A monthly report and watching a refugee crisis unfold at home.

Hi everyone,

Still no email access from Gituza - I'm back in Kigali for just 24 hours to submit my monthly report to UNHCR, so this will be short (for a change!) The medical coordinator we let go last month was in charge of these monthly reports and as we have not yet found a replacement guess who had to do this month's...? I HATE paperwork - and the UNHCR database requires the compiling of every imaginable data point. I can't see how putting all these numbers into little boxes saves any lives but as Theodore says - you can work all you want all month but if you don't put the report together it's like you've done nothing.... Well it's not to *me* or the *refugees* I've been taking care of that I've done nothing but to the ones who push the numbers around (and I know, I know they're very important too...) it might seem that way....

That plus our medical record keeping is good in the sense that we keep track of all the information *somewhere* whether it's this ledger book or that or the other - but it's not at all compiled so on top of working 12 hour days at the camp clinically this weekend I came home to compile all the data (nearly 2000 patient visits) by candlelight and paper as our generator works but all our lightbulbs are out and we can't replace them in this little village we live in ... sigh. So I can watch the food channel, MTV and BBC but by candlelight...

It's the least amount of fun I've had here - I can see patients all day and be happy... exhausted but happy - but sifting through records and putting numbers in little columns, just give me a pencil to stick in my eye!!!I am well though - it's really fun getting to create something - to build a medical center, hospital, laboratory - and to get to teach at every step of the way. Data collection is important... I know, I know - and so I'm doubling my efforts in that department - creating databases, weekly reports so that when I'm gone my staff will have an organized system of patient tracking. I've really been stretched in so many ways here, clinical medicine, I.T., administration, finance, nutrition, epidemiology, teaching, sanitation, hygeine... I don't think my head will ever stop spinning.

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On a more somber note - I've been watching in horror the unfolding refugee crisis in America. It's so strange to be overseas taking care of refugees and watching the kind of destruction that took place in Mississippi and Louisiana and hearing about the medical teams deploying there. In a strange and maybe a little warped way it makes me feel very connected - hearing about the threat of dysentery, cholera and typhoid - things I'm concerned about every day as well.

It reminds me that we are so fragile (hence the quote of the week)really no matter where we live... we are all a storm or earthquake or terrorist strike from being refugees ourselves. I think we have a false sense of security sometimes living in America - but suffering is universal. There's a lot of play here on BBC (my main news source) about the International response to Katrina and all the countries pledging aid to the US - even Sri Lanka - one of the poorest most devastated countries from the Tsunami made a "token" donation of $25,000 which isn't so token when you think about it.... Red Cross teams from France and Thailand, Norwegian water experts, Oil from Saudi Arabia and Kuwait - even an offer from Iran - and of course all the Americans who are helping their own fellow citizens. I'm not sure why it takes a disaster to bring out the best in us (and worse... I'm not forgetting about the looting and gang violence either) , but maybe it 's the fact that it is a reminder that "there, but for the grace of God, go I" it allows us to imagine ourselves in other's shoes for just a moment...and that's enough to mobilize compassion and action.

Thanks again for all the continued messages, support and packages. If any of you know an ophthamologist or dentist that wants to come visit a refugee camp in Rwanda... send them my way!!!

Much love,
Ann