Everything is the same and its all different

My week in Kigali is quickly coming to an end.  By now I've had a chance to visit with many people we befriended in 2011.  Each time I met up with someone I would be told that it is not surprising to see me in Rwanda again, that I haven't changed a bit (well except for the former student who told me that my hips look bigger) and then I was asked when I am next coming back.

Early in the week I had dinner with Chantal who was our housekeeper.  She is now in school studying hospitality while working 2 jobs.  With Chantal, everything was the same and we shared some food a few stories before she had to moto off to school, I hope she successfully explained to her teacher that she was late because of me.

Today I met up with Patrice who was one of our guards.  Patrice has just finished business school and passed the examination to be a public accountant.  He was dressed in his finest because the public accounting association was going to recognize his achievement in the afternoon.  Again with Patrice everything was the same only now, he has the skills and advanced certification to get a well-paying job and hopefully a permanent job

I've also caught up with some of the KHI faculty.  They are the same but the institution is no longer Kigali Health Institute as it is now the University of Rwanda, College of Medical and Health Science.  From what I can tell the name and organizational change has added many new layers of bureaucracy and has not been positive for the physio department.  When I was a visiting professor there were 8-9 faculty, now there are 3!  Spending a bit of time with Juvenal was a highlight but finding him was a trick.  The faculty offices have been moved off of the campus to the new Kigali City Tower, an expensive high-rise in center city Kigali.  On the visit I got to ride in my first Rwandan elevator in this very fancy, upscale and expensive office building that appears at least 1/2 empty.  I can't imagine how they will fill the other 6 planned high-rise buildings that are going to surround Kigali City Tower.  The noisy area where we used to pick up buses is now a quiet downtown street.

It may sound as if I've spent the entire week visiting old friends but that's not exactly the case.  I've been working with our grant manager and our local grant coordinator on evaluating our progress and planning the next 8 months of activity.  The evaluation piece meant that I got to visit with some clinics where I know physios including CHUK, King Faisel Hospital and Rwanda Military Hospital (formerly Kanombe).  The hospitals look the same, the staff look the same but in each place there were small upgrades or building changes and other evidence that the Rwandan initiatives to improve infrastructure are ongoing.

I've visited some new areas of the city.  The other night we took our local grant coordinator, a man named Bernard and his wife to Green Corner to eat the amazing slow-grilled fish.  Good thing his wife arrived early to make the order because I've heard from some people that it can take 2-3 hours to get the fish.  When it comes, you wash your hands and dig in.  I was so stuffed I couldn't eat again until late the next day.

I've had much more luck with food on this trip.  Not because Kigali is suddenly a gourmet city but because I know how to find things I like and how to avoid all else.  Aside from brochette, mangos, avocado, maracuja and bananas this time there were some new spots at which to eat and some new foods.  One afternoon while running between hospitals I grabbed a smoothie at the new Hero - quite delicious avocado, ginger, mango and coconut milk made to order by the "smoothie girls" in what looked very much like a Vitamix

The biggest transformations here have been to the roadways and buildings around the city.  There are far more high rises, tarmac streets and traffic lights than previously.  I think I may even have seen a crosswalk.  Gratefully the very old tree at the top of our street across from Parliament still stands.  In a city bent on changing an old tree is a miraculous find.

Where the streets have no name

During the day (today included) much of my time is going to be working on activities related to the grant.  Still, I've promised to show how Kigali has changed since our last visit.  Just before departing I did a little Google map search and was surprised to see that all the streets had numbers.  Its true, every street in the capital now has a street sign and is numbered.  Too bad, according to the two drivers with whom I've spoken (Zaidu and Richard), almost nobody is using them as actual landmarks or for directions.  They look great, very official and efficient. I guess if we still lived in that house "behind the yellow bar" we'd probably now say behind the yellow bar on KG 605 St.

Postscript return to Kigali

One goal of a Fulbright award, at least according to the government, is to create lasting relationships and possibly professional opportunities between Americans and the world.  In my case it seems to have worked.  On returning home in 2011 I started working with Health Volunteers Overseas (HVO) to set up a site for US physical therapists to do some training work in Kigali.  Along the way we applied for and received a USAID grant entitled the "Advancement of Rwandan Rehabilitation Services".  Details on the grant were nicely described in this HVO press release:

Health Volunteers Overseas will work with the Kigali Health Institute (KHI), a nationally-funded institute in Kigali for students pursuing degrees in health professions, including physical and occupational therapy.  The institute will be a key component of the Rwanda University of Medicine and Health Science, which will soon merge with the medical school, and public health school.  In recent years, there has been a large infusion of funds and resources for the medical profession, but physical and occupational therapy will need further development in order to address the rehabilitation needs of the country, where those with disabilities number close to 523,000.

