Time Flies When You’re Having Fun

Krystal’s Story

Since returning from Gahini, I (Krystal) have spent the last week and a half in the Theater (Operating Room) at Central University Hospital of Kigali (CHK).  The son-in-law of a NCM staff member is an anesthesiologist at CHK and offered to let me do part of my internship there.   Dr. Bona, the anesthesiologist, was able to spend six months in Canada on an anesthesiologist exchange program which made him the perfect contact for me (i.e. he speaks English, understands Western medicine and has a high standard of care).   His time in Canada made him realize how much Rwandan health care needs to be improved and has given him a desire to teach other doctors and nurses about patient safety, patient care and pain control (all things that are unusual in medical care here in Rwanda).

Dr. Bona was given a copy of my resume prior to my arrival and saw that I was both a nurse and working towards a Leadership degree.   He talked to the Director of Nursing about letting me teach OR nurses about “Leadership in the OR”and patient care.  She decided that whoever attended my seminars would be given a Continuing Education Certificate which validated my seminars and made them very desirable for staff to attend (any type of education is a big deal for Rwandans).

Krystal with the OR nurse director, Gene (Left), and Dr. Bona (Right)

Thus, for the next several days I spent every morning teaching a 45 minute seminar on patient care, discharge criteria from the post anesthetic recovery room, vital signs and common perioperative complications.  There were between 15 and 25 nurses that attended everyday while Dr. Bona translated my English to French and added in whatever he thought was necessary.

Krystal teaching on “Discharge Criteria for the PACU.” Wait, a patient should be able to breathe before we send them home?

While language made it difficult to build relationships and the OR is not my specialty in nursing, I was thrilled that I was able to offer some expertise and do some helpful teaching for the nurses.  Some of these nurses have never been taught about nursing interventions for things like hypotension (low blood pressure) or hemorrhaging (bleeding) or respiratory arrest so some of my teaching was new for them.  Additionally, this opportunity also reminded me how much I enjoy teaching.

The faithful class of nurses. After the last day of classes, many of them finally came up and spoke English! Where were you five days ago?

At the of the seminar, Dr. Bona told me that he is trying to help CHK gain some type of accreditation by implementing a World Health Organization (WHO) protocol of a surgical safety checklist.  What amazes me is that this protocol is an international standard that includes such things as verifying that you have the right patient and surgical site prior to surgery and giving prophylactic antibiotics within 60 minutes of surgery -these are all things we do in the USA and Canada to EVERY patient without even thinking about it but here they are hardly ever done.  Can you imagine, having a metal plate drilled onto your femur in Africa without any prophylactic antibiotics? I asked Dr. Bona if I could do anything to help him implement the safety checklist and he was excited to have me create a draft of the checklist and help with aspects of his presentation! I am excited that even in this short internship in a country where I don’t speak two of the main languages I have been blessed by being given an opportunity to help make a change that will save lives.

Nick’s Story

So Krystal posted in a cool, creative pdf about her week in Gahini.  I hope you had a chance to check it out.  I haven’t posted about my week away from her.  I got to spend some time in the dorms at the Pastoral Training School at New Creation Ministries.  My roommate, Jonny, is an intern from Moody teaching ESL to the pastors in the PTS in the afternoon and helping at another night class for community members.  I stayed in the dorms, ate with the pastors, and interviewed a few with the help of my translator, Silas.  To my loss, that was my time to “live with Rwandans,” and I forgot that it was one of my goals to “live among them,” to fully enter in.

Eating dinner with the Pastoral Training School pastors and Jonny. Can you guess which one is Jonny?

Silas, my translator, and Theogene, a graduate of NCM’s PTS

Since then I have had three major assignments.  First, I have been interviewing various people connected with NCM to learn about the church of Rwanda, leadership structure of the church here, and understanding of Christianity and Christian life. I’ve finished 14 interviews, but have about 10 more to go.  Preliminary results show that the pastors who participate in NCM’s training greatly appreciate the formative nature of the classes.  I’m sure I’ll have more to say on this later.

Second, I have been leading a Bible study on the book of Galatians for three Rwanda staff members.  It is definitely a learning experience all around.  I’ve actually studied Galatians quite in depth, translating it from Greek to English and examining most of the major elements involved.  But my “students” are mostly graduates from Bible College with degrees in theology.  Instead of being unidirectional, from me to them, it is truly a meeting of the minds.  The added benefit to them is that they get to practice English by listening to me and each other, and forming and delivering arguments in English.  English is becoming more and more important in Rwanda, especially since President Kagame required all education be done in English.  For that reason, NCM’s new university program, CLIR, will be in English, and these teachers are excited hone their skills in English.

