Thursday July 28- Tuesday August 2

Byumba and an internet fix/ Kigali Chinese Restaurants and never leaving the Novatel / “yes, it's really only me”/a staff meeting/ back to Ngarame / skeptical about tomorrow’s immunizations

Reading the U2 Documentary (U2- at the end of the world - thanks Shan) has made me a big fan of the divided title line as above. This past weekend I was finally back to Byumba which seemed like the cradle of civilization after Ngarame – staying with Kebe (the Senegalese camp manager of Gihembe camp) was like a reunion with an old friend. My room still had my stuff in it given that I wasn’t sure how much time I would be splitting back and forth and it was nice to come “home” again. Back on the internet was probably the closest I’ll get to a drug high given my aversion to mind altering substances. But the speed of the land line was so distressingly slow that I ventured into town to the internet café. Now when I say “town” it really is a town compared to Ngarame but I don’t want to mislead anyone – still with dirt roads, plywood construction… but there is an internet café and I am not ogled too too much there.

Louise has an extra room at the Novatel – well it’s her room but she’s going to a wedding on Saturday in Butare (south) and says I can stay there if I decide to go on to Kigali. It’s settled when Kebe says he will go Saturday morning to see a friend of his in Kigali and I can catch a lift with him – so off we go Saturday morning. The Novatel is this very very nice hotel in the middle of downtown Kigali – it’s complete with pristine swimming pool, patio dining, minigolf, tennis and volleyball courts out back. It’s where I stayed the first night I was in Kigali – interestingly Louise has the exact same room 216 – I wonder if it’s an ARC special… I don’t think I was fully appreciative of just how nice the Novatel was the first time around coming right from the first world. After my four days at the “hotel ngarame” it is in fact as close to heavenly as accommodations can get.

Kebe drops me off and we agree to go to an Ethiopian restaurant for dinner later that evening. Kebe’s not a big fan of Rwandan food (can’t say I blame him) and says there are no good Senegalese restaurants in Kigali. I adore Ethiopian food and I figure as long as I’m in Africa … (even though we’re really nowhere near Ethiopia) – it’s like someone saying that as long as they’re in France they might as well have Polish food…

Oh and wireless internet access… the Novatel has wireless access and I catch up on the Mariners (unfortunately) and the rest of the news, surf the web at high speed and generally become glassy-eyed, which isn’t quite as sad as it sounds given it is accompanied by a cold beverage lounging next to a pristine swimming pool surrounded by tropical foliage.

Kebe calls and says he’s on the way and I realize I’ve managed to exhaust 7 hours without leaving my poolside locale. I drag myself up to my room to change and meet Kebe in the lobby. A week of Africa has made me a little langourous in my timing – everything takes longer here – as Thedore pointed out “In America Time is Money – in Africa time is time” and Kebe is one of the only people I have met who is ultra ultra punctual – well to his schedule – like when he says he wants to go he means *NOW* where everyone and everywhere else the past two weeks it is really a gentle suggestion or even an abstract idea when someone says “let’s go”

Kebe’s friend works as a criminal investigator for the international tribunal (United Nations - can you imagine a job that would shake your faith in humanity so much - he investigated Serb atrocities in Bosnia and for the past 7 years, Rwanda) and is driving the largest minivan / sport utility gold monstronsity I have ever seen. It’s wider than a Humvee and up higher, it’s bigger than my apartment was in Boston… Kebe announces that there is a “small problem” with going to the Ethiopian Restaurant. “Oh” I say – disappointed, “was it closed.” Well no, well yes “the owner was shot.” I don’t really want details. He and his friend have the brilliant idea of going to Chinese food. I am very skeptical about Chinese restaurants (have grown up in one) even in the states but to go to one in Rwanda – well it’s an opportunity that really can’t be duplicated. It’s true that anywhere in the world that there is money to be made – there you will find a Chinese Restaurant. Kebe and Assama (his friend) say the same thing about the Senegalese (minus the restaurant bit).