Continuing professional development is a crucial aspect of a vital health care force.  HVO will partner with the Kigali Health Institute and the Association of Rwandan Physiotherapy (ARP) to develop a model of continuing education for rehabilitation providers to enhance their knowledge and skills.  The abilities of these professionals will be developed to reach out to medical providers, community leaders and rehabilitation extenders to expand access to services for underserved populations.

To further the capacity of KHI and to develop a vital rehabilitation community, HVO will work with the institute and the national therapy association to develop their leadership capabilities and promote the role of rehabilitation within the medical community.  With the commitment of the Rwandan government to its plan of action, Rwanda could potentially be a leader in regional rehabilitation care.  HVO will work with KHI and the Ministry of Health to explore this possibility and assess if it could realistically serve as an East African Regional Rehabilitation Education Center.

 So, here I am sitting in the Brussels airport celebrating my 52nd birthday with a return trip to Kigali for mid-grant evaluation and planning purposes.  Wow, I'm going back, Ngiye Kigali and I'm back on the blog!

KGL to BRU to IAD to BDL to 7B2

July 4th weekend in Northampton (Florence) seems a perfect time to post this last blog for the trip, after all, this is also a holiday weekend in Rwanda with July 1st being Independence Day and July 4th Liberation Day.  I delayed writing this last blog because of some "should thinking" that blocked my writerly instinct -  the last blog should sum up everything; the last blog should be some type of introspective and insightful reflection; the last blog should bring closure.  Luckily, I came to my senses and realized that just as I can't really respond to those people who see me on the streets now and ask, "how was it," I also can't write a blog that completely pulls it all together.  Instead, I can welcome myself, Patricia, Saadya and Nava back to Northampton and give you a little insight into how we ended our journey and how we made the transition and reentry into our more typical lives.

Saadya and Patricia left Kigali first on June 8 so that Saadya could finish the school year with his classmates at Heritage and attend the middle school graduation ceremony.  They opened the house, got the cars started again, stocked the refrigerator and brought the cats back.  Turns out they also came back just in time to get Saadya registered and ready for the fall when he will enter Northampton High School.  As we drove to the Kigali airport I watched them take one last look around the city and our neighborhood and tried to imagine how it would be for me two weeks later.  They got one last Bourbon treat at the airport and then with a stamp in their passports they were on their way back.  A day and a half later, I got up in the middle of the night and called my brother's mobile phone to hear that they had landed at Bradley with all of their luggage and were making their way home.  Over the course of the next 2 weeks, thanks to Skype, we talked frequently and heard about some of the difficulties of their transition back to the US.

On departing, Patricia reminded me to make sure that Nava had a good time in her last two weeks while I finished up my work.  Finishing, for me, meant giving and marking exams, writing reports and saying my good-byes. I was pretty busy but we still managed to get in a few more adventures:

One more trip to the Leico swimming pool with some friends

Leico swimming in the late afternoon

Nava and friends

One last safari (this time just a day trip) to Akagera to enjoy the unique East African wildlife

Hello big guy (don't be surprised by his size, he can move)

Lots of giraffe and zebra on this trip

Fun with her friends including 2 sleep-overs

Admittedly this photo is from Nava's birthday party in May but these silly girls were school-mates, pals and they all stayed awake to the wee hours at the sleepovers

Watched a lunar eclipse

Adventures and shopping in Kigali

I finally got to the wedding circle to get a photo and there was nobody there - still, here she is, the mother of Rwanda

Even President Kagame managed another drive-by to say good-bye

A good-bye party with my colleagues at KHI

A fabulous evening at Car Wash with the best chicken we had in Rwanda and loads of speeches

Finally the big day came, June 21 our departure from Kigali.  In the morning I sold off our kitchen items to the highest bidder on Kigalilife and gave a number of items to our staff.  Nava went to her last day of school while I packed, weighed and repacked our bags.  Chantal cleaned and cleaned and cleaned.  In the late afternoon, Elias and Joel came over and we sat on the back porch drinking a last Primus and chatting.  Finally at 5pm our convoy was ready to roll.  The toughest good-bye was house-staff:  Sylivan, Christine and of course, Chantal.  We didn't need 2 cars and an entourage but in the end Pepe and Zaidu came to drive us with the KHI car while Elias and Joel accompanied  in his sometimes illegal car and Jeanne (the woman who brought me to KHI) was waiting at the airport.  We waved, hugged, shook hands, hugged again and then passed through security, checked bags, did one last exit card and joined the crowd of mostly Muzungus leaving.

