Day 1: Evaluations

I arrived at the Kigali airport at 9:30pm last night. When I stepped off the plane it was warm but not hot and it smelled like wood smoke. Someone said it smelled like Africa.

It took about an hour to get through customs and for our baggage to arrive. Despite our plane being the only one at the airport, the process of getting the bags off the plane seemed challenging. Fortunately, every bag made it from the US to Kigali, which is pretty surprising considering that I changed planes twice and made a third stop but didn’t get off.

Today was evaluation day for the fistula team. There were approximately 170 women waiting at the hospital to be evaluated, all of them hoping that we could help them. They stay on the hospital grounds in 2 large tents, 3 or 4 to a bed. During the day they have to be around for when their name is called. We had 2 exam rooms going, with about 5 MDs (plus me) in each room. Two people examined, the others observed and kept records.

I can’t begin to explain what I saw. My room examined 20 women over the course of the day. Four of these women were not candidates for surgery (too severe/scarred to fix), one 50 year old had metastatic cervical cancer and we could only offer palliative care, a few had minor leakage that we can likely fix with surgery, and the remainder had fistula–mostly urinary, a few fecal.

The women were so stoic as we poked and prodded and hurt them. They thanked us for examining them. And they smiled. An amazing start to this journey.