January 25, 2018
Today was Day 2 of the Trauma Care Course. Things continued just as well as yesterday, so I don’t have too much to share. I gave two lectures, Musculoskeletal Trauma and Special Populations (Peds, OB, etc), then ran the students through the MCI/disaster table-top trainer. The students took their final exam, and based on the tests I graded vs the pretest, the improvements were remarkable. I can’t wait to see the statistical analysis of the score changes.
Memorable for me today was when one of my students asked me a “what would you have done?” question regarding a pediatric patient he had evaluated months ago. Motorbikes are common here as they are across Africa, and while there are helmet laws, there are still frequent, serious crashes. He responded to such a 912 call where 3 adults and a 10 week old baby were riding on a bike which crashed. Everyone but the baby had a helmet to protect the head. When he assessed the baby, he found it would not move its legs and indeed had a spinal cord injury causing paraplegia. He wanted to know how he could have stabilized the baby’s spine given that a cervical collar would not fit. I’m not sure I ever adequately answered his question because I couldn’t escape feeling a desperate hunger for a public health education program that might prevent such a crash entirely.
My favorite moment of the day was taking a photo with all of the inspiring women of SAMU. See, what’s interesting about Rwanda SAMU, is how many women they have on staff. I’m not sure if its because the staff all come from either nurse or nurse anesthetist background (both majority female) or something else, but a large portion are female. In the States, on average EMS is still male dominated since so many EMS systems are fire-based, and fire is disproportionately male. SAMU is third service (EMS separate from fire). I think these two things contribute to the number of amazing, unique women in the service.
I mentioned on Day 1 how captivated I was by the woman on the plane in the beautiful yellow dress. The clothing here is striking. Handmade dresses, blouses, wraps and jewelry in bright colors and patterns – Kigali rivals Europe in terms of fashion. I know I may be an independent feminist, but I also happen to believe fashion and feminism can coexist quite marvelously. Hence why I was desperate to take this picture with the inspiring, intelligent, gorgeous women of SAMU.
Tomorrow the students begin a new educators’ course taught by Basil and Dr. Sudha to learn theories and best practices in adult education and EMS instruction. Monday and Tuesday next week they will then instruct the course they just completed today and propagate that knowledge to even more SAMU providers. I’m excited to hear how tomorrow’s course goes.
Jane and I will likely be at the hospital again for Rounds like Day 2. I say likely, because what I’ve quickly learned in Kigali, like many low and middle income countries, is that timelines and plans are fluid, and when things change (which they often do), you have to just go with the flow. So with that, I’ve set my alarm and will see where tomorrow takes me.
Explore other days in Rwanda: