Sunday, September 20, 2015

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.

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