The first few days...

Life begins early here and follows the passage of the sun. It rises around 5:30/6 as do people and sets fairly suddenly at about 6:30pm. No long, drawn out Cornish summer evenings here.

For these first few days we have had our meals provided for us and they are brought to our little house. This gives us a daily opportunity to practice our rudimentary Kinyarwandan (the native language), which is soon exhausted after ‘good morning’ and ‘how are you?’.

The working day starts at 7:30 with singing, prayers and a brief sermon from the dramatic pastor in the hospital chapel for all the staff. The doctors then meet to discuss any problems overnight and decide who will work in each service each day. Whilst a number of the doctors have an interest in a specific area, such as maternity, they are all generalist, with a range of experience - the most junior being just 2 weeks from med school.

In an attempt to get a good idea of the running of the hospital we have spent the first days shadowing the doctors as they conduct ward rounds on the different wards. We’ve seen neonatology, maternity, adult medicine and paediatrics. There is usually a break for tea mid-morning (tea is a big export for Rwanda and there are large plantations nearby – so fortunately no horrible yellow label Lipton tea!).

There are some clear differences in the nature of admissions – unsurprisingly significant numbers of malaria, but also anaemia secondary to parasites and heart failure due to unknown causes. Within the maternity service there is a waiting ward for women who either live a long way from any healthcare or have previously had complications. Quite a sociable ward!

The language barrier is significant, but manageable. The doctors work in French, though speak good English. The patients speak Kinyarwandan and the nursing staff a mixture of all three. We have begun to do some crash course French learning and tried out our limited ability with the compound’s nightwatchman last night on our veranda – we managed to discuss the climate of Rwanda compared to England, that he is a fan of Manchester united and has 5 children (the weather and football – always great conversation topics to fall back on!)

We get asked a lot ‘how many children have you got’ and our answer of ‘none’ is always met with surprise and consternation after being married for a year and a half. Here in Rwanda the main purpose of marriage is to have children with most people having the first within the first year.

Back to the daily schedule…we meet back at our house for lunch after the morning rounds. We are based on the mission compound about a minute walk from the hospital which is convenient! The afternoons are much less structured here, as the ‘jobs’ generated from the ward rounds are carried out by the nursing staff (this includes taking blood, cannulas, discharge paperwork and x-ray requests – what a joy this would have been for our foundation years in the UK!). So far our afternoons have been meetings, hospital exploration and language practice. However on Friday, due to a countrywide rule, work stops at 3.30 and everyone plays sport. The take up of this however is quite varied. Yesterday we joined some locals playing volleyball which, given the court’s position on the edge of a near vertical drop, led to some significant pauses in play following some wayward shots from us!

Activities after 6.30 here are pretty limited due to the absolute darkness but we have spent some nice time getting to know our neighbours and one long evening attempting to cut Matt’s hair…and it doesn’t look too bad even though I say so myself…Matt’s opinion may differ.

 

You may have noticed that the last 3 posts have all gone up at once. The internet is intermittent here, very intermittent! Keep checking in for updates.....

 

Much love to all, matt and marie