Who's at the dinner table?

I joined a group last minute this evening leaving work headed to dinner. I serendipitously ended up in the middle of invigorating dinner table conversation. I talked at length with two colleagues across from me working to integrate quality improvement in the HIV/AIDS care and treatment systems here in Rwanda. I shared information about efforts at the National Cancer Institute toward connecting health outcomes to quality of care, and particularly about my experience working on patient-centered care initiatives. They were very interested and shared about elements they hope to include in a program here coaching and training trainers in the Rwandan health care system using various process indicators to track and ultimately improve the quality of care for HIV/AIDS. This was right up my alley and it was so great to connect my experience in DC with work here! I am excited to connect them with colleagues at NIH. On my left I found a friend who is working directly with the Ministry of Infrastructure in Rwanda to tackle energy issues. This is not right up my alley but I was fascinated to hear about possible solutions to energy crises and energy access problems in Rwanda. Further down the table I talked with a colleague who has worked in many African countries and shared about her dissertation on colonization in African countries. I commented about how I awoke this morning feeling the weight of the historical impact and footprint we have on a country like Rwanda- swooping in with millions of dollars in aid and then theoretically swooping out at some point. We discussed topics of great importance to me right now including sustainability and systems strengthening; critical to working successfully as a guest in a developing country. Another colleague brought her parents who are visiting Rwanda for 15 days. It was a joy to talk with them about their impressions and inquiries about what to see and do, and made me miss my own parents even more. On top of all of that, we ate at my favorite restaurant- stunning views and the best fish kebabs in the city. Just another typical evening in Kigali!

Uganda (Kampala, Lake Victoria, the Nile)

I've been in Kampala, Uganda in training this week taking the CDC International Project Officer course. I've met many CDC colleagues from Uganda, Ethiopia, Tanzania, and DRC.

Leah and I became fast friends and went to dinner together most nights. She is originally from Panama but is working with the CDC in Tanzania right now. One of the nights she and I took a taxi to the Munyono Resort on Lake Victoria.

Lake Victoria behind me.

Here is a view of our hotel courtyard (Protea Hotel). Very pretty, comfortable, fast internet, very efficient hotel management, and yummy breakfast buffet.

On Thursday, Leah arranged an excusion for a number of us to visit the Nile. Here we are in the bus leaving Kampala.

Sights along the side of the road...

My seat-mate Robert from Tanzania.

Uganda outside of Kampala looks alot like Rwanda...small towns, tea fields, green hilly countryside.

First we stopped at Bujugali Falls. This was a very pretty area of rapids on the Nile.

Dangerous waters!

We took small boats out on the water- thankfully they had life preservers for us!

This was a pretty pelican near the shore.

We stopped and went on a short hike.

The guide pointed out where they are building a new dam and indicated all of the islands and the shore here will soon be submerged, but more power is needed!

A cow on the pretty hillside.

Next we went to the Source of the Nile-- where Lake Victoria begins to flow into the Nile.
We took another boat ride to get a closer look at this source.

Here the guide is pointing out where natural spring water bubbles up from the under the water, also filling the Nile. We were skeptical of this story.

We stumbled accross some rocks and climbed on a small rocky island. I slipped at one point and submerged one foot underwater ver briefly. After reading about the water in Lake Victoria- I am a little concerned I caught schistosomiasis (a snail parasite that hurts the liver over time)- let's hope not! I am going to consult the very knowledgeable CDC staff in Rwanda about this when I get back.

We stopped on the way back and bought Casava- which is sold as "fast food" on the side of the road. I'd never seen it before. This harvested from the ground, grilled on the barbeque served in newspaper with salt. You eat the whole thing- and it tastes a little like a potato.

Pics from Week 1- apartment and Kigali Hash House Harriers

View from the balcony of my apartment-

A view of Kicyuru (my neighborhood) from the downtown hill-

Dining Room (I packed some of my own pictures, including an Obama calendar!) -

Kitchen (Brand new microwave and toaster...yay)-

I found the Kigali "Hash House Harriers" last weekend. For those of you who are not familiar- The Hash House Harriers began amongst some British in 1938 in Kuala Lumpur, Malaysia as a group of people coming together to run/walk/and make friendships on weekends. It has since become a worldwide phenomenon. In Kigali- you can send a text and receive instructions on how to join the weekly hash run/walk.

