Wednesday, January 30, 2008

First impressions of Kigali

After almost 4 hours on a paved road with potholes (mostly filled in so it's rough gravel/rocks) and road construction (yeah, they have that here too) you come down a hill and into a valley. Then you go back the same direction you came to get to the heart of Kigali. My first impression was it was a lot like Baguio in the Philippines. It is in the mountains with more cars than the average roads and taller buildings (like 6-10 stories some of them). There are a lot of people everywhere and I arrived around 5pm which is probably when people are getting off of work and flooding the streets. There are some really modern things here though, like some of the buildings with curved glass fronts and a round about with huge fountain and a digital bill board. It's so far an interesting mix and I'm excited to explore it a bit more. I'll probably stick around a couple days, or depending on what else there is to do or what develops, I could go back tomorrow.

So what am I even doing here? Well, Sam was at Maji over New Years and we talked about a lot of stuff, and he knows I'm interested in renewable energy. Tonight there is a dinner/meeting at 8 somewhere and it's going to be about Jathropa, which is a tree that has the potential to produce a heck of a lot of oil for bio-diesel. I'll stay overnight at Sam's house and come up with a game plan for tomorrow then. I don't know anything about Kigali, but I could just walk around the city a bit too. I think that would be kind of fun.

Unexpected Journey

Last night the guests of the guest house were celebrating Christine's birthday at a restaurant and Harper goes "Oh Josh, I remember what I wanted to tell you before. Sam wants to talk to you, something about a meeting in Kigali tomorrow." So I call Sam and instead of going to Beni like I was planning on, I took a bus to Kigali today. (I was actually going to go to Beni. In fact, I gave the money for the plane ticket to Judy to take into the logistic staff yesterday and she forgot to give them the money so they never booked my ticket. Thank you God.)

I almost didn't make it on the bus (really a van) that I took. I got a ticket for a bus to leave at 12:30 and because my phone had the wrong time, completely thought it was way earlier than it was. I went to the market with the girls and then realized after like a half hour that it was already 12:20 and I had to go. I went to the bus stop in Goma and the bus already left. I quick hopped on a moto to the boarder and got there no problem. The people in the immigration office on the Congolese side couldn't have been in less of a hurry and took their time looking at my stuff. As I approached the Rwandan boarder I saw the bus. At the boarder, it stops and the people walk across on foot and then get back on the bus before going to the stop on the Rwandan side. Well, the Rwandan people weren't in any hurry either and everyone likes talking to the white guy, even if they get lots of them a day. I went into a building so a security lady could search my bags and the bus was gone when I got out. I walked over to the immigration office with my immigration card all filled out and hand it through the bars to the guy at the desk. He looks at it and starts asking questions about how long I've been here and what I've been doing (in English). Then, he looks at the passport and looks at me and he goes "this isn't you."

Ok, so what if I've been to the Philippines and back and then to Africa and through plenty of airports with that passport and no one else has said anything at all? I pull off my hat and he's like "nope." I'm thinking "come on! I've got to go catch this bus" and he's just holding me up. I don't know why he thought that because I only insisted that I was the person like 3 times and then said "you are welcomed in our country" and I considered it over. Just kidding, he comes back again saying "are you sure this is you?" and I told him I had an American drivers license too but it wasn't any use. Finally he just let me go, so I don't really know what the deal was. Really, I thought it was stupid to ask all those questions and then not even do anything about it, but oh well. I made it through immigration.

I got on a moto on that side of the boarder and asked him to take me to the bus stop as best I could. He took me to the wrong place, but thankfully they knew exactly what I was talking about and told the moto to take me to the right place. The bus was still there and after showing them my ticket and explaining (one Swahili sentence) that I missed the bus in Goma, it was no problems. We only sat there for about a half hour then waiting for one more person to make a full bus. All that hurrying for nothing...

Friday, January 25, 2008

What I've been up to (work wise)

Sometimes I find myself talking about stuff I think many people don't know, so here's what I've been up to a bit.

Wilfrieda, Mawe Hai, and I are beginning to take agriculture to some of the programs of HEAL around Goma. Right now this is Ndosho (which is a transit house I believe and they also have programs for kids) and Grounds for Hope, and will soon be a school (Jethrope or something like that). We are bringing in soil to get things started and will teach raising vegetables and composting and things like that. We are also using rabbits to provide protein, fertilizer (manure), and a rather tasty end product. The rabbit houses is what I've been working on mainly. I have a design in my head that uses almost entirely bamboo, but I decided I wasn't going to say "this is how it should be done" because first off, that would be dumb since i have no experience in building rabbit hutches in the Congo, and second because I am very interested in what the workers are doing and trying to figure out why they are doing it.

Besides this, Wilfrieda and I are going to meet Sunday afternoon to talk about the objectives and purpose of Mawe Hai and to hopefully get some guidance for where we are going in the years to come. I'm really hoping for a great meeting where Wilfrieda will be challenged to stop following what other people tell her to do only and start having ideas of her own (that are realistic) and to start taking ownership in Mawe Hai and really being a leader for it. Now there isn't a clear leader for Mawe Hai and it lacks vision, which makes a lot of things more difficult.

We also got 6kg of moringa seeds from Bunia, Congo which is north of here. We're hoping these seeds grow a lot better than the previous ones we planted from Kigali, and we will also plant these soon to capitalize on their viability (which doesn't last that long in moringa, about a year tops).

