Sunday, December 4, 2011

(Late) Family Thanksgiving Letter

Mi Querida Familia,

I realize this letter is late for Thanksgiving, but I don’t think it’s ever too late to be thankful. I can’t believe over a year has passed since I wrote my last Thanksgiving letter. I’ve been away for the changing of four seasons, for birthdays, for family dinners, and time around the living room fire. But I’ve been ‘here’ (Niger, Morocco, South Africa, and Rwanda) for sun and rain, for births and naming ceremonies, weddings, and dinners with families that have invited me in as if I were their own. Like I said last year, time is a bizarre
concept.

Rwanda is a beautiful country, but as many of my phone calls and emails have shown, it’s not an easy country to live or work in. I’m not sure if it was the original excitement of being in Africa and joining Peace Corps, or if Niger just was that special—but reading over the letter I sent last year I have re-realized how much I have to be thankful for.

Of course right now, I am thinking mostly of Abuelo. I am so, so thankful for the time I had with him. There aren’t words to describe his mischievous smile, his whole hearted laugh, his deep and confident voice, or his affection. My heart aches that from now on I will only experience those in my memory, but I am forever thankful that those memories are many.
Abuelo

This year, I am also especially thankful for:

Rain. There is nothing more calming or cleansing than a good rainstorm. After a good rain, you can feel the difference. Rain is also hilarious. I challenge anyone to be caught in a rainstorm and not laugh hysterically, at least for a few seconds.

Avocados. In Rwanda, avocados are cheap, easily accessible, and delicious. When I start to think about the Western comforts I’m missing out on, I eat an avocado and realize that you can find delicious special treats everywhere in the world.

Latrines.
I know last year I told you to be thankful for seated toilets, and I stand by that statement. But this year, I am thankful for pit latrines. Because when your plumbing system is questionable, it’s better to have a pit latrine than a broken toilet.

My neighbors.
Because they have accepted this strange, young white girl as one of their own. In particular, I am thankful for my eldest neighbor Donatille, who gives me the smile of a thirteen year old girl when I complement her outfits; and Jaques, the four year old who runs to hug me at the beginning and end of each day, and reminds me why I wanted this job in the first place.

My access to healthcare. E-coli, giardia, and root canals, aside, I’ve been incredibly blessed with good health this year. When I have needed medical attention, the attention I’ve received has been world class. I
am painfully aware of how much this sets me apart from my neighbors here in Rwanda, but also in the United States. I cannot be thankful enough for this.

My friends and family.
I think about you every day. Last year, I really thought my appreciation could go no further, but I was wrong. Being in a country where so many have lost their closest friends and family members, and as a result have shut down and let no one new in, I am thankful every second, for the love, trust, and care I receive from my friends and family spread out across the entire globe.

So I’m not really sure if this year you’ll be all together when you read this letter or if it will just be on individual computer screens in Carlisle, New York City, and Ithaca… but I’m pretty sure Cristina and Mama are still crying a bit, so again I have what is intended to be comic relief—

Things you should be thankful for because I cannot be:

Oreo Cookies. Do not ask me why or how, but I crave them every day, and I am so jealous that you can drive to any store you want and buy a box (or send me one, hint hint).

Cement Sidewalks and Roads. Now I am very thankful for the rain, but I am not thankful for what it does to the mud roads and paths I walk on. Be thankful that you do not need indoor and outdoor shoes to (try to)
keep mud out of the house.

Fast Internet. I cannot wait until the day I can upload my Gmail without having to use HTML version, and know it will work.

Donuts.
I think I’ve said this before, but the fried dough here really doesn’t cut it. Dad, I am counting on you to go to GIANT after reading this email and buy a chocolate donut. Mama, please don’t stop him.

Weather.com
I’m glad being a weather woman or meteorologist was never a career aspiration of mine, because I suck at predicting the weather.

Sorry this letter is late, but I hope I was able to bring back some Thanksgiving spirit. I love, miss, and think of you all the time.

Besos,
Alma

Wednesday, November 30, 2011

Thief!


My friend Chantal, drinking sorghum beer before a wedding
Last week, as I walked down the main road of Kigali, a man grabbed my arm. At this point in my Peace Corps experience I’m pretty unfazed by street harassment, but this guy grabbed my arm hard. I turned and pushed him away, giving him a piece of my mind in a mix of English and Kinyarwanda. As he crossed the street, I realized my phone was gone. 

