June 30

To the right is a picture of Vestine, who works here at the mission cleaning and delivering meals. It's a pretty big place so there are several staff doing this. She knows very little English, but she managed to tell me a week ago that both of her parents had been killed in the genocide, which was in 1994. She appears to be 20'ish now, so during the genocide she would have been age 6-9 perhaps. This hospital made a special effort to care for orphans after the genocide and to keep them healthy. Something like 99% of children witnessed an act of violence during the 100 days of the genocide. Despite all that, Vestine smiles non-stop and seems to be a very upbeat person, from what I can tell during our limited interactions. HOWEVER!!!..... today after I took this picture, she asked me in stilted English, "Would you be my mother?" >: I'm reeeaaally hoping that I misunderstood her. What a blow to my ego, especially as today is yet another birthday for me! (sigh)

I was asked to move into a smaller apartment after Lucas left, and so I moved today. It is very nice and has a lovely garden around it with brick archways and flowering tropical plants. And Lucas, it has a shower! Unfortunately still no internet signal though, so I have to hike a ways up a steep path with my netbook computer in hand to send this. Top left is a picture of my room with mosquito net over the bed. People tie it up during the day. Not much to say about work today; still working on the payroll spreadsheet project.

As there is no television or really any nighttime entertainment at all other than socializing with the other expatriates (which I do enjoy), I have been reading a lot. Here's what I am reading on the trip :

• The American Plague, Molly Crosby, about the 1878 Memphis fever epidemic and subsequent efforts to identify the cause of yellow fever. I enjoyed this book very much, but I don't know if people working outside of the healthcare field would enjoy it as much. It was recommended to me by Dr. Campos, sister Stephanie years ago (I think), and others.



• People of the Book, Geraldine Brooks. Recommended to me by Lee Nix. This is a sort of historical fiction, very interesting. Hard to put down.



• Baking Cakes in Kigali, Gaile Parkin. Recommended to me by Melody Cunningham. The dialogue and characters in this book are exceptional, and it takes place right where I am! It's an upbeat book, though it manages to acknowledge the country's troubled period. A wonderful balancing act. I love the Angel character.



• Say You're one of Them, Uwem Akpan. Also recommended to me by Melody Cunningham. This is a series of short stories based in Africa. Lots of gritty realism. The first story was about an urban street family whose most successful family member was an adolescent prostitute. I had to put this one down for a little while, but I will come back to it when I'm in the right mood!



• Gorillas in the Mist, Dian Fossey. Lucas also read part of it when he was here. The two of us agreed that she spends way too much time discussing gorilla dung. But I enjoyed several parts of it.



• Olivia's African Diary, Olivia Stokes Hatch. This 1932 book just happens to be in my new apartment, and there are some great bl/wh pictures and personal stories about what it was like to travel through Africa during that time.

Tonight there was a group get-together to welcome the new British family which just arrived. Also I was thrown a kind of surprise small birthday party with about 10 of the people here present. They even had cards and a little present for me. That was really thoughtful, especially considering that these people only met me 2 weeks ago. Cake decorations are hard to come by in rural central Africa. But they had frosting, sprinkles, candles, homemade ice cream, and a little sign which said, "Merry Christmas" stuck to the top of the cake ;) It was very cute!

June 29

The picture on the right is of a gecko which was visiting the hospital. They are common here and often come indoors. I did not take the picture on the left - I downloaded it! - but we were unable to get a good picture of these birds when they were visiting us because they hid up in the trees. It's Ross' Turaco, a large colorful bird which only lives in Africa. It's not apparent in this picture, but when we saw them in person, the undersides of their wings appeared to be red. Several of them like to visit the guava tree on our property.

Spent all day working on Lucas' payroll spreadsheet and still not even close to finished - I should not have let him leave before he finished this project! ;) But he's headed back to the U.S. now.

I've been observing some of the work that people do here and how they do it. Yesterday and today, there was a man trimming a very large but partially dead jacaranda tree in front of my apartment - with a machete. It was slow work. That poor man needed a chain saw in the worst way. Most mornings I see a woman hoeing in the garden below my apartment, while her baby is strapped to her back. I am not sure who I feel more sorry for, the woman or the baby. Lastly, Lisa was telling Lucas and I about a man who works near Kumbya making his living sitting on a pile of rocks. He hits them with a hammer all day long, making smaller rocks out of the medium size rocks, then he sells the smaller rocks. We don't even ask felons to do that kind of work in the U.S. anymore. Some of these people work very hard for very little money. Reportedly, the nurses at the hospital only earn about US$50/month, and I expect that manual laborers earn quite a bit less than that.

