifique our driver for our planned trip to Nyungwe National Forest.  Nyungwe is one of the last tracts of primal African forest left.  It also drains into both the Nile and Congo basins.  This was accessible by a very rough dirt road last time but the road is now paved.  We headed out of Butare first passing the prison farm.  Orange and pink pajamaed prisoners were working in the field.  Genocide prisoners have to wear pink pyjamas.  We then proceeded through heavily cultivated hilly country.  Along the way we passed a large refugee camp made up of refugees from the Congo.

After an hour or so we ended Nyungwe Forest.  The road was windy and hilly with thick jungle on both sides.  At the higher points on the road you can see the forest canopy to the side.  Although the road is paved now we came across at least 5 large trucks off the side of the road.  At one place a truck carrying pigs had overturned and they were trying to catch the pigs.

Our first stop was Uwinke lookout where we planned to do the canopy walk.  I had turned down the opportunity to do this 4 years but wanted to try it this time.  To take the walk we had to pay $60 US each.  A group of 6 of us headed down the trail.  The guide would stop it seemed about every 10 metres to point out some nature feature.  This was getting a little frustrating after a while because it was getting later in the day and rain was threatening.  When we got close to the canopy we found the reason for his stalling.  A large group of Rwandan school children were ahead of us and we had to wait for them to get off the skywalk.

The skywalk itself reminds me of one of those bridges than Indiana Jones has to cross to escape from the bad guys or the bridge where Sean Connery made his last stand singing The March of the Irish Brigade in the Man Who Would be King.  Actually it is a lot safer than that.  It is a metal platform about half a metre wide with mesh on either side to my waist level and two ropes.  Our guide explained that it had been designed by a team of Brazilian and Canadian engineers.  Having 3 engineers as first degree relatives did not reassure me.

Our guide had to finally go and clear the school kids off the skywalk so we could get on.  This gave us about 15 minutes to stare at the skywalk crossing the void and watch it sway.  There is first a 10 m section to the tower which gives you a chance to chicken out which I thought about but didn't.  We then had to wait about another 10 minutes for the final school kids to get off before our guide took across the 100 m or so walk.  Had I not been scared shitless I could had looked to the sides on downwards.  I could have even taken a picture but that would have meant relaxing my death grip on the cables.  To enhance the experience our guide stopped mid way.  Finally we were off the skywall onto the second tower.

Me looking very calm and collected.

We had another short 10 metre section to get back to the trail and by the time we had walked back to the top of the hill my sphincters had relaxed.

From there M drove us to the Gisakura Guest House where we were staying.  I had remembered this as a spartan but pleasant place to stay.  We also stopped at the adjacent Ranger Station to buy our chimp tickets.

We had a pleasant dinner.  There was only two other guests, a couple.  The husband turned out to be an American Internist visiting Rwanda with.... HRH.  We had a nice conversation about medical and Rwandan matters.  It was soon time to go to bed because we were leaving for the chimps at 0500.

We met M, the guide and six other people the following morning.  Taking the guide with us, we headed west on the paved road.  It was still dark but people were already out on the road.  After about 15 minutes we turned onto a very rough dirt road.  We passed a lot of people out on the road, more as the sun rose.  We were outside the National Park so we passed tea plantations and farms.  After an hour we reached the drop off point.  There we met the trackers and also the porters who would for $10 carry your pack.  After getting instructions we headed up a path which become steeper and steeper, as well as more slippery.  The group spread out quite a bit.  We started to head down quite a treacherous downhill. As we got to the bottom, our guide spoke with the trackers by walkie talkie and then announced that we would have to retrace our steps as the chimps had moved.  We climbed back up the hill which was actually easier to climb than to go down and after all while we stopped and the ranger announced that we would wait here the chimps.  Waiting seemed a lot better than chasing them.  Eventually we learned that two or three were headed our way and we headed down a bush path to intercept them.  We were rewarded as we soon saw three chimps in the trees above us, who  dropped to the ground and ran by us within 10 metres of us.  We went further along the trail and saw a number of chimps on the ground and in the trees including a mother and baby.  They were heading away from us so the ranger decided we would go back to the road and watch them as they crossed.  We did this but the trackers soon relayed to us that the chimps had stopped again.  We went about 200 metres back up the trail and were able to watch about 10 including the mother and baby crossed the trail in front of us.  It was then a run back to the road were we watched them cross the road finally.

All this took a couple of hours.  Ironically our best view of the chimps camp 100 m from our vehicle.

We then had a 1.5 hour trip back to the guest house.  The roads were really busy with people walking, the women and some men carrying firewood, water or sacks of something on their heads.  We stopped at a tea field to get a closer look and a small group of children surrounded us including two young boys carrying a stack of bricks on their heads.

It was only 1030 when we got back to the guest house.  I had a shower and drank an African coffee.  The guesthouse also has internet so was able to check up on the world from the dead centre of Africa.  After lunch, it was nap time.

Dian Fossey

Sunday we hiked to Dian Fossey's grave.  Dian Fossey as I noted in my previous post looked nothing like Sigourney Weaver.  She is still a very controversial figure and while there is a lot of hagiography about her, likewise there are a lot of nasty stories about her.  I am currently reading Bill Weber and Amy Vedder's book "In the Kingdom of the Gorillas" and they certainly have very little good to say about her.  You can read the book, read "Gorillas in the Mist" which   is Dian's book or watch the movie.  Or maybe you just don't care.