Finally, I've been roped in to helping oversee and brainstorm some of the building projects going on at HEAL. Basically what I do is talk to Dick Anderson (who is here until March) and he runs all his ideas past me. I also keep in contact with an engineer from Canada who came with the team from Wisconsin and tell him what's going on and he gives me feed back. The biggest thing we're doing is rearranging the semi containers at the Jubilee Center that are used for storage. There are 7 of them and we are designing it so there is storage, office space, and a covered work area. Dick is heading all the logistical stuff with that, but we talk about it a lot and it's pretty fun.

One more thing is sometime soon (within a couple weeks) I'm going to go to Beni, Congo (north of here) and work with David Kasali and the Congo Initiative (www.congoinitiative.org) to help plan and throw out ideas for agriculture on their 90 acre plot of land. I'm really excited about that and am sure you'll hear more about that if I actually go (and I'm planning on it). So, all in all, I'm not very busy.

Wilfrieda teaches compost


Yesterday Wilfrieda and I go to Grounds for Hope to check out the feasibility of putting rabbits out there, and we decide it's possible, but while we are there, something interesting happens. There is an unused field next to Grounds for Hope and the women plant things there. They had harvested something or weeded something and one of the women had a pile of stuff she was going to burn. I looked at it and thought "what a waste, it should be composted." About two minutes later, Wilfrieda starts talking to her and in 2 minutes has her convinced. Wilfrieda asked something about having good soil and the other woman said no. Then Wilfrieda gave a blurb about compost and a minute explanation about it and the woman very quickly was putting dirt on top of the smoldering pile of organic matter making a compost pile instead of burning it.

The pile survived because this picture was taken today. Or I should say, the pile almost survived. About two hours after this picture was taken I saw a women (I don't know if it was the same one or not) pull off the dirt, and about 5 minutes later, the delightfully sickening smell of smoldering organic matter that is not dry at all fills the air. It almost worked, but kudos to Wilfrieda for her excellent description and guide to compost, and negative kudos to the woman who took something apart that had potential just to get rid of it and ignore the long term benefits compost represents.

Random stuff

Yesterday I saw a little boy with a shirt that was too big for him that read "Canadian Girls Drinking Team."

Today was another day to show the benefits of compost. After a hot day with lots of sun, the cabbage plants in the compost/fertilizer/control experiment set up at Mawe Hai showed the benefits of compost. While the cabbage plants in the fertilized and compost trial look similar on a normal day, today the lower leaves of the fertilized cabbages were drooping to the ground falling flat. The leaves of the compost cabbages were still upright and looked great. Why is that? Well, besides being a great fertilizer, compost has tons of organic matter and the humus really helps hold water in the soil. Another point for compost (did I mention it's free for the making?). Check out the Mawe Hai album on the right for the pictures (I think they are at the end).

Today Wilfrieda was going to pick me up at 8 and then we were going to go to Ndosho to check on the progress of some rabbit hutches they are building, and then on to Mawe Hai. She arrived around 8:45 and needed to talk to Harper for something. Harper was talking to Lyn and even though Wilfrieda just needed a quick signature, she wouldn't interrupt the talking. We finally left Maji around 9:30 and were on our way. Where to? The hardware store because we needed more nails. We show up and we need 8 packages of different sizes and amounts of nails according to which project they are for. I've never seen anyone weigh nails slower in my life. I wasn't really paying attention at first, but when it rounded 10 I started getting a bit bored and antsy. We were done with the nails around 10:15 but Wilfrieda paid with a 100 dollar bill and we waited another 10 minutes for change. Then we needed some wire mesh. There goes another 25 minutes. We are finally on our way to Ndosho again and then we stop for 5 liters of gas for Mawe Hai (which was 1.7 a liter or 6.50 a gallon). We finally arrived at Ndosho after 11 when Wilfrieda said yesterday she would pick me up at 8. Good thing I'm a patient person and used to African time, or it would have frustrated me a lot more than it did.

I noticed a while ago that you can buy boards that are cut, but not cut quite all the way through. Like there are 5 or 6 boards that are completely cut except the last 3 or 4 inches, so it's like a section of log that's been cut, but they are still together for easy transport and also it keeps the wood flat as they cut it. I've noticed the last couple days there are a couple places past Mawe Hai where two people will roll a log onto a platform and one guy standing on top, and one on the bottom, will saw logs to make boards with a saw maybe 6 feet long. I can't imagine that it's a very fun job, but the boards are usually pretty even, so kudos to them. I actually think it's kind of cool though.

I've been on the ground in a couple places I'm not usually at and there have been a lot of kids around. They flock together saying "muzungu" like mad and any other English words they know (usually "morning!" or "give me money"). Today I decided I was going to have some fun so after I was bored and tired from a day wasted doing pretty much nothing (except playing with pieces of bark), one girl was walking behind me and said "muzungu" kind of quietly, but loud enough for me to hear. I turned around and said "Minajuwa niko muzungu, hunapashua kunisema" (I know I'm a white person, you don't have to tell me) while smiling, to which she said something about me having long hair. It's true, I really need a hair cut. I decided though as people say English words to me, I'm just going to say what they said in Swahili, so the next kid that says "morning" is getting an "asubuii" coming at him.

I can't really believe it, but the generator just went of to (drum roll please)... city power. We haven't had city power in about a week and a half. It's about time, but I wonder how long it will last?

Thursday, January 24, 2008

Peace?

