Rwanderings

In my experience, in Africa, everyday is a new adventure.

Most afternoons I take walks around the various villages within my sector, in an attempt to become more familiar with the area and allow people to become more familiar with me. Slowly, I am beginning to feel more comfortable with my site and with Kinyarwanda, which allows me to go a little bit further each day. Last week I walked two hours to a neighboring sector where market was being held, and where a British VSO (a slightly more sophisticated version of Peace Corps) volunteer is posted.

Walking anywhere in Rwanda is a pleasure (and a work out) because of the spectacular views and endless green hills. On my way to the market, I passed the base site of the water project going on in the district right now. I’m told by December (actually I’ve been told this month, August, and December… so I’m going with December) the district will have running water and electricity! Talk about being a part of development!  

Passing a primary school, I put recess to a halt as all kids either froze or ran closer to the road to see me. This is a school I’ve visited before so there were less “umuzungu!” and more “Arrrrma!” which I assure you is no small feat.

As I edged toward the dividing line between my district and the next, I saw Mama Theofile, a very friendly woman I visited a few weeks ago. She was also going to the market, and so we continued together. Inevitably, we ran into several of her friends and stopped to greet them.

This particular market is a big one, set on a very steep hill. The “ground level” is a mostly animal—lots of rabbits, chickens, and very cute piglets! The second level, about half way up the hill, is what I call the general stuff section (baskets, pots and pans, and lots of plastic junk). The third and final level is where all the fruits and vegetables vendors sit, and all the used clothes. On my favorite screen print shirt of the day read: DO THE MACARENA!

Looking around, I felt a little bit like I was in the opening scene of a spy movie. You see George Clooney in sunglasses, walking through an African market unnoticed, until he realizes large scary men in khaki vests with earpieces and walky-talkies are following him. Next thing you know he’s back at the CIA operative office talking to his boss about an arms trade gone wrong.

Except here, instead of George Clooney it’s me, and I am very much noticed by everyone, and instead of being followed by large scary men, I have a long trail of small laughing children. I am not heading to any important office to discuss arms deals or potential coups; I’m just trying to find the only other native English speaker for miles so we can grab a Fanta and maybe complain about our latest outdoor latrine troubles.

While I walk through town, I realize I have no cell phone reception and no idea where exactly my friend lives. Luckily, I am in a remote African village so this presents absolutely no problem. I ask the nearest three-year-old where the umuzungu lives, and suddenly I have fifteen people (kids, adults, old people) offering to take me there. Te minutes and four different guides later, I reach her! After lunch, I take a bumpy motorcycle cab ride back home. This, all in a day’s “work”. 

Amandazi

 

I learned how to make amandazi, Rwanda’s version of fried dough! Although amandazi are at the bottom of my list of delicious international versions of fried dough, learning to make them is at the top of my international culinary experiences list.

It should come as no surprise that I have made great friends with the woman who sells amandazi and fresh bread. Athanasia is hilarious. She is an older, childless, unmarried woman—a rather marginal group in Rwandan society, yet she thrives. I admire her savvy and her wit, and I really enjoy spending time with her. When I visit, she always greets me with a huge hug and two kisses, “Muraho cheri!,” she says with open arms.

I recently confessed my love of all bread related things to Athanasia (as if it weren’t already painfully obvious), and she told me how much she loves chocolate. So we made a deal: she would teach me to make amandazi arachushe (the hot kind) and I would bring her cocoa to put in her milk.

The actual making of the amandazi was left mostly to Isa, a very nice young man who did not need or want much help from Athanasia or myself. He mixed the flour, sugar, yeast, hot water, oil, and eggs into a paste that he then kneaded, and kneaded, and kneaded some more. Then Isa cut the dough into small balls and fried them in oil, lots of oil. Amandazi arachushe: biraryoshe cyane! Delicious!

Pop Music in Rwanda

Despite my mother’s best efforts, I am not a musician. So I will spare you a useless and inaccurate analysis of Rwandan music and let you come to your own conclusions. Below, one of my favorite Rwandan pop songs at the moment. Hopefully I will post my own videos of traditional song and dance in the future.

Shout outs to the lovely Jesse Hyman and my wonderful sister Cristina, who I know will feel moved to dance to Rwandan music at the next Hyman Christmas party while everyone else laughs hysterically. 

Also heard on the radio (very often): Bob Marley, Enrique Iglesias, Backstreet Boys and, of course, Africa’s favorite-- Celine Dion.  

Health Insurance

I haven’t been able to keep up with U.S. national news, so I don’t know where the debate on healthcare stands right now. (Feel free to send me news articles to keep me updated though! hint, hint). What I have been keeping up with, however, is the rapid pace at which the Health System in Rwanda improves.