After eating an early breakfast at the Muhabera, Magnifique picked us up at 0630.  To do this hike you have to go to the same staging area as for the gorillas.  There we paid $75 each and were assigned a guide.  Our driver drove us and the guide to the drop off point for this particular hike.  This involved a fairly long drive up a very rocky road until we got too  the drop-off point.  There I hired  porter and we hiked through the farm fields to a gap in the stone wall.  The guide explained to us that Dian used to park her car there, paying a villager to watch it.  There we met 3 trackers including one with a gun who were to accompany us.  Keep in mind there was only Simon and me.  We set off on a steady uphill through the forest for about 30 minutes until we arrived at a clearing with benches to sit on.  At that point our guide informed us we were half way there.  The remainder was flatter but extremely muddy.  Logs had been laid across the path in a futile attempt however they were slippery and sometimes it just seemed safer too walk in the mud which went up to the top  of my boots in places.

We eventually arrived at the remains of the camp and the gravesite.  Most of the camp  is gone now except for the foundation stones and some stoves.  It has been reclaimed by the jungle and also was looted during  the genocide and aftermath.  The site is very muddy which according to Weber and Vedder is what it was like in the 1970s.  We walked somberly past the remains of several cabins which the ranger explained to us before arriving at the remains of DFs cabin.  This was bigger than the rest but of course she was the boss and lived there for quite some time.  This was where she was murdered.  The guide did point out that the camp was quite  spread out and her cabin was a ways away from the nearest cabin which may have accounted for why nobody heard the murder or tried to help her.

The whole area is very gloomy, shaded by large moss and vine covered trees that project out huge horizontal branches.  We proceeded to the grave site.

In addition to her grave marker, multiple  other gorillas are buried. These include Digit a silverback, whose death lead off Walter Cronkite's broadcast way back when, he having been featured in a National  Geographic Special.  According to the hagiography, Dian's body was at the airport ready to be taken back to the US when somebody found out that she had desired to be buried next to Digit.

Also buried there are the many gorillas she knew who have since died of natural or not so natural causes.  According to the guide only gorillas she knew get to be buried there and only 3 such gorillas are still alive.

It was sombre place, dark and damp and after paying what was a reasonable amount of respect we indicated to our entourage that we walked to leave and  so we proceeded back on the muddy path.  As we started down the steeper part which was a little damp, one of the porters would grab my hand during the sketchy parts and I didn't even feel insulted.

Magnifique met us at the bottom and with the guide we descended the rocky trail.  We stopped for lunch at a tourist lodge, a few steps up from the Muhabera.  They took our muddy boots and gave us flip flops and we ate a pretty decent buffet lunch.  It was a little expensive at $20 US each but when we came out and our boots had been cleaned it seemed like a fair deal.

I slept and gazed at the scenery on the 2 hour drive back to Kigali.

Gorillas revisited

Friday we left for the gorillas.

I had recovered from my GI upset but decided not to chance going to the hospital for half a day so I just hung around the apartment, read, checked the internet and at one point going a little stir crazy went for a walk.

At 1200 we walked across to the Merez gas station where we had agreed to meet our driver and just as agreed there he was. It is always gratifying when after wiring large amounts of money to a company, that they actually show up. Our vehicle was a large Toyota Land Cruiser which I remembered from our previous trip. Our driver's name was Magnifique. Really.

We pulled out on to the NR and around the mosque headed west down a very steep and narrow, cobbled street for about a km before joining an arterial road and heading out of town. This was my second trip so I remembered most of the route. Essentially we climbed a major fairly steep hill just out of Kigali. Climbing the hill, we noticed a couple of cyclists were hitching ride, holding onto a truck which was labouring up the hill. Reaching the top we proceeded along a ridge with views to the North and South of the valleys below and we were very high above the valley floor. It is the end of the dry season and a lot of the crops were harvested and so there were a lot of brown fields. As before terraced fields reached to the top of most of the hills.  Could have got some nice photos but our driver was no inclined to stop.

We eventually descended a little and after an hour stopped at collection of shops and restaurants. Our driver explained that the whole development was owned by one man who had a factory making banana wine. I said that I had never had banana wine and he directed me to where I could buy a bottle. After making sure it was okay for passengers to drink in Rwanda, I opened it and sipped it as we headed to Muzanze. It tasted somewhat like cheap port.

We arrived in Muzanze to the Muhabera Hotel. This hotel's claim to fame is that Dian Fossey kept a room there when she wasn't out with the gorillas. The room is still kept as she left it. Her room is number 12 and mine was 14 so we were quite close. They had pictures of her and she didn't look anything like Sigourney Weaver. Who knew

Otherwise there is nothing that impressive about the hotel. It is collection of square buildings, plastered and painted. My room had a large bed and not much else. There was an elaborate spray shower which the clerk who walked us to our rooms demonstrated.

I had a fairly substantial bowl of mushroom soup on the terrace as well as a beer. Then it was nap time after which I read a bit and checked the internet. Around 1900 I went down for supper with Simon and had a goat stew which was very good.

We were to be picked up at 0630 for the gorillas and the hotel advised me that they served a buffet breakfast from 0545. The buffet breakfast turned out to be a cellophane covered plate of fruit, some hard boiled eggs and white bread for toast. There was also coffee and hot milk. Thus fortified Magnifique picked us up at 0630 and it was a 20 minute drive to the staging area.

