Rwanda Day 1: Getting there is half the fun!

Jan 20, 2018

Coordinating the safe and timely travel of 2 physicians, 2 paramedics/RNs and 1 Rotarian from 2 different states and 3 different cities is no small undertaking. In addition to personnel, we had the added challenge of getting 300+ pounds worth of medical training equipment including CPR mannequins, needle decompression trainers and oxygen bottles to Rwanda with us. We found out about 4 weeks before we were to fly that these things aren’t readily available for purchase where we are headed.

We are going to Kigali, the capital of Rwanda, to teach. Our mission is to help build and solidify a formal EMS system with top-notch Prehospital trauma care. Ambulances in Kigali are currently operated by SAMU, but the providers are nurses rather than Paramedics or EMTs. That’s because there are no formal EMS certifications or programs there. Our aim is to provide the current workforce with prehospital-specific trauma training to improve provider safety. 50% of all EMS calls in Kigali are for motor vehicle collisions (MVCs). MVC trauma is a major cause of morbidity and mortality across Rwanda.

We carpooled from Richmond to Dulles. Basil, the creator of the Trauma Course content, was kind enough to offer up his Ford Explorer. More challenging than the traffic on I-95 though, were the back seat drivers offering our opinions on the best route. Dr. Sudha, a Trauma Surgeon and myself, an Emergency Physician – we are accustomed to being the pilots.

Fortunately the traffic gods showed us mercy, and we arrived at Dulles slightly ahead of schedule. The next challenge – get the 300+ lbs of luggage and equipment from the Explorer into the international terminal. It didn’t take long for the bellcap to notice me struggling to hoist a gigantic red backpack onto my back while desperately reaching for my rollerbag that was attempting to escape into traffic. He hurried towards us with his cart and began stacking our ridiculous assemblage of oversized bags. I can only imagine what he thought of us – between the bags marked “adult/child/infant” and “torso,” he must have thought we were body smugglers or really bad parents.

Inside the terminal, he unloaded our bags. I reached for some cash, knowing I was one of the few of us with smaller bills. In our pre-trip prep, Sudha advised us ahead of time to get $100 bills from the bank. In Rwanda, the larger the bill, the higher the exchange rate. I handed him the money and was met with a confused look. “Not enough, I said?” feeling confused and bordering on embarrassed. He mumbled something unintelligible but his face told me it wasn’t good. Frank, the Rotarian accompanying us on the trip, quickly slipped him more cash, which seemed to placate him as he then scurried away.

I have Dr. Sudha to thank for the opportunity to be on this trip. She’s a fellowship trained Trauma Surgeon with a focus on International Medicine. She and I have worked together for over three years in the Emergency Department at VCU taking care of trauma patients who suffer accidents and injuries throughout Central Virginia. She first travelled to Rwanda 7 years ago during her fellowship and has since made over 20 separate trips. (I get the sense she just stopped counting at some point). In October 2017, she was awarded 3 grants totaling over $700,000, one of which was from Rotary International; hence Frank’s presence with us on the trip. If you know her, you understand why she was trusted with so much money. She’s just impressive.

The 5^th person travelling with us is Jane. A nurse and a volunteer paramedic in Deltaville, VA, Jane worked at VCU for years in multiple capacities. Over time, she’s carved out a niche in International EMS, so she was an obvious choice for the team.

At the KLM* counter, we were met with friendliness and curiosity regarding our absurd quantity of baggage. We opted to check the medical equipment and carry-on our personal belongings. We didn’t want to take a gamble on the reliability of baggage transfer from Amsterdam to Kigali and end up with endotracheal tubes but no underwear.

I’ve decided for the privacy of those with me on the trip that I won’t include them from here on out. After all, this is just my perspective, and I don’t want to give the false appearance that I speak for anyone else. I will say I’m with a unique group of people and look forward to getting to know these like-minded folks. At dinner Dr. Sudha asked if we’d rather spend our 2 days off on a safari or at museums. The reflexive and immediate consensus was “SAFARI!” I knew then this was going to be a great trip.

*Bonus points for the free drinks on KLM.

Jan 21, 2018

“Day 2” is a bit of a misnomer. Technically it’s the 21^st, but only because we just jumped ahead 6 hours by time zone. That didn’t stop KLM from feeding us breakfast just 1.5 hours after we’d eaten a full dinner.

We landed in Amsterdam without a hiccup. The last time I was in this airport was December of 2002. I’d just spent 5 months living in Spain, taking advanced conversational Spanish classes. What I didn’t realize then was just what a turn my life would take. I’d gone to Spain for a reset. I’d hit some professional hiccups in my last job and went to Spain, I thought, to do the study abroad I never had the chance to do while at UVA. Yes, I became fluent in Spanish, but I also found myself and my way forward.

What’s amazing about your twenties is the same thing that makes that time very lonely. You’ve left the nest, launched into a wide-open world full of opportunity, choices and possibilities. But you’ve left your nuclear family. And unlike decades prior, your independence isn’t quickly followed by love, marriage and establishment of your own nuclear family. There’s a gap now, a road with thousands of potential turns, each of which could lead to an entirely different life. Endless opportunity can be paralyzing. After standing at that airport, I came home, applied for and landed a job, which resulted in a successful career in Internet Marketing. I also joined my local rescue squad.

The view from the window on this leg of our journey, Amsterdam to Kigali, can be summed up in one word: tan. I finally gave in to my body’s repeated requests and took a 2 hour nap. Since waking up, I’ve seen nothing but desert. I did have a view of a beautiful part of Africa on the plane itself. Wearing a handmade, yellow and green gown with her hair secured tightly in a bright yellow wrap, everyone’s eyes focused on this woman when she appeared at the boarding gate. I looked down at my hold-over maternity pants and Merrill shoes and suddenly felt boorish and underdressed.

We arrived on time into Kigali. I had hoped for daylight as we landed so I could take an aerial survey of the city, but this close to the equator, night overcomes day very quickly, with sunsets happening in about 10 minutes from daylight to darkness.

We’re staying at the Gloria Hotel , which is just the right combination of nice but not stuffy. My only regret again is that it’s dark, and I can’t fully appreciate everything the area has to offer. I’m settling into my room as we have a long day tomorrow spending time in the Emergency Department, on the SAMU ambulance, and hopefully paying our respects at the Genocide Museum

~Steph

Explore more days in Rwanda: