Hot off the press

The planning for the HHS visit over the past few weeks is finally paying off. The Secretary's visit has been a huge success over the past two days. Here are some photos from today...

Here members of the delgation are talking with a family about the home-based management of fever program where health workers visit homes and distribute medication, bed nets, and other supplies.

Here is a team of home-based counselors describing what supplies they distribute.
Here is Health and Human Services Secretary Leavitt addressing the community members and supporting the distribution of and use of bed nets.

Here is Admiral Ziemer (Coordinator of the President's Malaria Initiative) and Ambassador Arietti (U.S. Ambassador, Rwanda)
Here are students at a school performing a modern dance.

Here the delegation is watching a skit performed by an anti-AIDS club about voluntary HIV/AIDS testing and counseling.
Here Aimee is introducing Moise, the student President of the anti-AIDS club at a local school to the Secretary and she is standing next to Dr. Innocent who is the Government of Rwanda's Minister of State.
Here Secretary Leavitt is asking questions to a group of students participating in an HIV/AIDS education and pre-test counseling session.
Here Dr. Julie Gerberding (Director of the CDC) is talking to one of our counselors about the HIV/AIDS testing materials.

Here Secretary Leavitt is getting a finger prick HIV/AIDS test at the school.

Here is Secretary Leavitt with some of the students.

A lot of planning has gone into this visit, but of course seeing the product is exciting. I have also enjoyed meeting the Secretary and many of the delegation members. The programs we planned for the itinerary have really highlighted the impressive prevention and treatment activities in Rwanda along with the many positive results on the health of Rwandans.

Gorillas in the Mist

I travelled to Ruhengeri on Friday night to see the gorillas on Saturday! This was one of the most incredible things I have ever done; if you get the chance you should really come and meet the gorillas in Rwanda.

The first step to see the gorillas is to acquire a permit from the tourism office in Kigali. I had tried this twice before since I've been here and found the permits to be sold out. They only allow 50-60 people to go each day and each group can only spend one hour with the gorillas. This week I was invited to join my friend Laurie and her brother Michael and I lucked out by acquiring a permit from someone who was unable to go. We drove up the night before and stayed at a guest house about 300 meters from the Parc entrance. We arrived at the gates of the Parc de National Volcanes at 7AM on Saturday. There are seven groups of gorillas on the volcanic Mt. Karisimbi(4507m), Mt. Sabyinyo(3634m) and Gahinga(3437m) with between 7 and 30 gorillas in each group (roughly 80-90 gorillas all together) and there are only about 700 gorillas worldwide! At around 5AM the gorilla trackers (parc employees) go up into the mountains and find the various groups of gorillas; they then radio the location to the parc guides who alert all of the permit holders how far the gorillas are located. Each group is at least a 30 minute hike up the mountain, with the Susa group (oldest and largest group on the mountain; 30 gorillas) usually a 7 hour hike. There are a maximum 8 people per group; and they ask whether you'd like a long or medium hike. We did not hike to the Susa group (next time!) but we selected a medium distance hike to the HIRWA group (11 gorillas including one silver back, five females, and five babies.)

Michael, Laurie, and I with Mt. Sabyinya behind us.
We drove for 30 minutes with the parc guides, then hiked about 45 minutes around the foothills of this mountain. We passed a few villages, and many potato fields. The guides informed us that the buffalo and elephants on the mountain sometimes come into the fields and disturb the local villagers. But the gorillas rarely come down the mountain- only occasionally and just on the edge of the forest. During the dry season (June-Oct) the gorillas are often located higher on the mountain where there is still lush vegetation. We couldn't have asked for better weather on this day; sunny and warm!

We carried water and rain jackets with us. The guides instructed us about how to act around the gorillas. It is important to whisper, not bring any food, not point fingers, and turn away to cough or sneeze. We learned that the silver back gorilla in this group was originally in the Susa group but fought with the leader and about five years ago he took two of the females from the Susa group and started his own group. He also stopped by another group on the mountain and took another three females. Then over the years each of the females has had one baby. He is 28 years old, and some of the females are older than him (they live to be about 45 years old). The babies in the group range from one month to 5 years and are considered babies until they are 7 or 8.

Once we reached the edge of the mountain and forest we hiked uphill for about 45 minutes. Then they stopped us and pointed down into a valley of bamboo shoots and showed us where the gorillas were eating. We could hear them before we could see them; they were breaking off bamboo shoots and munching away. I could see the occasional head pop up out of the bushes. We then had to shimmy down a hill through these trees. Once down in the valley the guide approached the silver back gorilla and made grunting noises while we all crouched quietly. The gorilla grunted back a few times and rolled over to look at us. The guide indicated to us that the silver back has said it was okay to come closer and visit them. We all laughed; incredulous that the guide was able to communicate with him, but I guess it was true! We had two soldiers with us which made us feel safe. Although after our one hour with the gorillas we learned that their purpose is really to stay there after we leave and ensure no poachers have followed us or the trackers to the location of the gorillas.