We all milled around watching some drummers and dancers and drinking more coffee. The drivers generally negotiate with the rangers as to which of the eight groups their charges will go to. The Susa group is the largest and most desired but it is a one hour drive plus a 3 hour hike each way, so generally only the fittest trekkers get to go there. I was eventually assigned to the Hirwa group.

Our ranger explained that the Hirwa group was a relatively new group. Its Silverback, nick-named Lucky had been the number 3 Silverback in the Susa group until his penchant for, as our ranger put it, doing jiggy-jiggy with the females in the troop resulted in multiple “punishments” by the dominant Silverback and his eventual exile from the group. He did take one female with him and picked up 4 from other groups, starting his own group.

By the way “punishment” consists of being bitten and in the last year 3 silverbacks have been killed in love triangles. Park policy is not to interfere in gorilla politics.

With the information Magnifique drove me to the starting point of our trek about 30 km away. I hired a porter for $10 US to carry my bag and our group of eight headed out thru potato fields towards the park. 

 We were given carved walking sticks to carry which proved to be very helpful. We arrived at a stone wall where we were met by 3 trackers, one carrying a submachine gun which the ranger advised me was for buffalo who lived in the forest (we never saw one, but they do use it as a bathroom). We all squeezed thru a narrow slit in the wall and walked gradually uphill along a path in a bamboo forest. After a while, it became less of a path and a steeper climb. Fortunately the footing was good, there was bamboo (and nettles) to grab onto and the porters where very helpful. After about an hour we got close to where the trackers had located the group and we were told to leave our packs and walking sticks which scare the gorillas. We walked about 50 metres before spotting our first gorilla and soon the rest of the troop. The troop were spread out around the ground, with some in the trees. There were many young gorillas who ran around crazily. There were very young gorillas including at least one still riding his mother's back but no babies. The silverback was lying on his back being groomed by a younger gorilla.  

You are supposed to stay 7 metres back from gorillas but our guides did not enforce this, in fact hacking vegetation away so we could get closer. It was a fascinating  hour in the company of our close relatives,watching them eat and play but eventually it came to and end and we hiked out and back to the meeting place where Magnifique was waiting for me.

In the past four years Rwanda has embraced the carving shop concept so common in Kenya. To get our gorilla certificates we had to stop at one of these, the goods of course all made by local cooperatives. I bought a basket which I had planned to do anyway. I also bought a book about the gorillas. The shop-keeper asked me if I was interested in one of the carved walking sticks. How am I going to get that on the plane, I asked. Simple it comes apart like a pool cue into three pieces. He knocked off $5 and I now have a walking stick. Most of the shops took credit cards or would give change in US$$.

Returning to the hotel, I got to try the elaborate spray shower. The spray feature shot out thin but painful jets of hot water but there was a least hot water. After I had a goat brochette on the terrace along with a beer. Off for another nap. Simon who had gone on another group wasn't back so I walked towards Muzanze about a km. The road was filled with people walking in both directions. As usual when I walk in Rwanda, people still seem surprised to see a Muzunga walking. Or maybe my fly was open. Simon was on the terrace when I got back so I had another beer with him.   

If you aren't interesting in my bowels don't read this

About 2 am the night before last, I awoke with my tummy rumbling in serious fashion and I had what I  used to call a Havana Omelet and now call a Kigali Omelet.  Probably just the heat or my IBS acting up I thought.  5 Omelets later I realized that I had genuine case of Traveler's Diarrhea and popped my first dose of Cipro.

I have prided myself over the last few years on travelling and trying to live as much as a local as possible except for my preference for running water and nice hotels.  Especially when you are visiting somewhere for an extended period of time you can't or shouldn't isolate yourself from the local culture.

On the contrary when I visit Ecuador with my medical mission, we eat only in our hotel and have lunch delivered to the hospital lest we catch something nasty.  There is some merit in this, you really can't do much surgery if a lot of your team is sitting on the porcelain throne.  Despite this on some years a couple of people got really sick despite following rigidly the dietary laws.  I usually blame the sandwiches the well-meaning Rotarians bring into the hospital.  I never eat them, who knows how many days old they are or whether the person who made them washes his hands ever.  On the other hand I have often passed up appetizing street meat for fear of letting down the team.  This ended last year when I brought down a colleague who faced with the abundance and variety of street meat was determined to sample each and every variety.  "You have to talk to him" said the team leader, "what happens if he gets sick?"  I didn't mention the Rotary sandwiches and just said, that I couldn't really control my colleague (which is true).

Being both male and an anaesthesiologist, I am to blame for much of what is wrong in the world and of course when you do get something like traveler's diarrhea you blame yourself.  I shouldn't have eaten at that restaurant, I should have used bottled water to brush my teeth, I should have exclusively drank beer, I should have cooked the meat I bought at the local market for 3.5 hours instead of 3.  Instead there is a fatalism that my time had come and I was probably lucky to have gone as long as I did.  So many ways you can be obsessive and still contract it.  For example you can shake hands with somebody and then touch your mouth, the person who opens your beer may not have clean hands, even the most expensive restaurant is no guarantee etc.

TD is natures way of telling you, "you do not belong here, you are not part of this environment and this is your punishment for your pretentiousness"

It is also sobering to think that many visitors to Africa and the tropics in general succumbed and died of  diarrheal diseases.  Of course when you compare this to the diseases (and the guns) we brought down with us, we are still ahead if you want to look at things that way.