Nava in the waiting area

Good bye Kigali

A day and many hours later (and a short excursion into Brussels) we landed at Bradley to be met excitedly by Patricia and Saadya who had everything ready for our arrival.  Over the next days we managed our jet lag, finished our last doses of malarone and slowly slowly realized that we are no longer in Rwanda and Northampton is just not Kigali.   I returned to work where my colleagues had decorated my office in a jungle theme complete with monkeys and elephants.

At night, I often find myself waking up confused about which city I'm in and which house this is.  I won't whitewash the experience and make Kigali or Rwanda a glossy wonderful place where everything worked perfectly and life was charmed.  I will, however, go the bank early next week to open that new savings account targeted for our next trip.

Murabeho

Kinyarwanda is a difficult language.  I can just now begin to pick out a few words in a conversation, and can manage a dozen or so things that I would like to say.  The language is spiced with a bit of both French and English and my ear is more used to the sounds and meanings.  I've learned that there are any number of ways to greet people depending on the time of day, how well you know the person, and how long it's been since you last saw the person.  Goodbye is similarly complicated and now that I must say it, I understand just how complicated it is, not linguistically, but practically and emotionally.  Over the next few days I'll be saying "Murabeho" because that is the good-bye used when you won't be seeing a person for a while.

I'll tell you about a few of the people who make it hard to leave and who have touched me during my time here.

First of all, meet our house staff:  Chantal, Nelson, Sylvan and Patrice (I don't have a photo of Patrice, works for us a couple of days each week and is also a student at a university studying business)

Chantal has been our housekeeper, cook, shopper, and resident comedian.  She took care of us during our stay.  She is tremendously kind, caring and often came to work or stayed to work later when she didn't have to.   Chantal adores Nava and always threatens to keep her after we leave.   Chantal is studying English right now and one day, we hope to help her get a college degree and a new line of work.

Chantal and Nava

Chantal a little more pensive than usual

Nelson is one of our guards, our gardener and the hardest working individual I've ever met. He never seemed to know how to rest when he was at our house. He really doesn't speak English but we had fun trying to communicate in a gibberish mix of English and Kinyarwanda. The other night, Nelson, Nava and I stayed up late to watch the lunar eclipse together and he taught us the words for moon and stars in Kinyarwanda.

 

Nelson

Sylvan, Christine and Diana

Sylvan does the majority of our night guard work and he is a handyman fixing our plumbing and lighting problems. He lives in the house on the back of our compound (really right on top of us) with his wife Christine and his newborn baby Diana (the little guard). Diana was born during our stay and this photo was taken on the day of her christening and naming.

The little guard on duty

When we arrived in Kigali we were told by other expats that we would never survive without a car.  Well, we did.  I was lucky enough to have a driver from KHI who brought me to work and back every day.  This is Pepe; I had more conversations about more things with him than almost any other Rwandan.  He doesn't really speak English, I certainly can't say much more than good morning and how are you in Kinyarwanda, but we managed throughout the term with his and my limited French to communicate about life, politics, Rwanda, KHI, the genocide, music, sports - just about anything.  I still owe him a brochette and a beer so I'll be back to visit him one day soon!

Pepe

I was lucky enough to teach all 3 years of physiotherapy students at KHI, here are a few photos of the fantastic and hard-working physio students.

A great group of 3rd year students

4th year students working in the clinic with me

Vyvienne is a senior lecturer in physiotherapy at KHI.  She is an expat from Zimbabwe (Zim).  I worked very closely with her on a number of research projects and in the research methods/biostats module teaching.  Vyvienne has a great sense of humor and always gave me the inside scoop on all things KHI or Kigali.  I'm quite positive that Vyvienne and I will be collaborating for a few years to come and I'm hopeful she'll make a visit stateside to share her incredible knowledge and skills in the area of CBR.

Vyvienne

Elias had the role of Acting Head of Department (HOD) while I was at KHI. Elias is a therapist from Tanzania (T-Zed). He had an incredible number of administrative headaches on a daily basis that I was happy to have left behind when I started this sabbatical/Fulbright.  He is quick to remind me that starting at the end of June, his headaches in Kigali will be my headaches in Springfield.  Speaking of having those headaches, Manu, a therapist from India is Deputy HOD soon to be HOD.  I have great faith in Manu's ability to lead this department forward and wish him luck.  He is just back from presenting at a conference in Baltimore on ergonomic issues, his passion in physiotherapy.

