The Big Bump

Oh course when I signed up to ride the Icefields Parkway, I knew there was going to be some climbing.    The highlight or lowlight of the day would be the climb to the Icefields 3 km of 8% hell called by Ben, the Big Bump.  

To get there we of course had to ride 30 km.  

We had a rest stop along a lake 9 km before the big bump.  The 9 km went by very quickly and before we knew it we were climbing.  There was a rest stop/pull out 700 m up where Ben was waiting for a final word of encouragement and we proceeded on taking advantage of 2 more viewpoints to rest our legs and catch our breath.  Jake of course sailed up and then descended to take another crack at it.  Along the way we met a couple on a tandem bike carrying all their equipment.  We finally arrived at the top a little wobbly legged and proceeded to the Glacier Centre for lunch.  

The real highlight of the day is the 7 km descent off Sunwapta pass, which some people find fun while the last time I rode my brakes down, something I decided to repeat.  The day had been nice if a little cloudy up to then but we could see dark clouds in our path.  I briefly considered putting on a rain coat but didn't.

The descent has vehicular traffic travelling in both directions mostly campers and trailers so you are pretty much forced onto the shoulder.  That and there are cracks across the shoulder every few metres and a few cracks in the direction of travel that you could catch your wheel in.  As I started the descent the first raindrops hit and these gradually intensified into a torrential rain.  Ben had passed and we were to meet him at the Weeping Wall several km away but I was glad to see him in a pull-out near the bottom of the hill.  I joined everybody in the car and we decided to wait out the storm which didn't seem to relenting.  It finally seemed to lighten and we were a little warmed so we ventured out again and rode for a few km to the Weeping Wall where Ben met us.  It was decided at that point that 3 of us would abandon the ride while Jake would continue on the Saskatchewan Crossing.  As we drove on, our decision seemed justified as the rain was being blown horizontally into the direction we would have been riding.  By the time we had reached Saskatchewan Crossing it had stopped raining.  

The Crossing where we stayed is a large complex of hotel rooms, a restaurant, gift shop, gas station and a pub.  When we arrived there our rooms were almost ready and we hung out on the balcony drying off our clothes while we waited.  Our rooms were finally ready and we showered and then went to the pub where we sat on the balcony and enjoyed some beers.  

Saskatchewan Crossing is one of the better kept secrets in Alberta, a large valley with spectacular mountains all around it.  

Sunwapta Falls.

This is our second time down the Icefields Parkway so we thought we knew what to expect.  This day was supposed to be a 60 km ride to Sunwapta Falls with two medium size hills.  Ben of course had other ideas.  The night before, he asked if anybody was interested in first riding to Marmot Basin or Edith Cavell.  I was a little shocked but politely declined.  It was decided that Ben and Jake (who we were learning was in fantastic shape and a little crazy) would ride up to Edith Cavell before breakfast which they did.  It was decided that after breakfast and checking out we would ride our bikes a few km before securing them and Ben would drive us to Edith Cavell for a short hike and lock around.  The few km turned out to be about 5 km uphill to the trailer drop off point from where we were driven to Edith Cavell. 

From there we drove back to our bikes.  For our earlier efforts we were rewarded with a few km of downhill and proceeded down 93a to Athabasca Falls, a much quieter ride along the Whirlpool River with a moderate climb up to the falls where Ben was waiting with lunch complete with an umbrella.  

After lunch we continued on up the main 97 for about 30 more km with a longish uphill before a brief descent into Sunwapta Falls to the lodge where we were staying.  The lodge reminds me of places we used to stay at in the the 1960s on vacation complete with totem poles outside.  Despite this the rooms were extremely comfortable with a king size bed.  Ben suggested a hike up to a rock outcrop but beers on the deck sounded better and so we had two followed by a brief nap.  Supper was in the restaurant.  We spent the evening watching the Eskimos game resting up for the hardest day of the ride.