For the last two weeks or so (I know, I'm a horrible reporter) there has been a peace conference going on in Goma. This is the first such conference in North Kivu Province ever and has been attended by everyone except the FDLR (Rwandan Hutus responsible for the genocide) and there has been a lot of talking, a lot of politicking, and some hints of progress. It was only supposed to last a couple of days to a week, and I wasn't very optimistic about it and so was planning on writing about it when it failed. It has been extended many times and it might actually be going on to three weeks now, but last night all the groups that were present actually signed a peace agreement to stop fighting and work towards peace.

I don't know what the terms are, and I think some of them are still being worked out as to how they will be done, but there is hope because now, if nothing else, all the groups have signed this document so if they break the peace agreement, then international attention might be drawn because this is an official agreement. The meeting has been overseen by the United Nations, the African Union, and some American representatives as well. The groups were to receive compensation of some kind and that might have played a rather large part of the agreement, but either way, this is a huge step forward. Even if peace does not come, all the groups were together and talking, so it was great. If it fails, there is a document saying there should be peace, so finger pointing can come back to the document and say "hey, you signed for peace, what's up now?"

So what does this mean for Eastern DRC? Well, a meeting has been set up to start immediately to work out how the terms will be accomplished. There is a glimmer of hope in many people (I'm beginning to be a bit hopeful myself, in spite of my pessimistic view of peace in the area), and that is so sorely needed right now. Some people say the only thing to happen now is there needs to be international intervention to get rid of the FDLR in the area. If that happens, it is just a Congo conflict and Nkunda has no other excuse to fight. If the FDLR is gone and he continues fighting, then it's just ridiculous and there should be more of an international push to take him out. If the general fighting stops, then the Mai Mai militias have no reason to keep fighting.

Some say this will work. Some are less optimistic. This will show a bit about Nkunda's motives especially. Supposedly he is to protect the Congolese Tutsi minority (which isn't a minority at all in the Congo) and if he no longer has to "protect" them, will he keep fighting for economic and power reasons? It will be interesting times ahead and a candle is glimmering light into the darkness. Please pray that nothing blows the candle out.

For general news on Central Africa and recently some news on the peace conference (especially the last couple days) check out: http://www.mg.co.za/articleList.aspx?area=central_africa

Monday, January 21, 2008

Play ground

There was a container shipped to HEAL Africa about a month or two ago (okay, it was shipped like 6 months ago, but that's when it got here). In that container were lots of medical supplies (as always), a boat (inflatable and a motor) for Maji Matulivu as a get-away boat, and a play ground set. It was a prefabricated, all components in 7 boxes play set with swings, monkey bars, a slide, rope ladder, stairs and a ladder, a rock wall, and a platform with a canopy. It was a pretty cool thing made of cedar. Whoever sent the play set was thinking ahead because they also sent all the tools we would need to put it together. After Lyn decided it should go over by the church and the women's homes, Chris and I (he was on the Wisconsin team) started setting it up.

The only real problem was Lyn first told us it should go by the Jubilee Center. Or she told Chris where it should go and he just got it wrong. After spending half a day watching surgeries (a cleft lip and a rather messy abdominal one) and looking for all of the boxes, we were finally able to start putting it together around 1 or 2 in the afternoon. That night we worked until dark and everything was going fine. We got the ladder/step on one side, and the rock wall on the other to connect to the platform and it was a pretty solid set up. Only problem was it was in the wrong spot as we found out on the way home with Lyn that night.

Next day we spend an hour making it into three parts and then carrying those three parts to where it should go and building it again. Onward to the center of the earth!

We proceeded and set up the whole thing by that 2pm, including a bit of a drink break. It was so cool to build it though. Everyone wanted to know what it was and what it was for. No one here has ever seen a play ground. The adults didn't know what it was, the kids didn't know what it was, and very few people guessed what it was. After we told them they started smiling and thinking it was a great idea.

Jean Claude has a program with kids at HEAL and as we finished he was in one of his programs with the kids. I went up to him and told him we were done and that it was for the kids and he should feel free to use it if he wanted to. We went to get something to drink and came back. All the kids were lined up at the step/ladder end and going up one at a time to go down the slide one at a time and Jean Claude had everything organized and the kids were having a blast. Then Chris goes up to one of the kids in line, taps him on the shoulder, and puts him on a swing a pushed him. Chaos ensued as all the kids made a scramble for the two remaining swings, and once those were no more they just abandoned the line all together and did what kids are supposed to do. The chaotic jubilee was awesome to watch and all the women at the transit house were cheering and laughing watching the children. Everyone was so happy and thanked us many times. Building that swing set was so instantly gratifying that it almost made me want to stop doing agriculture and start an organization to just put of playgrounds for kids who have never seen one before.

For another bonus, I inherited the tools that came with the play ground and will keep them until I leave for upkeep of the playground if needed, and basically to make sure they don't walk off as is likely to happen if they are just left around the HEAL compound.

Again

After many days of trying to write something on my blog, my internet finally cooperated on an interesting story.

So I'm driving to Mawe Hai this morning, and I won't be caught again with my doors unlocked or windows open (read the bribe post below if you're confused) that are not occupied by people, so this time when I was stopped, no one could get into the car.

I'm on the main road this time, but at the same intersection as before. I get stopped in the middle of the road to let people cross the street. This has happened many times and I've thought before that this would be a good time for one of the police to decide to stop me, but so far I've been lucky. Today after letting the kids and women carrying 5 gallons of water on their heads for miles on end cross the street, the yellow clad police man motions for me to pull over. Being the upstanding citizen I am, I do and roll up my window a good two thirds of the way. Now he can't reach in here, and all the other windows are up and doors locked.