“HEY! That man has my phone! Stop him!” I screamed in Kinyarwanda. The man standing next to me looked concerned, and ran after the first. As I watched them both run, I realized the second man was the one who had taken my phone.

I walked in the direction the men had run, not exactly sure what I could do. As I turned the corner and looked around helplessly, another man approached me.

“Did someone just steal from you?” he asked. I explained to him what had just happened. “Yes! I saw the men running. My friends and I, we are the taxi drivers here, we will find your phone.” I thanked him, gave him the contact information for the Peace Corps Safety and Security Officer and headed back to the Peace Corps Office.

When I arrived at the office an hour later, the Security Officer saw me and immediately said “Alma! I’m so sorry about your phone!”. Surprised and confused about how she already knew, I started to explain what had happened. “I know, I know! Richard, the taxi driver, he called me. He has your phone!” she told me.
Back downtown, I met up with Richard and thanked him a million times. He and the other taxi drivers had tracked down my phone, which had already been sold off, and then found the thieves, who had kept my SIM card, and gotten that back from them too. “There are a lot of thieves downtown, and we business people don’t like it. You are a nice umuzungu, you speak Kinyarwanda! They cannot steal from you! We just want peace in the city, we are all happy to help.”

So my little Nokia phone and I are reunited again. No amount of Peace Corps evacuations, latrine falls, or thefts can keep us apart … I think it’s true love.

Volunteer Tourism

At Cornell, I took part in a service-learning course that culminated in a three week malaria intervention project in Ghana. It was my first time in sub-Saharan Africa, and the experience solidified my desire to work extensively in the region.

Before leaving, a professor, who would two years later become my thesis advisor, put the trip into context for me: “Listen, there’s no denying that no matter what you give or do for these people, you’re getting much more out of this experience”.

Service trips have become very popular in the United States. Whether building houses in the Mississippi Delta or stocking libraries in Nicaragua, energetic, inexperienced, idealistic young people are hoping to “save the world” and “make a difference”, all while soaking in sun and posing for a Facebook picture. The programs usually require more funding than the communities they visit will ever see.

Pre-Wedding Grub with two Local Leaders in my community
Full disclosure: I was (and in many ways, still am) one of those people.

Nonetheless, Peace Corps Volunteers love to hate these types of ‘volunteers’. We meet them in the fancy western bars in big cities, and after a two hour visit to the local school and health center, they claim to understand the problems faced by rural African families. After these volunteers make their flashy appearances, it’s pretty hard for PCVs to explain to our community why we don’t have suitcases of donated clothes and soccer balls, we do not eat at fancy hotels, but we are here to stay.

If you are considering this type of tourist volunteer work, I say by all means go for it. Just be realistic.
In September a group of twenty or so masters students from an American university came to my site for an afternoon visit. Before the group arrived, rumors spread around the hospital that abazungus from the Clinton Foundation and UN were coming to build a new maternity ward, pediatric ward, school, and cyber café.

The day was amusing. In many ways, I felt more comfortable with my Rwandan friends, who I’ve lived with the last nine months, than the Americans, who I share a language and culture with.
The group spent two weeks in Rwanda: meeting with the Minister of Health, talking to genocide survivors, touring a refugee camp near the DRC border, and coming all the way to my hospital to experience ‘village life’ and engage with ‘stakeholders’.

Before leaving, the group held a meeting in Kigali to share their experiences with everyone they had visited. The group said they wanted to help Rwanda. They gave everyone bookmarks.

I have no doubt the students had the best of intentions, and I found most of them to be very pleasant. But the patronizing attitude I observed from some (perhaps subconscious, perhaps intentional) was embarrassing. In conversations with the top two health workers of the district, the group kept referring to “the literature” they had read, and their unique solution which involved mobile health technology. The ideas and discussions presented by Rwandans themselves seemed barely heard. The group had come with a planned vision (researched and developed in a comfortable, American, university library), and no amount of experience or insight from Rwandans with years of work experience and a lifetime of understanding could stop them. We’re Americans, we know all!

My Rwandan neighbors were very excited about the big group of abazungus who came to visit. It was the largest number of Westerners most of them had ever seen. The Americans seemed grateful for the opportunity to experience something so different. Since the visit, a few hospital staff members have started intense English classes with me. I’ve exchanged emails with one of the professors from the group who said some of the students were now considering Peace Corps.

