Tuesday, July 8, 2008

A Blog is a funny thing

It's like reading a diary from back to front. If you haven't been following along the whole time you'll probably prefer to scroll to the bottom and read the posts in the order that they unfold. Otherwise, by reading from the top down, you get the end of the story first.

I've sent my reports to AIUM, SDMS & SVU. I've still got to send letters to some of the other donors. I've been invited to return and I'm in the early stages of working with KHI faculty, Lori Kimbrow and some other sponsors to return with a team of sonography experts in June 2009 to continue the effort of sonography education for the clinicians @ the district hospitals as well as any other persons who are interested in learning more about sonography.

If you've been following along, please add a comment so I can know who it was who was reading along from San Diego, Albuquerque, Ohio, Australia, Birmingham, Hanoi, England, Washington, New Jersey, Koala Lampur and all of those other places.

Tuesday, July 1, 2008

Wrapping it up - Final Report

The full report including issues and possible solutions can be accessed through this link. click here for full report in PDF format. The main jist of the report is found in the following:
Conclusion
  • There is an immediate need for initial and ongoing sonography training of those who are currently performing the exams in the district hospitals. This could be easily coordinated through KHI and should be seen as an opportunity for Kigali Health Institute.

  • There is a need to increase the level of training for the graduating Rwandan physicians. I am ignorant concerning the methods for change or ramifications for affecting this change but nevertheless see it as a very real and practical issue.

  • There is a need to codify and ratify the professional description of a sonographer within the Rwandan medical delivery system.

  • The medical staff will be accepting of individuals who are qualified and certified sonographers

  • There are currently Rwandans who are capable of obtaining the training and appropriate certifications to practice sonography in Rwanda but not within the country.

  • There is currently not a single acceptable clinical mentoring location within Rwanda.

  • The question of will, national pride and long term resources must be considered prior to implementing a Rwandan Sonography program. Alternative partnerships and non-standard methods of training may need to be considered if there is a desire for sonographers during the next 5 years.

Wrapping it up - List of Tens, , , , well around ten :-)

Ten ways I know it's time for me to go home from Kigali:

  1. I've decided to strangle the next person who calls me muzungu
  2. In a conversation with an American I answer "Oi and merci" instead of yes and thank you
  3. All the mulberries are gone
  4. My food supply left in the cupboard/refrigerator consists of a bag of salt, some margarine, 5 tea bags, some stale couscous, and a box of hot breakfast oatmeal.
  5. The water goes out for two days and I have a blow-out with the house boy - Philbert
  6. My $10 of Skype credit is getting close to zero
  7. Matatas - I can actually understand the Matata drivers, conductors, Can rapidly assess the quality of each matata, Look forward to the rides and The people (ticket agents and beggars) @ Atraco bus lines know be by name
  8. I realize I haven't had a single solid stool in the past 60 days
  9. I can walk up any hill without getting out of breath
  10. I start making a top ten list
  11. I'm able to quote food prices at @ Kimironko market

Ten Things I was most happy to have: (Either brought or acquired) (with input from Terry Loughnan)

  1. Kodak EasyShare DX6490 Camera - With 2 Gb SD Card & docking station
  2. My own pillow
  3. A cell phone that worked in Rwanda
  4. Laptop with wired and wireless connections, Skype with a headset and video camera on both ends of the earth.
  5. Fresh, clean and crisp, 2004 and newer $100 bills
  6. A nice large day pack
  7. 2 Mb USB Jump Drive
  8. Electrical Adapter Kit + Extra adapters
  9. Storage trunks
  10. Leatherman Tool
  11. Audience Response system for teaching
  12. I-Pod with speakers, my music and charge kit (Terry Loughnan)
  13. A big Sudoku book (Terry Loughnan)
  14. Light clothing and light hiking boots rather than heavy (Terry Loughnan)

Ten things I should have left home:

  1. Inflatable Thermarest sleeping pad
  2. Direct box for connecting autoharp to a sound system
  3. PDA
  4. Rolaids chewables - 3 packs
  5. Spare batteries
  6. $20 US bills (Terry Loughnan)
  7. Jacket (Terry Loughnan)
  8. Taste for coffee, because I didn't have a good cup whilst here (Terry Loughnan)