He comes to the window and I immediately say "why did you stop me?" and he asks for my license. Just then who shows up? The guy in blue I talked to before. "Again!" I demand and he smiles and sticks his hand in the window for a shake saying "hello." By this point I'm frustrated at being pulled over for nothing, yet am also laughing at this guy who ripped me off 10 dollars all of a sudden being my buddy. The first guy asks for my license again and I said "why? He saw it last week," indicating the other guy, but I got it out anyways. I opened it up and showed it to him from well inside the window so he could see it but not take it.

The blue guy said something about driving lessons at this point and I said no, I'm going to the field to work and I didn't do anything wrong, why did you stop me? At this point the yellow guy indicated he was done with the license and I took that as my leave to go so I said thank you and drove off without looking back. It was a bit interesting, and I was laughing about it as I drove away, but also my heart was pumping a bit too. Nothing like getting pulled over for no reason to elevate the blood pressure.

Wednesday, January 16, 2008

4 Surgeries

Here lies my rather lengthy tale of the surgeries I observed today. I focus a lot on the actual procedures as I thought it was fascinating. I liked the opportunity to write it down to help me think about it and the amazing bodies God has given us as well as the ability to operate on them. I'm going to try and report this as accurately as it happened, but given the fact that I'm not a doctor and am human, I'm sure mistakes will occur. Here is the gist of it anyways.

I entered the OR with Marc and Chris; they like working together. The first case was a (rather large) woman and she had a tumor on her right cheek. It wasn't complicated or big, so we think she was a paying patient (also judged by her rather largeness - if she could afford that much food, she could afford surgery). I was watching as they prepped her and was doing all right. Chris cut an incision over the tumor with the scalpel and then used a tool called a Bovie (ever heard of it?) to cut deeper into the tissue and to create a skin flap under the incision to get room to work with. The skin actually separates rather nicely from the other tissues and so this gives a large area to work with even though the incision is small.

It was somewhere around here where I started feeling really hot and soon after started having blackness crowd into my vision. I got a bit dizzy and said "I'm not doing so good" and made my way towards the door but another Chris got a chair and gave me some things to put in a plastic bag just as a stupid thing to keep me busy and occupied. What surprised me was the dizziness came on fairly quickly and I wasn't really thinking about it. I didn't think "wow this is disgusting' or anything like that, I was watching pretty interested because I love learning stuff and seeing stuff, and then I was gone. I didn't faint, but it was pretty darn close.

I got up after a bit and then watched maybe 20 seconds before deciding to call it quits for a while. I drank lots of water and walked around the hospital a bit looking for people for different things. When I came back I felt a lot better and waited for the next one. The surgeries actually went pretty quick today, but the time between the surgeries was at least an hour.

The next one I watched was of a baby, I think I heard 18 months. I think the condition is called hydrosephalis or something like that but basically there is fluid in the brain. Chris did most of this surgery too and after the baby was prepped and I well hydrated and taking deep, steady breaths, Chris made a "C" shaped incision on the right side of the baby's head. After making the incision he used the Bovie to separate the skin and tissue from the skull so when he peeled the skin back the bare skull was exposed.

As Chris did that, Marc was checking out the shunt and figuring out how this particular one worked and operated. He also filled it with a saleen solution and checked the pump on the shunt and got it ready to be inserted.

After the Skull was exposed Chris made an incision at the base of the shoulder and neck and another in the abdomen. Once these incisions were made and ready for later, Chris drilled a hole in the skull. It was maybe a quarter inch in diameter. I wasn't really looking at it for a size comparison, but I think that's about what it was. The first drill bit was really dull so he changed it and tried again. It was no time at all and he was through the skull.

This next part was so cool. The shunt itself was about the length of a pen but much thinner. There were little perforations along it's length and a tube opening at the top to attach to the pump and tube already strung through the baby's body. Lining up the shunt from the hole in the baby's right side of the skull to the left eye, Chris simply pushed it into the brain. After a couple centimeters, fluid started coming out of the top and I think he went another centimeter beyond that and the shunt was in place. There was a metal rod inside the shunt and he pulled that out and fluid poured out like a hose. Marc was clamping it shut a bit to slow the flow of the fluid so it wasn't too drastic of a change for the baby's body. The shunt was cut to size so it was a little past level of the skull, a 90 degree elbow was put on top of it, and the pump tube attached to the elbow. The pump tube is what made use of the other two incisions to get the tube from the baby's brain to the abdomen. This was really cool because as soon as the pump was attached, they tried it and pushing the pump caused fluid to come out of the end of the tube, so it worked.

Using a guide sort of like people sometimes use to guide feet into shoes (bad example of what it looked like but half way decent for how it worked), he started from the skull incision and worked the tube and guiding tool under the skin layer and down to the incision at the shoulder. That was pretty weird watching this thing push under the baby's skin from his skull to his neck. After the shunt was pulled that far they situated the pump for the shunt against a bone and got ready to make the next pass. Chris then made his way from the shoulder incision to the abdomen incision. After pulling the shunt tight from the skull, there was about two feet of tubing left. They conveniently just shoved the tube into the abdomen cavity of the baby so it would be there when he grows.

After that it was pretty basic as they closed the wounds up. The stitching is actually pretty simple and I was surprised at how much they could pull on it and get it tight. The human skin is pretty tough and can take a lot. I also noticed none of the incisions tore or anything like that, again showing how tough the skin tissue can be because at times they would move and pull on it quite a bit. To drain the fluid in the baby's head someone just needs to push the little bulb pump under his skin by his ear and the fluid should drain into his abdominal cavity where the body clears it out. It was a pretty spectacular surgery.

I'm not entirely sure if it happened in that order of shunt, pump, threading through the body, but that's the gist of it. That was surgery two of four.

I saw an X-Ray for the third surgery when we first got to the hospital in the morning. It was a chest X-Ray and you could see the esophagus and as it went to the stomach it was almost completely closed due to muscle tissue and scaring around the esophagus. The esophagus was a white tube maybe an inch in diameter coming up to a hazy looking circular shape (the stomach) and before it got to the stomach the white looking esophagus came almost to a complete point showing it was blocked off. I watched as Marc explained what was going on to the doctor in a book and got a pretty good understanding of what would happen.

The surgery started with us walking in on a young man (teenager maybe) naked on the table. They prepped him with sterilizer stuff and covered every part of him not being operated on with robes. This surgery started with an abdominal incision 6-8 inches long right in the middle of the stomach where there isn't any muscle to cut through. This surgery reminded me the most of deer hunting as I could see some of the organs and thought "hey, I know what that one is." Working within this incision Marc was looking for the esophagus and soon enough they found it. They were using these "L" shaped tools to hold the organs and skin back and also pieces of sterile cloth to get a better grip on the skin and organs. Once they found the esophagus they got around it and put a rubber hose underneath it. This they clamped to the cloths covering the boy and this kept the esophagus from falling down again.

From here they used the Bovie to cut the tissues and muscle around the esophagus starting all the way at the stomach and extending about 6-8 centimeters up the esophagus. Marc said the biggest failure rate on this operation was not clearing close enough to the stomach. Marc actually worked a bit on the stomach making sure there wasn't any muscle tissue in the way that would grow again and cause more problems. What surprised me here was how much Marc was showing with this guys stomach cut open. He was moving around organs and at one point actually had the stomach out of the body completely to show things and it was cool. When they sewed up this guy they first sewed the tissue under the skin and then sewed the skin shut so it was a double stitching (I think). Marc let the doctor from HEAL finish up the stitching and he's pretty confident it will be a successful surgery and this boy who hasn't been able to eat for a long time will be able to have fluids for a week, soft food for a week, and then real food for the rest of his life. Having just come from dinner, I think that's pretty darn incredible.


The fourth surgery was a long time in coming. The surgeries take less time than the turn-over between patients here and really we waited well over an hour, and possibly two for this last surgery to get under way. This final surgery was on another boy who had some lumps on his neck. Marc found out right before the surgery that he was being treated for TB so the lumps were probably expanded lymph nodes (which they were) and that at least answered one question. For this surgery, Doctor Luke (a doctor here) was doing it and Marc was assisting. This was a good one to watch because there weren't a lot of people and I could see everything great, but was much less dramatic than the last two.

An incision was made and the hunting with the Bovie began. As lymph nodes were identified Luke would cut the tissues around them and Marc would position it for a good cut until the whole node was free. This surgery was a bit cautious because of nerves in the area but they determined there weren't any in the immediate area and went along fine. They removed 4 nodes and there were more smaller ones, but they were too difficult to get at or were too small to worry about. They might shrink a bit as the TB gets better, or stay that size, but it shouldn't matter.

The coolest part about this surgery was watching them stitch the wound back up. Marc was showing Luke how to make a hidden stitch and once it was done, there was no stitches showing and it was a pretty smooth wound. The boy is young enough that he will have a scar, but it won't be that bad at all.

Overall, I was surprised at a couple things. I always knew they had to do something to stop the bleeding as they operate and the Bovie does a great job of that. The Bovie is an electrical instrument that has different settings for cutting tissue and coagulating blood. A metal plate with some sort of jell is placed under the patient to create a circuit and this is how all work inside the body was done today.

I was also surprised about how little blood there was overall. When they made an incision it was usually in a safe place to do so and not a lot of blood was there.

I was again surprised at how hard they would pull when they were stitching the wounds shut and how hard they could be on the skin and tissue. Looking at a deer I can kind of understand it, but I thought our skin would be a bit weaker than that, and it might be, but it didn't really look like it. They were always clamping and puling on it and it was fine.

All in all, it was pretty cool. I might try and catch a couple more, but the next couple days might be busy for me too so I'll wait and see what happens. I could always watch Joe too when he operates, I just have to remember to breath and drink lots of fluids.

Saturday, January 12, 2008

Surgery

Next week I'm going to witness something cool. I haven't decided which surgeries I'm going to watch, but the surgeons are more than happy to show off and explain things to an ignorant young person who probably won't be able to watch surgeries anywhere else (well, at least not in the states). I'm going to ask around and find out which surgeries will be the best to watch, and then go watch those. The only thing is I have to get better before going into the OR.

Yesterday morning I woke up and felt stuff draining down the back of my throat and it didn't get any better as the day went on. Last night it wasn't too bad, and this morning it felt fine, but now it stopped draining down the back of my throat and started draining down my nose, and I haven't decided which I dislike more. So far it's just the nose though and I'm going to go swimming as soon as I get back to Maji and loose a couple pounds of snot in the water and should be good to go. I love swimming when I have a cold and always have. It makes me feel so good. Granted, my body might be in a weaker state and less able to fight stuff off, but I feel better for a little while, which is always a bonus to me.

So far things are going really well with the team. They are in a zone and they come to the hospital, do their surgeries, lecture, and swim/shower in the lake. Eating takes a while, but we're eating at 7pm vs. 8 or 8:30 so there is also time to watch a movie if we want. Last night was Mr. and Mrs. Smith. I never get tired of watching that movie. It's so poetic at the end when they annihilate everyone. My favorite part is when they dodge the RPGs. It's like dancing.