A short service trip can do a lot of great things for all parties involved. But it will not save starving children from malnutrition or provide steady jobs for the local population. I encourage anyone to join or support short service trips, so long as the people involved take some time to reflect about what they can do, and more importantly, what they cannot. This is true for anyone interested in community development, long or short term, in sub-Saharan African or in the Mississippi Delta.

Lake Kivu from Kibuye, Rwanda
Millions of people across the world (hundreds of thousands of them born, raised, and educated in sub-Saharan Africa) are working hard, every day, on improving education, healthcare, and economic conditions of the poor. It’s great if you want to join them, but you won’t be the first, or the last, and you certainly won’t solve anything by yourself.

Saturday, November 26, 2011

Obama Style

Overgeneralized Alma Fact Number 230984: Americans are sloppy dressers.

Example: American citizens are the easiest people to spot in airports around the world. While in American culture comfort is key, the rest of the world sees traveling as an important time to show off your stuff. It makes sense: you’re making a lot of first impressions—sweatpants and a hoddie don’t translate to anything impressive, in any language.

Not long after President Obama swore in, a New York Times article described the controversy surrounding the ‘casual’ makeover the White House was getting, particularly as it related to the President’s attire. I remember thinking the attention was ridiculous. As far as I know, coats and ties have no magical powers to fix the economy or stop terrorism. If wearing sandals and Bermuda shirts help Obama concentrate, that’s fine by me. 

Well, it turns out New York Times reporters are not the only ones paying attention to what the leader of the free world wears to work.

Rwandans are very formal dressers. They are particularly serious about their shoes, which are always perfectly polished, no matter how much mud and dirt they've tracked through. My outfits are scrutinized on a daily basis for spots, holes, and ironing (or lack there of). Mama Fils has given up reminding me that my shoes are muddy.

I recently acquired a cute pair of khaki pants, courtesy of an unknown Peace Corps Volunteer who left them in the volunteer grab box. The pants are perfect for Rwanda: they look nice (I think), they're dark (to hide dirt), with pockets (for my phone and hand sanitizer), not too light but not too heavy (perfect for the consistently changing weather patterns). Best of all, these pants have special buttons so they can be rolled into capris, ideal for the many rainy days that turn the bottoms of my pants into mud sponges.

When I showed up to work wearing my stylish-yet-practical “new” pants I was expecting complements. Instead, Mama Fils gave me a good up-down and asked “Alma! Are you going to farm?!”. I didn’t understand. “Why are your pants rolled up? It’s ugly, it’s not correct.”

It should be no surprise that my attempts to explain capri pants failed miserably. Fashion isn’t my thing. Just as I started to unroll the pants and make them acceptable for my counterpart, a young hospital nurse came over and complimented my outfit. I laughed and explained to Claudine that Mama Fils disagreed. The two women began a heated argument about the legitimacy of my outfit. Much to my surprise, Claudine won and Mama Fils agreed I might have some sense of style after all.

Claudine’s winning argument? Well, Alma is just following Obama’s style of course! The man roles up his sleeves; his countrymen role up their pants.
Sporting Rwandan Style Festive Attire at a Wedding in Kigali

Thursday, November 10, 2011

Abashitsi (Visitors)


Ben drinking traditional sorghum beer
As I’ve mentioned before, hosting visitors is a huge honor in Rwandan culture. Visiting someone is a way of showing respect, appreciation, and friendship. I love visiting my friends and coworkers, and have been honored to receive quite a few visitors myself, Rwandans and Americans as well! 

Several volunteers from the most recent health group have been installed at sites near mine, and showing them around my community and the District Hospital has been a really great way for me to see how far I’ve come since I arrived eight months ago.

The most exciting visit so far was from my world traveling friend Ben Cole, who worked for Google all of last year and was based out of Accra, Ghana. Introducing my “cousin” to neighbors and colleagues was really fun and a huge cultural moment for me. In a society where family is so highly valued, why a single, twenty-three year old white girl would move half way across the world to work is hard to explain. A visitor from home seemed to make my existence a little more real. 

So: karibu, karibu! You are all welcome!  

Latrine Adventures, Part II


I really saw this one coming. 