Ten things I really wished for while in Kigali

  1. Having Shaloy with me
  2. Petting a pet
  3. My own transportation
  4. Safe water from the tap
  5. Water for showers
  6. My kitchen and it's utensils
  7. Better maps of Rwanda/Kigali
  8. A smaller laptop
  9. My church/Sabbath School support group/friends
  10. French lessons before arrival in Rwanda

Ten Restaurant reviews in Kigali, Rwanda

  1. Serena Hotel - The Mongolian Grill Buffet on Wednesday evening is the best value in Kigali. All you care to eat buffet with a salad bar, 1st drink, Mongolian Grill, hot bar with multiple choices, desert bar and fresh breads in the most upscale location in Rwanda. It feels like America for only 8,000 FRw or $16 US
  2. Indian Khazana The atmosphere is exotic with a wait staff dressed in fantastic Colonial Indian garb. The menus is extensive with many options for vegetarians. The staff is attentive without being obtrusive. The food is delicious and authentic but you should expect to pay between 8 - 10,000 FRw or $16 - $20 US. A great place for a birthday.
  3. KBC - The best lunch buffet in town is a hole in the wall on the north end of this complex of shops. Next door to the African gifts is a small shop with no external sign but from 12:30 - 2:30 some of the best lunch food in Kigali is served here. Expect to sit wherever there is a seat as the place will be packed. A great selection of well prepared local fare with multiple meat dishes which always had options of beef, chicken and fish. an assortment of salads, potatoes, greens rice dishes with some fruit and a glass of juice for 1,800 FRw $3.60 US. Food is cooked elsewhere but brought in for lunch only.
  4. Africa Bite - In the Kimihurura district two blocks down from Rue 1. This is a hopping place at lunch time with a great buffet of tasty authentic African dishes for 2,500 FRw or $5 US. 1 drink and a fruit desert included. A good value @ lunch time it changes character in the evenings as a quite reserve from the hubub of a Kigali day. The quiet garden seating is a great place to spend a few hours quietly visiting with friends. A limited menu in the evenings but the kebabs are a great value and the weekend chef specials would be your best options.
  5. Ice and Spice - Tasty Indian cuisine in Mumunge. It's a little less expensive than Indian Khazana but has none of the class. Expect to pay 6 - 8,000 FRw. ($12-$14 US)
  6. KIST Canteen - The cafeteria service of Kigali Health Institute (KHI) and Kigali Institute of Science and Technology (KIST) provides a wonderful meal value to the faculty and students. Traditional African fair at a very reasonable price. Nothing fancy about the atmosphere but it's close, good flavor and cheap. The secret is that there are options but you've got to ask. These include Kinyomoro juice, fresh pineapple desert, chapats and African tea are all extra but you'll leave with having spent between 1,500 & 2,000 FRw ($3 - $4 US)
  7. King Faisal Hospital Food Service - Hit and miss but mostly miss. Expensive for what you get. It's only saving grace is that you don't have to leave to eat. My suggestion, , if you have time , , leave to eat. There are a couple of small restaurant options on the road approaching the the hospital. They are all better and cheaper.
  8. Flamingo Oriental Food - just down the street a few hundred meters from Africa Bite. Upscale dining hidden in a a neighborhood. You won't wander wander by and find this place by accident. Call ahead to get seating upstairs for a great view of Kigali by night. Service is above average with hot steaming, minted towels given before eating and to refresh you. The combination of atmosphere, service and good oriental dishes makes it a good option if you're okay spending 6 - 8,000 FRw ($12 - $14 US)
  9. Karibu - Just down the street from CHK hospital and around the corner a couple of blocks from KHI is a good value for lunch. 2,500 FRw ($5 US) is a great lunch buffet with outdoor seating in a gravel courtyard. Drinks are extra (standard prices) but the fruit desert is included. The best part of this restaurant is the options. It's standard African fare but there will be around 18 different dishes prepared and available.