Occasionally it slips my mind for a few minutes that I am in Africa. But tonight as I write this blog outdoors (I have to go outdoors to get a wireless signal), it's almost completely dark, and there are torches lit on boats out in the lake as far as I can see - that has not happened before. I do not think those are fishing boats, or at least they are not being used for fishing in the dark. Also someone nearby is playing a drum by hand, while girls sing along. I think perhaps it is a special day. One of the Rwandans said it was Icheza (but I will have to look that up!)

June 28

This little girl was waiting to be seen at the dentistry clinic. She seemed curious about me and came over to take a closer look. I thought it was interesting that her dress was kind of fancy, but she was barefoot. BTW, hookworm is prevalent here so children should not go barefoot. I think there are agencies including this hospital which hand out free shoes, usually a knock-off version of Krocs. I believe that lots more women know how to sew here than back in the U.S., and someone must have made this dress for her.

Lucas left today to go back to Kigali, the capital of Rwanda. He will spend the night there in a house with other people he knows from the mission here, then start flying back to Memphis tomorrow afternoon. I miss him already! But it was great to have his company for the first 2 weeks of my trip, and he seemed to enjoy this experience.

I met with 2 Rwandan managers and a British manager today to present my report about how to improve the hospital's inpatient and outpatient chart tracking and numbering system. The meeting was held in mostly French, with some English thrown in. It was quite challenging to try to bridge the communication gap! Thankfully the British manager was fluent in both, so she translated what I said for the Rwandans. One of my next projects will be to evaluate the cash handling and claim filing system, which I think will take a little while to dig into (especially considering the language barrier), but I'm looking forward to it. I am curious whether they use anything like CPT codes, ICD-9 or ICD-10.

Monkeys at Kumbya

There are 5 monkeys in this picture taken at Kumbya (see previous post for more about Kumbya) - can you find them all?

Kumbya

Kumbya is a "rustic" missionary retreat located a rough 1-2 mile truck drive from here. It's about a 20 minute drive, and we could probably walk it in 45 min. to one hour, but as muzungu we would draw an uncomfortable amount of attention and many requests for empty water bottles, which are apparently in great demand here. "Rustic" in this context means no electricity, no plumbing, and using outdoor latrines. Needless to say, I have not been tempted to stay overnight there yet! I am perfectly happy driving back to my little house with electricity and plumbing. But it is a great place to visit for an hour or two when we have free time. It has a little beach on the shores of Lake Kivu and good picnic facilities.

The picture on the left is of Lisa and myself at Kumbya. Lisa is British and about my age. I have really enjoyed talking with her and plan to spend more time with her after Lucas leaves tomorrow to go back to America :( Her family is volunteering here for 10 months, including 2 adolescent children. I think it has been a good experience for them, but I also can tell that she is looking forward to returning home in August. She told me last night that she has been planning her first meal back in England in detail :) ....all of her favorite things that she cannot get here.

The picture on the right is Lucas visiting a traditional grass hut on the Kumbya property. I am not clear on whether anyone stays in the hut overnight - perhaps - but again, it won't be me! Not far from Kumbya I saw the bottom rung of the local housing. It was a mud brick hut about six feet in diameter, with a dirt floor and a thatched roof. Sitting outside were 2 women who looked quite content and waved happily at us as we drove by. Wow. That sight was really good for my perspective. Sad and heartening all at once.

June 26

Went hiking in Nyungwe rain forest this morning with Lucas and a very good local guide. It's about an hour from where we are staying. This bottom left picture was taken in the tea fields surrounding the rain forest, as we prepared to enter the forest. Rwandan tea is delicious - I bought some to bring back - hopefully the customs officials won't take it away. Everyone here stops for a tea break around 10 am. They call their tea "chai" and serve it with milk and sugar. Lucas and I have come to love the tea break ritual. He had to work through his tea break yesterday and was very disappointed!