In Niger, I had a rather unfortunate incident with a latrine and my iTouch. Here I will pause for a moment and endorse all Apple products full heartedly. I managed to get said piece of electronic equipment back to the States, and with the help of my loving parents and my dear friend Brian, it made its way back to me in Rwanda, fully repaired. Apparently dropping your iTouch into an outdoor toilet, pouring a bucket of water, and a bottle of anti-bacterial gel on it, will not cause water damage.

Anyway, I’m a slow learner. You would think after such a scaring experience I would keep all electronic equipment far away from large, dark, deep holes filled with human feces. Actually, you would think anyone in their right mind would keep everything away from such holes. As I said, I’m a slow learner.

The latrine at my health center is, what Rwandans would call, serious. It’s actually four latrines that all dump into the same enormous underground hole. I try to use it only in the case of emergency, and on this fateful day, I had an emergency, and in my rush, I let my phone slip.

Unlike in Niger, there was no question about whether or not I could stick my hand in to retrieve the fallen article. My phone was at least twenty feet down, lost forever. I walked out of the latrine feeling defeated. I told a couple of my coworkers, who responded with very sympathetic “yooooo”, “ihangane”, and head shakes. Luckily, one of my friends was heading into the big city that day, so I went over to his office to ask if he wouldn’t mind getting me a new one.

Ten minutes later, three maintenance workers ran towards me, demanding a flashlight. Noticing the confused look on my face, the head cleaner Shashi exclaimed “we’re getting your phone back!”.

 “I really don’t think that’s a good idea,” I responded hesitantly. “It’s probably broken, let’s try to call it first”. But Shashi’s reasoning: there’s no service that far down, and I have an original Nokia so it definitely still works, won over my hesitation.

Three hours later, a triumphant maintenance worker walked towards me with my recovered phone (disinfected with the tools used to sterilize surgical equipment at the hospital). Just as I opened my arms to give this kind, brave man a hug and offer him a beer and my most sincere gratitude, I was stopped in my tracks.

“That will be 5,000 francs” he said with a huge smile on his face. I looked to my other coworkers in disbelief. I hadn’t asked this man to retrieve my phone, and while I had been planning to express my gratitude in financial terms anyway, I had not agreed to anything specific.

A screaming match between the maintenance man and my very honest coworker followed, allowing the forty plus people standing around to learn about my latrine troubles and give their own opinions on a suitable reward. Three thousand was the amount agreed upon, which I handed over as quickly as possible, eager to put the whole fiasco behind.

PCVs getting ready for a boat ride on Lake Kivu
The next day, my counterpart smiled and handed me her phone, “Alma, I’m going to the bathroom, could you hold this for me while I go?”. This time, I think I’ve learned my lesson. 

Saturday, November 5, 2011

Joy Ride


On a particularly slow work day a few weeks ago, a friend asked me if I wanted to go for a ride. “Sure!,” I respond, not entirely sure what I was getting myself into. Squished between Innocent, my favorite ambulance driver, and Fulgence, one of my favorite nurses and closest friends, I set off for another sector in my district. 

On the road, we discuss everything from the status of the road (atrocious, the worst in the district, possibly the country), to the physical appearance of the gorillas in the north (really ugly, but I still want to see them, like every other white person who comes to Rwanda). Conversation flows between Kinyarwanda, French, English, and the language if laughter, which I am becoming very fluent in.

We arrive at the health center and are greeted by its head nurse and director. They tell us about the patients who need immediate transfers. The first patient is a young man who just had a moto accident. His eye is covered with a bandage but blood is pouring out, his arm is also wrapped in bandages tied tightly to his torso. 

The second patient is a woman who has been in labor for over twelve hours. I accompanied Fulgence to the health center’s birthing room where she lay on the delivery table, fear and pain in her eyes. She slowly walked herself to the car (over one hundred feet away) and onto the ambulance stretcher. Her husband tried to follow but was turned away for lack of space, he’ll have to walk. 

“Has anyone ever given birth in the ambulance?” I ask Innocent. “Oh yes, plenty of times,” he responds. 

We head off, but after a minute realize the woman in labor has forgotten her insurance card, so we make twenty point turn on the narrow, pot holed road that drops off into a steep valley, to retrieve it. The woman in labor tries to hold her pain first with deep breaths, then quiet moans, but the road is just awful and the pain too much, and pretty soon she’s screaming bloody murder.

