Kibogora Mission Hospital and Marvelous Market

View from our place in Kibogora- Lake Kivu- Rwanda

Kibogora Mission Hospital and marvelous markets

There is nothing quite as sickening as that feeling of having been ripped off. I felt numbly around my various pockets but it was gone. My treasured leather wallet from Bodrum in Turkey was now in the clutches of some Congolese or Rwandan urchin and with it my credit card, NZ drivers licence and 15 000 Rwandan Francs (R180.00). I know that I had opened it when Ilda needed change to buy spinach and then I had been marveling at massive rolls of handmade twine, golden buckets of spicy sauce and piles of multi-coloured beans, as well as clutching the hands of Margot and Zara, and then it was gone. Shock and humiliation. Never put a purse in your pocket, watch your money, and don’t carry credit cards. The market on the edge of Lake Kivu in Rwanda and on the border of Democratic Republic of Congo was heaving. Every imaginable vegetable; pyramids of blood red tomatoes, gnarled, purple sweet potatoes, large spreads of drying cassava, robust green cabbages and fresh crisp spinach; bleating goats, squealing black pigs and cow, freshly slaughtered in roadside abattoirs, with thick red blood dripping in rivulets into the orange African earth. A man with a machete hacks at white ribs while another slices through rich burgundy fillet and another delicately manipulates metres of slithery grey entrails ensuring that nothing is wasted. We are the only “Wazungu” in a sea of black smiling faces and are constantly accompanied by a scrum of persistent urchins and curious onlookers. We seek refuge in a ‘café’ and suck thirstily on cold Coke. Then on we go and I lose my wallet. I enlist the help of a responsible looking local and in broken French explain my predicament. Before long my sorry tale is being broadcast widely and there seems to be genuine disappointment at the Wazungu’s misfortune. Soldiers arrive brandishing offensive looking weapons, the crowd has swelled alarmingly and I am relieved to escape having being assured that they will return my wallet to the hospital should it be found. I have my doubts and after a struggle manage to speak to my bank in RSA and cancel cards. To cheer us up we opt to use the motorbike taxi service and the four of us enjoy an exhilarating ride up the hill and back to our haven at Kibogora Mission Hospital.














Classroom at Kibogora

Street Scene- Kibogora

Entrance Class!- Kibogora

We were meant to stop off here for a month but Ilda, Margot and Zara were only given a 2 week visa and at US$180 I was reluctant to extend it for a further fee. My RSA passport was a breeze and I got 90 days for free! Kibogora hospital is perched high up on a hilltop above Lake Kivu with the most exquisite views up this rift valley lake to smoking volcanoes lurking in the distance in Uganda, Congo and Rwanda. Our accommodation is in a beautiful 3 bed roomed house with all the comforts we could wish for and is in stark contrast to our park-home box we lived in for a year at Mseleni. We were welcomed with a lovely hot dinner, clean made beds, filter coffee and cold cool drinks and milk in the fridge. Why can’t RSA hospitals treat their staff like this? Thank you so much Sheila for all your kindness and hospitality.

The hospital feels about the same size as Mseleni but has about 250 beds to Mseleni’s 160 and this is probably explained by there being 21 patients to a ward the same size as ours, where we had 10. The wards though are immaculate, patients clean and our nurses would do well to pay this place a visit. Big difference though is family members hang around, feeding and caring for their relatives. 9 of the 12 doctors here are Congolese, enjoying better salaries than they would get back home, and the standard of care seems generally pretty good. There is a constant stream of ex-pats visiting for various lengths of time and I was fortunate to hook up in theatre with a retired American surgeon who was completing a 6 week stint. He was doing lots of hernia repairs, open prostatectomy’s and thyroidectomy’s, so it was fun to scrub up. I spent a day in the “ED”, which is really a couple of small rooms where clinic referrals are triaged to the various wards and procedures sent to minor theatre. I tried to see a few patients but it was fraught; me taking a history in broken French via nurse speaking similar broken French and asking patient in local dialect, translating back to me and then me recording in English. Oooof, too hard, so helping in OR was more appealing. Lots of the minor surgery (that we would normally do in ED) is done by nurses and ALL the anaesthetics, including GA’s, Ketamines and spinals are done by nurse anaesthetists, which I found remarkable. They seem very competent but seemed to stick to standard recipes comprising Thiopentone, sux, halothane and Pancuronium. Referrals are near impossible and forget about fancy stuff like CTscans, histology and image intensifiers! That said, these guys seem to do a good job, but a striking difference with our wards at Mseleni is the much lower acuity here. Patients that wouldn’t get a look in the door at Mseleni spend 3 days in bed here, why, I don’t know. The other staggering figure is their HIV rate of 3% compared with our 30%.

Heading to the market

Beans

Moto-Taxi

Rwanda Flag

Zara Art

Morning prayers happen at 07.30 and all the staff seem to attend. The singing is good but a sermon in local dialect is heavy going at 07.30! Then there is a brief handover from night nurses after which the doctors meet for a brief chat. They all start by shaking hands, which I found touching, but they don’t do grand rounds like we did at Mseleni. Otherwise, they do a horizontal midline incision for their c-sections, which I found unusual, and their hospital stores supplies the “ED” 3x per week where I struggled with our stores at Mseleni who thought that once a fortnight was ok! I was able to demonstrate the rapid “grab-and-slash” South African method of circumcision which was well received and managed to give a demonstration of trauma ultrasound in French, which I thought was a fair effort!

So, although brief, it has been very interesting to see what happens at a rural mission hospital in the depths of Africa. More than that, this has been a breath of fresh air, living in a lovely home with fabulous views, great food and an opportunity for the girls to get a solid week of school done. Sadly we missed our school delivery in Lusaka so that Ilda is a wee bit short of teaching material. However the road is rich and I am certain that as we head up into the mountains of Uganda we will all learn lots!

Boats on Lake Kivu

Coffee Cooperative- Coffee beans drying

Dried Coffee beans after 15 days

Workers doing the road to Kibogora under Chineese direction

Tea Plantation

Some more tea!