The top right picture was taken in front of a high waterfall, right after I had fallen on my hind quarters on a wet and slippery rock. Ouch! Well at least I didn't fall far. The walking sticks really came in handy, especially for 40+ year old women like myself trying to hike through an African rain forest with a couple of youngsters. The hike we chose was described as "strenuous". There was also a "very strenuous" option which we chose not to take. Afterward, Lucas said he wouldn't have described our hike option as strenuous (but I would have!) So tomorrow he is going on the "very strenuous" hike, but without me! The top left picture is a green viper who was sunning himself on our trail - thankfully the guide saw the snake a few feet in advance and flipped him off the trail after we took this picture. There were wild pink begonias growing all through the forest - just like the variety we grow as houseplants in the U.S.

Our driver this morning was named Innocent. Once Innocent stopped a man walking by the side of the road with a big container of handmade clay jars balanced on his head. Innocent bought one for 500 Rwandan francs (less than $1.00 US). The man who was selling his handmade pots appeared to be one of the Batwa, a pygmy race which has lived in Rwanda for thousands of years. Batwa used to be hunters, but there is not much land to hunt anymore, so I've heard they have turned to making clay pots and baskets (among other trades of course).

I don't think it's really possible to convey the beautiful scenery of Rwanda through these few pictures and my limited camera. The lake, the hills, the tea fields, the lush vegetation - the camera doesn't do it justice.

June 25

To the left is a picture of the sign which is posted at the entrance to the hospital, named "Kibogora". There is always a friendly guard at the gate. To the right is a picture of Lucas standing in front of the hospital's internet cafe (a benefit for staff members), which is located near this same sign.

After spending some time in the physical therapy department, I was impressed with the variety of modalities that they perform, considering that they are in a rural area of Africa: TENS, casting, exercise bike, ice therapy, massage, thera-band, and made-to-order wooden crutches (made on-site in the wood shop by a carpenter). The lead PT showed me some pictures of babies' legs with congenital deformities, which he has improved by applying a series of casts over time.

Today I finished my first report/assignment, regarding improving the chart tracking system here. This weekend I should also finish my evaluation/report about bottlenecks in the outpatient clinic process. I hope that the administration here can use some of my suggestions! I should start a new project early next week. I think it will have something to do with cash handling and collecting hospital coinsurance. I have heard that the hospital and clinic coinsurance amounts are very small - the equivalent of $1 or so - therefore most people are able to pay these small amounts. Hope to learn more about this next week.

I should mention how well Lucas and I are being fed here. We get 3 hot meals a day delivered to our little house. Basically it's room service. Bread is baked fresh every day, and daily we are served papaya, bananas and pineapple straight from the garden just a few feet from our door. We are really getting spoiled!

June 24

This morning I spent some time in the eye clinic. They have a slit lamp, wall charts, refractive lenses for the purposes of creating a prescription, and an ophthalmoscope. There was one sad story. A 45-year-old woman with an infant came in because she had reduced vision and eye irritation. She must have walked here. The healthcare provider thought that she probably had early cataracts due to some type of chronic condition and needed surgery. She has government insurance which would cover most of the surgery cost. But the eye surgery center is several hours away by car, and this woman is poor with no access to transportation. So it seems that she is going to get increasingly blind with small children to care for, and no real hope for an intervention.

Attached is a picture of a different woman, showing how the local women carry their babies. They of course do not have strollers or anything of that nature. So they wrap the baby in a piggyback position on their backs, using a few pieces of cloth (sometimes a towel). This keeps the women's hands free, and the babies seem to sleep a lot in that cozy position on their mother's back! This woman was very friendly and did not seem to mind that I wanted to take her picture. She has a beautiful smile!

June 23

Spent a few hours in the emergency room today. This 7-year old boy was brought in by his mother because she thought he had swallowed a coin. Sure enough, a coin showed up on the x-ray that was taken of his chest/abdomen. I guess the saying that "boys will be boys" is also true here in Rwanda! He was very sweet and seemed to want to stay by my side.