Anyway by tomorrow the Cipro may be working and anyway even if I| have to wear a diaper I have going to see the gorillas this weekend.

LIfe goes on in Kigali

Monday was the teaching day which is supposed to be run by the Canadian volunteers however this monday Dr. Paulin wanted to give a talk on non-technical skills.  These are things like communication, situational awareness and team work etc.  These are things that of course really can't be taught and have to become part of the institutional culture something I don't see happening anytime soon in Canada.  As the visiting professor I got to make a few sage comments at the end.

Dr. Paulin also introduced 9 or 10 new first year anaesthetic residents who are more in number than the current number of residents.

In the afternoon, we had a joint session with the surgeons again covering non technical  skills and we also went over the Safe Surgery Checklist something having been involved in its development at our hospital gave me flashbacks.  After that it was definitely time for a swim at the Serena.

I should mention that the anaesthesiologists and surgeons do incredible work here with very little resources.  I would to see one of our OR princesses come down here to work.

Getting home I decided that a beer was in order and picked up my empties.  A beer in Kigali costs 600-700 francs but the deposit is 500 francs which is why you don't have any broken glass on the streets in Kigali.  In the little grocery store, I ran in Emmy who drives for us sometimes and he invited me to have a drink with him at the Blue Bar across from my apartment.  We sat outside on lacquer chairs and ate goat and tilapia brochettes as well as fried bananas and talked about life.  As we were about to leave a car pulled up and very inexpertly tried to parallel park in front of the bar.  Parallel parking is a little dangerous because there is a three foot deep drainage ditch between the street and the bar.  Having parked about 4 very drunk guys piled out.  It was the first real public drunkenness I have seen in Kigali. (I have heard lots at night while trying to sleep).

Tuesday as for some reason no resident was available for OR teaching, we had off.  I arose late for me had a coffee and then walked to the Bourbon cafe for breakfast.  I ran into one of the HRH American docs on the way.  He asked where I was going, I said for breakfast which satisfied him.  I lingered at the Bourbon cafe for about an hour before walking back to the hospital  I wanted to the check with the Public Relations guy who handles things for us.  It turned out that for various reasons our licence applications still hadn't been submitted.  In my case they needed a passport photo, even though they had a copy of my passport and so somebody drove me downtown and I got 8 passport photos.

I then proceeded to the Serena Hotel for a shower and a swim, topping it off with a latte. I then walked home in the noon-time heat.

Mary had asked that I bring back some fabric to make a quilt so I asked Christophe who helps us out if he could help me.  We walked over to the local market.  It was very hard to explain to Christophe or to the ladies selling fabric that no I did not want something sewn for my wife but rather the she intended to chop the fabric into squares and make what I told them was a blanket because I don't think they have ever heard of quilts.

My next mission was to get a shirt made, so Christophe took me to a tailor shop just off the market. There was no fabric there that I liked but the tailor a women dressed in a faded brown business suit said that if I provided the fabric, she would make a shirt for 10000 francs.  So it was back to the market to pick out fabric, enough fabric to make 3 shirts for an ordinary person or 2 for me.  The tailor took my measurement and we eventually agreed to 2 shirts, one short sleeved and one long sleeves.  A during this time Christophe and the lady bantered back and forth in Kinyarwandi.  I hope they weren't making fun of me.

Wondering where the lions are?

On Sunday we visited Akagera Park which is on the Tanzania border.  This is Rwanda's answer to Masa Mara and Serengeti.  I had visited this 4 years ago and it was my first experience with savannah until I went to Kenya which blew it all away.

I was therefore ambivalent about visiting it however Simon had never been there (I must stop letting Simon enable me), so I booked another trip for the day.  My enthusiasm was piqued by the knowledge that 7 lions had been introduced into the park.  Lions have been  extinct since after the genocide.  In order to have land for the refugees who returned, the government gave 2/3 of the park to farmers, who, when the lions started eating their livestock, poisoned the Lions.  Nasty but there is a difference between trying to eek out a subsistence life and paying 10s of thousands of dollars to lure a lion out of a park so you can shoot it with a crossbow.  The park is now surrounded by an electric fence.

Our driver Clement arrived at 0530 and we went down to meet him.  We headed off thru the street of Kigali.  This time of year it is still dark at that time.  A few people were jogging and the soldiers were still on the streets.  We swung thru Kigali and headed east.  The sun was coming up.  Everywhere you go in Rwanda you are never out of sight of another person and we saw tons of people.  Most impressive were the people carrying green bananas to market on their bicycles.  They would put one bunch on each side like a pannier and then would stack up bananas behind them as high as the height of the rider.  I wish I had taken a photograph but I knew that it wouldn't turn out well.  They would ride their bikes on the flat and would push their bikes up hill.  We saw at least 50 such bikes and as well people carrying firewood or water on their bikes.

Along the way we passed banana plantations and fish farms.

About 2 hours in we turned on to a dirt road towards the park.  The terrain and vegetation was starting to turn to savannah like although we still passed farms and banana plantations.   There were a lot of cattle with long horns.

We entered the park through the south gate and proceeded to the entrance.  Akagera is  much better organized than 4 years ago.  There is now a tented lodge and you are able to camp behind an electric fence.  There was a reception area and you can even pay your park fees by VISA.   At our driver's suggestion I bought a coffee.  The lid was  too big for the cup so I wore some of it but absorbed enough to make the drive over rough roads somewhat uncomfortable.  During our previous visit we had entered through the north gate which you can no longer do so I was hoping for a new experience.  We picked up a guide Bosco who joined us in the truck.