“Ihangane Madame!”,  Fulgence says from the front seat, have patience. To me he says, “the pain and stress of the road can induce labor—I’m not trained in deliveries, so you’ll have to help!”.

Lake Kivu from Kibuye, Rwanda
 “I’m dying! Stop! I’m dying!” she repeats every few seconds. “Hold on, we’re getting closer!” was the only comfort any of us in the front could provide.

After what seemed like days to me (probably years to the woman), we finally reach the hospital. She is carried to the birthing table and connected to an IV. Reviewing her transfer sheet, the nurses tell me the woman is thirty-two years old and this is her seventh child. “Madame, you have too many children!” they say disapprovingly, but she is barely conscious.

A doctor finally comes to check in. He checks her cervix and discusses with a nurse the correct plan of action. The nurse thinks she needs a c-section, the doctor thinks she’ll deliver soon. An hour later, I help prep the surgery room and put on surgical scrubs. “I am going to look only!” I remind everyone repeatedly.

Two seconds later, another nurse runs into the surgical room “Hurry, it’s coming!”. We run back to the patient and within sixty seconds the most enormous newborn baby I have ever seen (and I’ve seen quite a few at this point) is out! Now I know why they call it the miracle of life.

Over the last few hours I could not stop thinking about the atrocious conditions this woman was being put through—from the excruciating hours of labor at her health center, to the hellish ambulance ride, to the lack of bedside manners of the hospital staff. Once she recovers her senses, this woman is going to raise hell, I thought. Instead, all she did was thank me and the other nurses, praising God for her healthy baby and asking him to protect us and our future children.

And now you might know what to expect if a hospital nurse in Rwanda asks you to go for “a little stroll” on a slow work day.

Thursday, October 20, 2011

Performance Based Financing

In an earlier blog post on data recording, I mentioned Rwanda’s use of the performance based financing system, which has been largely praised by the international community. Because I obviously think my opinion is more important than that of the United Nations, the World Health Organization, Rwanda’s Ministry of Health, and hundreds of International NGO’s and think tanks, I would like to inform you all that I too, am ready to praise Performance Based Financing; and that the Peace Corps is turning me into a staunch supporter of capitalism, free market enterprise, and fiscally conservative social policy (sort of).  
wedding guests arrive (Gitarama District)
Traditionally, governments and international organizations have funded inputs in developing countries. That is to say, money is given to build facilities, pay doctors, purchase medicine—results are assumed to follow suit. But decades and billions of dollars later, malaria has not been eradicated and many of my neighbors still opt to give birth at home.
Performance Based Financing (PBF) rewards health care providers (like my health center staff or the community health workers’ cooperative) for work they have already done. Money, proportional to the quantity and quality of the job, is given after results are reported. Then, the people who delivered the results decide what to do with the money.
The staff meetings where PBF is discussed can get pretty heated. My health center happens to be the worst performing of the district, and the bonuses reflect it. For months I’ve been trying to talk to staff about giving pregnant women iron and folic acid tablets (which are required by national policy). No one seemed to care until the PBF report came back criticizing the low attendance at prenatal consultations. Suddenly everyone was brainstorming how to get pregnant women to the health center. Three months later, I now help distribute the vitamin supplements during prenatal consultations and am happy to report that the number of women coming for consults during their first trimester has increased!

Choosing the Right Battles

During my Peace Corps job interview I was asked to describe a time in which I had been part of a group that was doing something I did not agree with, but I could do nothing to change the situation. The question surprised me. When I disagree with something, I’m generally not shy about voicing my opinion or trying to change the situation—that’s why I wanted to join the Peace Corps, to make change happen! Was this a trick question?

My (boy) neighbor, Queen of the Universe
After some thought, I told the recruiter about my Catholic upbringing which directly conflicts with my strong beliefs about women’s reproductive rights. “In high school I often attended mass with my mother, and there was a particular Sunday the priest was delivering his sermon, talking about the evils of contraception. I got so upset I had to walk out of the Church to collect myself in the bathroom before going back in”. The recruiter smiled, “You’re going to have a lot of situations like that in Peace Corps; it’s all about picking your battles”.

There are plenty of battles to choose from at my health center. The number of battles I choose not to fight is actually rather depressing. But, if I told everyone at work when I disagreed with their actions, I would have no friends and probably no job. Gaining trust and acceptance is a long, daily process that I’m working hard on. If I attain the trust and respect of my coworkers, I can hopefully fight, and win, one or two battles. What often keeps me up at night is that seven months into my work, I have friends, and I’m starting to notice that coworkers do trust and respect me, but I still haven’t picked a battle.