Jasper to Waterton first days

Last Wednesday Ben arrived outside out house with his van and trailer to take us to Jasper to start our trip.  We loaded on our luggage and bikes and  met our two fellow travellers, Jake a young man from Ontario and Theo a man about my age from Germany.  Leaving Edmonton we went West along the Yellowhead.  We stopped at the Tim Hortons in Edson to get a coffee and a snack and to gas up the van.   Theo noticed that large number of pick-ups in Edson and asked if everybody in Alberta drove one.  No just almost everyone.  Leaving Edson we got our first view of the Rockies and it was neat to see Jake and Theo who had never seen them before react to the first site.  We passed on thru Hinton and the Jasper gates before turning into Miette Hot Springs, a place we had driven past but never visited.  Ben suggested we might like to ride our bikes from the hot springs as we headed upwards (meaning we would ride back downhill) the idea looked attractive but then we headed downhill (which means riding uphill) and reached the hot springs, where we changed an soaked for a while.  Miette Hot Springs are much nicer than the hot springs in Banff and worth a visit, even though they are 17 km from the highway.  After our soak, Ben drove us to near the highway and Mary, Jake and I rode to Jasper about 40 km away.  Theo who had arrived from Germany the day before passed on it.  

The road to Jasper is predominantly downhill and even with the head wind we made pretty good time. Eventually we let Jake go at his own speed and he peeled off at amazing speed.  We continued on into Jasper into a headwind which got stronger as we approached town. In town we stopped at the Bear Paw bakery for coffee and pastries before riding the final 3 km to Becker's Chalets where we were staying.  When we got there Ben had already got us checked in and we were able to ride to our cabin. Becker's Chalets are a mix of faux and genuine log cabins along the Athabasca River.  We had stayed there a long time ago.  Our rooms were extremely comfortable.  After showering and cleaning up, we joined the other three at the on site restaurant for what was a great meal.

The next day according to the itinerary was supposed to be a chill day but Ben's definition of a chill day is different.  After the buffet breakfast we loaded our bikes and headed for Maligne Lake.  The road to Maligne Lake is predominantly uphill so the plan was that we would drive to the lake and we would ride down.  We had an exhilarating ride down, broken up by a couple of uphills until we met Ben down the hill and he took us to the top of Maligne Canyon.  We walked down the canyon along the path.  Despite living in Alberta for 24 years, it was our first visit to Maligne Canyon which really is a must visit.  Ben met us at the bottom of the canyon so we wouldn't have to walk back up. 

 From there we went to Pyramid Lake where we ate a late lunch.  

This elk was just hanging out in the picnic area.

From there we went to the Gondola.  Jake and I rode up while Mary and Theo were driven back to Becker's to chill.  There was a thirty minute wait for the gondola plus despite standing together in line Jake and I ended up on different gondolas.  It was a little cold up at the top plus it was getting late in the day so I decided to go down.  There was unfortunately a long and somewhat disordered line to go down so I waited for 30 minutes.  Jake who stayed up even longer waited 40 minutes.  

We had another dinner at the restaurant and went to bed to rest up for the first ride of the trip.  

Rwanda, final days

Somebody reminded me that I hadn't written much about  my last week in Rwanda.

The week started leaving Ngungwe.  We had decided to leave early to get back to Kigali at a decent time.  We had breakfast at the guesthouse and Magnifique picked us up and we headed back on paved road through the park.  About an hour into our ride, M pulled up, he had heard something coming from the back of the truck.  Sure enough when we stopped to look, one of the wheels was loose, the lug nuts had not been tightened.  M got out the lug wrench and tightened them, standing up on the wrench for extra torque.  Unfortunately in the process he broke one off.  There was a discussion but we felt that with 4/5 nuts we were pretty secure and we proceeded on.  

In time we left the forest into the heavily cultivated land to the east of the park. It was interesting to think that hundreds of years ago this land was part of the same forest we had just left. It was quite beautiful with rolling hills extending far off into the distance.  We arrived at Butare and re-fuelled there.  I was standing outside while we re-fuelled when a local man got in my face and started yelling at me.  I don't understand Kenyarwandi, but I did hear the word Muzunga repeated over and over.  He may have wanted money like so many people do, he obviously needed some guidance in how to win friends and influence people.  Hey though I have been yelled at by crazy people in Canada too (frequently while at work).  

It was not M's day.  About half an hour out of Butare he got pulled over for speeding.  Speeding is taken very seriously in Rwanda, the traffic cop is accompanied by a soldier with a sub-machine gun.  The traffic cop took M's driver's licence and sent him back to the town we had just passed to get the 10000 Rwf fine.  After some driving around M couldn't find anywhere to get the cash so he asked my for a loan which I would have given him earlier if he had asked.  We paid the cop and his friend and proceeded uneventfully to Kigali where M got the cash to repay me and I paid him his tip.  

Simon and I walked to the Serena for a shower and swim and then had a nice Indian dinner before walking home.  