This is the silver back. We were about 5 meters away from him. We were told he weighs about 220 kg (close to 500 pounds!) And that he can eat up to 40 pounds of food a day (needless to say he was eating for the entire hour we were with him). This is him behind me. We watched him eat, and he mostly watched us take pictures of him. He rolled around sometimes and mostly remained patient while the baby gorillas moved around playing. The females were scattered throughout the bamboo also eating and tending to the babies occasionally.
This is the silver part of his back.

This is one of the babies. They were the most fun to watch. They would roll around. Often fall down, wrestle with each other, and pound on their chests. They were pretty much oblivious to us but very involved with each other and their mothers and father.
This baby is 8 or 9 months old.

At one point this baby came over to us. But the silver back came and got him and seemed to reprimand him. He ran crying away. It was fascinating.

This one mimicked the silver back the whole time; like his shadow.
This is our group after coming out of the forest.
It was exhilarating!

Sunset over Ruhengeri

Uganda

I traveled to Ha'Buharo Island Lodge on Lake Bunyonyi in Uganda this weekend, with five friends from work. We left in the early evening on Friday (traveled 2 hours, just over the border) and made it to a dirt road leading to the lake just after dark. At the border I realized I had not brought any US dollars or purchased a Visa from the embassy. This is surprising given the planner that I usually am! I guess I was thinking of this spontaneous trip to Uganda like travelling between states in the US. I was lucky- because I was travelling with friends with diplomatic passports I was able to pass without a Visa. Also, I was lucky to be travelling with people who had extra money and were willing to "cover me" in exchange for Rwandan francs! After we arrived at the lake we hiked down to a boat landing, and took a dugout canoe ride (25 minutes) to one of the 29 islands on the lake. It was so dark out, and it was raining at that point; quite an adventure. We stayed in the only four tents on the island (they were not too rustic- we had beds and bathrooms with running water). After midnight they turn off the electricity. I had no idea how dark it is with no light (it was cloudy so not even any moonlight). On Saturday we awoke to over 200 different kinds of birds chirping on the island. We took a motor boat ride around the lake and hiked around the island. I took hundreds of photos of the flowers and scenery! It was a relaxing weekend, we played games, ate mostly crayfish from the lake, and had a great time. For my brief excursion over the border I noticed Uganda has more import/exporting than Rwanda (the supermarket had things like Vanilla for baking, and more variety of diet soda, etc.- and we stopped for gas at a Shell station) and most people spoke English (Uganda was colonized by the British).

Here is a link to more photos of the flowers and scenery in Uganda.

News Release

Here is a recent press release about the Secretary's visit, for which we are busily preparing!

Goats, culture, and lessons in diplomacy

Today was an interesting and challenging day. I was in the field conducting site visits in advance of the upcoming visit by U.S. government officials. First, I visited a rural health clinic 2.5 hours from Kigali. Along the way I considered the transportation needs of 40 people, feasibility of buses, bathroom breaks, and sharing the winding roads with people, animals, and minibuses everywhere. After the last uphill dirt road, we drove over the crest of one of the many thousand hills here and arrived in a picturesque village with a school, church, homes, and the health clinic. I was greeted by the Director of the clinic and representatives from our partner university implementing the HIV/AIDS programs at this clinic. (In Rwanda it is customary when you first greet someone to shake hands in a sort of hand slapping "high five" way. As you get to know someone better it is customary to give three air kisses on the cheeks in hello and goodbyes.) We gathered for a meeting in one of the buildings of the clinic and I spoke both French, English, and had my colleague translating into Kinyerwandan to get acquainted with everyone and discuss plans for the upcoming visit. (It takes so much longer to conduct a meeting in 3 languages!) They proposed a large welcome with involvement of local government, singing, and dancing. I loved this idea but also had to respectfully suggest shortening the timing/keeping activities brief. They asked what food and drink they could prepare and suggested a large reception at the end of the visit with the whole community. I found myself expressing appreciation for their efforts and ideas but tactfully and regretfully declining plans for food or large receptions due again to timing. We walked around to various buildings where visitors will learn about HIV testing, counseling and prevention activities, and HIV/AIDS treatment services. They had many ideas about how best to highlight their programs and participants. This was the start of a long, tiresome, yet rewarding day, learning the diplomacy of and importance of getting consensus, respecting suggestions and traditions, and negotiating the constraints and requirements of the visitors.

After reviewing the proposed clinic activities we walked down the lane to a community building where it was proposed we would see basket weavers (as part of the "People Living with HIV/AIDS" Association work project) and would be the location to exchange gifts. It has been decided that the visitors will be give the Association 25 goats. As you can only imagine, logistics include determining how we will get the goats to this location, how we will store the goats before the "ceremony", and how we will take pictures of 40 visitors giving goats similar to giving a symbolic over-sized check. (Luckily I am not tasked with figuring out how to buy goats!) The goat logistics provided endless entertainment throughout the day. We joked about how these goats would need to be tagged with our logo, and whether we should order special collars for them. Is it appropriate to put red bows on goats? I learned that goats are good gifts which keep on giving because when they breed the Association can sell the offspring. I think I actually asked how one picks out goats that are most likely to breed?! By the end of the day I had suggested to my team that I needed a t-shirt with the slogan "goat coordinator".

