By Ray Schmidt
It’s good to be back in Rwanda, the country of a thousand hills. I’m here as part of our partnership with GE and the Developing Health Globally project. This is our second phase in Rwanda and it will involve donating and installing medical equipment to six hospitals throughout the country, and providing training to hospital personnel. Our first two sites were completed last year at Nyamata and Mayange.
This week I will be working with a team of GE medical technicians and application specialists at hospitals in Rwamagana, Kibungo and Nemba. But first the equipment needs to get out of customs, so I came a few of days before the rest of team to make sure the equipment gets delivered to the hospitals in time. Because of various factors, the shipping and installation timelines are very close, and we had to ask the Ministry of Health if they could accommodate us on this short notice. They assured us that they could work with our schedule and make it happen.
So, I’m sitting in the car at the cargo area of the Kigali airport waiting for Primo from MOH to arrive with the trucks. He keeps saying he will be here shortly but my driver, John, and I have been waiting for over 90 minutes. I’ve finished my paperback fiction about the search for Alexander the Great’s body and the discovery of the cure for AIDS/HIV (yes, in the same book), a TIME magazine that declares that crisis is good for America, and a Sports Illustrated that featured the NCAA Sweet Sixteen (and a good article on Gonzaga University and their coach, Mark Few, whom I played against during high school).
The excitement of humanitarian work is always preceded by the minutia of shipping documents, customs clearance, trucking, and that always involves a healthy dose of waiting. Yesterday, John, Primo and I were at the main customs office in Kigali waiting for a couple of signatures. Primo was guiding the shipping documents through the various offices while John and I stood by, waiting. John is also my translator, well sort of. He speaks English better than I speak French or Kinyarwanda (the national languages of Rwanda). I would occasionally say something just so I could justify my presence at the Customs Office and John would faithfully translate, though I can’t vouch for the accuracy of the translation since many of my simple questions would lead to lengthy discussions between the various parties and so I finally stepped out into the lobby and let Primo do his work without my interference.
We were down to a final signature needed for a customs waiver but it would take a couple of hours to get that. John drove us to a little roadside café that featured a few plastic round tables and matching plastic chairs. It was sunny outside so we took a table under an awning. Good thing. Halfway through my second Coke the skies opened up. Raindrops the size of jawbreakers bombarded our covering, which promptly starting leaking. We retreated further into the little shop but the rain didn’t relent. We waited and waited for the rain to subside at least a little, but it was not about to quit. One of the waiters pulled out a large table umbrella and walked us to our car, but we were still drenched by the time we got to the Toyota.
I think my soaking elicited some sympathy from Primo—kind of how a wet dog looks so pathetic that you can’t but feel sorry for it—and he suggested that I go back to the hotel and he would call me when he received the final signature. I gladly agreed. After two hours Primo called with the news that all the paperwork was done and we could pick up the equipment on Saturday.
And now it’s Saturday and I’m waiting at the airport…
Primo finally did arrive with the trucks and they were loaded and on their way to the hospitals. The Rwanda Ministry of Health and their people did a great job and now we are set to begin the installation.
Sunday, April 5, 2009
A couple of days before I left for Rwanda, our office was informed that Tuesday, April 7, was a national holiday commemorating the genocide that occurred in 1994. It was too late to reschedule the trip and so we would have to work around that. That means we had to work at one of the hospitals today. Only one GE tech is here but we actually were able to install all the equipment at Rwamagana District Hospital and Kibungo District Hospital. It was a long day but I’m glad we were able to get it done.
Monday, April 6, 2009
We worked at the Nemba District Hospital today installing what 
equipment we had. We were missing four packages of equipment including the monitors, ultrasound, and infant warmer. I drove back to Kigali and went directly to the airport to see if the missing items were still in the warehouse. I met the company’s agent and she was reluctant to let me go in the cargo warehouse but I informed her that the offices of the cargo company in Amsterdam were blaming Kigali for the missing pieces. It was a small warehouse and in a few minutes I determined that our items were not there. I called the company’s office in Amsterdam and they insisted that the items were not in their facility. They had gone through their warehouse three different times and could not find any of the pieces. They said they would put out a worldwide search notice for the missing pieces.