Rwandan national policy requires every malnourished child who comes to a health center for treatment to receive an initial health check up. In theory, a nurse will complete a malnutrition patient chart and file that includes prior medical history, vital signs, and tests for tuberculosis, HIV/AIDS, and parasites. At my health center, this does not happen. When a mother comes with her malnourished child, my counterpart, the health center nutritionist, takes down the family names and address, the child’s age, weight, and MUAC, gives the mother Plumpynut, some advice, and then sends them on their way.

A few months ago I organized the patient files for all the malnourished children. When I say organized, I mean I started charts for all children who were enrolled in the program. I included all the information available (which was not much) and talked with the nutritionist about completing the rest. She seemed genuinely interested, but then reminded me that she is not a nurse and has no training or knowledge on how to complete the files. So I sighed, and we agreed to keep better records and complete as much as the two of us were capable. 

Several weeks later, the district hospital nutritionist along with the nutritionist from the International NGO working on childhood nutrition in the district, came to “supervise”. They asked for the files of all children being treated for malnutrition. We took out the incomplete files I had worked on. When they remarked about the incompleteness, my counterpart stared blankly and then asked me “Alma, why aren’t these done?”. 

I was furious. Was this not her job? Had I not tried to get her to complete the files? Was she seriously putting the blame on me? What I was most furious about, however, was my sudden realization that this was a battle I had decided not to fight, and in retrospect, I probably should have. There are a million excuses to let things go here. Was I becoming lazy and apathetic? Am I ever going to choose a battle?

Since the “supervision” I have made more contact with the nutritionists at the hospital and NGO. With my counterpart and the health center director, I have discussed the challenges we need to overcome to ensure all children receive checkups and proper service, not just Plumpynut. Everyone verbally agreed to collaborate, but action remains slow. Still, I think I have found a battle to fight.

A Day in the Life


6:00 AM- I wake up, realizing I’ve pressed my cell phone’s snooze-button too many times to make it for a run. This happens often, which I always regret later in the day when someone inevitably reminds me how much weight I’ve gained since arriving. They say in Peace Corps you learn a lot about yourself; I have learned I am an emotional eater. 

6:30 AM- The tea kettle on my kerosene stove is ringing. I have hot water for my bucket bath, oatmeal, and coffee. I have always been a morning person and I take after my father in truly relishing this peaceful morning ritual. Sipping the delicious Rwandan coffee, I try to relax and prepare for the day.

7:00 AM- Daily Health Center staff meeting, which begins anywhere from five to twenty minutes late. These meetings help me gage language progress. In seven months I’ve made a lot of progress but still not enough to give me confidence to contribute my opinions during the meetings. Accustomed to running meetings in college, this is often a source of frustration for me. 

8:00 AM- I spot the new nutritionist for the international NGO that works in my district. The organization have just started a “new” nutrition program across the district—which is exactly the same as the HEARTH program the previous volunteer worked on, except it has a different name, and therefore everyone I work with insists on completely dismissing all previous work and starting from scratch. I want to show the nutritionist all the data I’ve imported onto excel from the nutrition work I’ve built on, and discuss with him how we can collaborate. I take my computer to his office, and realize it’s broken. The nutritionist is busy and my lack of visual aids and language skills makes him quickly lose interest.

9:30 AM- I sulk back to “my office”, only to realize that my counterpart has left for the primary school in the village furthest away from the health center. She’s gone to work on the national Maternal and Child Health Campaign that is being implemented across the country this week. I’m frustrated that she didn’t let me know she was going, since I try to take every opportunity I can to leave the Health Center to make field visits and get to know the community better.

10:00 AM- M&CH Campaign is fully underway. I help the staff distribute Vitamin A supplements to children under 5; mebendazole (which kills intestinal parasites) to children under 14; iron and folic acid to pregnant women; and bleach (to clean water) to all mothers. This is very cool, but at this point in my service I’m itching for a project of my own. What I’m doing can and should be done by health center staff. My attempts to conduct “education sessions” as I give out medicine are received with blank stares by mothers, terrorized faces by children, and hysterical laughs by my coworkers.