This was our last week teaching and I really felt we hadn't really connected with the residents so I was hoping for big things in the last week.  Monday was the teaching day, and Simon gave a very good talk on cardiac physiology, to which I added a few salient points.  Tuesday we were in the OR at CHUK in the morning before I left in frustration for lunch and a swim.  We were at this point going through the motions.   Wednesday at the military hospital I remember as not productive.  We were supposed to be at KFH on Thursday but when we asked our driver about getting a ride there, he informed us that Thursday was a holiday due to it being the first day of Eid (10% of the population of Rwanda is Muslim).  As we were taking Friday off our work was suddenly over with a whimper.  

Simon who had to be back earlier was leaving Thursday, my flight wasn't until Friday evening.  I did make a half hearted attempt to get on the Thursday flight with KLM but ended up spending most of Thursday and Friday chilling at the Serena Hotel.  When I left Friday, I told the ladies at the pool, that I was leaving.  "We pray you will return soon," they replied.

So it was Friday afternoon I was all packed and Christophe got a taxi for us.  Christophe who likes to take care of us just doesn't get any taxi but it had to the right one.  He insisted on coming a to the airport with me.  We talked on the way.   He told me he hoped one day to visit Canada and that he hoped I would be coming back soon.  I asked him if he needed taxi fare back but he said it was taken care of.   I gave him a large tip; he had really taken good care of us in the four weeks we had spent there.  

I was having some mixed feelings leaving Kigali.  I have spent 8 weeks in Rwanda, mostly in Kigali between 2011 and this trip but I knew I wouldn't most likely ever return.  I like Rwanda but there was a feeling of disappointment about what I could have done on this trip.

Like many airports in the developing world it is necessary to go through security before even entering the airport.  Despite this the check in process and further security went quickly and I was soon in the departure lounge, which to my disappointment didn't have a bar.  There was an overpriced restaurant with even by Rwandan standards, slow service and some souvenir shops where I was able to unload my remaining Rwandan currency.  

To board the plane we had to go thru security again (because you can never have your hand luggage Xrayed too much) and then to another departure lounge before walking across the tarmac to board our  plane.  

Sitting in my seat, I noticed the flight attendants busy trying to get an oxygen mask on a small baby.  This baby was going to Germany for heart surgery.  They were having trouble with the non-rebreathing mask, so I finally identified myself as a doctor and showed them how to put the mask on properly.  They were very grateful.  I had to explain this again to the new flight crew who took over at Entebbe.  After dinner was served I managed to sleep until we landed in Amsterdam.  After a couple of hours in Amsterdam airport I flew to Toronto.

In Toronto airport, I had my luggage searched by Customs.   I am not sure how I got picked out, it could have been my complicated itinerary.  The Customs man asked me if I had bought any carvings which I had and he inspected it.  Turns out he was just looking for insects.  He asked my what I had done in Rwanda and I said I had been teaching.  That completed, I re-packed my bag which had been torn apart, and re-checked it.  

I was hungry enough to have a meal and a few beers in the Toronto airport before flying on West Jet to Edmonton where Mary met me in the airport.  

Guayaquil and Cartagena

Many years we take a little trip after the mission.  This year we decided to visit Columbia, specifically

Cartagena.  We did consider other options in Columbia most of which involved a lot of travelling which means a lot of packing and unpacking and time in airports.  Going to Cartagena gave us the option of staying in one place and taking day trips.

To get there we have to go to Guayquil first.  We have never visited there before so it was a place we had to check off.

We finished our surgeries on Friday but Mary had to go in to the hospital for a couple of hours to look after the post-ops before we transferred those still in hospital to the local staff.  Many of the mission left earlier in the morning for Quito to spend some time there before flying home on the red-eye.

Many years leaving Ceunca has been a frantic adventure with late buses, large groups and crowded airports.  With just 3 of us this year and a 1430 departure we felt we had things in hand.  Unfortunately in Cuenca it was Carnivale a yearly festival perhaps corresponding to Mardi Gras.  Because of parades on Saturday, no taxi was able to get to our hotel.  The hotel staff were very helpful and helped us carry our bags a few blocks away, and flag a taxi that would take us to the airport.  We ended up arriving way to early and had to wait about an hour to check in but were eventually on our way to Guayquil. 