I haven't heard anything too bad that the team has faced yet, but there are a couple stories where things didn't go as planned and they fixed it. They are doing a lot of teaching in the OR and the report is today went better than yesterday. Right now is the biggest conflict so far. A routine surgery was being done and they opened up a woman (I think) and it was cancer and nothing routine. They are working on that right now.

And now I'm off to Maji, to swim, and possibly to sleep.

Thursday, January 10, 2008

I almost cried

Going to Mawe Hai today was so awesome. After a lazy morning talking with the Wisconsin team at breakfast, I headed out to Mawe Hai around 9 and it was great. I walked around a bit and they made some more raised beds (well, they outlined them in rocks to be filled with soil when it is available) and are looking towards expansion. I talked to one of the workers a bit and then walked over to the nursery. Then I headed down towards the lake to check out the sights. One sight that hit my eye that I was not expecting was about a dozen compost piles that were made yesterday. I wasn't there yesterday and didn't say I was coming today, so there was no fear of being reprimanded in any way (a couple times they quick start to do things Wilfrieda suggested they do on her last visit as soon as the car comes in sight). It was good, honest acceptance of compost as they made each pile. They continued to make it today, and it will be three weeks or so before it is ready to put in the afore mentioned new fields.

The other day too we were weeding soy beans and there was one part where there was a huge contrast between the beans grown in soil and the beans grown on rocks. They planted soybeans in these fields because nothing else would grow there and in a place where there was some soil, the plants were doing well, were dark green, and looked great. Two feet away it was all rocks and the plants were severely stunted, yellow and even brown from death. It was a great visual of the power of soil. I mentioned this to the workers and said we needed more compost because compost is good soil. One of the workers then said "yes, compost is the best soil." It's pretty exciting to see things that I've been doing for a couple months now finally taken hold of. It goes to show though how much work sometimes needs to go into acceptance of something new. I spent a lot of days making compost alone and now they are doing it. I almost wanted to cry as I walked towards the small brown mounds of freshly made compost piles.

Christmas!

For those avid readers of Josh's Life, you will know I already talked about Christmas. We've had one yes, but what about second Christmas? Well, unlike Aragorn in the Fellowship of the Ring who ignores Pippin's longing, I was blessed with a second Christmas.

Yesterday, a team of doctors arrived from Wisconsin (I knew Wisconsin was amazing). This is their 6th year coming here. They started coming before the volcano erupted, and were actually here for the eruption. Only one of the 8 person team has not been here before, and many have been here multiple times. When they come, they bring bins of medical supplies and some things (sutures and some drugs) they bring enough of to last all year. HEAL Africa knows that January is the month for Wisconsin so they plan on it every year. They have training and they line up tough cases that can be used to teach people as well as getting tough surgeries done by doctors with lots of training and experience. The hospital has been gathering these cases for weeks and getting lecture ideas and in general, getting ready for this annual event.

Maji has been getting ready too. There are lots of bottled drinks here (coke, fanta, and beer) and the mamas have been baking bread and making granola. This Wisconsin team is so special that they actually have a lunch option. Like the mamas prepare lunch for them. That's unheard of. I've been here for almost 4 months and my lunch option is peanut butter and jelly or a bag of granola. These docs are getting all sorts of portable fare.

Because many of them have been here so many times, they see Goma, the hospital, and Maji change with real interest. Joe downplayed the new house that's being build for Lyn and him and the team insisted on getting a tour. You can tell the team is loved by Goma and that they love to be here.

You can also tell that the team loves me (or some other way was convinced to be my personal UPS) as they brought some stuff for me from home. I sent a list of some stuff that would be nice to have and I got everything on the list and then some. Most prominent of which is a pair of Wisconsin Badger shorts that I'm wearing right now over my Badger lounge pants (along with my red badger t-shirt over my white badger long sleeved t-shirt and badger hat). I figured since it's second Christmas I might as well celebrate in style. They also brought Megan's Christmas present for me, which I greatly like and will enjoy for years to come. Most prominent besides that was my WATER POLO BALL and tennis racket. I'm so excited, especially about the ball. Now I just have to find an air pump and Mikasa is my Wilson.

Monday, January 7, 2008

Josh pays a bribe

I'll start off saying that I know I broke the law and was at fault. Following is the chronicle of the event for your perusal and enjoyment.

I was tired this morning so I slept in a bit. A little too much "bit" as I realized it was after 8, the time which I usually eat breakfast. I wasn't worried about missing breakfast, I just like getting to Mawe Hai fairly early in the morning so it's not so hot. After eating breakfast and getting ready to go, I saw two of the guests getting ready to go to the peace conference and it's on the way to Mawe Hai so I offered to give them a ride (or they would resort to motos). We're in the car about to go and the one remembers his press pass is in his room. We finally pull out of Maji, windows down (except the guy in the back never opened his) and we're cruising along.

The peace conference is at a university and it's off the side road a bit, but soon enough they are on their way to the conference and I'm on my way to Mawe Hai. I remember looking at the gas gauge and lamenting the fact that I forgot to replace the last 20 I spent and therefore only had 10 dollars. Man was I lucky to have forgotten! I'm chugging along the side road that links to the main road out of town and everything is fine.

I approach the main road and am met with a dilemma. Looking back, it was quite a stupid decision (hind sight's 20/20) and it was so obvious what I should have done. Then again, everyone makes mistakes, and this was one of those times.