The restaurant sits on the top floor of an office bulding (go figure) that among other things houses Rwanda Telecom (I’m disappointed they’re closed so I can’t personally go in and lobby for a line to connect me to the internet at Ngarama). It’s the oddest thing to me to see the classic Chinese décor complete with red hanging paper lanterns, red table cloths, the doublehappiness sign on the chair cushions – but all the waitstaff are black Rwandese. It’s a little mind numbing and I get such a sense of dislocation – like I am floating around a little above where the experiences are going on – I can’t unite all of the worlds I have been in the past few days – it’s been too fast-paced and the rapidity of changes makes my head spin. The food is perfectly adequate Chinese though – about a middle of the road restaurant in anywheresville America. Kebe and his friend get such a big kick out of bringing me there that it’s completely worth it for that aspect alone.

Louise has unexpectedly returned to the Novatel instead of staying the night in Butare – she has had quite an adventure with the Rwandan wedding planning – which as everything here never goes exactly as planned. And she has had to come home in the dark = something we are advised *never* NEVER *NEVER to do = don’t travel in the dark is like a mantra – unless you really want to tempt fate. We meet up with her on the patio and she is obviously harried but glad to be back in one piece.

Sunday comes and I was planning to go to the Genocide memorial having finished a book on the Genocide but I can’t bring myself to leave the Novotel. Henry calls – my friend from Partners in Health who is instituting Antiretroviral treatment for HIV patients in southeastern Rwanda and says he’ll spring me from the hotel since he has his own vehicle. I really don’t want to leave I say – it’s very nice poolside. Henry and his colleague – a recent pediatric grad from Dartmouth and a visiting 1st year Dartmouth student walk openmouthed into the lobby of the Novatel and out to the back patio. I think they’re getting an idea of why I’m having such a hard time going anywhere in Kigali – to set them straight I feel obliged to tell them that I am living most of the time in much less posh accomodations in Hotel Ngarame to the tune of no electricity, running water or internet. I’m telling Henry and his colleagues about my first week at the camp and they keep commenting on the fact that I’m “alone” you mean there’s no one else? They are coming from a place with abundant funding having been taken in hand by the Clinton foundation and have multiple American doctors now working together. It’s funny but I really don’t feel that alone.. not yet anyhow ... we discuss collaboration and funding options... Henry knows people who "know everyone" - it's nice that he's around.


The second of 2 Chinese meals in Kigali in two nights, Louise's last night in Rwanda, this time around (from left around back to me, half of Kebe, Samassa, Louise, Top (from Kigali ARC office, finance) and me

Sunday night and we go back to the same Chinese restaurant - this time with Louise - it's her last night in Kigali and as if that isn't disorienting enough - why not a Chinese restaurant?

Monday and a meeting of the camp managers w/ headquarters in Kigali. I fall asleep several times before discovering the ARC office has wireless internet. There’s lots of talk about budgets and such – things that I'm just not very good at paying attention to, (although I need to goet better. I turn on my computer in pretense of checking HIV proposal stuff and spend most of the rest of the time instant messaging with Tim who happens to be logged on in Hawaii – his Web cam is working too so I actually get to see him! We forego trying the voice conversation b/c it would be a little too obvious in the middle of the meeting.


Sunset on the way back to Ngarame

Finally we head back to Ngarame where on the road the sun setting behind the green hills makes me feel like there's nowhere else I'd rather be in the world right now. I check in on a few patients at the camp - who are all doing well on the way back to our lodgings. Tuesday and a full day of consultations, but baby steps – I have numbered all the beds and booklets so we can find patients easily. Now all we need is the whiteboard where we can sit and discuss the patients… I’m tired by the end of Tuesday – I think I will always be tired by the end of my consultation days. Ben laughs and says it's because when the camp hears the "Muzungu" doctor is working they line up with any and all complaints.

I have told Richard he is in charge of getting the vaccination logistics set up – we are supposed to have the mass vaccination take place Wed – Friday. We confirm with the hospital coordinator that there is in fact vaccine that is being driven back from Kigali. I had met with the district health supervisor as one of the first things when I had arrived - after finding that no immunizations had yet been given - we hammered out a deal and he said that if we provided him a list of children with the vaccinations needed by Friday (which we did) - by the next Wednesday (tomorrow) he would come up to the camp with the vaccine and supplies and a few extra nurses

Richard, Ben and I pick a site at the camp where normally the food distribution takes place – and discuss forming five lines, needing chairs and tables, and needing the community health workers to go out to the refugees' dwellings and inform everyone to bring their children. Richard says “no problem” but I’m not all that convinced that things will be as organized or – even organized at all. I can only hope for the best as I drift off to sleep under my mosquito net at 9PM...