Several things in the ER were just like in the U.S. There was an electric blood pressure machine on a rolling stand (only one). A foley catheter was put in using the same procedure that we use in the U.S. But they use mostly mercury thermometers and take axillary temps. I bet they would love to have a few electronic thermometers, but I wonder if they could get continual supplies of disposable probe covers (or be able to afford them). Perhaps not. They use drip IV's, but of course they work just fine for fluids. I have not seen any electric IV pumps, and I have not seen any antibiotic fluids, just oral antibiotics so far.

A muzungu nun was in the ER this morning, and one of the nurses took me to her saying, "I think you may speak this patient's language," but the nun was French and did not speak any English. Again I was asked, "so you ONLY speak English?" A recurring question....

June 22

Spent all day today in the outpatient pharmacy. They are very fast and no-nonsense in the way that they fill prescriptions. Different than our procedures in pharmacies in the U.S., but in a way that is suitable to this situation. The hospital has about 270 beds and sees about 180 outpatients a day (most are walk-ins.....quite literally, as they may have walked 2 hours to get here).

Learned today that the staff is getting performance management objectives which tie to their job descriptions. So back in Memphis at UTMG, we are at least a half step ahead of Rwanda! Good validation for what we already knew we needed to do. Hey Sheri - I'm attaching a picture of myself wearing your skirt - thanks for the loan! The picture was taken in front of my apartment here.

The hospital managers are called "chefs", French for chiefs. So you might hear someone say, "I'm going to a meeting with the chefs." I try not to smile. A return appointment is called a "rendez-vous". And everyone refers to a medical record as a "fiche". Medical records are one of my projects, so when referring to me, people will say, "She is working on the fiche!"

I helped one of the staff, Safi, a bit with her English homework. I heard her tell one of the others that it was "dificil" so I offered to help. (English, at least, is a language that I speak.)

They had 2-3 H1N1 cases here last month, in one of the high schools. But it is not widespread.

One of the hospital managers is widely referred to as "the Secretary" (note the capital S). I was told, "oh, you should meet with the Secretary!" He is over medical records, the cashier area, bookkeeping, procurement, medical testimony, and several other areas. So I did request to meet with him, but I had to wait on a chair in the hallway for a little while until he was available. He is a busy man, as so many things in the hospital have to go through him. He told me that his name is Abraham. He is a slight man, thin, medium height, probably in his 30's, with a pencil moustache, and sharp facial features. He usually wears a long sleeved shirt buttoned up to the neck, but no tie (I have only seen one tie here so far.) I have trouble thinking of him as an "Abraham" - the name just does not fit him - and instead tend to refer to him as "the Secretary" like everyone else does. When I met with him, he was very serious and the answers to most of my questions were "non". But I have seen him play both the keyboard and electric guitar, as well as sing. This was both at morning devotions and at the big local Sunday church service. So I asked him about his music, and his face lit up. He told me that he put out a CD and video DVD with a local choir called the Alliance Choir. Also he said that he was going to put out a solo CD, as he composed his own music. I asked him if he was on amazon.com or iTunes yet, and he just smiled and laughed. However, I would not be surprised to see him there one day....

Chelsea and some local children

This is my favorite picture of the trip so far! I think it's beautiful. Lucas took it. Chelsea is in the left of the picture. She is about 16 yrs old and part of the British family who is living here for nearly a year and volunteering their time to the mission/hospital. Many of the local children just love to be included in pictures and then to see themselves in the digital pictures after they are taken.

June 21

I see that Memphis is supposed to reach 101F today. Ugh! It is very pleasant here in southwest Rwanda. The elevation is about 6,000 ft and there is a large & deep lake here, so it's breezy and cool. No air conditioning, but it is not a problem. At night it's about 65-70F, and during the day it gets up to about 80F. Strange that it is so cool, because we're just 2 degrees south of the equator. While it's not hot, the sun is fierce, so people try to stay out of direct sunlight. Many of the local people carry umbrellas for shade. This is my first time in the southern hemisphere. Last night the "southern cross" constellation was easily visible (once someone pointed it out to me).

This morning I spent some time in the hospital outpatient clinic observing patient flow. I felt like I was working with Carrie Hazlewood again on the Process Team! The front desk has a 2 sided copier surprisingly, and x-ray has digital capability. Front desk staff copy insurance cards just like at home. Paper is conserved, so if a 1/4 page or 1/2 page will do, then the staff uses the smaller piece of paper. We were copying 4 insurance cards to a page. When I asked for a scissors to separate the 4 insurance card copies, the staff just handed me a ruler to use as a straight edge. So here's another example of dichotomy: digital x-ray, but no scissors in sight! Maybe I could donate some after I get home....