Manu

Elias

My office-mates were Jean Baptiste and Gerard both of whom got their initial physiotherapy training at KHI some years back in the diploma program.  I'm still not sure how all three of us managed in the tight little space we called an office but they were always gracious to make space for me when I came to work.

Jean Baptiste

Gerard

Hey, who is that Muzungu guy? This is Joel, a recent DPT graduate from Arkansas who taught anatomy at KHI this past term and who is planning on starting a PhD program in the U.S. when he returns.

Joel

David

David is busy completing his PhD dissertation work while he is teaching at KHI.  He and I did some clinical supervision together and I gave him some Stata tutoring.  It doesn't show well here but David has a great smile and always brightened the day.

Maurice is also doing independent work toward a PhD, naturally when I consulted with him I spent my time encouraging him to consider multivariable approaches to his analysis.  We'll see where that goes.  Maurice is a great critical thinker and debater with strong and often valuable opinions about how the department should be run.

Maurice

Princy

Princy and Hetal are both from India.  Hetal is actually Manu's wife.  Hetal and Baptiste run the KHI Physiotherapy clinic.  Princy often assists with department managing issues such as assigning clinical sites and setting up class schedules.  I got to do clinical supervision at two different sites with Princy and Hetal.

Hetal

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Sadly I'm missing photos of a few more of my colleagues, Juvenal and Nuhu with whom I worked in the clinic and on some research projects.

Finally, meet the woman who actually brought me to Rwanda...Jeanne Kagwiza.  When I first inquired to KHI about doing a Fulbright it was Jeanne with whom I conversed back and forth over many months about the possibilities and needs.  On my first day at KHI she came into the room where I was being introduced and excitedly walked up to me hugging me and shaking my hand and hugging me again in her excitement that I had arrived.  Jeanne is the former HOD in physio at KHI.  She was gone for a good part of my time at KHI as she is in the final stages of her PhD dissertation work.  I did some consulting/advice giving for her about her dissertation and I'm quite sure that she and I will continue to work together though at a distance until I return here.

Jeanne

Who did I miss? Plenty of folks and to all of them, murakoze, asante sana, jambo and most importantly turongera - see you soon.

"Helping" the poor

A couple of days ago at breakfast Nava was talking about a classmate who was wandering around the school fair with a fistful of Rwandan Francs.  I asked her what is father does and she responded "he helps the poor."  Yikes, time for a short rant on the issue of aid and NGOs here in Rwanda.  NGOs are supposed to care about the most vulnerable population - the poor.

Patricia and I are amazed at the luxury in which many Muzungus live here.  They have huge mansions (with monthly rentals of $2000-$3500), drive large SUVs, fly to South Africa to shop, send their children to an expensive private school (so do we, ISK is the highest price school in Kigali, thanks Fulbright), take tennis lessons every day and live in a sheltered isolated expatriate community.  Some of these wealthy Muzungus are here working for private companies but a large majority are spending the money of the NGOs who are "helping" the poor.  Seeing their lives has certainly soured me on the ways in which NGOs spend their money.  Worse, Muzungus drive up housing, food and commodities prices in the areas in which they do their work, how can that help the poor?  As it currently appears now in Rwanda, I'm certainly not convinced the NGO model works.

Mercer tracks cost of living for expatriates around the world.  This year, the highest cost of living is in Luanda, Angola.  Surprised?  Why Luanda?  In an editorial on this finding that I read recently, the author noted that whenever the UN arrives en masse, the cost of living goes up and especially the cost of housing.  I would argue that these efforts at helping are more often hurting and I will think twice and examine the motivations, goals and financial reports of any NGO before I donate in the future.

Joburg

We gave Saadya the opportunity to take a weekend trip to a place that we could get to from Kigali on a non-stop flight.  He picked Johannesburg (Joburg, Jozi, Egoli), the largest city in South Africa and, he picked our itinerary for the 2 day tour.  First stop...Kigali airport where the national women's handball team from the Congo was also waiting for their flight back home after winning the IHF Africa challenge tournament held at the stadium this past week.  It was great to see them hanging out in the waiting room with their medals.

