Wednesday, June 25, 2014

Goodbye Kigali, Hello Rwamagana!

Well, plans quickly changed again late Saturday night/early Sunday morning.  On Saturday Casey and I were supposed to meet with the director of the hospital before he flew to Kenya Sunday morning, but his schedule was booked and we didn't meet.  Around 11 Saturday night, we received a text from him asking to meet at 7am before he caught his flight.  We found general directions to where we were supposed to meet him and so 6:30 Sunday morning we were traveling across town to meet up with him.  Well, so we thought.  The place we ended up going was Chez Robert when we were supposed to go to Chez Lando.  Thankfully Ben was able to pick us up and take across town to the airport where we were able to meet the director for 10 minutes before he boarded the plane.  During our meeting, our departure time from Kigali to Rwamagana changed from 10am to 9am so we quick rushed back to our home stay and hurriedly packed up.

The trip to Rwamangana is only 1 hour from Kigali, so we then had all of Sunday afternoon to explore the town.  We drove up to what seems like a small mansion by Rwandan standards and met the houseboy, Patrickq, who takes care of the house and also cooks all of the meals.  I feel like a spoiled American between having my own room and someone who cooks all of our meals for us.  It's nice for a few days, but it's a little bit of a weird feeling going from doing everything yourself at college and now someone is paid to cook your meals and wash your dishes.

When walking around Rwamagana Sunday afternoon, I was pretty sure the population of muzungus (white people) there was a grand total of 1.  Eventually Casey and I passed 3 other white people and we all were pretty excited to see someone else who spoke English.  In the afternoon we were also able to meet up with Cyprien who is the hospital's BMET but is actually in Kigali for 2 weeks taking some classes run by EWH for additional training.

Monday morning we reported bright and early at 7am to begin our 5 weeks at the hospital.  Before heading to class, Cyprien was able to show us 2 departments and then Casey and I worked on some equipment for the rest of the day.  Our repairs included fixing a loose connection in the tubing for an oxygen concentrator, making a new power cord for a suction machine, and fixing the wiring for an oxygen concentrator.  For the new power cord, one of the prongs on the old plug was broken, so we used the plug from an extra cord and connected it with the remaining part of the old cord, soldered some wires, and it's as good as new by Rwandan standards!  Unfortunately, none of these machines can be returned to the departments yet since they are still missing some parts that we hopefully will find or make this weekend.


One of the oxygen concentrators needs a new 9V battery for the alarm system which sounds like an easy fix, except we are working in a developing country.  After work, Casey and I visited 5 hardware stores to try to buy a battery which is going to cost us 2,500 francs ($3.50), but no luck.  After struggling to describe what a 9V battery is in Kinyarwandan, everyone said that we have to go to Kigali to find one.  Practically everyone back home takes it for granted how easy it is to replace a battery, but here it is a major scavenger hunt to find one and it's expensive.  The oxygen concentrators and suction machine also need new canisters for the humidification systems which is something that we probably will end up making since it will be practically impossible to find spares.

Tuesday we worked in the workshop again, taking inventory in the morning and then working on some un-interruptible power supplies (UPS).  One of them was a simple user error that we were able to fix once we took the UPS apart and learned how it worked.  In the afternoon, we attempted to repair a brand new fetal monitor that wasn't printing.  Luckily the user manual was still with it, so we read that in hopes of finding a solution but had no luck.  After reading 3-4 manuals, front to back, of how to operate the monitor and setup the printer, we decided the problem was with the thermal printing system which uses heat instead of ink to print the fetal heart rate (FHR) and uterine contractions (UC).  I currently am trading e-mails with the company of how to repair the thermal printing system and thankfully they have been responding and are being helpful.  Fingers crossed, hopefully this fetal monitor will be working by the end of my trip since the maternity ward could definitely use this addition to their current supply of 2 monitors.

While working on the fetal monitor, I saw a bunch of wires run up through the window from right outside the workshop where all of the welders work, plugged into the outlet.  I couldn't help but laugh a little bit at how crazy the sight was, but also take a step back from the outlet in fear of getting shocked.  Here they had 2 thin, loose wires connected to a welding torch, run across a walkway, run up through a window, and simply stripped the ends and stuck the bare wires into the outlet.  Of course I had to take a picture so all of you could really appreciate the sight.





Wednesday morning, Casey and I went on an adventure to the laboratory to begin taking inventory, since we had been waiting for the past 2 days for Batiste, one of the maintenance guys, to take us there.  Since Monday morning, he kept saying he would take us that afternoon, the next morning, that afternoon, etc., so we finally went on our own to get it done.  For a developing country, the hospital had some extremely nice equipment, some of which had been donated by various foreign countries.  From there we were able to visit pediatrics, surgery, physiotherapy, maternity, and neonatology.  Each place we went had their pieces of equipment that were waiting for repair, ranging from a broken freezer to an otoscope needing a new light bulb.

While taking inventory in maternity, I definitely had a 'TIA' moment.  Last month, some of the group would say TIA (this is Africa) when we saw something that you would never see in the States, like a goat carcass hanging in the doorway of a shop entrance.  Today definitely was one of those TIA moments as a midwife just took us straight into one of the delivery rooms where a mother was in the middle of labor and let us take inventory on a machine right next to the mother's bedside.  During the inventory process, the baby was born right next to us which was quite the experience; one that I'm ok with not repeating for at least a few more days here.  After that, we also got to visit the neonatal ward where we had to put on special shoes and inventoried infant incubators that were warming babies whose legs were the size of my finger.

By the end of the week, we hope to have finished the inventories for all of the departments and begun some of the repairs.  Over the next few weeks, we will be biomedical engineers, technicians, electricians, heating and cooling repairmen, IT, teachers, and many other random jobs.  Continued prayers for safety are greatly appreciated as the work poses some dangers such as being shocked and unsecured containers of oxygen exploding.

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