I was sitting with 2-3 nurses doing triage today. We were having a bit of trouble communicating. They asked me if I spoke French, and I replied no. They looked surprised and asked, "You ONLY speak English?" How embarassing for me! These folks speak Kinyarwanda, French and English. One of the male nurses said, "If we can learn English, you can learn some French." How can you argue with logic like that?! I certainly won't be learning to speak Kinyarwanda fluently. I saw one Kinyarwanda word today which was 27 letters long. But I am picking up a few of the easier words! Mirakoze means thank you, mwiramatse means good morning, muzungu means white person (usually accompanied by finger pointing!), Imana means God.

Children in Rwanda

My nephew, Lucas, took this great picture of some children who were following him around on a day trip to the peninsula in Lake Kivu near here, to a village called Chara (not sure about the spelling).

Where we are at Kibogora Hospital in Southwest Rwanda (street addresses are not used here!)

Latitude -2 19'34.91" south

Longitude 29 7'56.41" east

June 20

My journey started a week ago today. I can't believe it has only been a week! It has been a busy one. This morning Julie, the American nurse, took me along to the Methodist church about 50 feet from our house. I could not understand the words because everything was in Kinyarwanda, but the singing was beautiful! There were 3 separate choirs, which took turns singing. Interestingly, the children were dismissed to a children's liturgy right before the sermon started, just like at our church at home. Julie is a pediatric nurse and has been here for 3 years. I look forward to hearing more about what brought her here and how she copes with the isolation and high infant mortality rate.

Above left is a picture of the house which Lucas and I are living in. It is a duplex, and we are in the left side. Above right is a picture of the living room.

June 19

It's Saturday, and I'm not working today :) Lucas and I walked down to the shore of Lake Kivu. Lucas had told me that the path down was "ridiculously steep" and he was right. He estimated the grade at about 45 degrees. I was certainly huffing and puffing on the return, while he easily made the climb. Ah, to be 23 years old again! Lake Kivu is a HUGE lake, on the order of one of the Great Lakes in the U.S. The top left picture is of me next to one small inlet of the lake, about halfway through our walk.

We spent the afternoon at another spot on this lake with some of the other visitors to the mission. Attached is a picture of the view we enjoyed while we sat and talked this afternoon (bottom right picture). Unfortunately there is schistosomiasis in the lake, so we chose not to swim in it.

Our house also enjoys a lovely view of the same large lake. There are mountains in the background, which are usually partially hidden in mist or clouds. Attached is a picture of the view from our front porch (top right picture). Can you make out the mountains across the lake?

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More June 18

Today is the anniversary of when the massacres in 1994 reached this part of Rwanda. Some patients and hospital staff were killed. It is really difficult to imagine those terrible events happening at this place. It is so peaceful now. Attached is a picture (which Lucas took) of the hospital and mission complex. It covers the better part of a hill overlooking a beautiful lake (Kivu).

I was talking with the English teacher (Edward) at the hospital this afternoon. His job is to teach the hospital staff to speak and write English fluently, and eventually they will convert the medical records to English as well (he says it will be "soon"). He asked where I was from. He had heard of Tennessee, and when I mentioned that Memphis was on the Mississippi River, he asked if it was near the city that had flooded. So he was pretty knowledgeable, though he has never lived outside of eastern Africa. I mentioned that Memphis was famous for Elvis and the blues. He was curious about the blues, so I downloaded a BB King video for him on YouTube. It was a pretty interesting cultural exchange ;) I told him that if he ever got to Memphis, I would show him around. I would like to feed him some BBQ and cole slaw, and see what he thinks.

June 18

At 7:30 am devotions today, there was electronic music. One man played the keyboard and one played electric guitar (sort of strummed it). Then the next song was keyboard, electric bass guitar, and about 20 people sang in a choir and the keyboard player sang as well. While the choir sang, they swayed from side to side in unison. The singing was very beautiful! So yesterday there were traditional tribal drums, and today an electronic band. This is a good analogy for how I see Rwanda and this hospital. In some ways, it is very modern, but in some ways, it is still primitive or traditional.