Galatians Bible Study: Jean Bosco, Gaudiose, Joseph, and Nick

Third, I have had the opportunity to travel with Gary to visit two pastors in their churches in the area called Changugu, aka the middle of nowhere.  Far to the southwest, almost on the border of Burundi, on the other side of the African Continental divide.  After six hours of driving, we arrived to the first church on Saturday afternoon, so they held a special Saturday service for us.  They fed us, and then began to clear their living room of other furniture.  I was curious, but I soon found out that they were making room for the two beds they borrowed from their neighbors for us to use.  I had been prepared for anything, including sharing a single bed with Gary, but that the pastor went out of his way to borrow two beds….

They got us a second bed! Usually mosquito nets drape over the bed, but here they put them on the walls to prevent pieces of the new mud walls from falling on us while we slept.

The next morning we ate breakfast: sardines, potatoes, cow stomach, beans and rice.   (I don’t have many pictures of food because Rwandans are VERY private about meals.  They close the doors and windows, and eat in relative quiet.)

Later Gary said, “Nick was able to use one of the worst longdrops [out-houses] I’ve ever seen, and was able to stomach stomach for breakfast.  He’ll be a great fit here.”  We went on an walk to the place where the first European entered Rwanda: A German in 1901!  Then we rushed off to another church, 3 kilometers away.  Thirty minutes later, we arrived.  Andrew S. is right, “close” is a relative term.  I’ll make a special post next time about Rwandan church services.

Krystal and I are traveling with the Sheers, Finleys and Bennetts out to Changugu again from this weekend through next.  Apparently, there is an annual retreat on Lake Kivu for all Christian missionaries in Rwanda.  This year over 130 people will be there.  While there, Krystal will get to go on two pastoral visit with Gary and me.  We will also get to know many of these other missionaries and ask them about their call and ministry to Rwanda.  For Krystal, especially, it will be a great chance to network with other medical missionaries.  Thanks for your prayers on her behalf.  This week has been especially profitable for her as she considers her skills and the type of ministry that Rwanda needs.

Please pray for us as we get to know the team better, visit pastors, and network.

The team here seems to like us, and we love them, too.  The current ministry, training pastors, is highly valued by the pastors themselves.  The future ministry, a Bible college, is also something I would greatly enjoy doing.  Rwanda is starting to look like a good fit.

The National Museum and A genocide memorial: meeting people with stories of conflict

National Museum

Up until Tuesday, we were getting an orientation to local time (jet lag), Rwanda history, the NCM faculty, and our agenda for the next 7 weeks.  We stayed with the Scheers for most of that time, but had one night with the Finleys, too.

Last Friday, yes over a week ago, we went on a trip with the NCM staff and their wives to the National Museum in Butare, in the southern province.  While it is not far from the traditional capital of Rwanda, where the King lived, it was a two hour drive from Kigali.  Since I (Nick), don’t get carsick, I sat in the back row of 15 passenger Nissan Urvan (don’t think youth group 15 passenger van, think VW bus on steroids).  I spoke with Benjamin for two hours on the way.

He pointed out the papyrus, pineapple, corn, sorghum, sugarcane, coffee, rice.  But he also spoke of his desire for there to be reconciliation in Rwanda, among the people, but especially in the church.  Many churches work in competition with each other, meeting next door to each other and preaching against each other.  Some local “Pentecostal” churches even preach that if one is not a member of THAT local church, he or she cannot be saved.  I suppose only a few will get to heaven, by their thinking.  If the church cannot be united, what hope is there for the country?

Benjamin works for NCM to help develop the University program.  They were working with another local organization to build the program together, to share many resources, and it appeared that everyone was happy for the cooperation.  However, the united effort fell apart, setting back the process of building a university program.

The Cultural Museum was enjoyable, complete with dancers, drums, dioramas, grass huts, artifacts and pictures.  But Ben’s story weighed on my mind.  Please pray with me, for unity in the church of Rwanda.  May we be an image of the reconciliation offered by Christ.

At the end of the dance, they pulled each of us up to learn to dance with them.  Am I sunburned or embarrassed?