Getting Home - To Chattanooga


Even though it was after 2 a.m. when I crawled into the lower half of the bunk bed I awoke around 7 without an alarm. The shower was open and I revelled in hot water and plenty of water pressure. I quietly had all of my stuff collected and the room triple checked by 8:00 am. A few minutes later I was standing @ the ticket counter buying my one way into London Bridge station. Eight o five I'm on the train, moto in hand, pack on my back I'm on my way to Heathrow through.

I didn't have to wait for more than 5 minutes for any of the connections on the tube but it's almost 11:00 am by the time I arrive at the Heathrow. I don't know which of the 5 terminals to go to and first go to terminal 2. The guy @ excess baggage is helpful and I hurry back toward the correct terminal #3. I'm almost there when I realize that both my hands are free, which means I don't have the moto. That panic feeling quickly hits and I can't remember if I left it on the tube train or @ the excess baggage. I'm trying to get back before my 24 hours is up and they charge me for "each portion of a day". We've gotten this far without losing it so it's worth the retracing of my route. Run the ten minutes back to excess baggage to find it sublimely resting on the counter. Then hurry back to terminal #3 and excess baggage. The cost is 36 pounds because I'm 24 hours and 20 minutes. I explained that I'd gone to the wrong terminal and the guy drops the extra 20 minutes and 18 pounds of fee. It feels like it's going to be my day!!

Hurry to American Airlines ticketing and there are no lines. Yes there are three flights today and for $200 extra (Non-refundable) I can take my chances and fly standby. The first flight is not too full and I have a good chance (I'm standby passenger #8). The 2 p.m. flight is very overbooked and the so is the 4 p.m. Things are going my way and I want to get home so I pass the credit card and hurry over to baggage check in. They take my bags and only charge me overweight on one. Print the boarding pass and tell me that the plane is a bit late but is boarding now. . Not only is it a long distance between this place and the plane but I have all of British Air Authority (BAA) screening to pass through. I run up the escalator through pre-screening and then hurry through passport and boarding pass check, then through declarations, then wait for the X-ray, then personal screening and metal detectors then through immigration where they stamp my passport out of the country and into the huge duty free plaza waiting area. Past the food court and the throngs that are shopping and down the passage ways to boarding terminals into another que and they check my bag and boarding pass again. At the gate counter they ask me to wait in a special section with the other standby passengers. Boarding has just begun and there are eight of us hoping for empty seats. Had the plane left on time the last five might have gotten places, but with the delay other stragglers with confirmed seats were able to make the flight.

One of us already had a confirmed seat on the 2 pm flight. I'm number four on the standby list for that flight. They issue me a new boarding pass for that flight and assure me that my luggage hasn't left yet. Unfortunately we are not allowed to wait in these terminals and must recycle through security. It's after 12:30 and I haven't eaten yet. It's only an hour before boarding begins, so a trip back into the duty free area will give me a chance to grab a quick bite. Through customs, x-ray screening, metal detectors and I'm back in the lounge area and filling my empty water bottles. As I'm waiting in a food line for my sandwich, I realize my hands are both free. In the rush I've left the moto somewhere but I've only ten minutes to eat and get back to the terminal for boarding. Once at the terminal and checked into the standby area I ask the friendly counter staff to call back to American's ticketing and baggage area to see if it's been turned in but to they don't have it and there is certainly no time to check with BAA before this flight departs. American Airlines has overbooked perfectly and though they get reassigned seats every passenger with a confirmed seat who arrives in time gets on. But no standby passengers are seated. There is still the 4 p.m. flight but when they issue my new boarding pass for this flight they tell me eight new passengers are waiting standby for this flight and they all have priority over me.