Along those lines, here is a picture of how the poorest people live. I believe this is an abandoned dwelling, as the door and windows seem to be closed up, but otherwise it is representative of how the poorest people live. There are many buildings just like this in the poorer areas. I'm told they have dirt floors and that the family sleeps on the floor.

School children in southwest Rwanda

Rwanda

Rwanda, on the drive from Kigali to southwest Rwanda

Rwanda

Amsterdam

June 17

My first day of work here! Started with 7:30 am devotions, which were all in the Kinyarwanda language. But there was some nice singing with a drum accompaniment (drum played by hand). I was introduced to the 30 or so hospital staff who had come to the devotions, but I was introduced in French, so I could only catch a few words of what was said. I heard "American", "administration" and "fiche". Later I learned that fiche means records or medical records. I stood up and said a few words, which were translated, about how I was glad to be here and Rwanda is a lovely country. There was a smattering of polite applause, so hopefully I did not offend anyone with my remarks ;)

My first project will be to find a better chart tracking system, using the constraints that exist here (small number of personnel, few computers, paper charts, rules/regulations). I have many pages of notes already and have toured the hospital, so today has been a good orientation/a good start! One of the volunteering doctors here is a general surgeon from Virginia (Greg Alty) and as soon as he heard about my assignment, he started bending my ear about how bad the chart system is here and how it needs fixing. So I have traveled halfway around the world, and I am still fielding complaints from surgeons! ;) I guess it is my destiny.

I am facing a bit of a language barrier here, as French is the medical language of choice for charts, orders, and official documents. The Rwandan people speak Kinyarwandan mostly in their day to day conversation but understand varying amounts of French and English. Oh, how I wish I knew more French. It would really help with my medical record project. There is a big push by the government to make English the primary language of Rwanda eventually. It must be being taught in schools quite a bit. Lucas and I were walking down a dirt road this evening, and a little 5-6 year old boy stuck out his hand and said to us in perfect English, "how are you?" Then a few minutes later, a group of school age children said, "good morning!" to us and waved. It was evening time, but we just waved back and replied, "good morning" as well. :)

June 16

Heading out this morning to our final destination, Kibogora Mission. It will be about a 6 hour drive. Had a rushed departure because I overslept at the mission house. It was so good to sleep in a bed again! We picked up Pastor Wakana from Kibogora, who was also in Kigali at this time. He is a very nice Rwandan gentleman, very soft spoken, quiet and smiles a lot. Matt told us that he was a Tutsi and had to leave the country during the '94 genocide. The SUV is quite full now, with Matt, Jack, Lucas, Pastor Wakana and myself, plus Matt's supplies for the mission and our luggage. I pointed out to Matt that he would not be able to see out of the back window of the SUV while driving, and he just laughed and laughed about that. So I guess he usually has the SUV packed up pretty full.

One notable thing about Rwanda is that most people walk everwhere. So on all roads there is a constant stream of people, including small children walking by themselves. Many of the women have babies strapped to their back with a piece of cloth and have something else balanced on their head. There are a fair number of motorbikes, and a few cars. Surprisingly all of the main roads (highways and many city streets) are paved. Matt (and my guide book) says that the Chinese paved these roads in exchange for mineral rights. I am not sure that the Rwandans got the best of that deal. On the drive we saw hundreds, perhaps thousands of people digging trenches to lay fiberoptic cable. There have reportedly been donations including from the Bill & Melinda Gates Foundation to try to increase the tech level of the country. Most everyone also has cell phones.

Stopped in Butare about 10:00 am for tea and some breakfast. This is a usual tea break time for the locals, I understand. Butare is a university town, even with a medical school (though I believe it is only 2 years). It came up that Kibogora Mission needed blood today, and Butare has a blood bank. So Matt drove us to the blood bank and we picked up a cooler with 4 units of blood. But where to put it in the already stuffed SUV? Somehow Matt squeezed it in, and off we went again.

Drove through Nyungwe Forest, which is a rainforest and animal preserve. Lucas and I hope to go on a more detailed tour of it before he leaves in 2 weeks. During the drive we saw about 6 monkeys by the side of the road, much like we would see deer by the side of the road at home. They were black with a white fringe of "beard" around their faces. Their bodies were about 2 feet long, plus the tail.

