Once more, with pictures!

Hello again!  I'm checking in after a busy first month here in Rwanda, and everything is going well so far!  As I detailed in my last post, I've been working on learning about the way that the health care system works here, and how people exchange information to treat patients.  It's been an interesting process so far to learn a new system, meet dozens of new faces, and get out and about in the villages surrounding my home base of Ruli.

I spent the first week or two just getting used to the hospital, and learning my way around the system.  Ruli Hospital is a district hospital, the middle ground between the primary-care oriented health centers and the specialized referral hospitals in the capital, Kigali.  It's a busy place, averaging 40-60 outpatient visits daily, and performing around 60 surgeries, delivering close to 100 babies, and giving hundreds of vaccinations each month.  In addition, it offers physical therapy, dentistry, and ophthalmology services to the local population.  With all these resources and people in one place, it's a complicated machine.  For my first weeks at the hospital I found myself in a constant deluge of introductions and welcomes, and I was struggling just to keep up.  Simply remembering everyone's name and where they fit into the hospital system was a small victory in itself! 

Since then, I've gotten to know a number of people fairly well.  Though there are too many to list them all here, there is one who deserves special mention.  My partner in this project is Delphine, a Ruli native with great ideas and vision for our work.  In addition to lending her mental faculties to The Ihangane Project, she serves as a phenomenal translator and source of cultural understanding.  To top it off, she's finishing school to become a radiographer, and this experience allows her to come up with insights into the Rwandan medical system that a newcomer like me would take months or years to think of.  With her help, we've been able to make the most of our time here so far!

After taking time to acclimatize to the hospital environment, we have spent a few days traveling to some of the health centers that refer patients to Ruli Hospital.  We're spending most of our time in the village of Nyange, as this is where we hope to begin using the information that we're gathering about information and patient flow to create a tangible product: improvements to the referral system between health centers and the hospital. 

Once or twice a week, we have been making the trip to Nyange to build relationships there and gauge the best way to improve this process of communication.  The roads in Rwanda aren't the best.  In fact, in many cases, they are really “roads” only in the loosest sense of the word – and the road to Nange is particularly bad.  The village is only about 10km away, but it takes between an hour and 90 minutes to go each way.  Although I'm sure it will all be worth it in the end, the fact remains that four rides per week in this rough terrain takes a certain toll on a traveler's tailbone!

And so for now, I must go to nurse my injured coccyx and spend some time analyzing the heaps of data we've been collecting.  I'll be back in a week or two, internet-permitting, of course, with more East African updates!