This is the restaurant where the Hash met last weekend. It was difficult to find- and we got lost twice but we made it!

There were about 6 of us who traveled together- invited by two women who attend the Hash regularly.

We knew we were in the right place because of the pink "HHH" sign above the door (Barbara and I)

There was a very pretty view from the restaurant balcony of the road back to Kigali.

Jenny and I

Once it started- we circled up and the leaders explained some of the rules including that Hash attendees receive a nickname from the group after participating 10 times and can only request a re-name after 25 times participating. His name is Rambo. He also explained that two "Hares" have marked our trail for this evening hike and we should watch for white paint markings to follow the trail. There are sometimes when the road parts ways and the group yells out indications of which way is right if they find the right markings. I realized quickly this would be especially hard because this Hash would be by flashlight! Some people run on a trail and others do the walking trail and everyone meets at the end for dinner. I decided to go with the walking group for the night Hash!

I couldn't get many good pictures of the trail because it was so dark as we walked. But here I am staying close behind the "hare" (I didn't want to get lost on my first Hash!) and much of the trail went through neighborhood alleys, up and down hills, around the Kigali stadium, and through the nieghborhood. It was about an hour and a half of walking/hiking.

When we returned all the new people (including me) were introduced and some people changed into ties and dresses because this was the Valentine's Day Hash and formal attire was "suggested" in the instructions.

We ate dinner at the restaurant when we returned. Yummy chicken and goat and rice.

Drinking beer is a definite part of the Hash tradition but not required of course. I especially liked that there was a DJ and dancing after dinner!

I liked that the Hash in Kigali included as many Rwandans as ex-pats, and that many Hash trails are outside of the city. I learned that next week it is in a "suburb" of Kigali called Rwamagana, and the next week they are headed all the way to another city- Ruhengeri. I hope to attend another one soon!

Observations at the start of my 3rd visit

What’s Changed?

1. Me
On my first trip to Rwanda I had a lot of fears- I didn’t know anyone and everything was new and different. I was forced to adapt, overcome fears, and make friends quickly. I notice these traits kick in much more quickly each time I return. I also don’t feel the immediate pressure to travel the whole country in the first month. I’ve seen many parts already, and I have more weekends to spread out the fun. I’ve been approached by two new friends who were “told” I was the person to talk to for weekend trip ideas and outdoor activities. Not a bad reputation to have! In some ways returning is easier because I already know people, I’ve worked in this building, and I’ve lived in this apartment complex. In other ways it is harder because I miss more things from home now that some of the new-ness of Rwanda has worn off. For this trip I ended a job, moved out of an apartment, and left a significant other in DC, these things are much harder.

2. The City
Each time I return to Rwanda, colleagues and friends update me on many changes to buildings, roads, and restaurants while I've been away. Rwanda continues to develop at the speed of light. I heard that a new Kenyan grocery store chain had opened called Nakumat, so I went there on my third day. It is amazing! Almost like Target (although pricier)…there are even beauty/health and electronics sections. I sort of miss the challenge of finding all these items secondhand from street vendors or in small un-marked shops around Rwanda. I also learned Indian Kahzana restaurant closed, which was a favorite among ex-pats especially for the lively birthday singing and yummy food. There is a new flashy, neon-lit, hilltop hotel that no one I know has stayed in, but is rumored to be bringing slot machines to Rwanda. The Novotel (where I stayed in July) has changed management hoping to boost the quality of rooms and service (which was needed!) The Ministry of Health is re-organizing…we are not sure how this will impact our work yet; it may only be structural/name changes or may involve new authorities.

3. The People
There are constantly new members of the CDC and US Embassy team. I am sad that Marie-Claire is no longer here in Rwanda and we have lost two other important Rwandan members of our CDC team to other jobs. I will miss Mahita who provided my first introductions to Rwanda life and expectations. She worked here 4 years, and has now moved back to the States for an exciting new job. I am happy though to have already met some fun new friends on the team.

4. The Work
Both times I have been to Rwanda have been in the summertime and we worked mostly to gear up for and execute end of fiscal year spending and the next year’s budget and HIV/AIDS program planning. I am here for that time period as well as the “off-season” this time. The work is still very busy but more focus is made on managing human resources (hiring and transitioning team members), working with the grantees proactively, and planning ahead for retreats and the upcoming budget season. I also had a chance to visit Atlanta and meet many headquarters staff before I came this time, which will immensely improve my efficiency. I am excited to be here during this planning phase and hope to develop more tools to leave behind that will help future teams track and plan progress.