The items were trucked from our warehouse in California to Atlanta. They were put on an aircraft and off-loaded in Amsterdam. A day or two later we received notice that all 21 of our pieces were on board a plane headed to Kigali. We gave the GE team the o.k. to travel to Kigali since all of our items were in route.
Later this afternoon I received an email from the cargo agent in Amsterdam. They found our equipment—in their warehouse. They were going to try and put our items on another carrier since they only flew into Kigali once a week, on Saturdays.
Tuesday, April 7, 2009
Today was a holiday marking the anniversary of the genocide. It’s hard to fathom that in 1994 nearly a million people were slaughtered in 100 days. The previous times I have been to Rwanda I visited different genocide memorials around the country. They were packed with bones, separated into skulls, arm bones, leg bones and so on. You could see where a machete whacked through a skull or where a bullet entered and departed someone’s head. You saw the cut marks on arms where people tried to protect themselves from the machetes. It is a vivid reminder of man’s cruelty to man.
Wednesday, April 8, 2009
Yesterday is still a blur. I got up and headed out with the team for Rwamagana. A few minutes from the hotel I had my driver turn around and take me back. I went back to my room and was sick the rest of the day. Sick like a dog sick. I’ve been traveling with Assist International for nearly 12 years and have never been this sick. I guess people had tried to call me throughout the day and I think I recall the phone ringing, but at times I thought I was delirious. Not a great way to pass the day.
Thursday, April 9, 2009
Kibungo
Today we were training the hospital staff at Kibungo District Hospital on the newly installed GE medical equipment. Rose Lesobre from Paris began training on the ultrasound, then moved on to the fetal monitor, patient monitors, incubators, and the infant warmer. Rose told me later that the hospital has an infant mortality rate around 15-20%. I corrected her and said 15-20 per 1,000 births—right? No, they had told her that the mortality rate is around 15-20%. Yesterday when Rose was at Rwamagana she was told that last year the infant mortality rate was 30%, but they brought on a new doctor and the rate is now at 20%. Those are incredibly high numbers.
A big part of the training involves using actual patients. Pregnant women were scanned with the ultrasound. A mother in labor had the fetal monitor on her, monitoring the baby. The vital signs monitors were put to use on patients. As Rose was training the staff on the new incubator, a newborn was brought in and handed to her and she slipped the baby in the incubator and continued with her teaching. By being hands on with real patients, it makes the hospital less fearful of using the equipment. One area of concern is no one on the staff is familiar with fetal monitoring. They now have a fetal monitor; they know how to hook it to the patient. Now they have to be able to interpret the information generated by the fetal monitor. It’s something that will have to be addressed.
I spent some time in the hospital’s sterilization room assembling an incubator cabinet. The radio has been playing all morning and all the songs were about the genocide of 1994.
Never, never, never again,
Let us keep alive, the memory of genocide.
A man working in the sterilization room told us that these songs have been playing all week as part of the genocide memorial activities.
Friday, April 10, 2009
It’s been a good week in Rwanda but I’m also glad to be headed home. I left Kigali this morning and have a layover in Nairobi. Overall, things went well in Rwanda. The equipment we installed and training that was given will save lives. There’s no doubt. Several images stand out in my mind:
- Two babies packed into a single incubator
- A pregnant woman seeing her baby for the first time through the magic of ultrasound.
- The Kibungo Hospital biomedical engineer excited about all the new equipment he is now responsible to maintain.
I appreciate the efforts of the GE team who put in some very long hours to make up for the day that we lost to the holiday. Mohammed, Sameed and Rose were great and I look forward to working with them again.Ray