People here live in all kinds of dwellings, from mud huts with dirt floors to mansions (in Kigali). The Rwandans I have met so far are soft spoken and put out their hand to shake when they greet you. They seem to smile easily. Many of them know at least a few words of English and many are fluent in English, but I hope to learn a few words of Kinyarwanda while I am here so that I can return the favor and communicate with them a bit in their language.

Once settled at the mission in our apartment, Lucas and I joined Matt's family for dinner. His wife Lisa is quite friendly and says that she enjoys having some new faces and people to talk with. She is from the Isle of Man, and she had some wonderful stories to tell about that place (between Ireland and England). We had "western" food for dinner: shepherd's pie, peas and carrots, and pineapple upside down cake for dessert. They have a very nice family and have made us feel welcome. In addition, the hospital administrator, Sheila Etherington, came by tonight and welcomed us, and we talked a bit about what my (and Lucas') work will be. Will learn more about that tomorrow.....

June 15

In Nairobi this morning after another long overnight flight. Saw Lucas briefly in the airport! So I know he is alive and well. Unfortunately he is on a different flight than me from Nairobi to Kigali, Rwanda. Flight to Kigali is only about an hour, then I am met at the airport by Matt Murfitt and his son Jack. Their family is living at Kibogora Mission (where I'm going) for about a year and basically volunteering their time. Matt and his brother own their own business, so the year of volunteer work worked out well for them. Lucas' flight was delayed, so we ran errands in Kigali for the mission (grocery shopping and such). Kigali is a modern city in some ways (paved streets for example) and primitive in some ways (people still use wood burning stoves to cook, so their is smoke hanging over the city). It is a very scenic place with hills and lovely weather. Once Lucas arrived, we went to dinner at Republica, an African cuisine restaurant. I had a fish called Liboke, and Lucas had goat. I was proud of him for trying something new like goat! We also had plantains with our dinner. Both of us were pretty tired after days of traveling and not enough sleep, but we still enjoyed ourselves. Tonight we are staying at the house which the mission rents in Kigali. So we don't have to drive tonight to our final destination.

Matt's son Jack is autistic, so I found myself wishing that niece Carolyn was here to advise me about interacting with autistic kids. He is very bright and has a remarkable memory.

June 14

Lucas (nephew) is joining me for the first part of the trip to Africa - great for me, and hopefully good experience for him. So we had a 7 hour layover in Amsterdam. Upon the advice of former travelers to Amsterdam, decided to try to catch the train from the airport into the city. This turned out to work wonderfully. We found some luggage lockers in the airport to stow our bags. Then bought some tickets and hopped onto the train for a quick 15 minute ride to the old part of the city. It just so happened today that Netherlands is playing Denmark in the world cup. So the city was very festive with many people dressed in their team color (orange for Netherlands). Lucas and I had lunch at a sidewalk cafe and walked miles around the center of the city. The canals were fun to see. When we got thirsty, we stopped in a pub that seemed to be frequented by locals. Everyone was watching the bit soccer match. There were 2 guys there who looked suspiciously like soccer hooligans. Their heads were shaved, just like I have heard about other soccer hooligans. We tried to fit in as best we could, though we did not look like soccer hooligans at all. Fortunately the soccer hooligans were happy because their team won the game! Seeing Amsterdam was great, even just for a few hours.

Back at the airport, we split up again and I left for London while Lucas waited for his next flight. I was on Kenya Airways in London waiting to leave for Nairobi when the captain said that we could not push back from the gate for an hour because the air traffic controllers were on a "work slow down". Can they do that? (apparently they can) After we finally got going, I had my first African meal, though it was airplane food. Lamb with rice and spicy potatoes/peas. It was actually good!

June 13

Overnight flight from Memphis to Amsterdam

Emergency contact info while in Rwanda

Emergency contact:
Sheila Etherington, Administrator
E-mail: sae@kibogora.org
Kibogora Hospital and Mission
Southwest Rwanda near south tip of Lake Kivu. Closest town is Kamembe/Cyangugu.

Mailing address:BP 861, Kigali, Rwanda

Hospital or Administrator Phone # : (00250) 0854 1206
Alternate Hospital Contact: (00250) 0823 2766