Clinics, Earth Boxes, and Hospitals

Sorry for the boring title. So Day 2 is complete. We began today at the WE-ACTx clinic in Nyamirambo. The kids (Jill and myself included) were herded off immediately to help package pills in the pharmacy. It was the first time many of us felt useful. The pharmacists, Marie Rose and Edith, were very engaging. I was grateful to speak French for their English wasn't strong. We chit-chatted about lots of things. It was nice to interact with Rwandans on an individual level rather than in the large group setting. As for the pills we packaged, Jill and I worked on a pill that prevents opportunistic infections. There was also ibuprofen, a multivitamin, an anti-fungal pill, and some others we didn't understand.

We had a sobering moment when the pharmacist turned to me and told me to tell Jonah (12 years old) that the boy on the other side of the window was his same age, but had the misfortune of contracting HIV from his mother. The boy had come to the clinic for his appointment all on his own and Marie-Rose assured me he was diligent enough to take his medications (it's very important to take them at specific hours). Can you imagine? What a sad reality for a 12 year old, but thank God he has access to these pills.

Overall, it was a good start to the day. Marie-Rose and Edith were grateful for the assistance. They explained that it's too hard to have to package the pills and serve the patients, so we had at least provided them with an adequate supply for the next couple days.

After this we proceeded to the WE-ACTx income generation and family counseling site in the neighborhood of Ramera. It was interesting to see. Our group brought Earth Boxes (www.earthbox.com). The idea behind the Earth Boxes is it allows for productive gardening in areas without a lot of soil or space. The Boxes are only so productive though because of carefully prepared soil, for which a lot of research has been conducted to determine the proper proportion of nutrients and all that. The soil must be replaced every year. They don't have this special soil blend here in Rwanda and, from what I understand, normally it must be purchased. Fortunately, a local agricultural expert is experimenting with different local soils to see if he cannot create something compatible. We're all crossing our fingers that it works.

I was pulled aside by a government official when we first arrived; he's the head of the Agriculture division, I believe. He asked me politely in French. "Excuse me, what are these things? I've never seen anything like it before." Yes, here we were 25 white people arriving with our 'efficient technology'. Thanks to my senior seminar in political ecology, I'm rather skeptical of projects like these, but WE-ACTx has had a few before and asked that we bring them. So that's good. There are lots of benefits too, as Beth just pointed out to me. For example, they allow women who do not own land to be able to grow produce and maybe even sell some for a profit. That's great! My biggest concern, and the rest of the group's too it sounds like, is regarding their sustainability.

But generally speaking, they were a hit, and at least a good mid-day activity. :) Rich led a training session and it was translated into Kinyarwanda. We were training the recipients of the Boxes. These were generally heads of associations that work with WE-ACTx, including many different groups for people living with HIV/AIDS. Women dressed in their lovely bou-bous donned aprons and gardening gloves and got down and dirty as they tried their hand at preparing and planting an Earth Box. It was great to watch. Watch, yes. I didn't participate much, rather preferring a seat in the shade.

The income generation project at this site is essentially a co-op for women with HIV/AIDS. They sew all types of bags, shirts, computer cases, etc. The products were beautiful. We all bought many souvenirs. I got myself a lovely purse. Me, always thinking of others.

The counseling component of the site has all types of activities. On Sunday we will experience some of these, so I will spare you now and write about it then.

After lunch, we went to the Public Hospital. This was the hardest part of the day for me. Brant put it best when he said to me after we left the children's ward, "There is fine line between bearing witness and voyeurism." I couldn't agree more. I felt uncomfortable and inappropriate going through the pediatric and adult wards observing the facilities, but also just seeing the sick. One woman tells me it's important to see though and be able to go home and tell people about the conditions, but I'm not sure what that will achieve either. The facilities were not state of the art like I see at home. And maybe I've just been fortunate enough to visit nice hospitals, I don't know. There were no private rooms, no monitoring systems or IVs. I don't like hospitals to begin with, and I have no qualifications to know what is important and what is not for patients. I presume that the care they receive is good, it's just hard to see so many sick people and to consider the costs of treatment. They have private insurance here, but there is also government assistance for those that need it, from what I understand.

Lots of hard moments. At one point a pick-up truck backed up the children's ward. A man and woman came out crying and carrying a suitcase. They were followed by people carrying a child's body covered in a blue cloth. They laid him in the back of the truck and two men sat to tend to the body during the drive. Later I saw an adult rolled out on a stretcher, again covered in a cloth. Not easy. I can only console myself thinking that now, at least, they are out of the pain that may have accompanied their illness.

There were also lots of children that followed us around the premises. Oye! I seemed to be their target of choice. It was so sad. "one hundred" one boy kept asking me and putting out his hand. (100 francs is the equivalent 20 cents.) He used all the English he knew with me, ranging from "How do you do? I'm wonderful," to "pilot" when a helicopter flew over head, to "my chest" describing his ailment. One small girl came and held my hand and wouldn't let go. They did this with everyone, I wasn't special but a couple of them refused to leave me. One girl's stomach was bloated beyond belief. At first we all thought she had a pillow under her shirt. She had to hold onto people's arms when walking or standing on a hill because she couldn't balance. This is a result of severe malnutrition.

It was so hard not to be able to give the kids anything. It tears me up inside. I really can't afford to give to every child that asks for money. But there I was holding my $40 filtering water bottle and not able to spare a little change. (I didn't have any change on me, but I did have $30 in my pocket.) Oh how can any of it be reconciled? Why are there such drastic differences? How did I get to be so fortunate?

One of the little kids had the most contagious laugh. The boy that kept pestering me for "one-hundred" would make jokes in Kinyarwanda and the other little boy would laugh in the most contagious way. We all would laugh along with him though we had no idea what was being said. It was pretty adorable. It was hard not being able to communicate with the kids. They didn't really understand English of French. Soon, I'll be back with small children that will understand Wolof and my heart will be broken all over again when the kids on the street ask me for money. Facing reality is the hard part about traveling.

We went to an Ethiopian restaurant for dinner. Yum. Tomorrow some of us are participating in WE-ACTx home visits to families with HIV+ members. Then some of us will go to the Memorial in Niyamato (sp). It is a Church at which a great massacre occurred and they have left it as it was after the Genocide to serve as a reminder to people. I'll tell you more tomorrow. Until then.