As the road I'm on approaches the main road there is a divider in it. Now coming to the main road you are supposed to stay on the right side of the divider, and I clearly saw the divider and was trying to decide what to do. It wouldn't even have been an issue and I would have known which way to take except the divider was very much not a square but a triangle and it appeared that the right side of it might have been just for turning right because that's the way the triangle pushed you. The left side of the barrier was straight, which made it seem like that would be a better option for turning left. I was still trying to figure out what to do (while in the back of my mind tossing in the positions of the yellow-clad police men) when I realized there was no one on the main road and there were a lot of people on the right part of the road where I should have went. In a bout of pure stupidity I decided to defy the law (by this time I had decided I probably should be on the right side of the barrier and even remember passing on the right side of the barrier heading to Mawe Hai with someone else driving) and just go on the left because it would have been so much easier.

It would have been except for the yellow-clad police man who I didn't see and hadn't taken into consideration because he was behind a sign until it was way too late. He also did the only thing which would have caused me to stop by standing in front of the car. He didn't even talk to me but motioned for a guy in blue to come and talk to me. He knew a bit of English and they would have their fun. Before the blue guy got to the car I had locked the doors, deeming that a good precaution against possible vehicle entry. The guy comes over and I ask "Shida iko nini?" (a justly asked "what is the problem?") and he starts talking in French. "Sijue French" (I don't know French). The conversation followed in various volumes and quantities of Swahili, English, and drawings as each person (the blue guy, various yellow people, and I) saw fit.

"Papers." he demands and I hand him my license (as a side note, the license is a manly pink). "Registration papers" and I point to the stickers on the windshield. Only problem is that's not what he was looking for. I tell him it's a DOCS/HEAL Africa car and he knows it has the registration when I remembered something. I flipped down the visor having seen one of the HEAL staff put something there once and it was only a log book. Crap. But wait, the papers were in there. The yellow clad man who stopped me first enters the conversation a bit and says I should be on the other side of the road and I plead a case for the people, the road, etc... While he does this, the blue guy (with my papers) goes around the car and tries to get in. Haha, it's locked.

Crap, the window is open. I forgot about the window and since I had taken the people to the peace conference, it was open with all of it's "reach in and unlocking" potential. He unlocks the door and I quickly push it down telling him he doesn't have to enter my car and we can talk here. He keeps talking about what I'm going to do and I keep telling him I work for HEAL Africa and I work in the field and that's where I'm going to go. He meant what was I going to do about my situation, and I decided to play stupid. Unfortunately, on his fourth try to unlock the door and get in he succeeds, but I had sort of stopped trying. He wasn't armed and we were only going to get out of the wrong side of the road and I couldn't really drive away because there were people everywhere around the car, so there was no use trying to stop him because he would have succeeded eventually. I had made my point by defying him thrice.

We turn onto the main road and pull over as soon as there was an open spot and almost instantly a crowd is outside my window. I pull out a pen and start drawing the intersection and he right away grabs it from me showing me what I should do. I grab it back showing him the triangle and telling him it's hard to turn left from the right side, but it wasn't flying. He started talking about going to the bureau and here was my dilemma. I almost wanted to go and see what would happen, but also knew that I might possibly be screwed if I went - there would be no promise of justice and even less chance of escape than here. I asked him why and he said to pay the money.

"What money?"
"Do you know how to drive?"
"I'm not going anywhere but to Mawe Hai to go to work."
"We go to the bureau."
"Why?"
"To pay the money."
"Ok, we go to the bureau. How much is the fine."
"What?"
"Ok, we will go to the bureau, I want to know how much the fine is."
"The bureau is in the city."
"I know, we will go and I will pay the fine. I know I did it wrong."
"We don't have to go to the bureau" and then to the crowd outside my window " Toka!" (go away). It had no effect. Here enters the moral fight inside my head and I decided to opt out of the unknown at the bureau and make the best with the corruption at hand.
"Ok, if we don't have to go to the bureau, how much is the fine?"
"500 dollars." Not lying, this was his response. Now I really wanted to go to the bureau because there is no way the fine could possibly be 500 dollars. That's 10 months wages for the average Congolese. My outrage followed and I was done being polite. I deemed it necessary to make it known that I was not going to be pushed over with this stupidity.
"500 dollars!? Are you kidding me? That's ridiculous! Do you know how much 500 dollars is? Do you know what you can buy with 500 dollars? The normal person doesn't make that much in a year (ok, I over-exaggerated here, but he had no clue what I was saying anymore. I kept my tone elevated and outraged, but not mad. I made sure it didn't sound hostile, and I talked fast and I knew he had no clue what I was saying). You've got to be kidding me."
"it's 500 dollars"
"bull shit. If it was 500 dollars no one would be able to pay it. Get out of here with that. You're being dumb."
"ok" and he reaches for the paper and writes out 50 dollars.
"No way. Even if I had 50 dollars, there is no way the fine at the bureau is that much. (I calm down and speak in Swahili so he can finally understand me) I don't have 50 dollars. I might have 10." There was a yellow clad lady at the window and he looked at her and she shook her head. "Fine, then we go to the bureau." He writes 20. I open my wallet and pull out ten "I have 10 dollars. That's it. See?" and I showed them the wallet.
"ok" and he hands the 10 to the woman. He makes one last attempt to tell me what I should have done as he exits the vehicle and I tell him (not very kindly) I know what I should have done and drive away rather quickly.