At least recycling through customs again will give me a chance to check with BAA for the moto. This time through there is an American just ahead of me and he's being quite the pain to the BAA people. Loudly complaining about the process and how it's not this way in the U.S. @ home we take off our shoes here we can leave them on. At home the computers come out of the bags but here you leave them in the bags. He's being obstinate and no amount of encouragement from his wife can get him to comply without complaints of "they ought to all agree on the same screening!". We ended up next to each other in the final x-ray screening area. I don't know what came over me, but I commented to him that I had once had a boss who had two types of employees "flexible and former". IT startled him that another passenger had said something so he asked "What?" and I reminded him that adaptation was a key quality of the success of the human race. Based on his glare, I perceived that this was not a teachable moment for him and was glad he didn't punch me. The supervisors @ BAA had a whole heap of left items but no moto (it's gone, I hope whoever got it enjoys it). I had an extra 20 minutes in the duty free area to scope out where I might spend the night if I didn't get on the 4 p.m. flight. The flight is overbooked and 12 standbys seems pretty dubious, but I've got nothing else to do so I head to the terminal again.

The four of us from this morning are becoming friends. There is a young lady returning from volunteering in southern Africa. She missed her AA flight this morning when her South African Air incoming was delayed two hours. She is on her way to Fort Wayne and is out of cash. She's looking forward to getting on the flight for the food. There is a couple from St. Louis who have been touring Ireland. They had not planned for the long ques they encountered @ 8 a.m. and by the time they got to the ticket counter their seats had been given away to standby passengers. The other 8 standby passengers were the overbooked folks from 2 p.m. who had missed the flight.

The plane started loading first class and business class, no standbys called. Then group 1 and then group 2. A standby woman with two small children was called up. Group 3 and another woman with two older kids were called. We weren't surprised when the young lady from Indiana got a seat as she was #1 standby for the 2 p.m. flight. We cheered and clapped when her name was called. Group 4 was called and they called for couple from Missouri. I hooted for them and they wished me luck. There was another woman with two kids but luckily for me just one seat left and she wasn't going to send just one child or leave them both so that left the last seat, , on the last row open , , , , for me!!!
I'm @ Chicago's O'Hare International just after 7 p.m. I'm through customs by 8:00 pm. I call and leave a message on my wife's cell phone to let her know I'm in Chicago. I've heard there is a train I could catch to South Bend, Indiana. South Bend is just 30 minutes from my daughter's home and Shaloy is visiting her this weekend as well as attending the Thomas family reunion today. Someone recommends a bus to South Bend and shows me where to catch it. While I'm waiting I borrow a phone to leave a message I'll be in S. Bend around 1 a.m.. Shaloy, Tria and Ben are waiting when I arrive. Thirty minutes later we're at their house in Berrien Springs, Michigan. Although they both had work Monday we couldn't go to bed until after 3 a.m.
I enjoy another warm shower Monday morning before Shaloy & I start the 10 hour drive back to Chattanooga. We enjoyed holding hands and having nobody else to talk with. We didn't even care when we took a wrong road and added an extra 2 hours to the trip. I was only gone 8 weeks. It was busy and exciting and new for me but for Shaloy it was just a long slog of having to do her work and mine as well. We both agree that it's too long to be apart.

Going Home via London

Once I gave my goodbyes to Saidi, Betty & Abdhula I had a brief wait before being allowed through security. After Rwanda Air Authority x-ray scanned my two black trunks, looked in one of them and stickered them cleared, I duct taped them shut with the last of my roll of black tape. (the tape was still intact when I arrived home). Of course I was overweight on one of the trunks and had to pay extra. I'm carrying one bag about the size of a purse, my backpack (with all the clothes I need for the next four days, my pillow and the wire moto.

Inside, I've got a couple of hours before departure. In the lounge area I meet a group of Indian military officers. They are on their way home for a few weeks of leave. They've been assigned to the United Nations peace keeping force in Democratic Republic of Congo (DRC). A very nice group of men who offer to share their lunch (I decline because I'm still stuffed from KBC). It's a delight to be able to visit with them about their observations concerning DRC and mine in Rwanda. Individually and as a group they are the kind of guys with whom I could become instant friends. They like the wire moto.

The Ethiopian Air flight is on time and we walk across the tarmac and up the stairs. First class enters through the front set of stairs, economy through the rear. The plane looks new and I've lucked out and gotten the seat by the emergency exit (lots of leg room) and the man assigned to the seat next to me decides to move to an empty row further back. There is a movie screen that shows our current location and flight information. I'm reminded just how small Rwanda is , , , in less than 45 minutes we've left Kigali (in the center of the country) and we're out of the country. The meal was delicious and soon we arrive in Addis Ababa, Ethiopia.