My sector health center and government are currently campaigning to get everyone health insurance. In Rwanda, you pay 1000 RWF (around $1.50, about the same price as a liter of vegetable oil) and receive health insurance for a full year. Each time you visit the health center you present your card and pay 200 RWF (30¢, about the price of a kilo of onions) for whatever you need: consultation, lab tests, medications, etc. If you don’t have health insurance, just like in the U.S, things get pretty expensive.

Health Center Staff

I cannot imagine this system being feasible without the enormous donations Rwanda receives in foreign aid. Still, the government’s management of the health system is impressive and should serve as a model for other developing and developed countries.   

This month I’ve seen the health center and local government staff mobilize in an incredibly effective manner. People were posted on the road Friday (market day) ready to sell insurance. After Saturday’s umuganda every village leader rounded up her community to discuss the benefits of health insurance. Monday, most of the health center administrative staff went out to visit the villages furthest away from the center, talking to more people about the benefits of health insurance. 

I am fortunate enough to never have been in a position where I have had to make a choice between buying health insurance and buying food or shelter—but I am currently surrounded by those who do, and they mostly chose health insurance. It’s certainly an interesting comparison to attitudes and debates in the United States!

Sleep Out

For once I am not talking about the Cover Africa Sleep Out on the Arts Quad… although shout out to those who did just a few weeks ago!

A week after the National Genocide Memorial Week, my community organized its own memorial event: a sleep out at the exact place (and on the exact date, I think) where seventeen years ago hundreds of Tutsi were locked inside the local government building where they had been seeking asylum, and burned to death.

Around 6pm on Friday April 22^nd the community gathered in the center of town and slowly, singing, walked together to the site at the top of a hill. There, the local Genocide Memorial Association had set up large tents, chairs, and spread hay over the rocky ground.

People greeted each other with silent nods and smiles instead of the usual handshakes and loud “Muraho!”s. Waiting for the final preparations to conclude, everyone spoke in whispers. Once the microphones were hooked up to a generator and enough people were seated, several older community members gave speeches. These were followed by more lighthearted youth performances: dance, song, poetry, and even theatre. These acts served to lighten the mood, and by the 9pm when a storm hit the tents, most people were smiling.

Once the weather calmed down around 11pm, a TV was turned on and music videos of songs remembering the genocide played on repeat. At this point most of the older adults went home to bed. The young people stayed and invited friends, who came and crowded around the bonfire and the television. By midnight there were at least 600 people watching music videos on a screen no bigger than the one in my family’s basement in Pennsylvania.  

Throughout the evening and into the night the atmosphere became noticeably less solemn. What seemed to prevail throughout the entire event, however, was a powerful feeling a unity and collectivity. It’s very possible that my lack of understanding of the language, culture, and each individual’s background allowed me to have rose tinted glasses for the event… but I know the toddler sitting in front of me throughout the night was laughing genuinely, and I’m pretty sure the adults who surrounded him were smiling frankly as well.

The Paper Trail

In an early blog post from Niger, I mentioned my interest in health data and record keeping. Well, I am in the right country. Rwanda has some of the best health related record keeping in Africa. At my fingertips are stacks of logbooks on everything from the number of HIV/AIDS counseling and testing sessions conducted in my district this year, to the number of ibuprofen tablets in the pharmacy and their value. This impeccable data recording does, however, come at a price.

My health center has only two computers and very few people who know how to use them. One computer is used mainly for accounting purposes, the other for sending monthly reports to the Ministry of Health in Kigali. Day to day statistics are all kept in large graphing paper notebooks.

It takes three or four of the ten trained nurses at the center to work prenatal consultations. Every Thursday, as pregnant women line the hallway and outside waiting area of the center, the nurses sit in the consultation room and write.

The forms to fill out during each prenatal visit include: the center’s prenatal logbook, the laboratory logbook, the mosquito net logbook, the HIV/AIDS voluntary testing and counseling logbook, the individual prenatal health sheets for the health center, and the individual prenatal health sheets for the pregnant women. Each form/book requires a lot of the same information in a slightly different order, plus one or two additional facts (usually irrelevant to your health) that make it unique.

Recordkeeping is essential for successful monitoring and evaluation, and overall better healthcare. I spent many hours writing my thesis in Olin Library convinced that if only developing countries could record data effectively, most health issues could be resolved in no time. Now I spend my mornings in the consultation room wanting to tear the record logs apart.    

Rwanda’s healthcare providers are currently under a performance based financing system, which has been largely praised by the international community. This system stresses data accountability and puts pressure on health workers to record their every move.

All of this is great, until a twenty year old woman, eight months pregnant, who can neither read nor write, stands in front of a row of nurses with enormous notebooks who ask very personal questions and write answers without bothering to look up.

Keyword in all Peace Corps projects: behavior change.