We headed north along a dirt road.  The grass had been burned along the road which our guide told us would result in fresh green grass which would bring the game back towards the lodge.  Eventually we were on a road running between the lake and a ridge which jutted up about a km away.  At first we did not see many animals except some Impalas, baboons and a large lizard sunning on a rock..

At one point we ascended higher above the lake where we stopped on Bosco gave us binoculars where we could see elephants down below by the lake in distance.

We stopped at Hippo beach where appropriately we saw a number of hippos as well as some Nile Crocodiles.  Later at another stop we were able to get quite close to the water where we saw a large hippo and some smaller hippos.  Our guide told us that the larger hippo was mating.  This means that his lover was under water.  Hippos are able to submerge for up to 6 minutes which certainly limits their stamina or gives a new meaning to "coming up for air".  We also saw two hippos on land.

As we got farther north we started to see more species of antelope, a lot a warthogs and just two giraffes off in the distance.  We also finally saw some zebras although they were far away and not as numerous as during my last visit.

It was overall a great visit.  We didn't see the lions but it is still a large park and the Lions are probably just settling in or lying somewhere gorged out because of the abundance of prey who have never known a lion in several generations.  There are also leopards in the park.  These are nocturnal and I didn't expect to see one.

We had a 3 hour drive back to Kigali, dropping Bosco off about half way where he would take a taxi back to the South Gate.  The roads were very busy with  people  walking along the side of the road or just visiting.  We saw bicycles carrying all matter of outrageous materials.

Clement dropped us off at the Serena Hotel where I had a shower, a beer and checked email and we walked home along the busy NR.

Genocide Musuem

With lots to see in Rwanda and only three weekends here, our time is pretty well mapped out so it was nice to have a free Saturday with nothing planned.

Simon who has not lived thru kids and dogs was able to sleep in while I awoke at my usual default wake up time.  It did occur to me that I had never really walked around the neighbourhood so after drinking a coffee, that is what I did.  I followed the paved street outside our apartment south until after about 500 m I hit a cobbled street where I turned left and followed it for a while.  There were some modest well kept houses along the street all surrounded by a wall of course.  In walled compound with the gate open, kids were playing soccer on what on closer inspection was an artificial turf field.  After a while the the road petered out to a dirt road which was heading east down into the valley so I retraced my steps and visited the local market before returning home.

Eventually Simon got up and I convinced him to come to the local market to buy some vegetables and fruit which we did failing miserably at haggling.  We looked at some meat but the goat's heads on the counter were a little off-putting.

Simon wanted to go to the Genocide Museum and although I have been there before (if you look in the archives, I described my last visit in 2011) I felt I should pay my respects.  We walked down the NR towards town, passing the hospital  and the Serena Hotel.  Simon wanted to do some business with the phone company so I had coffee at the Bourbon cafe after which he joined me and we had lunch.

According to Google Maps, we were now 3.7 km from the Genocide Museum.  Weaker people would have called a taxi but we decided to walk.  Kigali has a new street numbering system which makes very little sense mainly because there is not a single right angle intersection in the entire city and there are hills and valleys all over the place.  To get to the Genocide Museum it was necessary to descend to the bottom of the hill we were at the top of and then climb halfway up the next hill.  This we did and arrived at the Genocide Museum.  We had to have our bags manually searched.  The guard took great interest in my business cards.

I have described the Museum before and not much has changed except that whereas 4 years ago 200000 bodies were buried there, now 260000 have been buried there as bodies continue to be found.  I walked around respectfully reading all the plaques (which of course I always do).    There is a second story devoted to other genocides.  I visited Aushwicz 10 days earlier.  I am always amazed at how badly we treat our fellow man.   I am wondering how many more rooms they are going to have to add to this museum.

After that we turned down a taxi and walked back which involved a big climb back to downtown Kigali.  We stopped at the Nakumat to pick up provisions for our safari on Sunday and to the Serena to wash off the day's sweat.

After beers and dinner in the bar we walked home along the uber busy NR.

I should mention that the night before we had walked 45 minutes home after dark.   How many cities developing or developed world could you do this?

Surgery Camp

When we were arrived Monday we were notified that a Surgery Camp was in progress. Surgery camp as it turns out is not about campfires, counselors,or  pubescent love affairs.  It involves doing way more cases than they would normally do in order to clear up the back-log but also partially just to see what they could actually do if they were pushed.

This Friday we discovered how they coped with this extra demand and only 6 rooms.

Simple you do two cases in the room at the same time.

They planned it so that one of the cases in the room was either local or spinal as they only have one anaesthetic machine per room. I am sure someone will or has already figured out how to do two patients with one machine (which is what might happen at my hospital in Edmonton if administration doesn't replace our aging machines). Having anaesthetic techs who can start cases including spinals on their own does help.

One of the American surgeons explained to me that they tried to ensure that a septic and non septic case were not done in the same room.

I personally would love to have our infection control people down here just to watch their heads explode.

King Faisal

Today we were to go to King Faisal hospital to work with a resident assigned there.  This was the first morning with water which meant I was able to have a coffee.  There are a selection of stove top expresso makers left around the apartment but I have never used one so I used my trusty French press mug from MEC.  I also ate the small bananas and some of the pineapple I had bought at Simba today.