At one point I thought a better location for the goat exchange was further down the lane near a school and church because their suggested location had little yard space and potentially the goats would destroy the garden. We walked to this new location and I felt it was picture-perfect. However through translation and much discussion I learned that the Director did not feel this would work because it would be too disruptive of the school and community; the children would be in school until an hour after we arrived. I found myself asking if the children could be dismissed early for the event and pushing for this incredible location and photo opportunity. (When did I get into the business of PR?) The Director stood her ground and in the end we agreed to stick with their initial location. We set a plan for how best to handle the goats; determining they will be tied to a tree in a graveled area of the yard so as not to harm the grass and garden. Then after the formal ceremony they will be moved to their actual farm location a few miles away. I ended the visit expressing my sincere appreciation for the Director's commitment to the children and the community and how lucky we are to have people like her implementing our programs!

After the clinic we headed to the proposed lunch location. Identifying a close, comfortable, and tasty lunch restaurant in this rural, mountainous part of Rwanda is no easy feat. Luckily 30 minutes away on the edge of Lake Kivu is a new hotel with a stunning restaurant balcony view of the lake. I met with the owner and continued negotiating the planning. The owner is a savvy businessman and rightfully sees this lunch as a money making opportunity. He set high prices, strongly urged that we rent hotel rooms for "washing up", and eluded to his "usual" protocol with "VIP" visitors. (The hotel and restaurant are less than 6 months old!) He introduced me to his "internationally renowned" chef, and I navigated menu planning having to explain what possible vegetarian items could be included, and how to avoid any raw vegetables or salads in the meal for the visitors sake. We joked about how it may not be appropriate to serve the popular goat brochettes (grilled on a stick). He wanted us to pay in advance and I had to explain how our government does not pay for non-working lunch meals so everyone will pay individually on this trip. Eventually he agreed to a "set price" for the buffet and one soda and one water per person and I agreed we would collect money and pay one amount after the lunch. He was not keen on limiting the number of drinks and teased me asking whether I would be able to "restrict" the VIP's? I held my ground and pointed out, didn't I look strong enough? (When did I become a savvy business person?)

Running late, we rushed from the restaurant to a rural district hospital 10 miles away for the final proposed location on that day's itinerary. On the way there it was clear that it would not be feasible to include this site on the itinerary as it was. I was concerned because the hospital Director and others had already put in some effort organizing and making plans for this visit. Like the health clinic, they had a long list of proposed activities and parts of their program to highlight, and there was a large group waiting for us and greeting us when we arrived. I met with the team including the Director of the hospital. I thanked him and commended him for his role in these programs. I became acquainted with him (again through a tri-lingual and partially translated conversation) and eventually had to break the news that this site would not be included on the visit after timing the itinerary today. The Director took this news in stride and was gracious and accommodating. I offered that he and a few of the hospital staff join in the health clinic visit and be invited to lunch and he was happy with this idea. We rushed back to Kigali before dark, timing the way home with traffic and other considerations. At 6pm we began the re-writing of the visit scenarios, timing notes, and other details learned from the day.

I'm sure I will fall asleep wondering will the goats arrive on time, will the VIP's order more than two drinks... will we pull this off?

Exploring Kigali

Did I mention Kigali is beautiful?

In front of "Hotel Rwanda" (which is actually called the Milles Collines Hotel)

Nandita came to visit Kigali this weekend. This is on the balcony of "Hotel Rwanda". This is Bane, my taxi driver and friend.
This is Francine with Nandita.

I bought some paintings from this artist named Paul.

We went to the market to pick out some fabric. I hope to have some clothes made here.

This is Caroline with us in front of her shop.We visited the Genocide Memorial. There are over 250,000 people buried here in mass graves. It is estimated that over 800,000 people died during the genocide in 1994. They continue to have burials here as people are found, identified, and brought here.

They have begun a list of names of the victims on the wall.

There are beautiful gardens at the Genocide Memorial. It was a wonderful place but also terribly sad to visit. I did not take pictures inside; the exhibits cover pre- and post- genocide Rwanda. It is hard to comprehend how this could have happened and how the International community did not help.

Nandita and I had dinner with my friend Laurie and her brother Michael. We ate at Sole Luna; my favorite restaurant so far. This is Susan, from Atlanta, here to help with the Secretary's upcoming visit.

Donald hosted a brunch on Sunday.
Noni and Marie Claire. It was Marie Claire's birthday on Sunday. Her brother designed the Memorial in Kigali; they lost almost everyone in their family during the genocide.

Donald and Aimee on the back porch. There are incredible views everywhere in Kigali!