What is the Same?

1. The Beauty
I always wonder if the striking beauty of this country will fade the next time I visit. Not so. When I arrived after dark last Saturday (the sun sets at 5:30pm), I couldn’t decide whether I liked Kigali better in the dark or in the daylight. At night the view includes rolling hills of flickering lights, the sound of palm leaves waving in the tropical breeze, and the smell of burning wood mixed with lush green (is that a scent?!). In the daytime the sun shines brightly nearly every day. The view includes rolling hills of brown/red city streets, green lush ground cover in the distance, and bright flowers in nearly every yard. The streets are crowded with hundreds walking, uniformed school children headed to class, cars speeding around motos, and small mini-buses packed with busy people.

2. The Weather
I’ve never known a place with such perfect weather. If it is grey for 10 minutes in the morning the office is a –buzz wondering what is wrong, questioning the effects of climate change in the world? I have yet to be here in the heart of the “rainy season” but have heard it also merely involves a brief heavy afternoon shower.

3. The People
The culture is as cautious and yet welcoming as ever. I had warm welcome from many friends and colleagues. Our relationship with the Rwandan government to get our work done remains strong. The Rwandans are active participants in our partnership on improvements to health care and disease prevention; it continues to be a privilege to work here.

4. The Work
Daniel (our Deputy Director) is leaving again. This time he and I only had 3 days to transition. I will fill in for many of his duties again. He needs shoulder surgery, will recuperate in Atlanta, and will return to Rwanda in mid-August. More than his oversight and advice, I will miss the energy and companionship he brings to the team here. Wearing many hats, jumping-in to big decision-making, navigating the collaborative teams among three bureaucratic organizations- these things have not changed and I hope to thrive again under these challenges.

Travel Notes- Friday and Saturday

(Friday 6:15pm in Dulles on the tarmac...) I have a whole row to myself on this leg of the trip. Row 39 EFG. Lucky me! Now I can stretch out. It's already strange on the plane- no one is speaking english around me. I hear french, german, and dutch. All of the ennouncements are in multiple languages. The flight is 6 hours and 12 minutes. They are showing a series of movies 3 different times during the flight. I can choose from Flash of Genious, Secret Lives of Bees, Nights at Rodanthe, Dutchess, Max Payne, Rachel Getting Married, or Burn After Reading. I think I'll choose Rachel Getting Married. There is a picture of a plane and a map on the back of the seat in front of me. We are still over the U.S. heading up the eastern shore.

(Saturday 15 hours later...) I'm the second leg of the trip now. I had a good flight to Brussels and arrived there at 7AM. I always forget how hard it is to transfer internationally. United Airlines did not print an actual ticket for my flight out of Brussels so when I went through customs they told me I had to leave the international terminal and go to the ticket counter at the front of the airport. I had to wallk very far to go outside and then back in a long line at the SN Brussels desk- the American Airlines partner. They couldn't find any reservation for me. It was scary for a moment. But I stayed persistent and asked for a supervisor, etc. I explained 2 or 3 times that I flew United and was switching to American Airlines (complicated by the fact that I was at the SN Brussels desk because they are the carrier...) Eventually they called United and it got sorted out and they found the ticket. whew. As it turned out when they talked to United, they learned my bags had been offloaded in Brussels by United. So, I had to walk down to baggage claim and pick out the 5 bags! I guess this is the silver lining, because I would not have learned my bags would not have made it, if I had not had to go out to this airline desk. Unfortunately they also told me that SN Brussels only allows one carryon bag...so they made me check my other one. (NowI have 6 checked bags!! This was particularly stressful to me because my carryon bags were jammed full of expensive electronics and migraine medecine. I watched it go away on the baggage carousel with fingers crossed that I would see it again soon!

My layover in Brussels was from 7AM-10AM. I wondered around the International terminal looking at the duty free things. I was reminded of how Belgium is an english speaking country but I think french is the preferred language. There is a little hint of annoyance when you ask people to speak english (airport personnel and store clerks). I wasn't brave enough to break out the french yet., but will have to soon. I am always a little shy at first- the accent is so hard. I
stopped at a cafe and bought a "jambon and fromage" (hame and cheese) baguette for 4 euros and a coke light (diet coke) for 2 euros. That was an expensive snack!

