Mille Collines

This is a typical view of the route to Butare.

We made some friends who loved seeing their photographs and wanted us to keep taking more pictures.

Genevieve is doing a machine check in Butare. Nepo is giving us the tour. He is a clinical psychologist and trained in conflict management but is working as an OR nurse since there is no support for his other skills.

There are huge contrasts in Rwanda. Even at CHK ( Kigali Hospital), some areas are very modern and well renovated and other areas are in dreadful condition. There is a large amount of construction ongoing. They are building 6 new operating theatres as well as a pre-surgery area and a recovery room. We have seen the rooms, which are structurally built but still need a lot of finishing work. They are large, with windows and high ceilings. It will be a beautiful OR suite on completion. A large building is also under construction which will contain a new emergency department, step down unit, trauma bay, duty rooms, administration and clinics.

One of the most vivid experiences we had was walking into the surgical ward at CHK. I was raining hard as we passed through the surgical ward to get to the room for teaching rounds. The floors were wet from the rains and being mopped. The ward must have had 100 patients, of all ages. There were old people and children and babies. There were people lying on the floors and beds with many patients. Everyone was very crowded together and there was little space. As we walked through, a couple of children smiled and waved.

On Saturday we traveled to Nyungwe National Park in the south west corner of Rwanda. En route we passed entirely through rural Rwandan countryside, which is absolutely spectacular. They call this the land of 1,000 hills but it must be closer to one million. The hills are all terraced with crops like tea, coffee, banana, pineapples, sweet potatoes and corn. Every part has been cultivated even though the hills are extremely steep. The hills go off to the horizon in ever fading layers with mist in the valleys. It is unbelievably beautiful.

Rural Rwanda probably has changed very little in the past 100 years. Along both sides of the road, in the most rural areas imaginable, there is a constant stream of people, usually carrying heavy loads on their heads or pushing bicycles fully laden. Even little children carry huge sacks of potatoes on their heads. We drove through country, with a few little villages, for one hour and through the whole journey there was no point where one person was more than 20 feet from the next. The women wear colourful dresses, usually with matching headwear, and often have a baby strapped on their backs. There are children everywhere and they find us hugely amusing. They love to wave and smile and go into fits of laughter when we wave back. The only motorized vehicles on the roads are buses and trucks with very few private vehicles. Bicycles are fully utilized –even to carry loads of lumber or animals or a whole family!

Nyungwe National Park is huge and it’s great that Rwanda has preserved this area. It contains 20 % of all African primates. It is a rainforest high in the mountains near the continental divide that separates rivers flowing west to the Congo from rivers flowing east and north to the Nile. When we arrived there was another small group of people getting ready for the tour and they were Italian. Some heads turned quickly when I said, “Buon giorno. Siete italiani?” They were doctors and nurses from Italy working at a mission in a remote village north of the park. So, we ended up having four hour tour through the rainforest together. The guide spoke French because it was the best language for all of us (needless to say, he spoke no Italian). African French is fantastic. They speak so slowly and clearly we can understand almost everything they say. Our guide, Cumbogo, is extremely knowledgeable about the flora and fauna of the region so we learned a lot about the various trees – on which induces abortion, another is like a combination of Ecstasy and Viagra, and another has large seed that 14 year old girls used for bra stuffing. We saw blue monkeys swinging from the trees and old growth mahogany trees that reach 60 metres. It poured rain for a good portion of the trek, which took us down a huge descent to a waterfall and back up a very steep hill. The rain cleared leaving mists in the valleys.

Back to work tomorrow.

Ciao, Patty