Christophe called a taxi and we were off across the city to the King Faisal Hospital.

The KFH was donated to the Rwandan people by King Faisal in the 1980s.  Unfortunately the government couldn't afford to run it (where have I heard that before) and it sat empty although General D'allaire appropriated it as a field hospital during the genocide.  After the genocide, the cash strapped government sold it to a South African company and it has functioned as a private hospital since.

We arrived and after the guards searched under our car for bombs with a mirror, we were dropped off at the entrance.  I was smart this time and called Dr. Paulin to come down and meet us which he did in time.  The OR was actually easy to find although there is a passcode to get into the OR.

Unfortunately, Dr. Paulin told me, the resident we were supposed to teach is not here because his infant son has a strangulated hernia. He apologized and said the resident really should have phoned us.  I told him, if my son needed surgery, calling a CASIEF volunteer would not be the first thing on my mind; not even the second or third.

I asked Dr. Paulin if he could show us around the hospital and we got to tour the ICU, and OR and watched him start a case.  It was not a very busy day with 3 rooms running, two staff anaesthesiologists and some techs.   The hospital is much nicer than the other hospitals I have seen in Rwanda although a little shabby by Canadian standards.

Since I was at a private hospital I took the opportunity to ask Dr. Paulin about the Rwandan healthcare system.  Patients at KFH either pay for their own treatment or if they have good insurance can come there.  In addition some public patients get treated there if the treatment is not available in the public system.  I asked about the public system and he said that while it is free, patients have to pay 10% of the costs which may explain why patients often get delays in their treatment.

Doctors at KFH are salaried and earn significantly more than those in the public system which I know is a source of bitterness in the medical community.

View of Kigali from KFH

We had kept Dr Paulin away from his work so left around 1030 for the Union Trade Centre in downtown Kigali where Simon hoped to get a sim card for his I phone.  I went to the Bourbon Cafe for a coffee after which Simon joined me and we had lunch there.  We then walked to the Serena hotel.

I left Simon there after a while and walked home because I wanted to visit the Nyamirambo market to buy dinner.  Having only been in Rwanda for 4 days, I wasn't sure whether Simon could stomach the market.  On the way to the market I stopped at the "Kigali Cake Empire"  to buy croissants and samozas.  The KCE motto is "happiness is guaranteed" and I hope this is the case.

I walked around the periphery of the market.  At one point a woman yelled out,  "You must have been beautiful when you were young?"  I told him that I assumed that was a complement and she told me she had been married to a white Canadian in the past.

I bought some tomatoes and peppers for probably more than I should have paid and also bought some meat from a butcher who hacked it off a carcass with a machete.  I am currently simmering all that for dinner.

Rwanda Days 3 and 4

We had more or less a slower start to our first day in the OR. Simon had to go back to the airport late in the evening and so I felt we should skip morning report at 0700 and just show up around 0730. My recollection of CHUK was that they started slowly in the morning. As it turned out CHUK was on a “surge” which should be familiar to Alberta physicians. The government had mandated that to clear the backlog of cases waiting to be done, the OR must work harder and do 60 cases per day. Nobody told me whether this came with more resources but if their administrators are anything like ours I suspect not.

Did I mention we still had no water in the apartment.

Arriving in the change room we were immediately accosted by a friendly American surgeon with whom we chatted for a while. He was from Boston but when I asked him whether he was a Bruins fan he said he didn't follow hockey. Like most Americans he was bright eyed, bushy tailed and enthusiastic if only because he had had a shower that morning, had had coffee and hadn't been kept up all night by the Nyamirambo road all night party.

The operating room at CHUK has changed a great deal. They have a much larger change room and actually have a locker for the Canadian volunteers (unfortunately we had to share it with the American anaesthesiologist who arrived bright eyed and bushy tailed while we were changing). The OR did seem to be a little more organized than I remember, the anaesthetic equipment is in better repair and the turnovers were pretty quick. In mid morning , the hospital brought in tea, coffee and deep fried dough balls which were much appreciated by me.

At noon I decided that we had taught enough and we both headed over to Karibu for the buffet followed by a visit to the Serena, where Simon who I should have figured was seriously jet lagged slept for about 3 hours. As it was getting towards 1700 and we didn't know whether we would be able to cook in our apartment I suggested that we eat in the downtown tourist area. We ended up at the Mille Colines which is the real name of the Hotel Rwanda and ate at the pool side restaurant. Aside from the atmosphere and history, the food was pretty good. It then started to pour as is becoming a custom every evening so we took a taxi home.

The power was out when we arrived but we had water ....and then we didn't. I started to put water into a pot to boil for drinking water and after about a litre, the water ended. I was also able to flush the toilet once and then we had no water again. The power went on and off during the evening.

We were supposed to go to the Military Hospital the next day which is 20 km away. We got Christophe who helps us out to call a taxi and negotiate a fare which he did quite efficiently and so a taxi picked us up and it was off to the Military Hospital. We quickly veered off the NR to the east descending into valley and then climbing up. Morning traffic was heavy. Our driver had a hate on for motorcycle taxis and made sure he passed them as close and as fast as possible. We eventually arrived at the Military Hospital where he dropped us off at the Emergency Entrance. We then had to find the OR which turned out to be difficult as nobody knew where it was. Okay this is the Military Hospital and maybe the location of the OR is a state secret. Finally somebody knew where it was and walked us over there. We started to change when a very tall, stern man came into the change room and interrogated us as to who we were and what we were doing. Eventually we satisfied him and he lead us into the OR and into a room where all the anaesthetic techs and our resident were. I learned that he was the chief tech and he gave a short welcoming speech. He told us that normally they had 30 techs but that 10 of them and one physician anaesthesiologist were Peace Keeping in the Central African Republic.