Congo National Womens' Handball Team captain with trophy

Ready to fly the friendly skies

We arrived late afternoon and were met by our tour guide and host, Janet from Ekala Guest House who drove us directly to our first stop, the Carlton Centre, a 50-story building that may actually be the tallest building in Africa.  From the top we got oriented to our surrounds and started to learn about Johannesburg and its history.  I was surprised to see what appeared to be multiple small hills that looked like landfills as I had not realized just how important gold mining is/was in the city.  The land dumps were dirt extracted during the gold mining process that are only now being cleaned and recycled with yet more gold extracted from the sand.  No surprise, mining is an environmental disaster ruining land and water supplies (they use cyanide in the process).  The Carlton Centre sits in downtown Joburg, an area that has been vacated by many businesses and residents due to high crime rates.  The building itself is now about 40 years old and it is showing signs of aging.  I could imagine it was once a "destination" back when it had an ice rink, movie theater and restaurants.  Instead it now houses some stores and empty office blocks.  After being on top of Africa we drove a bit more around Johannesburg and then returned to Ekala where we had our first of a few wonderful meals complete with fresh fruits from the farm. 

Soccer City!

Joburg Skyline, Carlton Centre is on far right

In the evening, Saadya and I watched "Invictus."  Saadya chose to watch it because his class at ISK was viewing it and he was pretty sure they would finish it while he was away.  Although it was a Hollywood depiction, I enjoyed watching the movie more than I thought I would - possibly the Joburg effect?

Sunday our itinerary included the Cradle of Humankind where we visited the Sterkfontein Caves and Maropeng.  This is the area that has an incredible wealth of paleontological finds and is the center of much archeological work.  It is called the cradle because many people believe it is the site from which humans originated.

In the Sterkfontein Caves we saw where the famous pre-human skull known as “Mrs. Ples”, and an almost complete hominid skeleton called “Little Foot”, dated 2.3 and 4.17 million years old respectively were found. 

Saadya deep in the earth looking for fossils

Statue of Robert Bloom and Mrs. Ples.  Supposedly, if you rub her head you are bestowed wisdom and if you rub his nose you get wealth.  Any guesses about what Saadya rubbed?  I of course went straight for the head.

Area of archeologic work at the caves

The Maropeng museum was a nice touch and we dined there at the massive Sunday buffet (yes, this was an eating tour) with views over the hills outside of Johannesburg.  Somewhat shocking to our eyes were the sight of fire (even right in the city) on the land.  It is winter in South Africa and the dry season so there are often fires burning.  At one point, we drove by a gas station with fire burning all around it and to our surprise, nobody was doing anything.

In the "Cradle"

Fires burning in and around Joburg

In the afternoon we went to the Apartheid Museum where we visited an exhibition about Mandela and were overwhelmed by the history and story of apartheid which, prior to going to the museum Saadya knew very little about.

Tickets to the museum are randomly stamped "white" or "non-white" with seperate entrances and displays

The museum is quite big and in 3 hours of time we barely made a dent but still felt overwhelmed.  The evening saw us sitting down to yet another film, this time "Gorillas in the Mist" which Saadya had never seen and I saw with new eyes.  We were not too surprised to find that our knowledge of the background for this film was much broader than before we lived in Rwanda.

Sunday, our last day on this quick jaunt we started the morning in Soweto not only seeing the township but visiting the sites and memorials that were related to the 1976 uprising.  As we were leaving our parking spot we had a fortuitous celebrity spotting as Hugh Masakela was pulling in to go teach at the studio upstairs.  Saadya, of course, said who?  No, HUGH!

After Soweto we went to the Standard Bank building to visit the old gold mine that was found when they were digging to erect the foundation and to see the exhibit of work by Peter Clarke at the art gallery.

Saadya at the gold mine entrance

Our final stop before the airport was a visit to Constitution Hill which houses the old fort, the constitutional court and the prison known as Number Four that housed Gandhi, Sisulu, Mandela and many others.  I've decided the next film on Saadya's list will be Gandhi and he is planning to read Mandela's autobiography which should keep him busy all summer. 

We returned to Kigali with a few treats for Nava's birthday and ready to prepare for June and the end of our journeys.

THE POSTSCRIPT
Every blog post has a backstory (you may recall I've titled my blog Mbwira ibindi which means 'tell me more') and this one is no exception.  In this case the backstory is twofold and related.  First, there is  the black/white divide that continues to this day, and to my eyes, pervades life in Joburg.  Neighborhoods don't appear to be very integrated and certainly there continue to be disparities in health, education, work and other aspects of life.  Second, there is the high crime rate and fear of crime that determines how many people and certainly how tourists live their lives around the city.  Mbwira ibindi