Friday, June 29, 2012

P-Neumonia, as my dear friend Monica would call it...


Flashback: July 2011
Interviewer for my current position: If I may be blunt and go off the script for a moment, can I ask you what you are afraid of because you seem to be fearless.
Me: I am afraid of not having access to Western medicine and a drugstore around the corner. 

Present Day: June 2012
Yes, the same fear still lives inside me and I have yet to adjust to the Rwandan medical system or seemingly complex pharmacy protocol for purchasing over-the-counter pain or cold relief.  Recently I had my second more serious bout with “sickness” since I arrived in Rwanda, and the frustration with being so far away from Western medicine and my grandmother’s homemade chicken noodle soup recipe has not ceased.  I have always been one of those people who gets SICK when I get sick, and more often than not, I am the one who somehow picks up the random affliction that only affects 1000 people per year (ie. Rocky Mountain Spotted Fever at the beginning of 2011).  One of the downsides of feeling under the weather here is that whatever it is that has a hold of your system, doesn’t seem to let go for a long time.  Simple colds last weeks, coughs drag on for nearly a month, and allergies never seem to go away.  This does not just affect me, as each of the volunteers in the Village has battled one too many long-lasting colds, coughs, and other medical problems.  I can deal with all of that, despite the long duration, but when more serious symptoms arise, medical advice is needed, yet in short supply.  Despite Rwanda being the most densely populated African country, very few of those people are medical doctors.   On top of that, most every doctor is a general practitioner, without a specialty in any area.  Case in point, Rwanda is a country with 12.5 million people, however there are only 10 Pediatricians - 10!  This is a place where the sun is intense and it feels as though you are baking each time you are outside, yet there is only 1 Dermatologist.  

There are common go-to diagnoses for sickness in Rwanda.  If you are sneezing, or have a runny nose, people diagnose you with the “flu.”  If you are having difficulty breathing, you have “the asthma” (yes, they call it THE asthma).  If you have a headache, you have malaria, and if you are coughing, you have TB.  Things here are very black and white, except when they aren’t.  

Case #1
In March, I developed a headache which lasted many days without relief.  It was dizzying and just downright awful.  Of course everyone immediately said that I had malaria, so I went to the hospital that “white people” go to in Kigali to seek medical advice and to get tested for malaria.  What would seem to be a simple process was anything but straightforward, and the conversation with the ER doctor went like this: 

Dr.: What seems to be the problem?
Me: I have had a headache for over 2 weeks.
Dr.: Where are you from?
Me: America
Dr.: NO, WHERE?
Me: You mean the state?  Originally I am from Ohio.
Dr.: What about your grandparents?
Me: Is it going to help you diagnose my problem if I tell you they are from Germany?
Dr.: Ah, you come from an intelligent family.
Me: Is that a question?
Dr.: Are you married?
Me: No
Dr.: Why not?
Me: I have a headache
Dr.: What about a boyfriend?
Me: I live in Rwanda.  I have been here since December, and my head has hurt since March 18th.
Dr.: Do you have children?
Me: No
Dr.: How do you feel about pregnancy without marriage?
Me: Do you want to know if I think it is right or wrong?
Dr.: mmm (Rwandan way of saying ‘yes’ without really saying anything – sometimes it’s accompanied with a raised eyebrow)
Me: It doesn’t jive with my life, but it works for some people, and for them it is fine and I won’t judge them.
Dr.: So you say your head hurts?
Me: (sigh) Yes.

Following that riveting examination, the doctor felt my pulse, and sent me for blood work and a urinalysis.  (I am still waiting for the urinalysis results…3 months later…)
I returned to his office several hours after the lab work, and the following transpired:

Dr.: You are sick.
Me: Oh? What did the lab results show?
Dr.: Results? I don’t have any results. But you are sweating and look tired. I will give you medicine.
Me: It is a hot day and I have had to walk a long distance from the lab to the pharmacy to here.  That is why I am sweating and look tired.
Dr.: No, I believe you have a fever and are sick.
Me: ok
He then wrote me an order for 3 prescriptions and several weeks later my headache subsided.  

Case #2
I developed chest pain several days ago, and with each passing day, the pressure and intensity became more and more severe.  Chest pain doesn’t fall into any of the “usual” categories (flu, the asthma, etc.), so I caused a bit of a conundrum among those who wanted to diagnose me within the Village.  I know that the chest and lungs are quite connected to the nervous system and emotions, so I hoped that I could attribute it just to that, but feared it might be something more serious.  I was bound and determined not to return to the hospital for the same circus-act of an examination, so this time I went to a private doctor at his practice.  When I entered the clinic (spelled CLINIQUE here), the nurses/lab techs were sitting with their bare feet propped up on the sofa, watching a Rwandan soap opera, of sorts.  I almost turned and walked out, but was encouraged to give it a chance by a colleague who said that what I was witnessing was, “normal” in Rwanda.  Normal?  Right.  I could hear my mom in my head, saying, “Why the hell are you doing this to me – living in Rwanda????”  (Indeed she said that exact phrase to me that night when I called to tell her what had transpired.  Do I know her well or what?)    
This time the doctor actually listened to me, took copious notes, truly EXAMINED me (even with a stethoscope), and 5 minutes after his tech took lab samples, the results were being reviewed by the doctor himself.  Efficiency and effectiveness…amazing!  The bad part was that some of the results were inconclusive, but I did find out that I don’t have worms, and I don’t have parasites.  The doctor said that it is likely that I am trying to recover from bacterial pneumonia and that my chest pain is from musculoskeletal bruising from all the coughing.  He put me on 2000mg of antibiotics a day, cough syrup with codeine, and a prescription pain killer.  If nothing else, I’m more comfortable than I have been in days, and I can finally get some sleep without squirming in pain every few hours and turning like a rotisserie, trying to get comfortable.  I asked the doctor if the medicines will help me feel better, and his response was, “I hope so.  Good luck!”  I honestly don’t know what I expected him to say, so why did I even bother? 

