It's not often in most developed nations that a large hazardous material truck would be laying on its back on the side of a well travelled mountain at the apex of a switchback with no guardrails, and not be cleaned up. Rwanda doesn't seem to think that's a problem. How would I know that it wasn't going to be cleaned up you might ask. Well, the driver of the disfiguringly dented vehicle had a tarp hanging over a well worn bed within the 10 foot area between the road and the drop to the bottom of the mountain. He even had a marked off roadside latrine area. I guess fate gave him a new home.
The six and a half hour drive from Kigali to Kibogora Hospital was a postcard-esque climb through the hills of Nguyen National Forest. Aside from the littering of downed tractor trailers, the steep switchback roads provided views of forest canopies and plants that could only have been drawn up by Darwin's trippiest imagination. The mutant sized aloe plants would defy gravity as they emerged from the cut away dirt siding. The arms would reach for the fervent passing of women colorfully clad in bright fabrics and men with handmade wooden carts. The women had heads which would be holding goods from bowls of fruit, to bags of rice, to bundles of firewood. Babys would be tied to their mother's backs with a simple cloth slung across the waist. They pay no bother to the passing traffic feet from their face. The men, tired and worn, mostly dressed in dirt stained rags raised their eyebrows as a bus of white foreigners, "Mzungus", point their cameras.
It's as if there are no borders. The people never stopped presenting themselves. From Kigali to Kibogora, there is no one without neighbor on either side. The thin colored metal and stick houses were just a natural progression of the path through the landscape. We stopped suddenly in a seemingly meaningless area of the jungle to find a baboon and her baby look down at us from a mounted bush. Our first extra-sapien primate experience silences the loud games we were playing to pass the time. We were then on full alert. We bacame very good rangers as a colobus monkey was waiting for our group at a turn not too much farther up. He had one hand fidgeting and a stump of an arm tucked in by his other side. I assume it was a he, because its more fun to imagine a stupidity induced, testosterone based brawl resulting in his amputation.
Our turn from the surprisingly paved road onto a dirt and stone menagerie signaled our arrival into town. We passed a stretch of about 100 yards of shops advertising fabrics, fruit and tools. Everyone was outside. They were just being. No rush or care was evident in their naturally stoic faces. The first emotion we saw was of a horde of children escaping the gates of school to play for the afternoon. Bright white contrasted grins spread across their faces as pinkies fled from thumbs and wide waving hands pleaded a return hello.
Kibogora Hospital is a Christian hospital perched atop a large tree filled-hill overlooking Lake Kivu. It started as the house of a western pastor, in the 1960's, to whom the villagers would come even for medical needs. It sounds as if many a band-aid were provided. He then hired a nurse and eventually a doctor. Today, Kibogora stands a legitimate hospital. It has many concrete buildings, housing operating rooms, men's and women's wards, an ICU, ophthalmologist, maternity ward, NICU, dentist, physical and occupational therapy, radiology (with x-ray and ultrasound), a basic lab to test cell counts, malaria and HIV, and of course, the most important of all, Kibogora has a pediatrics building. No one would ever mistaken Kibogora for a western facility. However, the infrastructure and quality of health care professional astounded me considering how far from a city we were. It is evident that a lot of love and hard work went into taking care of the community's health.
One thing that really stood out to me was the amount of children here. I don't know for sure, but I think that the skewed paucity of adults compared to their little ones is due to a concerted and subconscious effort to repopulate after the genocide ravaged the census in the mid 1990's. There will be plenty of patients for me who will certainly have many tropical diseases, of which I have only imagined from textbooks.
I am very excited to provide you all with some serious color commentary on all of the fun and strange diseases to come!
