Wednesday, May 21, 2014

Rwanda-- Week 2

Update: We are spending our second week at the hospital in the C-section unit. This unit has twenty-four beds, and it usually stays full, sometimes two women having to share a bed. This week we have been taking vitals as we did in the pediatric unit last week, but we also are taking blood pressure which we could not do last week since they do not have child-sized blood pressure cuffs. We are also learning how to clean the incision wound of the post-op mothers and how to check if it is infected or healing properly. The head nurse is very good at teaching us how the nursing care in this unit works, and one nursing students, Vincent, has been particularly kind in showing us what to do and explaining to us what he doing, whether writing a report, drawing blood, starting and IV, or giving an injection.

Highlights of the week: I’ve learned many Kinyarwanda words now! Well, I know thirty-five words/phrases, which is not enough to really communicate, but I can do such things as greet and thank people and ask the bus man where the bus is going. I began learning when I came in December and since then have been practicing. Babu has been my faithful teacher and Mama, Emily, or Shami help when we are confused with spelling and such (yes, it’s a hard language that even fluent speakers can’t always spell it…). But each new word learned is great excitement for me.

Leslie is also a highlight of the week. She is a midwife from the US who has been here in Rwamagana for a year now, working as part of a team doing a seven year program to bring better education and care for the mothers and babies of Rwanda. She has taught us a lot about the conditions of the medical care in Rwanda and how she is working to improve them.

Challenges of the week: Getting on the bus. Yes, just the act of getting on it! Local buses which remain in the same city or town are no problem. However, buses that go from city to city are another story. For the weekend, Claire and I took a bus from Rwamagana to Kigali, and the problem is that the bus companies sell more tickets than seats. I did not realize this, nor that the seating is not a first come, first serve. It’s a crowd of people literally pushing and shoving each other over in order to get into the bus. I’ve never intentionally pushed a stranger out of my way before, and at first I was conflicted. As I saw Claire disappear onto the bus, I knew I had to push as hard as I could or I wasn’t getting on. I don’t know why they do it this way, but they do, and it only took me one time to learn how it’s done. I’m now becoming an expert at stranger-shoving at the bus stations, while being conscious of my backpack due to the fact that bus stations are the prime location for pick-pocketing.

My watch. In order to hold the stethoscope with my right hand and look at my watch at the same time, I have to wear my watch on my left hand. Even though I’m right handed, I’m a weirdo and have always worn my watch on my right hand. A minor change, but I am not quickly becoming used to it.
Our water bottles reek! Something in the water here in Rwamagana makes them smell so badly that I have to hold my breath while I drink, and this is with washing it with bleach regularly. At least we’re not getting sick from whatever it is that is making them smell so badly.

Humor of the week: this is actually something that happened last week, but it is a story that we are still laughing about. The first day of work it was pouring rain, but we had no choice other than to walk, so out in the rain we went. Not five minutes later, we heard someone running up behind us but we attempted to ignore him. He came up to the left of Claire and it seemed as though he was grabbing for her bag. Claire jumped towards me and shouted very sternly at him. He stepped back quickly and began explaining to us something in Kinyarwanda and he was pointing towards the house. We smiled and told him that we are fine to walk in the rain and that we are just going down the road to the hospital. All three of us were confused but Claire and I assumed that he was offering us a bike taxi or an umbrella or raincoat and went on walking.
Later on that day when the house boy let us in, it was he who was the one chasing us that morning! Our host mother, Odette, had sent him after us to let us know that she could give us a ride.
Odette owns a restaurant in town and she took us there for lunch that day. We were walking from there to the house before going back to the hospital, and on our way we noticed someone chasing us down again. This person knew English and told us that we have gone too far and pointed to the road we had just passed. He was a server at the restaurant and told us that Odette had seen us walking the wrong way and sent him to redirect us. These poor people chasing us around, being so kind and caring for our wellbeing!

Last Friday after morning rounds, one of the med students told us we were going to a “nursing ceremony” and that Claire and I were to come… we tried to inquire what this ceremony was about, but we didn’t get any clear answers. So we walked for about thirty minutes to the health center, which we found full of doctors, nurses, and midwives. We saw Leslie there, and she told us this was a gathering to celebrate nurses and midwives, and to talk about the history and future of their roles in Rwanda. We sat through speech after speech (all in Kinyarwanda) which were each separated by a few minutes of traditional Rwandan dancing. They had told us the ceremony wouldn’t last long… the room was hot and crowded, and we had not a clue of anything being said. About three hours later it was finally finished, and we got to walk all the way home in the mid-day heat. At the time it was not comical, but looking back now it’s quite funny!