Genocide Memorial

The next day, we took a short drive with Gary Scheer out to a rural genocide memorial: a church in Ntarama that had been attacked, killing the refugees inside.  While there is an official memorial in the city of Kigali, one can get a more visceral picture in one of the many memorials that dot the countryside.

I (Nick) don’t know what I expected to see when we arrived at the church, but as we approached, I could see a normal brick building with a tin roof, holes in the side from grenades, and doors hanging loosely from the hinges.  I rounded the corner into the church and was met by row after row of human skulls.

Purple is the color of mourning in Rwanda. No pictures allowed inside, but you can see a glimpse.

I was reminded of the pictures released from the Pol Pot genocide in Cambodia.  Each skull a person, a woman, a child, an old man, who had fled to the church for safety, for sanctuary, but had been trapped by an angry, indoctrinated mob of their neighbors.

We entered an saw not just the skulls, but pelvises, leg bones, and arms displayed on metal shelves (6’ x 12’).  Looking around we saw clothes, stained, displayed on the walls and from the rafters.  Toward the altar of this catholic church, we saw their possessions, suitcases, shoes, pots and pans.  Our guide, a survivor from the next village over, explained that the victims within the church could not be properly buried because they could not be identified.  In an effort to survive, they discarded their identity cards that proved their tribal identity.

Clothes of the deceased.

The tour continued, and our guide told  us his story of how his father was on the black list, and so was sought out and assassinated.  He saw his father killed, ran through his house to warn his family, but only he and his youngest brother escaped.

This man is a survivor of the genocide.

July 4 commemorates my sister-in-law’s birthday (go, Kendra!), the independence of the United States of America, and the marriage of Andrew and Andrea Ramsey, but also the last day of the genocide against the Tutsi.

Where there are officially no longer tribes in Rwanda, it seems difficult to remember the genocide against the Tutsi if there is no longer Tutsi….

Please pray with me for the reconciliation in this country between neighbors, and between the government and its people.

Next post: Our week apart

As Promised Rwanda: by the book and as experienced

Hill after hillRwanda FactsSee: http://en.wikipedia.org/wiki/Rwanda Rwanda is a small, landlocked country in Sub-Sahara Africa. Of all Africa, it has the highest population density with over 11 million people in an area the size of 10,000 sq mi. That is twice the population of Colorado with one-tenth the area! Or 50% more people than in the state of Washington with one-seventh as much land. Kigali, the capital, is located in the center of Rwanda. Like Denver, Kigali is about a mile high (5140 ft), but with the rolling hills, it varies by location in the city. To the east, the land gets higher and hillier and Lake Kivu forms the border with the Democratic Republic of Congo. To the northwest lie the volcanoes and gorilla reserves. To the northeast, Uganda. To the west, the hills become lower, the weather warmer, and the great swamp provides moisture for farming in the dry seasons, leading to Tanzania. To the south, Burundi. Rwanda’s main industries are coffee, tea, and tourism. The government makes the majority of its money by taxing alcohol, but there is about 25% income tax (including social security), and 50-100% duty on vehicle imports. Rwanda as experienced (These thousand hills roll ever on…) Electric wires in the background, but most rural houses do not have electricity or running water.A common way to transport water, milk, and people is the bicycle, but uphill you walk.

Do you remember the song, “The bear went over the mountain”? He went over the mountain to see what he could see. What did he see? He saw another mountain. And another. And another.

Rwanda is a land of rolling hills covered in houses and trees, and valleys covered in crops. It is surprisingly cool here. Technically, we are south of the equator, in Winter. Practically, we are in dry season, but at a mile high with hazy “dry season” skies. The sun isn’t hot. At night, we’ve needed a light blanket in addition to the standard sheet. In fact, it rained for two days before we came, very odd for the dry season, which has tempered the weather even more.

While we passed many types of crops, I only captured this rice patty.

Mosquito nets are necessary while we sleep, but bug spray has not been necessary during the day. The malaria mosquitoes come out later at night, but even the little black and white mosquitoes have been benign, so we have been able to enjoy both sunrise and sunset outside without itchy consequences.

The fruit is fresh and delicious. A usual Rwandan meal consists of potatoes and beans (like refried beans before they have been mashed up).

The language barrier has been difficult, as expected and our continual prayer is that we could both learn more phrases to communicate and make friends with the people. Also, we want to make good connections with those people around us who do speak English.

A common way to transport water, milk, and people is the bicycle, but uphill you walk.

Next post: The National Museum and A genocide memorial: meeting people with stories of conflict