Short Rains and Looming Departure

Plough & fuel in hand

Well, the riding paths are tacky and the dust has settled from the air.  The short rains have come. The concrete-hard brown earth is greening.  Fields are being ploughed for the  third planting of the year.  The farmers have had a few weeks "off" at the end of the dry season - where nothing grows- time spent buying cows, adding walls, rooms and repairs to the mud home, and brewing some banana beer. 

On some Saturdays this month, we have ridden into villages hungry and been unable to find anything other than banana beer for sale. It's recipients sitting back against a wall, sipping the brew from 2L fuel jugs, quite drunk by 9 in the morning.   We have been thankful that hardware shops stock a few biscuits...

Brick works

The Rwandan farmer - approximately 85% of the population- almost always has work to do.  For the next few weeks, it is hand tools moving tons of earth before planting. The brick makers are also back in business with the rains. Moulding mud into bricks, building a house-sized stack about some eucalyptus charcoal, then baking the structure for several days from the inside out.

Some boyz and a flower

The tracks are smother and faster - which is good as the riding has increased. A circular five day 400 km off road tour of Rwanda is looming. Light packs, a stack of francs, a toothbrush and 2 similar-minded friends. Ride all day, find some beans and brochette to eat, a beer, sleep in a village, and repeat. 

Fortified town of Carcassonne

I miss the girls.  We parted in France after a Paris stint and a 10-day VW camper van tour. Visiting old haunts and good friends from the Carcassonne triathlon days. The Girls are re-entering "Canada Life" and I'm orienting three new HRH EM staff to the challenge and the burgeoning reality that is EM training in Rwanda.




It is a bit of an unsettling time to arrive. There are skirmishes along the Rwandan and DRC border, and Ebola fear grips the country. ....everyone is a bit twitchy.

 For Ebola, the government is orderly and organised tho- there are airport checks and quarantine stations. We have started to screen all ED patients and visitors, but in reality, people and patients pass thru the ED as river water thru a wicker basket. Malaria, TB, and typhoid are all common presentations and can look very similar to Ebola. It is hard not to let one's guard down.




 The trauma also continues to pile in. 31 people died this weekend in "road traffic accidents". Another 5 died when a soldier opened fire in a bar over a dispute involving a girl. 2 more children died when the grenade they found exploded while they were playing catch with it.  It is also the time of year when everyone has to pay for their yearly medical insurance - Mutuelle de Sante. Many haven't been able to put aside the money.  As a result, elective out-patient medical visits are down.  Late-presentation of serious medical illness' to the ED are up.  

The strain on ED resources and care-delivery from the combination of trauma, Ebola fears and exacerbation of non-communicable disease, is impressive. Unfortunately, the ED response to caring for these cases is less so...I can't help but see the ED through the eyes of the new expat staff I am orienting who are fresh from their resource-rich(er) practices.  No matter how experienced they are with resource-limited health care delivery (and they all are), the first few days and weeks of immersion are intimidating and frustrating at best and shocking and cruel at the worst.

Waiting repair

Rm 9 window view

CHUK evening

Say "ambulance" 5 times fast in kinyrwandan

I'm on the way out...but I'm still so very much here now.   And I will be till the plane leaves. Then I am not here and the life and the work and the people that are in these spheres are suddenly out of my immediate life.  My role here will be over and gone - my desk, my view, my friends, my home, my practice - poof!  Like that....I return to another fabulous life. Sort of crazy really.  I can't get my head around it...yet.




 I've stretched myself and my family- I think mostly for the better. I am motivated to capture the time and wrap it up neatly, pin it on a board and frame it for future viewing.  But it can't be hung like that!  Vain attempts have repeatedly failed.  The experience doesn't fit in a bottle and it can't be dried and stored. I move on then....thankful that pieces of the smell, the colour, the edge and the light of the life here will always stay somewhere with me.  

Thanks again for reading.