Today was my final day of clinical work; tomorrow I will tour Kigali and then leave on the 11PM plane back home. I knew the time would go quickly, but I feel like I have had a lifetime of experiences in these 6 days.
One of the MDs told me that my friends and family should thank me for coming because this trip will make me a better person. I completely agree with that–it would be impossible to come home unchanged. Another MD said that this trip, which he has done 4 times previously, is like a touchstone; he comes here to fill up with gratitude.
Today was a very good day. I worked with the MDs on rounding (to see the prior days’ postoperative patients) in the morning and afternoon. Most of the women are doing very well and should be able to move from the hospital room to the very large tents (two) set up at the back of the hospital. I don’t know if the women regard moving out as a good thing, or if they prefer being in the hospital room. Many of them have babies, as I mentioned before, so I would imagine that being in the tent is easier in some ways; there are other women who have not yet had surgery who can help out.
In-hospital care in Kibagabaga is not like hospital care in the United States. You are inches away from other patients, the room is hot and smells bad, there is no bathroom, and the beds are a foam covered mattress on a flimsy spring support.
After rounds, I took a short bus trip with the director of the IOWD, Barbara Margolies, to a local health center. We also took along a Rwandan medical student and midwife. The purpose of the visit was to present information about pregnancy, childbirth, and fistula to the women who get care at the health center. This place was maybe 10 minutes from the hospital where we are based (Kibagabaga), and it was overflowing with men, women, and children. We met the director, who told us that they have about 60,000 patient visits per year and about 1200 babies are born in the health center.
This place was maybe 2000 square feet, all corridors and open air hallways, similar to Kibagabaga. The patients must wait hours to be seen, fill their prescription, get lab testing done, etc.
The Rwandan midwife did a presentation for about 40 women, most of whom were pregnant, holding an infant, or both. Her presentation was wonderful to watch–she showed them illustrations to hold their interest and asked them direct questions to gauge their knowledge. This was under a big tent in the open air on a hot and sunny day. The women were so engaged, calling out answers and asking questions. I took a ton of photos and shared some of them on Instagram and Facebook.
After lunch, I went with the trip leader (Dr. Star) to talk to the fistula patients at Kibagabaga who were waiting to hear when they were having surgery. The medical student told us that an uprising was brewing because the patients wanted to know their status. They had been evaluated several days before and told only to wait. These women worship Star–they know she has the power to heal them. They clapped and cheered when she told them to be patient, and that she would do her best to operate on as many as possible.
I will stop here as this post is getting long, but will finish the story tomorrow. More joy to come.
Leah's Rwanda 