Peace Keeping; isn't that something Canada used to do?

Somewhere around that time, I figured out that we were probably the first CASIEF volunteers who had actually gotten sucked into going to the military hospital.

We spent the day with Christine the resident finishing up around 1400. At around 1000 very sweet tea with milk and more fried dough balls were brought to the tea room. The hospital also provided a very nice lunch, rice, plantain, potatoes and peanut sauce, as well.

We had kept the phone number of the taxi driver and he picked us up about 40 minutes after we called and we had a fun drive to the Serena hotel, almost killing several motorcycle taxis and their passengers. Unfortunately he charged as almost twice what he charged in the morning but on the other hand we probably would not have found a taxi way out in the boonies.

I had a shower and brief dip and then savoured my first coffee of the day.

As we now had water in apartment (at least when we left in the morning), we headed off to Simba which is the more proletarian of the supermarkets to buy food for supper and breakfast. Of course it started to pour right on schedule so we took another taxi home where we still had water and I made spaghetti with meat sauce after running through the rain to buy some beer.

I will be able to make coffee for breakfast tomorrow. I am so excited.   

Day 2

I had always thought that coming back for a second time would make things easier but I continue to be amazed.

Late last night Simon the resident accompanying me arrived sans luggage.  His flight here had already been moved from Saturday to Sunday because of a concern that the connection was too short and then they lost his luggage anyway which of course means a trip to the airport this evening.

So I roused a seriously jet lagged Simon at 0600 this morning so we could walk to the hospital and make a good impression on the residents.  Keep in mind that we still don't have water so I couldn't make coffee and it is not like I could just run to Starbucks or Timmy Hos.  We made good time and were at the entrance I thought I had to come into by 0705 but there were a bunch of patients waiting on the steps and the door was locked.  I realized that in 4 years they just might be meeting somewhere else.  I remembered it was possible to get to the room from inside the hospital grounds but I also remembered 4 years ago even after 4 weeks I still had difficulty finding it, which is what happened this time.  At 0730, I said we've missed them, lets just sit down and wait until 0800 when we were supposed to meet the Public Relations guy who would help us get a licence here.  We sat in a conference room off the OR and discovered that they have free WiFi in their OR.  What a concept.

We met with said PR guy and gave him our papers and he walked us over to the conference room which was in the same place as 4 years ago, however the door was locked although there were signs people had recently been there.

Eventually the residents all arrived along with the program director.

Now some people are able to discuss any topic off the top of their heads with a power point presentation properly prepared but I am not one of them which is why I was a little perturbed to hear that the teaching program had been modified.  Our topic today was to be sepsis.  In 25 years of anaesthesia I have learned a little bit about sepsis but mostly what I have learned is that whether or not you survive is more related to karma, than to anything ICU does and less so to anything anaesthesia does.  I could have just said that and then gone to Serena Hotel pool but instead had to listen to presentations until past 1400 (with a nice African buffet at lunch).  The other issue is that that typical Rwandan anaesthesiologist will deal with more sepsis in one year than I will in my lifetime, and that maybe prevention and early detection might have a role to play  (the case they presented was a septic induced abortion which judging from the discussion is not uncommon here).  It is nice however to see the Rwandans doing research in a Rwandan context.

There was a visiting American anaesthesiologist who is there on a longer mission.  His mission provides him with a car and I bet his apartment has water.  He was quite nice although in an academic American way.  He tended to monopolize the discussion which was a bit of a relief because  beyond telling them about karma and warning them that no matter how gently you induce that patient, shit is going to hit the fan I really had nothing to say.  There was also a visiting Canadian cardiologist again on some type of long term mission who came in the afternoon.

We escaped to the soothing waters of the Serena Hotel where Simon bought a pool membership and we were both able to shower (separately).  \

It was then back to our still waterless apartment.

There have been a few changes in Kigali in four years  There are a lot of new buildings including some which were being built when I was there last there.  The most significant change is that the Mutatus the minivans which were the primary means of transport in East Africa are gone, replaced by slightly larger buses.  (I could be wrong, it could just be that they were all being serviced today.today).  This has been compensated for by an increase in the number of the annoying motorcycle taxis.  There is a disturbing increase in the number of adults now asking for money although still way less and not as aggressive as on Whyte Avenue.  Also it is now necessary to go thru a metal detector, have your bag searched or Xrayed and get patted down in order to enter a shopping mall or even the Serena Hotel.

Will eventually post pictures.

First days in Rwanda (lets see how long I can keep posting)

We had a great trip to Hungary, Slovakia and Poland which I will eventually blog about followed by 2 incredible full days in Amsterdam, a city I can't believe I waited 58 years to visit.