Cuenca while near the Equator is at 8000 feet and is quite temperate.  Guayaquil is at sea level and we were warned to expect hot and muggy conditions, which we found when we landed after a one hour flight.  We got our bags and tried to get a taxi to our airport.   In what seems to be an increasingly common event,  the taxi driver did not know where our hotel was but I now expect this and had the address which also didn't seem to help him but he radioed and somebody gave him directions and so about 10 minutes later we were at the Marriott Courtyard.   Some people may like authentic local hotels.   I do too but we had an early flight out in a day and besides I knew that without air conditioning we wouldn't sleep much.  

It was later in the afternoon when we arrived.  In the humidity we were content to just chill in our room. I did go up to the pool on the roof which was quite small, fairly warm and had a couple making out at one end so I didn't stay long.

The hotel directed us to a Peruvian restaurant at an adjacent large shopping mall which was really good for supper.

We had a day to explore Guayaquil before flying to Cartagena.  Based on advice from people who had been there before, we took a taxi to the Iguana Park.   This is square adjacent to the Cathedral with... Iguanas.  Lots of them.  Walking around, climbing trees, sunning themselves.  We spent a little time there then went off to look in the Cathedral which being Sunday was actually being used as a church, not as tourist attraction.  Not as nice as the Cathedral in Cuenca.

We then walked a couple of blocks over to the Maracon which is a long walkway adjacent to the river.  The river is in itself interesting just for the amount of vegetation floating slowly down it.  The Maracon itself was a bit of a disappointment.  Lots of fast food joints.  A parade came by on the adjacent street which we watched for about 15 minutes. 

We walked along it a km or so to Las Penas and then climbed the 400 steps getting a nice view of Guayquil from the top.  We walked down, stopping for a cerveza on the way down before catching a taxi at the bottom back to our hotel.

Sunday was Super Bowl Sunday and so we just had pizza in our room and watched the somewhat dull game.  We had an early flight the next day.

Monday morning we took the hotel shuttle to the airport.  We found out that our flight to Cartagena was not direct but rather that we changed planes in Panama City.  Confusing things was that both flights had the same number.  The airport was not that busy with none of the bustle and confusion of many South American airports.  We had an uneventful flight to Panama and after a brief stop flew to Cartagena.  

Arriving in Cartagena we learned that Canadians have to pay what is called a reciprocity fee.  That is a fee equivalent to what it costs for a Columbian to get a visa for Canada.  The US also requires a visa for Columbians but their citizens don't have to pay this fee.  Because we came from Panama they weren't expecting any Canadians and so had to get somebody from his siesta or lunch to process our payment. 

We were met at the airport by Brian our guide.  I have never met another Brian in Latin America.  He and the driver drove us to the walled old city and then through the busy, crowded streets to our hotel.

The Ananda Boutique Hotel is one of those Died-and-went-to-heaven places.  It is a hacienda style hotel with a courtyard pool at which I could have spent the entire visit and a rooftop patio with a refreshingly cool jacuzzi tub.  Our room came with a rain-fall shower and a large tub as well as its own small balcony.  The restaurant in the hotel is considered the best in Cartagena which is both good and bad.  Good because it is close and bad because you need to make reservations.  We couldn't get a reservation for the first night but the concierge got as one at a nearby restaurant.

We got out and walked the walls of Cartagena before venturing into the crowded streets.  Like Cuenca Cartagena is a Spanish Colonial town only the architecture is slightly different.  It is also quite flat.  Finding our hotel again we had a dip in both pools before heading out to Alma a nearby restaurant for the first of several excellent dinners in Cartagena.

Ecuador mission the rest.

Every year I vow to keep up on my blog however I never do and I am home now.  There are a number of factors. Firstly this year we were really busy, often not getting home until the evening and after dinner I just didn't have the energy to type.  I also blame Skype.  Whereas when I first went to Ecuador we used to make long distance calls from a call centre for a ridiculously low price; now many people on the mission communicate with their families by Skype which means that in the late afternoon and early evening, the Wifi in the hotel slows to a crawl.  

I normally don't like to criticize my hosts when doing missions in the developing world but it is hard this time not to.  Five years ago we moved to Santa Ines from Monte Sinai at the invitation of Santa Ines.  We did this because we were offered the use of 2 operating rooms which were larger than the one OR we had at Monte Sinai.  We felt that this would enable us to do more surgery and maybe finish earlier in the afternoon.  We met with the medical director and got the usual Latin American welcome, Mi Casa, su Casa.  This worked well for the past 5 missions.  A couple of years ago they took the monitors out of the rooms which meant scrambling to make sure we had monitors of our own but even that hadn't been a problem for the last two missions.

