Week 3

With just one week left in Kigali, we’re starting to prepare for our five weeklong jobs of fixing hospital equipment full time. But that hasn’t stopped us from experiencing all that Rwanda has to offer. In addition to having two “hospital days,” we managed to squeeze in a volcano hike and a safari, all in addition to our regular schedule of French and medical device repair classes. Here’s a brief recap of some of the events:

 

Hospital Assignment

In preparation for the second month of the EWH Summer Institute, each ‘team’ was assigned their respective hospitals. Jonathan and I will be working in the Western Province at the Rubavu District Hospital near the city of Gisenyi. Although we do not know much about it yet, our current host family told us the city is a major tourist area and is “very nice.” We’ll find out more about the hospital and our lodging accommodations at our briefing tomorrow. Here’s a map I made of the hospital assignments.

 

Hospital Work Days

So far, we have had three ‘hospital days’ interspersed with our classroom studies. During these days, we had the opportunity to go to hospitals in Kigali and try our hand at actually fixing some medical equipment. We first went to CHUK (Centre Hospitalier Universitaire de Kigali), a teaching hospital and one of the best hospitals in the country. While there, Jonathan and I ‘fixed’ some equipment, which mostly just amounted to finding the correct chargers and then charging batteries. We also tried our hand at an ultrasound machine. This was the first time either of us had ever touched an ultrasound machine, let alone powered it on (luckily that part was pretty easy). Someone had sent the machine to the workshop because it was “displaying images twice.” What does that mean? Good question, we were wondering the same thing. Unfortunately, that is typical for repair requests. We realized that, in addition to the technical aspect of fixing equipment, this communication barrier could easily inhibit our ability to do our job. Since neither of us had used an ultrasound machine before, we didn’t know how it was supposed to work. So how can we fix it if we don’t even know what the problem is?

After powering it on, we realized the screen was flickering every second or so, which we fixed by adjusting the video cables between the monitor and the computer. Then it took us about an hour to figure out how to configure the device, select the proper mode (B mode, which is the mode usually shown for TV shows like House), adjust the gain, and select the different sensors. At first, we weren’t even getting an image when we pressed the sensor to our skin. We quickly realized that it was probably do to lack of conductivity (all of the ultrasound gel squirt bottles were empty, something we were learning to expect in Rwandan hospitals). After two hours we finally had the machine working as it was supposed to, or at least how we thought it was supposed to work. Then we saw how it was “displaying images twice.” Essentially, it was overlaying the image on top of itself, which can cause confusion for a physician trying to make a diagnosis. We troublshooted the problem and, since it occurred with all three sensors, decided it was probably a software issue rather than a hardware one. Thus, the next hour was spent testing every single setting (and there were probably over a hundred), but unfortunately we never found the fix. We sent an email to GE (the maker of the machine) but haven’t heard back yet.

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The ultrasound machine with ‘double vision.’

In addition to working with medical equipment, we also got a chance to tour the hospital and speak with some doctors. I wrote about some of my interactions and perceptions in my monthly article for the Hopkins Biotech Network publication, The Transcript, which can be found here.

Tomorrow, we will be going to Kanombe Military Hospital—hopefully we’ll have better luck!

 

Volcano Hike

Two Saturdays ago we hiked Mount Bisoke, one of the volcanoes in Rwanda. Although not the tallest, it still towers at over 12,000 feet. Fortunately, we didn’t have to ascend all 12,000 feet because the base of the mountain is around 8,000 feet. But the ascent was brutal. It was incredibly steep, but the real challenge was navigating the mud. Most of the trail was either very slippery or so thick with mud that your shoes would get stuck without being careful. After about an hour of intense hiking we took a rest break at a small clearing. Our guide smiled at us and said, “That was the easy part.” It’s great when you know your guide well enough that they can joke with you like that. Unfortunately he wasn’t joking. Somehow it managed to get steeper and muddier. At the top of Bisoke is a beautiful crater lake that makes the trek worth it. Supposedly. We didn’t get to see the lake because when we reached the top (after around three hours of hiking), it was so foggy you could only see ten feet in front of you. On the way down we had apparently gotten to know our guide well enough that he felt comfortable joking with us. At one point he shushed us and whispered, “Gorilla!” The volcano is one of the few regions in Rwanda where the gorillas live. For at least three to four minutes we stood as still as possible, our boots sinking into the mud. It was then that our guide said, “Gotcha! There’s no gorilla!” As funny as it was, it was tough to smile. When we reached the bottom, the clouds at the top were just starting to part. I tried to get a group interested in going back up to see the lake, but for some reason no one felt compelled to do the hike all over again.

As it turns out, Jonathan and I’s hospital is about thirty minutes away from Mount Bisoke. Although it’s tempting, we probably won’t do the hike again.

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Mud, mud, and more mud. This picture doesn’t do justice to the steep incline of the mountain.

 

Akagera Safari

This past Saturday we went on a safari through the Akagera National Park. The trip lasted about six hours, most of which we spent sitting atop our Land Cruisers enjoying the wildlife. We started out in the densely vegetated southern part of the park and made our way northeast along the Tanzanian border. Initially, we only saw some water buffalo and baboons. But as we made our way onto Lake Shore Road (the park is scattered with lakes) we began to see hippos, a massive Nile crocodile, and some African eagles (they look very similar to bald eagles). The winding road eventually led to the savanna, but before we could get there our vehicles suddenly stopped. Just twenty feet in front of us there stood a family of giraffes, right in the middle of the road. Seeing them run was quite a spectacle—their legs seemed to barely move but their heads glided rapidly some eighteen feet above the ground. By the time we reached the open savanna, there were dozens of zebras and impalas grazing with each other in harmony. There were also wart hogs trotting across the savanna (they had a striking resemblance to Pumba, but sadly there was no meerkat to serve as Timon).

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My favorite was probably the impala—they were jumping as high as ten feet in the air, virtually from a stand still!

 

Miscellaneous

During the evenings I’ve been keeping busy with a range of different activities. Sometimes we play ultimate Frisbee or basketball with some of the locals (despite ever having seen a Frisbee before they pick it up very quickly). I also taught my host family how to play some card games—Crazy 8’s, Black Jack, Egyptian War, and even Killer. They love playing cards. Last night Jonathan and I made peanut butter cookies for them, which was a real treat since they don’t have an oven and thus rarely have baked goods. The cookies didn’t taste quite like they usually do, but they still brought smiles to our host family—mission accomplished.

Last week I met Herve Kubwimana, a friend of a friend of a friend. Herve is the director of the Africa Innovation Prize, a nonprofit that strives to “inspire university entrepreneurship in Africa” with annual business plan competitions. He offered some great insights into the economy of Rwanda and how the unemployment rate, even for university graduates, is quite high. One major problem, he said, is the prevalence of humanities majors—economics, language, business management—and lack of technically trained workers. At some point I want to visit The Office, which Herve described as a co-working space for people trying to build businesses in Rwanda. Sounds pretty cool!

It’s hard to believe that the trip is 1/3 over, but I’m excited to get to the hospital to start fixing medical equipment.

 

 

Bonus Picture:

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People traveling on bikes hitch rides up the steep hills. The really scary part is when the car they are holding onto tries to pass another one (Rwandans like to cut it REALLY close when it comes to driving).

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