One adventure had to end and one had to start for me at least and so on Saturday Mary and I headed out to the airport.  Mary to return to Edmonton and me on to Kigali.  Schipol airport was crowded and confused like most large airports.  We were able to get our boarding passes and then proceeded to the baggage drop.  KLM has an automated system where you put your suitcase into what looks like a large clothes dryer, which then weighs your luggage prints a luggage tag which you have to attach to the side handle and only the side handle.  The contraption then closes and your luggage disappears.  The problem is that the system doesn't seem to work for back packs or duffle bags which over 50% of the passengers passing thru Amsterdam carry.  These people after lining up find their luggage doesn't work and then have to line up to have it processed the old fashioned way which is what happened with my second bag.

It was then thru security where despite being scanned by that stupid photoscanner, a security had to check to see if I had anything strapped to my penis or at least I think that was why he pushed his hand down the front of my pants.

I should mention that that I took my first dose of Malarone, which for some reason makes you feel like your just drank 5 expressos.  Definitely should have taken that after getting thru security.  It was then the long walk to my gate with Mary, after which we said our goodbyes and she headed off to her gate.

I can't say enough about KLM although I only have Air Canada, West Jet and United to compare them with.  The quality of service was fantastic in economy.  Our flight was stopped at Kilamanjaro on the way to Kigali so the plane was filled with future motivational speakers.  It was 8 hours to Mt K during which I read or slept.  I must have slept pretty deeply because I slept thru them passing out the customs cards and thru one snack.  After a one hour stop in Mt.K. to disgorge the motivational speakers, we took on more motivational speakers for the short flight to Kigali.

Canada Customs must have a training agreement with Rwanda because we had the slowest surliest agents I have ever seen.  First we had to line up to pay $30 US for our Visa, then again to have our passports checked, and then to have them look at the tourist card.  Mine wanted to know the exact address I was staying so I had to pull out the volunteer manual.  Last time I was in Kigali, there were no addresses.

Despite the lengthy stay in Customs there was another wait for our baggage which despite my doubts about KLM's automated system, did actually make it.  I was then able to leave where Emmy the driver was waiting for me.  Emmy had been away the last time I was in Rwanda, so I had never met him.  He drove me along the winding and hilly streets of Rwanda some of which I recognized.  There were a lot fewer people on the street than the last time, however it was a little later in the evening.  We arrived at the apartment and met Christophe who cleans the apartment and does odd jobs.  The water was not working but I was assured it would in a few days and there were buckets of water to flush the toilets.  Christophe went out and bought some more electricity (it is pay as you go in Rwanda) and finally I was able to hit the sack.

Our location is quite noisy and there seem to be even more bars than the last time but with a combination of ear-plugs and the traveler's friend zopliclone I was able to sleep until 0630 finally getting up around 0700.  I must have slept thru the the church bells which I remember used to ring at 0500.  It was Sunday and I could hear hymns being sung in the background.  Of course I had water and I hadn't bought any food.  There was a gas station nearby, where I remembered one could buy food but when I walked over a group of men told me it was closed.   I picked up a bottle of water at a little store and returned to the apartment to ponder my plans.  It was then I found that even though I had no water I did have internet so I fooled around on that for a while.

Finally I set out.  My plan was to walk to the Simba supermarket which is over a 30 minute walk and where I remembered you could get a good coffee and pastries.  On reaching the Nyamirambo Road (henceforthe known as the NR), I decided to try out the nearby market to see if I could buy some fruit or maybe even some tasty roasted morsel.  I ended up buying a banana for 100 RWF.  I could feel the smirks of the women at the mazunga who would buy just one banana.  The market was not busy and only just setting up, it was Sunday after all.  I proceeded back to the NR which as before is a long chain of small stores, hair saloons and bars.  It was quite quiet with very few people out..

Passing the Mosque, I headed towards the hospital, passing that Serena Hotel which I planned to visit later.  I noticed that the notorious sign was still there.  I then headed to where I thought Simba would be getting a little lost but eventually ending up at the Union Trade Centre where the Nakamat is.  A new change since my last visit is that to enter a mall now you have to go thru a metal detector, have your bag searched and get patted down.  I stopped at the Bourbon Cafe to have my first coffee of the day and use their internet.  Next I went to buy some internet time.  In Rwanda, you can get a USB stick for your computer where you can buy data for a very reasonable price.  It is not possible to walk more than 10 metres in Kigali without somebody trying to self you a phone card.  I am not good with Sim Cards and so I took the advice in the volunteer manual and took the stick to the MTN centre in the UTC.  I figured the guy there would just load on some more minutes using his computer which is what I think we did last time, however this time he demanded to use the cell phone I bought with me, then demanded 21K RWF in cash (notwithstanding all the signs in the office saying they took VISA, gave it to the security guard who then took it outside to one of the annoying phone card salesmen, brought the cards back in and the guy loaded the minutes onto my memory stick.  I suspect he gets kickbacks from one of the salesmen outside.

This had made me a little hungry so I headed over to Karibu for lunch, which was the usual starchy assortment I loved some much.  On the way I decided to change some US$ and saw a currency exchange.  A guy outside offered to sell me money.  He first offered me 600 RWF to the dollar.  I told him no, the exchange is 750 and that is what I eventually got.  I was pretty proud when I got to the Serena Hotel and they were giving 715 to the dollar.

Final stop was the Serena Hotel where I also had to go thru a metal detector and get patted down.  I was able to buy my pool membership and spent a lovely afternoon there, including two glorious showers in their rainfall shower.  I had an early supper there and walked home, missing a torrential rain storm by about 15 minutes.

Simon the resident will arrive by taxi tonight  hopefully.  Tomorrow we start teaching.