12:30 PM- A friend from the hospital invites me for lunch, which I accept immediately despite being exhausted from the morning activities. Peace Corps is all about integration! On our way, I see a few nurses staring and whispering to each other, to which all I can do is sigh. Rwanda is fairly progressive when it comes to gender relations, but two young people of opposite sexes enjoying time together seems to translate to gossip in small towns everywhere around the globe. But, lunch is delicious and our conversation is a rather comical mix of Kinyarwanda, English, and French on topics that range from Colonel Kadafi to why my father insists on 600 cows.

2:00 PM- Back to work, which in the afternoon is slow to nonexistent. I sit with the nurses, help distribute medicine, try to understand the conversations around me, and try to laugh off the jokes. Teasing is a huge part of Rwandan culture, which on a good day is funny, and on a bad day unbearable. Today is turning out to be rather difficult, so the various imitations of my poor Kinyarwanda pronunciation, the poking of my acne, pinching of my muffin tops, and demands for money and American visas are not appreciated.

5:00 PM- Work day is over! As I leave the health center with a coworker, another nurse invites us for drinks. Despite my exhaustion, I accept. I might not be saving the world, but at least I’m making friends!

6:00 PM- As we sip our sodas, I’m feeling inspired to study more Kinyarwanda. The two nurses are talking and giggling, and I’m getting parts of it, but still feel pretty left out. When I realize my friend is telling the other nurse about her brother’s newborn son, I jump in the conversation. “Congratulations! Your family must be so happy,” I exclaim. Both women become silent and the nurse tells me in French, “she’s an orphan, her parents died during the genocide”. There’s a few seconds of awkward silence and then the two women continue the conversation as usual, but I remain dumbfounded. This part of Rwandan history and culture, no matter how good my language gets, I will never truly understand.

7:00 PM- I’m ready to go home after a long day, but just as I get ready to say goodbye, one of the men who works at the local government office comes to greet us. In a loud voice, so that everyone at the bar can hear us, he begins to berate me. “ARRRRIIIIIMAR! Where have you been?! What work are you doing?! Why have you not come to see me?!” I’m caught off guard and embarrassed that everyone is now staring at us, but he continues, telling me how much the previous Peace Corps Volunteer did for the community, how well she spoke Kinyarwanda, and how good of friends they were. “She gave me reports every week! What work are you doing? You are not seenable! You do not speak Kinyarwanda!”. This hurts, a lot. I try to remain calm and collected, when one of my supervisors from the health center comes over and tells me “Alma, people at the health center are not happy because you refuse to speak in English with them. They want to learn English but you only want to speak in Kinyarwanda”. Confused and exhausted, I tell the government worker that I am not the previous volunteer, that I do not like comparisons, and that if he has specific work he wants me to do he can talk to me at work. Rwandans seldom show their emotions and talk about them much less, but I make sure he understands that what he has said has made me unhappy. I say goodbye to everyone else and head home.

8:00 PM- Frustrated and exhausted, I get into bed. I want to tell someone about what just happened: talk about my emotions and get advice, but who? Tomorrow I can talk to my counterpart about it, but the language and cultural barriers will make the discussion limited; I can call another volunteer, but the truth is not having gone through training in Rwanda, I have not formed very close friendships with many other volunteers; I can call home—but explaining the situation, the context, and the repercussions make relatability and any advice offered rather strange.

Through this blog I try to document the more positive aspects of my days, but I would be lying if I said it was all easy and fun. I get a lot of emails asking me to describe what my average day is like, and what my most difficult challenges are. There is no such thing as an average day, and what I might consider difficult one day I might find easy and enjoyable the next. What I just described is a particularly bad day, but the difference between a bad day and a good day generally depends on my attitude, and maybe my computer not breaking.

Preschool Graduation


Owning a digital camera provides me with the unique privilege of a guaranteed invitation and good seat to pretty much every event in the community, like the preschool graduation at the local primary school.
The graduating class included about twenty students, most of them children of my coworkers, who were precious beyond words. 

While the setting for this graduation (bare classroom with wooden benches and no electricity) was worlds away from any preschool graduation in the United States, everything else was remarkably similar.

The President of the Parent-Teacher Association talked for a bit and then handed over the stage to the students, who could barely sit still, unaccustomed to so much attention. The very patient and graceful teacher then lead the students in the recital of English, French, and Kinyarwanda lessons. Parents ogled, awed, drooled and clapped at their children’s work, praising each other and their children for how well they performed, completely ignoring any and all mistakes that were made. 

