Up the Lake

 This week we drove from the southern tip of Lake Kivu, all the way up the lake to the northern tip. The road was not good, but we bumped and swerved our way up the road. And I was so thankful that we had a big land rover.

You know you are in for it when you ask "how long will it take to get there?" and the reply is invariably "what type of car do you have?"

It was an interesting trip though. Some days we traveled for many hours, some days only for a few. I spent most of the time gazing out the window at the scenery. Rwanda is very densely populated, meaning that you don't go for without seeing someone. It is also very cultivated. There are very few areas that appear to be undeveloped. It seems that almost all of the jobs are in agriculture here in the rural areas, as there are very few shops and many fields. We saw swaths of rice, bananas, tea, pineapples, carrots, and cabbages, and many other fields that I still have no idea what they are.

One new thing I saw were small wooden hutches set above small ponds, and the ponds are grouped 8-12 in a group. Turns out there are rabbits in the small hutches and fish in the ponds, and that the fish live off of the rabbit manure. Eventually both animals are sold at the market. Pretty inventive. (sorry, no picture).

Early morning drive

One morning we got up at 5 to take a six hour trip north to the next hospital. This was exciting because we got to see the school kids all going to school in big groups along the road, and then about an hour later, all of the workers headed to work in the fields, including women balancing hoes on their heads. The people emerge from the hills, having walked up or down very steep paths to get to the main road where we were traveling. The houses are built into the hills and seem to just pop impossibly out of the hillside as if they have been here as long as the hills have. Schools and churches are built on top of the hills on man-made patches of flat.

The kids are very quick to yell mzungu, although in these rural areas it was immediately followed with a plea for either money, pens, or water bottles (they know that mzungus are dependent on these and they are required to bring a water container to school).

Tea!

The houses vary, but the landscape did not. Still with the up, down, all around. Really, the land of a thousand hills is a total misnomer. More like land of a bajillion hills. (think I will coin that phrase and sell it to rwanda for their next tourism campaign).

In the hospitals, we saw it all and met many interesting and earnest individuals striving to do the best for their communities but struggling with limited resources, old equipment, lack of educational resources, and enough staff. This trip was really my first chance to spend time in hospitals in my 'global health career' (whatever that means) and it has been very educational to learn about this avenue of healthcare, having spent more time in the educational and social parts of health. No big surprises, and many things are similar to hospitals in the states, although most details are to a more concentrated and stark degree that almost stops you in your tracks. Each hospital has crowds, smells, varying degrees of lack of materials and resources, trains of family and friends bringing lunch to the patients they know, mothers praying over their children, kids giggling and playing among the laundry. Hospitals are a unique mix of both desperation and hope. And the staff we meet are both aware of their circumstance and hopeful for both the institution and the population that they serve. We are seeing a lot of good work being done and in many cases I am impressed.

Our translator, Jean-Luc, and a hospital staff take us from one bloc to the next

In other words, this week was exhausting but very productive. This weekend we are taking a bit of a respite at a nice hotel and storing our energy for 7 more hospitals in the next two weeks.

So excuse me, I am going to go back to staring out at the lake for a couple more hours before the driver comes to take us away.