There are so many medical issues here that don’t exist in America.  Aside from a mosquito bite being annoying, itchy, and red, you don’t give a bite much thought in America.  Here, that simple, annoying mosquito bite could very likely be the cause of malaria -  a painful, scary, and sometimes deadly disease.  A simple cough in the states is aggravating, but you don’t automatically think that it might be tuberculosis if it lasts a few days longer than you hope.  I live in a whole new world over here in Rwanda, with new realities and those realities can be a bit terrifying.  

Hopefully I have had my fill of medical mysteries and curiosities in Rwanda.  If nothing else, each medical experience seems to make for a good story for everyone back home.  Think of me next time you run into CVS or Walgreen’s for some cough and cold relief, and be thankful that you have a doctor nearby who is well trained, trustworthy, thorough, and knowledgeable.  Maybe he or she wants to volunteer in Rwanda????  

Favorite Picture of the Week is to the Right (story coming in another blog...)

Favorite Quote of the Week: “I do not understand why you are not feeling better – I prayed for you last night.” 

Highlight of the Week: A traditional dance performance by the students at Agahozo-Shalom Youth Village to wrap up the “Restoring the Rhythm of Life” celebration week in the Village.  See a portion of the performance in the video below:

video


Sunday, June 10, 2012

when a job is more than just a job

There are some days when I feel like all I do on a daily basis is a “job.” Granted, I was chosen to serve in a specific position when I signed on as a year-long volunteer at Agahozo-Shalom Youth Village, however since arriving here 6 months ago, I have come to realize that life here is about so much more than just a job. Due to an influx of visiting groups and day visitors during the second term, I have only had 1 day off since May 14th. During busy days like those over the past few weeks, I still find myself being caught off-guard by how much pleasure I reap by spending time with the Village youth. They bring such delight into my life and bring rays of sunshine to even the darkest of days. Their naiveté and curiosity fill me with joy, and their questions and comments make me laugh with bliss. Here are some highlights from the past few weeks – questions/comments/conversations that have brought smiles to my face:

o M: What do you call a head with no hair?

o Me: (smiling) Bald

o M: BALD?!

o Me: (laughing) Yes, bald

o M: You must spell it for me.

o Me: B-A-L-D

o M: So I can tell that man that he is bald?

o Me: (laughing) No, I wouldn’t suggest going up to anyone and commenting on them being bald

_________________________

o H: You know the Prince of England’s son who just got married?

o Me: Prince Charles’ son William? Yes, he married Kate

o H: Yes, him. You are as beautiful as Kate

o Me: (Laughing in amusement) Wow, thank you very much. You are also very beautiful

o H: Yes, I know I am beautiful. But you do look like that girl Kate. You just need to shower and put on a smart dress. Then you need to do your hair, not like it is now, but do it nicely and put on some makeup and jewelry. You will look just like her. But you have a bigger belly than she does

o Me: (heartily laughing) Yes, she is very thin

o H: Yes I think if you do that (shower, do my hair and put on a smart dress), you will find a man who is as handsome as you are beautiful. I cannot wait for you to meet him and introduce him to me!

o Me: Neither can I!

_________________________

o I: When I was in America [at the StandUp benefit in NYC for Agahozo], do you want to know what I found surprising?

o Me: I would love to hear about your trip!

o I: The beggars on the street

o Me: What about them surprised you?

o I: I thought everyone in America had money, food, clothes, a home, and a family

o Me: America is not all that different from Rwanda in that there are many classes of people – very rich with a lot of money, a middle class, and then poor people, some of whom do not have houses or clothes or food to eat

o I: Yes I see. America is not all that different. I am glad I got to visit America, but I was very happy to come back to Rwanda

o Me: This is your home, so that is understandable

o I: Yes, Rwanda is my home and although I liked America, it is not Rwanda

_________________________

o C: What are you doing now?

o Me: I am going home to go to bed.

o C: Bed? It is only 10:30pm. This is the time babies go to bed. First you eat like a baby (b/c I apparently don’t eat enough at each meal) and should use a spoon to eat because that is what babies use. Now you are going to bed like a baby. What are you, a baby?

o Me: (laughing) No, I’m old and tired.

_________________________

When I meet with visitors to the Village, I often mention how magical this place is and how each and every person here is truly exceptional in so many ways. In the middle of a developing country, filled with so much darkness from its past, Agahozo is filled with so much joy, positivity, thankfulness, and hope. I came here to do a “job” and to take a year for myself. What I have found is that my job extends far beyond what my position description reads – it extends into the student body, staff and faculty realm – I am a part of the Agahozo community and family. I am one of the pieces of the puzzle here, and although I can see how my presence is having a positive affect on the students here, I have also come to realize and accept that their presence in my life is having an immensely significant and encouraging influence over me.

_________________________

Other Enjoyable Bits:

Most enjoyable event of the week: Sitting in the stands, cheering on the boy’s basketball team as they took on the #1 Club Team in Rwanda and played men who were 3x their size and twice as old! The ASYV boys were fantastic! I never had so much fun at a sporting event!

Proud moment of the week: Sitting and watching my household of girls debate whether a single-sex or mixed-sex school was more conducive to learning. They were incredible analytical and critical thinkers! Master debaters :)

Beautiful moment of the week: Standing outside one of the volunteer houses, looking up into the sky as the sun was setting, and seeing a rainbow develop…it was magnificent!

Favorite meal of the week: a peanut butter & jelly sandwich…something about it calms me and comforts me in a way I can't quite explain. I think it takes me back to a state of childhood happiness.