In December we got a letter from the medical director telling us we could only have the operating rooms from 1300 on.  This meant in order to have 8 hours of OR time we were really looking at 2100 hour finishes.  Keep in mind that the recovery room and floor nurses would stay 1-2 hours after the end of surgery.  Now you could say, okay you have the morning off but again the floor nurses have to be there in the morning and doctors have to round etc.  Makes for a long day.

We were able to get a compromise that maybe we could start one room a little earlier.  

It ended up however being a frustrating week, waiting around in the am to be able to start as soon as a room was ready and late days.  We also worked Sunday in order to get a few extra cases.  We ended up doing 34 or so total joints including 2 bilateral and one revision, which is only a little less than the 40 we normally get done but with a lot more time spent at the hospital much of it just sitting around.  

The hospital we work at is a for profit hospital like most in Ecuador.  In 10 years I haven't quite figured out the medical system which is a mixed public private system that right wing politicians would like for Canada.  There are public hospitals but a lot of public work gets contracted to private hospitals.  I often wondered how I would have reacted if our hospital told me that a surgical team from another country were taking over 2 ORs at my hospital for a week.   Probably with enough notice we would have just taken vacation as we do when the surgeons or the hospital close rooms for other reasons.  Anyway just saying that maybe with enough notice we could have accepted doing fewer patients or staffed differently to accommodate longer days.

The whole issue of voluntourism and should teams from the developed world even be doing surgery in the developing world is of course another topic.

I can't say enough about our team because as I say we worked some fairly long and irregular hours in order to accomplish what we did.  We do come down to help people but we also come down because we enjoy each other's company before, during and after hour and because we love hanging out in Cuenca.

Ecuador Mission 2016, getting there.

I am right now almost half way through my 10th mission to Ecuador.

This year our son Bill came down with us. I went down to Canmore a couple of days early to mostly chill but also to nag him about packing, making sure he had found his passport etc.  We left Canmore about 1700 on Wednesday to go to the Delta Airpot hotel.  Our plane was to leave at 0640 the next morning and quite frankly being able to just walk across to the airport is priceless.  We of course had the ubiquitous mission hockey bags 4 in total plus our own stuff.  In Calgary I was able to find long term parking quite close to the terminal.  There didn't seem to be a shuttle but there were luggage carts so we wheeled our bags about a km to our hotel.   Mary was coming down by Red Arrow and arrived just after 7.  We had an expensive meal in the hotel restaurant after which we tried to sleep.  We all awoke shortly after 3 am, got dressed,  drank some coffee and then checked out picking up our bags and rolled across the street to the departures.

Even just after 4 am there was a huge line to check.  Fortunately I had managed to get Prestige status which meant we all got to go the head of the line.  This didn't help much as it was a long slog through customs and security.  One wonders how much productivity is lost through the long process of crossing borders, especially having travelled in Europe.  The US departures area in Calgary is much inferior to that in Edmonton in terms of places to eat.  We had pastries of indeterminate age from Starbucks and sat down to wait for our flight.  Gradually other mission members trickled in including my work colleague John Soong from Edmonton, the Pediatric team from Calgary and a few members of our adult team who were flying through Calgary.

After finally boarding, it was a 3.5 hour flight to Houston which I spent trying to sleep or read.  In Houston we went to our usual go to place, Pappadeux for a feed of fish and of course a beer.  We had a 5 hour stopover in Houston so this only killed about an hour, the rest of the time we spend wandering around, reading etc.   It was a 5 hour flight to Quito which was long if uneventful.  We cleared customs in Quito in an acceptable time, picked up our bags without event and were outside.  We had to wait a bit for the bus to our hotel and also for the bus which would take our bags to Cuenca (they are too heavy for  the plane to take off).  We stayed at beautiful and comfortable Hacienda style hotel about 20 minutes from the airport and were in bed by shortly after 2 am.  

We got to "sleep in" as our flight wasn't until 1230 which meant leaving the hotel around 1030 so we awoke around 8 am got dressed, had a nice buffet breakfast before loading ourselves back on the bus to go back to the airport.  Our flight to Cuenca was a short hour flight.  Unfortunately it was cloudy and we couldn't see much until we approached Cuenca.  We landed, got our bags and were greeted by the Rotarians who help us out every year.  We went in two buses through the crowded streets of Cuenca to our hotel the Inca Real.  It sounds hackneyed but after 9 years I find Cuenca and the Inca Real to be a second home.