Beautiful empty facilities

Last night there was a very serious meeting between the Ujama team and our American liaison as well as two of his Rwandese counterparts. Given that Ujama is a test group, there are many wrinkles. While Rwanda has welcomed one or two health practitioners at a time, they have never hosted agroup of this magnitude.

Last Friday there was a case of symbiotic shock- us and them. Clearly the staff at Kibagabaga Hospital had not been adequately prepped about who and what was to descend on them. The American personnel were taken aback wtih varying levels of dismay at what represented a reasonably well supported district hospital. A patient roaming the hospital grounds with TB, pre op patients sharing a bed with a patient with an infected wound. The delivery of a dead baby that easily could have been saved with the limited resources that this Rwandan hospital offered. Cardiology patients that clearly would have been surgery candidates with no technological or financial means to make that surgery possible. A very African sense of time and cleanliness.

Today, things are better. The OB-Gyn team is delivering babies as fast as women push them out. Three c-sections before 2:30;a couple of other deliveries and a set of twins. Hal and his cardio team are doing echos, diagnosing and teaching. Advocating for the smallest change which may make all the difference in the world and take all the time in the world. Ryan, our surgeon, has been extremely creative in thinking about systems for the future. The remainder of the team is off visiting and beginning a pilot project in a pygmy village.

I visited the center for mental health and trauma treatment. It is a beautiful building on a very large plot of land and potential to expand. The landscaping is beautiful. The director was looking forward to me teaching classes in anxiety, depression and PTSD. Unfortunately the director was called away ...a death in the family. How many times I have heard this line in my past African experience? Without the designated director, decisions can't be made. My tour of the beautiful building included halls of empty counselling rooms with plastic chairs and a mattress covered with a dirty piece of fabric.

No budget for training however, no trainees, and the counselling staff has currently been reduced from 37 to 7.

Two delightful women weree my tour guides. The cancelled counselling program that they work for is a year of training following 9th grade. There have been a total of 115 counselors trained since 1996. One psychiatric hospital prescribing valium or halidol and one psychiatrist for an entire country that is walking around in varing stages of agony. I cannot imagine 16 year old Chloe serving as the trained mental health support for this situation.