I've got a 3 hour wait and take the time to get a accommodation reservations for London using hostelworld.com . I find a Queen Victoria hostel which has good reviews except for the location which is "Superbly located only 20 minutes from the world's most famous and historical bridge 'LONDON BRIDGE'". It's okay by me especially since I can't find anything else that's available for a price I'm willing to pay on a Saturday night. I book the reservation and write out the information as there is no printer. As I wander around with my two bags and moto, I find a cafe selling tiny cups of coffee and giving away popcorn. I'm not interested in the coffee but as I sit I see they have a juicer and I can get fresh squeezed orange juice @ $1 US per large glass. I'm on my 3rd glass when a couple of the Indian military guys join me. They want the coffee and had some from this place on their way in to DRC. They claim it is pure nitroglycerin, super charged. I'm not surprised to find that one of the doctors is a psychiatrist. Some of the things that the UN peacekeepers are forced to do (or not allowed to do) as part of their "Mandate" would really be disturbing to rational people. Things like: burying your left over food so that no one gets it and starts a riot (and then allowing the little boys to slip in at night to dig through the dirt down to where the food is).

At a bit before midnight we are allowed through security. Even though I have my boarding pass I have to go to the counter and get a special sticker. What's happened is that there are enough seats but many of us are assigned to the same seats and have to be re-assigned. Down to waiting buses that take us across the tarmac, out to the plane to climb the stairs. I'm at the back of the line and get a few minutes to enjoy the cool night air. The flight is good, stewardesses accommodating, food is great, plane is clean and new, I'm holding the moto in my lap, electronics all work and my digestive system chooses to have bout #2 of purging. I should have just switched with the man in the aisle seat next to me. He didn't get his full nights sleep as he was large and would have to get up to let me out of my window seat. My anti-diarrhea meds are in my trunks. Just after the sun comes up we arrive in Rome and the plane loses 2/3rds of the passengers while it picks up some fuel. A couple of hours later we're landing @ Heathrow.

I expected that as soon as I arrived in London I'd be able to understand all of the conversations but London is a cosmopolitan city and Heathrow a major international airport. I'm still hearing many tongues I'm not able to decipher. It's pretty quick through customs and I've got my trunks. I spend a couple of hours exploring my options with my 110 pounds of luggage. I end up using the obvious solution of storing them with Excess Baggage. As I'm getting ready to leave I realize I've almost forgotten the moto sitting on the counter.

Down to the "tube" I start the 1.5 hour trip into London. Someone in Kigali had told me to get an "Oyster Pass" and the helpful worker down in the Tube area confirmed I'd get the best rates and have the easiest time of traveling if I used the pass. I have to remind myself repeatedly that although I'm on a grand adventure the people around me are doing their everyday lives. The moto gets quite a few looks as it is quite unique. I have to change once to get to the London Bridge station where I'm to board a train which is to get me to Woolwhich/Arsenal.

It takes a while but soon I'm on the platform and 15 minutes later I'm leaving central London and on my way to my accommodations. Twenty five minutes and I'm off the station and walking through the suburb of Woolwhich. Five minutes later I'm standing outside the Hostel but the doors are all locked. I can see that the upper floor windows are all open so I stand on the street hollering "Hallooo" until a head pops out and says they'll let me in to wait for the proprietor. It's taken almost 3 hours to get here from Heathrow. The owner wants to know about the moto.

I'm given fresh linen for my bed but there are no towels provided. Once in my room I find that the bottom of one of the four sets of bunk beds doesn't have a backpack on it so I assume it's the one I'm supposed to sleep in tonight. My seven roommates are no where to be found. I stash the moto under my pillow and sort through my stuff. I've got no shampoo and head down the street to purchase some and get some food. Once back at the hostel I find the shower and all the warm water I care to enjoy (I could really get used to warm showers). It's 3 pm and I'm clean, I've made my bed I'm full and I want to see London.