In case you’re wondering what aspects of my daily life I really enjoy, I suggest checking out the video--

Sunday, August 14, 2011

Rwanda Swear In


Congratulations to the brand new Peace Corps Rwanda Health Volunteers!  On July 13th, eighteen Peace Corps trainees became volunteers at the American Ambassador’s residence in Kigali. My return from South Africa coincided with the event, so I was able to attend the ceremony, which was lovely. The trainees even arranged a traditional Rwandan song and dance routine!
Although the group had been training in Rwanda for ten weeks, I had not had the pleasure of meeting any of them before. Most of the new volunteers have been placed in the Southern Province, and several of them will be living in my district, so I was anxious to get to know what my new “neighbors” would be like. They’re wonderful.
It feels like just yesterday, and also a lifetime ago that I loaded the bus from Hamdallaye to Niamey with my fellow CHARM trainees, Tondi driving and everyone singing along to The Beatle’s “I get by with a little help form my friends”.  It’s been eight months since my swear-in. As I watched the new volunteers deliver their speeches (English, French, and Kinyarwanda) I thought a lot about my training group, now dispersed across Africa, Eastern Europe, North, and Central America. My heart sank as I thought about the various events and ceremonies my stage cannot do together. I miss you all so much!
At the same time, speaking with the new group fills me with hope and excitement. After the ceremony, they had lots of questions, and I realized I was semi-qualified to give some advice about work and life in Rwanda. Finally, I am not the new kid in country! This group is Rwanda’s fifth group of trainees, but the first group to have lived with host families during training (not including my mini-group of four Niger transfers). They are energetic, passionate, and dedicated. I am so excited to be in Rwanda with them.

Friday, August 12, 2011

Things I did in South Africa

  • Meet amazing volunteers from other Peace Corps countries. Two other volunteers from Rwanda, also PCVs from Zambia, Lesotho, Malawi, Cameroon, South Africa, and Madagascar. The PCV from Madagascar started her service in Niger! I also met three Cornell alumni who now serve in South Africa. That brings my total Cornellian count to seven serving as PCVs in three different countries.
  • Enjoy time with former Peace Corps Niger Volunteers. Although I was unable to visit their sites, the three volunteers from Niger who transferred to South Africa were in Pretoria for their In Service Training and I was able to visit with them briefly. It was fantastic to see them, reminisce about Niger, and also hear about their successes and challenges in South Africa.
  • Attend mass in Spanish. You read that correctly. I attended a Catholic Church service, in Spanish, in South Africa. This was thanks to a wonderful couple also staying at the Rose Guest House, also for medical reasons, who also generally work in Rwanda. The husband works for the U.S. Treasury Department in Rwanda, and his wife is Bolivian. I don’t consider myself a religious person but I really enjoyed the mass. Sitting there, in South Africa, with people from across the world, speaking in Spanish… it put a whole new perspective on how small of a world we live in.
  • Go to the movies. I saw Transformers 3, and laughed through the entire movie, although I don’t think it was intended to be a comedy. Still, going to the movies was awesome.
  • Eat Sushi. Delicious. No explanation needed.
  • Spot Zebras from the Highway. Within twenty minutes of landing in South Africa. I’m not sure if that’s normal, but it was awesome. 
  • Bird Watch. I’ve never really cared about birds, but the birds I’ve seen in Africa are incredible. I’ll wait until my new binoculars arrive for a more detailed post on my bird watching adventures.
  • Use a Washing Machine. Never take for granted running water, or the fact that you don’t have to wash your underwear by hand.  
  • Play with Lions. The picture really says it all. They liked my hair. 
  • Visit the Apartheid Museum. A very enlightening experience. The museum is very dense—a lot of information, which I am still processing, but I’m really glad I went. I bought a copy of Nelson Mandela’s memoir A Long Walk to Freedom that I am now preparing to read.
  • Feel incredibly lucky, and conflicted, about my privileged access to amazing health care. I’ve been joking about how lucky I am to have needed a root canal during my service: free trip to South Africa! But it’s a strange reality I am living where I see malnourished children everyday and offer them "counseling"; the United States Congress debates how many millions of Americans should have their health insurance benefits cut; and yet my relatively painless tooth allows me to travel thousands of mile to receive some of the best dental care of my life.