     Our walk to the hospital from the house. The buildings ahead on both sides of the road are bilingual schools, and the children like to shout greetings to us each time we pass


 The center courtyard of the hospital. the wards surround this area in a circular configuration 


The bright sun shining into the pediatric ward. I am in the back half of the ward, looking into the first half, with the nurses office behind the yellow walls on either side

 The medical students we worked with during the first week. From left to right: Francis, Everest, Claire, Leonet, myself, and Franc. We learned so much from these students and enjoyed working alongside them


 
 Operation Laundry
Once a week we are becoming better and better at hand washing our clothes.
The picture on the bottom right is of Claire pretending to have to beat her white uniform "clean" against the dirty rocks... it was a joke with a friend before we left that we would have no way to clean our clothes properly so our white scrubs would be brown when we returned




Wednesday, May 14, 2014

Rwanda-- Week 1

Muraho! Greeting from Rwamagana, Rwanda.
Claire’s and my first week here has been an adventure. Each week I hope to share a small update, a highlight, a challenge, and something comical that has happened from our experience here.
We arrived Thursday night and spent the weekend in Kigali with my sister Emily, her finacĂ© Shami, Noel, and Mama Nyanja and Babu (our friends with whom we stay while in the city). We were able to adjust to the time change quickly (really no jet lag at all- we are becoming experts at this!) and we enjoyed adventures around the city to exchange our money into Rwandan francs and go to the outdoor market to buy vegetables and fruit. I was also so excited to go back to Emily’s church which I very much enjoyed while visiting in December.
On Monday we were ready to go the Rwamagana Hospital (about an hour from Kigali) for our first day to become orientated and see where we would be doing our rotations. This is a government hospital and it has an ER, a pharmacy, a mental health ward, an outpatient ward, a physical therapy ward, a surgical ward, an internal medicine ward, a maternity ward, and a pediatric ward.
Although they mostly speak Kinyarwanda and French, the doctors and medical students know enough English to communicate and they are very welcoming. We learned that this is one of the four teaching hospitals in Rwanda, and we are thankful to be in this learning environment where the nurses and doctors want to help us learn and achieve our goals.

Update: This first week we have been working alongside three Rwandan nursing/ medical students who are on rotations in the pediatric ward with us, and they speak English very well. They taught us how they fill out the nursing care plan for each patient on a daily basis, how to take vital signs, and we learned what it sounds like through a stethoscope when a patient has pneumonia or asthma. We also learned how to read an x-ray to check if a patient has tuberculosis.
The most common illnesses that the pediatric patients present here is malaria, malnutrition, and pneumonia. Cases of cleft lip and palate are also present.

Highlights of the week: Rwamagana is beautiful! It is also very safe so we can walk around the town without needing a Rwandan to accompany us, even after dark. We both agreed that we could live in a place like this. 
The people here are very friendly and we are enjoying learning how hospitals are operated in countries of limited resources. The staff are very welcoming and we are learning a lot about the common diseases found in in children here and the proper treatments.

Challenge of the week: Both Claire and I have new Dansko shoes for nursing, and we are currently breaking them in (we will be ready to start clinicals at school in the fall!) but because we leave to walk to the hospital at 7:45am and get back for lunch at 12:45pm, then go back from 1:45pm to 5:00pm. This many hours of standing and walking for multiple days in a row is making for very hurting feet! Claire also has problems with her left foot and right knee, and I have problems with my lower back, so we are in much pain while getting accustomed to standing for so many hours at a time.

Humor of the week: on our first day of work, I poured salt instead of sugar into my coffee! I missed out on a great cup of coffee (and caffeine). The next day I skipped attempting to put sugar in altogether.
Also the toilet clogged this day, and by the time we acquired a toilet plunger, it was after dark and the electricity had also gone out! How Claire and I have both gone our whole lives without having to plunge a toilet, I don’t know, but it would be a first for both of us, and somehow I was elected to do it. Thankfully Claire brought her headlamp (so glad I gave that to her for her birthday a couple years ago—it certainly comes in handy so often for us!) so headlamp on head and plunger in hand I went into the dark bathroom without a clue as to what I was doing. But whatever I did worked! On my first try, I successfully plunged a toilet (and good thing, because clogged toilets are becoming a daily theme). As I washed my hands afterwards, the sink started to leak. Nothing the bathroom floor rag can’t clean up for now. 
Another funny was that Claire and I have started a small running club… here in Rwamagana the neighborhood dirt roads are great for running, but every day after coming home from the hospital when we go out for a jog, the neighborhood kids think it’s a great idea to join us so as we go, we collect a small pack of kids jogging behind us, and they think it’s hilarious! 


the road outside Mama's house in Kigali


Africa Bite! Lunch with Shami and Babu for authentic Rwandan food in Kigali 


Spending time with Emily and Shami before leaving for Rwamagana for the week




At Mama's house before leaving for our first day at the hospital 


Rain clouds coming over the beautiful hills on the way from Kigali to Rwamagana


African tea with ginger.. a favorite


toilet plunging 


Tuesday, May 6, 2014

Sophomores no more...summer is here!

Today is a big day... Two years officially in the bag. By the grace of God I am now going to be a junior! Big congrats to everyone in my nursing cohort for all the hard work that has brought us to be official nursing students now! What a blast it has been learning with each of you these past two years... I look forward to two even more exciting years! Our official EU scrubs will arrive any day in the mail now and it will be one more way to look forward to next year. 

Today I bought my white uniform and Danskos and am ready to leave for Rwanda tomorrow to spend a month interning at a hospital with my dear friend, classmate, roommate (and let's be honest, sister) Claire, and spending time with my sister Emily, her fiancé Shami, and friends!!

Please follow our blog if you are interested for (hopefully) weekly updates! THANK YOU to everyone who has been supporting me and  as I work my way through becoming a nurse, and for those of you who are praying for me and Claire and have financially supported us to make this trip possible. We can't say THANK YOU enough!


Happy summer everyone!