Back to the train station where I enjoy the 25 minute ride back into London. At London Bridge I get off to explore the River Thames. I recognize some of the sights and although the area is packed with pale skinned people I hear only a few conversations that I can understand (lots of French, German and a smattering of Asian dialects). Lots of couples holding hands and getting their pictures taken in front of the sights and I'm suddenly very homesick for Shaloy's company. She is spending the weekend with our daughter who lives near Chicago and will be at her family re-union in Midland, Michigan tomorrow. Wander to the Tower bridge, wander to the castle, wander to some of the modern architectures and get some pictures, wander to the memorial to merchant marines who've been lost @ sea. As evening approaches the streets are filling more with couples and groups of friends. I get some food and find an Internet cafe. A search for Irish music and I find a place that has music in the room upstairs from a pub every Saturday night. I get directions and catch an evening bus in the right direction. I'm able to find my location on the map and walk to the pub. It's at the end of a dark street in an area I'd call "Little India" based on the number of hole in the wall Indian restaurants. The streets smelled of curry. As I approach the address an alarm starts to go off. The pub is dark and there is no on around. The alarm is coming from the business next door whose plate glass window was recently shattered by a heavy object. I can hear sirens approaching and decide to stroll away as the London police arrive to investigate. By now it's after 9:30 and I decide to go to the hostel. I'm starting to consider catching an early flight home.

My main issue is that Woolwhich/Arsenal is so far out that it is not on any of the maps that I have or find. I head in the general direction of Southeast London by train. At the end of the line I ask which street bus to take and I'm directed to the bus station down the street. Down the street is a 25 minute walk. The driver suggest I take bus #40, , , , , no bus #38 , , , , no actually you can take my bus to , , , , no , , , really you should walk back to the street and take bus #45 and let the driver know where you want to go and he'll tell you which connector will get you there. Back to the street I see the bus but it won't stop except at a bus stop. I follow it down the street and come to a corner where pedestrians are not allowed to cross. Instead of crossing, I enter a well lit "pedestrian subway" which takes me under the street (to avoid mixing vehicles and pedestrians) but under the street there are 5 options of tunnels. I take my best guess but when I pop up on a street I don't recognize it as being the opposite side of the street I entered. Now I'm really turned around and start to ask directions but the only guy I can find is from Brazil, is also lost and has been looking for the Chinese restaurant and his friends for the past hour (Do I have a cell phone I can lend as his is now dead?). I eventually find a parked bus and ask the driver who tells me to take bus #30 across the river and the driver will tell me where to get the connection. However, he doesn't know which stop #30 will stop at but there are lots of bus stops around the corner and just look at each one until I find one that says #30. I don't find #30 but do find the tube and decide that at least on the tube I can navigate back to London Bridge and catch the train home.

I arrive @ London Bridge station and the first thing I hear over the public address system in the tubes is "Last car on North Line is leaving in 2 minutes!" Great!#$! the tube is closing for the evening. Lucky for me I'm not riding the tube anymore, I'm catching a train. Up the stairs and I quickly see that the entrance to the trains is dark, quiet and obviously has been closed for a while. I'm not in despair as I know there is a system of night buses but which one?? Woolwwich Arsenal is off all the bus maps in central London. I decide #48 will get me in the general direction but where is a bus stop for that bus?? I see the bus and where it stops and dash the two blocks to jump on. "Yes, , , If I ride this bus to where #53 crosses I can get a bus to Woolwhich" It's now well after midnight and the ride takes almost an hour until we reach the crossing where I switch. We've picked up and dropped off many of the revellers who stagger onto and off the bus. They are loud, obnoxious and uncoordinated but they seem to find their way. Thirty five minutes later I recognize that we've just passed the hostel, ask to be let off and walk the few minutes back up the street.

It's close to 2 am and I'm happy to find my bed as I left it. Only four other sleeping bodies are occupying bunks. I assume the rest are the young people I passed on the way to my room. I'm done with London. In the morning I'll take a shower, grab my moto and head to Heathrow first thing and standby until I can catch a flight home.

Link to all of my London Pictures