I so wanted to go to the bureau and see what would have happened. Would it have been more corruption and trying to get as much as possible? Is there even an orderly, normal fine for traffic violations? How would I find out to know if I was getting screwed? I can't imagine it was 500 dollars, and even 50 dollars to me doesn't make sense. I wanted to record the whole conversation and take it to the bureau and say "this is what your officers are doing out there." I so wanted to ask for a receipt as he got out of the car but decided to not push my luck. I figure I'm going to be here for a year and I shouldn't really go around making enemies of the police people.
I knew I was wrong and messed up with the driving on the left of the barrier, and would have faced the just punishment for that mistake. As it was, I was not assured of that in any of the possible situations, so I paid a bribe.

Friday, January 4, 2008

The Dry Season

I do believe the dry season is upon us. I hear it starts about now and we haven't had rain in a while, maybe even a good rain in about a week. The vegetables at Mawe Hai are looking a bit limp as the sun bears down upon them in full force and the thin soil is suffering for want of water. What does this mean? Watering the plants is another job added to the list for the Mawe staff. Also, there is dirt and dust everywhere. I worked yesterday and wore jeans and a t-shirt and shoes. My legs were covered in dirt. I never took them off, and I didn't stuff dirt down them for fun. The only two possibilities I can come up with are it's so dusty that it came up from the bottom, or it just went right through the pants. I haven't decided which is more likely since to me, neither one makes sense. My left eye is also bothering me a bit and I think it has to do with the dust. It's not bad, it's just annoying every once in a while. Maybe if I got someone to hit me really hard I would cry and clean it out.

Oh, and when I got back to Maji yesteray, I had the blackest nasal effluent I've ever seen. It wasn't a bit dirty or gray, spotted, or anything like that. My boogers were completely black.

I was talking to Wilfrieda today and figured out the work schedule of the workers at Mawe Hai. Mawe has 11 workers. Two guards, a head worker, and two teams of 4 workers each. The head worker is there most days unless he has other business. This is Moese (Moses) and he's either at Mawe or on other business for HEAL Africa. The two teams then each get one week off a month. The first week of the month team 1 works. Then both teams work for two weeks, and then team 2 works the fourth week. I'm not sure how they do the rest of the month, or if they just start over after that. After each month Wilfrieda assesses the workers and decides if they get to stay or not (I'm sure Moese helps too). The workers get paid 55 dollars a month with one week off a month.

Wednesday, January 2, 2008

A Congolese New Year

New Year's Eve passed rather uneventfully for me. All of the young people went to a party at the Ole Cultural Center, but I stayed back. It would have been cool except I'm not a huge party person where I don't know the language and the party is going to last all night and I was already tired when they left at 9. I spent my New Year's Eve e-mailing Megan while she was at work doing nothing.

New Year's day came and was a pretty relaxed morning. I started playing Age of Empires III on my computer and then Charles came to pick me up. Charles is the teacher for the school at HEAL Africa. He deserves a post just for him and his school some day. We drove to his house and it was pretty cool. We drive off the main road and into a compound after maybe 3 or 4 minutes. The compound is fairly large with a nice house in the middle. At the back of the nice house are "normal" houses made of wood almost put together tightly (the wood is warped and not cut even so the boards don't line up well) and covered with simple tin roofs. We hung out first though in the shade of some trees in front of the main house. Charles had a bunch of his friends there who knew varying degrees of English and it was really cool. We talked about all sorts of things about getting married and living in the Congo and US as well as what I liked about the Congo and some of the problems of the people gathered there. It was really cool. Oh, and this was all done over Primus beer. It's not bad at all, but it's also usually not cold, so that works against it.

After maybe an hour and a half the food was ready. We sat around a table with a pagoda set up over it and the food was brought out. There was cabbage with mayonnaise and onions (a simple cole slaw), fries, goat meat, corn fufu (basically a mass of cooked starch - cassava, maize, wheat), and the specialty. When the plate was brought to the table I knew it wasn't normal stuff. There were two goat hearts cut in half and maybe 8 pieces of lung wrapped in intestine. I tried asking Charles' friends to see which one was the best and each person had a different answer and finally they said I had to choose. I opted for the intestine wrapped lung. The lung itself was a cylinder shaped piece maybe 4 inches long and 3/4 thick. It was grayish in appearance and had a texture similar to a sponge, but after biting into it, was more chewy and rubbery than a sponge might be. The intestine was a beige colored hose wrapped around the lung and had a texture similar to a balloon. It didn't taste that bad. It had a slight aftertaste like liver, but not nearly as strong. I ate it with a lot of fufu and it was fine. It added something to the plain corn flavor and didn't overpower it too much. I also just ate pieces of it too. The first bite I just picked it up and had at it. I'll leave it at it wasn't bad, but I'm going to stick to regular vs. organ meats if I'm cooking.

After eating (with our hands - they had forks but hands are so much more fun and economical) I saw Charles' room. It was pretty small, but he was the only person staying there. It was actually two rooms, a sitting room and a bed room, and it was nice. He had the wall covered in posters and pieces of cloth and it really didn't look bad. Maybe my standards are completely falling, but I could see myself living in a place like that and being fine with it.

We tried going to a club to take another drink, but they were really crowded, so we just went to a simple bar. A bar might be a strong classification, but it was a place where you came and got drinks. There really wasn't a bar though, so that's where the classification problem lies. Unfortunately I forgot to get my camera from Harper (she was borrowing it) so I don't have any pictures, but I plan on going back to his house, so I'll have some of them some time.

Happy New Year!