Day 2 Centre Hospitalier de Kigali

What a pleasant day. Visited with Shaloy over the Skype connection this morning at 5:40 AM which is 11:40 PM at home. I got the new webcam working so we could see each other periodically. The consistency is coming slow but it's much quicker to be live talking than any other method. We've had lots of problems with echoing on Shaloy's end of the connection. I'm naturally a morning person and Shaloy is naturally a late evening person, , , so this actually just might get to be our normal gig. I had to leave our visit before I wanted because it's taking longer to get ready with no running water. I'm oily skinned though and MUST shampoo my hair every day to be presentable. The first morning without water I sacrificed some of my boiled drinking water.

Pleasant greetings when I arrived at CHK @ 7:45. Both of the Radiologists are real jewels. Dr. M is from Tanzania. I was quite impressed that this morning he had all of the radiography students in the reading area and was giving them a kind fatherly lecture about being good people and life long learners. Of course I had to mention that "Every day you don't learn something new, , , , is a wasted day!!" (so predictable). I worked with Dr. C and helped teach Dr. Lando today. Dr. C is quite a skilled sonographer as well as a super Radiologist. He is kind a patient with the patients and the rest of us working around him. He is willing to learn and to teach, , That makes him an A#1 in my book. Dr. Lando is a primary care physician who is wanting to add sonography to his practice. Most patients were scanned by at least two of us and sometimes three. Luckily it was slower morning and we only scanned 23 patients between 8:30 and noon.

Pathology Wow: I've seen more pathology in the past two days than I'd see in a month in the states. Today I saw four very advanced stages of metastatic or recurring carcinoma, gall stones, multiple patients with lymph nodes some huge, too many ascites patients to remember, a number of pleural effusions, cholelithiasis, renal cysts, some portal hypertensions, too many splenomegalies to remember, cervical carcinoma, advanced bladder carcinoma, Thyroid with a mass so big it looked as though the man had a racquetball under the skin under his chin, uterine fibroids enlarged with pregnancy. All that on only 23 patients.


I scanned just four more between 2:00 and 4:00 pm. Afternoons would be the time to get a radiographer to teach one on one. Today I decided I would try for the next few days to see how they liked having a skilled sonographer. If I can convince them of the value of freeing up a radiologist for that time then perhaps they'll consider assigning one of the radiographers.


Processor time: trying to win a few friends. When I arrived I was surprised to see a sheet laying outside of the imaging department on the cement. The sheet was covered with Radiographs drying. It seems that the Protec processor dryer section has been down for 3 months. So in the day time (if it's not raining) the set them out to dry. At night they hang them on a view box to dry for around 90 minutes. I spent about six years running a processor maintenance service for extra cash. So the first day I volunteered to take a look at it. The department manager did not want me to do anything without the maintenance people being present so we made an appointment for 2:00 today.




I'd brought my leatherman multi-tool and a T-shirt to change into while I worked The problem wasn't hard to find. I removed the blower tower and unscrewed the the inline heating element , , it was obvious that it had simply burned up (melted most of the bottom row of element wires). Hmmmm that seems odd. I remembered I'd seen a non-functioning processor that looked similar in another room. The maintenance guys said that they'd already swapped out the heater and that this was the second one. Hmmmm I asked if I could have the old burned out one since it didn't work any way and what more harm could I do. They were a bit hesitant but agreed. So I lay on the floor and traced the wires back to the circuit board and pulled the wires. It was just too tempting to pass up. The people standing around could only see from my pelvis down and they knew I was reaching up into the guts from below. So I gave a little shout/scream/gasp and start jerking my legs as though I was being electrocuted. I didn't get the full enjoyment because I couldn't see their faces, but the gasps and sudden jump back that I could percieve was a great ice breaker. As soon as I started to laugh they realized the joke.


After getting the element out, the maintence person said the blower was bad as well. I reached down into the blower expecting to be able to easily rotate the fan but it was solid as a rock. I asked if they had already scavenged that as well and they said yes. So I unscrewed it and asked If I could have it as well. More hesitancy than before and the maintenance person did not want to have me lose or damage the housing while trying to get the motor repaired. He finally acquiesced and then I had to do my best persuasion yet to get him to agree to let me borrow the service manual for the evening.

We put the processor back together and they started to use it again, , couldn't be any worse than it had been for the past 3 months. I found a quiet corner and started to read the manual and documenting the specifications so I'd have them without having to remove the manual from the department. Then I took another look at that blower. Hmmmm something's not right... Somebody had rigged a fan into the housing, but it was the wrong style of fan. It was configured so that there was absolutley no way that any air was going to move out the blower end. So now I knew why the heating element had burned out, , , no air flow....



I explained to the manager what had happened. I told him that I thought I could fix it or rig it to work until the part could arrive next week (estimated date of arrival according to maintenance). He said he'd been told next week for 3 months... I decided to scope out that other processor and found that the heating element had not yet been removed (as previously asserted by maintenance) but that the blower motor and housing had. I also found that the black tower on this unit was missing the fan that was present in the other processor's tower. Hmmmm, ,, , on closer inspection of the processor being used, someone had installed a personal computer cooling fan and had hung it in the tower and jump wired it into the circuitry to get some air circulation..... Hmmmm. The radiographers said there was never enough airflow even when it was heating.... I can see why..

So solution, , , install good heating element and retrieve other blower and housing from maintenance, take the motor out and have it rewound at the closest electrical motor repair and we're back in business... If they can reach maintenance, , , nope gone for the day. So I take the rigged housing and head out to find a solution. I caught my ride on time, asked to be dropped off in a likely section of town and commenced to try and find a motor repair shop that might have a squirrel fan motor assembly that can be made to work. Five shops and a half mile of walking and I've found someone who speaks a bit of English and knows a man who can help. Twenty minutes later a squirrel fan is delivered and is plugged in to show me it works. We took it out of it's housing and attempted to mount it into the processor housing.. Holes aren't right, fan is too narrow and the blades send the air the wrong way, , , , but if I leave it I'm assured they'll get it to work somehow for only $45,000 Rwandan Francs..... Hmmmm, , , If it gets bunged up and the real motor arrives but can't be used because of me, I won't have helped the situation. No deal but they said, if I could bring the other fan/blower assembly they'll rewind the electric motor for only $15,000 FRw. Collected my stuff and agreed to come back tomorrow.


My hands were filthy from disassembling two blower fans but where can I find a bathroom. about a half mile away I came to a nice American style shopping area and was able to use the restroom for $100 FRw. As the sun went down I started to walk to look for groceries for tonight's supper then vacillated and decided to walk to a restaurant instead of shopping commuting and then cooking. I didn't really get lost but couldn't find the restaurant and kept walking, , then got were I couldn't find a mototaxi, kept walking and walked out of the section of the city with street lights and kept walking, saw a major road that I recognized but there were physical barriers that kept me from getting to the road and walked another 1/2 mile along dark side streets until I could reach the road. Another 1/2 mile and I found a gas station where I caught a moto and arrived at the guest house a around 7:30pm. It had been dark for 1.5 hours by now and Dr. Konn was quite worried that something had happened. Gotta love those cell phones (but I hate to get one for only 8 weeks). Supper was done by 8:30 and we'd have washed the dishes buttt, , , there's no running water and none delivered today.