Every time I wake up from napping on the second flight (7.5 hours long!) I spend time watching a Rwandan woman accross the aisle from me with her 1 year old little boy. This flight is full, so she has to hold him in her lap the whole time. Besides the fact that the baby boy is adorable, smily, bright eyed, and very active...I am struck by how "universal" her mothering is. She is speaking french while singing lullaby's to him, keeping him from chewing on the seatbelts, giving him high "fives", waving at him, and pretending to be a train when feeding him. There is something so heartwarming to see universal human behavior. Part of my reaction is feeling validated that everyone should be themselves, especially in uncomfortable scenarious like traveling in a new country or being in a new setting with no one speaking your language...it's calming and amazing to be reminded that we are all human and much of who we are is natural and shared regardless of place or language.

Other random thoughts on the plane:
-the food on planes is BAD. Wish I'd packed some granola bars in my carryon bag.
-it's cold on planes! Wish I'd put a jacket in my bag too. I've had to sneak 3 airline blankets to stay warm. brrr.
Wait!...SN Brussels just handed out swirled chocolate and vanilla ice cream cups and warm hand towels. What was I saying about bad food on planes? All is forgiven. haha

(Saturday 8:30pm, arrived in Kigali...) Our CDC driver Syla picked me and my six large bags- which all arrived thankfully, up at the airport. Syla told me Kigali has been waiting anxiously for my return. :) He took me to my apartment- in the same building as the last time I was here for 3 months. It is a slightly bigger one-bedroom- with a full size kitchen this time. It is furnished with a TV with cable, microwave, and much of the kitchen stuff and linens that I will need. I mailed about 10 boxes too- so once I have that stuff it will look more like home. Daniel came over and brought me welcome goodies including toilet paper, paper towel, bottled water and snacks. So nice!! I totally forgot those were the essential things I needed upon arrival. We are off to go out with friends tonight- Daniel is leaving Rwanda again and I am filling in for him again. He needs shoulder surgery which will take 6 months, so this is his last weekend in Kigali. I am tired from traveling...but how can I pass up a last weekend night out with Daniel before he goes?! It will be great to catch up with friends tonight too. Packing and resting can wait until tomorrow...

On My Way!

9 hours before departure....Today I am finishing up last minute details, re-packing my six suitcases (thanks to CDC for excess baggage allowance), headed to the bank, pondering what really has to go in my carry-on bags. I learned a lesson the first time I went to Rwanda: the lighter the carry-on bags the better while walking through airports!

I leave today at 6pm from Dulles airport with a 5-hour layover in Brussels tomorrow morning, and I arrive in Kigali at 7pm on Saturday. I can't remember whether it's best to sleep on the first flight or the second flight or not at all?! Oh well, I'll figure it out and probably sleep whenever I am tired anyway.

I have an apartment arranged in the same building I lived in last year, but a slightly bigger place. It's great because it is furnished and only 3/4 mile from the office, so I can walk to work. I learned from a co-worker in Rwanda that Kigali is as beautiful and sunny as ever right now. I can't wait for the 75 degree weather everyday!

I was very happy to hear today that the person picking me up in Kigali will have keys to my apartment and a cell phone for me. Yay! I am thankful that I will not be wondering around the airport or trying to get 6 bags into a taxi. I also got an email invitation to go out dancing Saturday night. I will be exhausted...but I rarely turn down an opportunity to go dancing, even after 24 hours of travel! It's so nice that I have been there twice already and so many friends are still there.

I am very sad to leave DC and all of my friends and loved ones. I've had an amazing last week. Paul threw a fantastic goodbye party in the party room of his building with lots of dancing and karaoke. I ate yummy food this week that will hopefully last me throughout my 8 months away...Oysters (my very favorite!), sushi, steak, and Ethiopian food. Fun activities included a superbowl party, movies, Air & Space Museum in Virginia, ice skating, and a fun wine bar. I am so thankful to my friends who helped move my stuff into storage and helped organize the party last weekend. Also, a huge thank you to Paul for taking time off this week, helping me take care of everything, and taking me to the airport today. I could not have done this without him.

Many more Rwanda adventures to come!