The Dukees....

So I knew April would be busy and it hasn’t disappointed. Let me start with the bundle of Joy. Just yesterday, I visited the home of two residents, one a senior anesthesia resident and the other the obstetric resident. It was heartwarming. Both come from very humble beginnings. Both were simply so grateful that Lola and I could grace their homes. I was very touched. Jean Paul the anesthesia resident was seconded to me for the time I was here and has been given so much opportunity.

Jean Paul and his lovely family. He is a senior anesthesia resident and a bright light for his country

Last month, he was in Virginia and this month, going to Canada and next month Minnesota. It is rare to have such opportunity but for the strong leadership of Paulin Banguti who is simply a firebrand of a resident director who wants all his children to succeed. I am really proud of all his accomplishments.

Adolphe is a senior resident and had hoped his wife would get good pain relief. The short version is she did get an epidural and they were so grateful. It has been a month now and here we are visiting their home and meeting the bundle of Joy, “Owen”.

Adolphe, a senior OB Gyn resident and his family hosting Lola and I. And there is our bundle of Joy, Owen.

These small blessings of life is what keeps one grounded and grateful. It really is the expression of gratitude that is the real pleasure of Life. Isn't that something. No wonder the Lord railed against the ungrateful, the ones who never expressed thanks. Strange, scripture calls them the “unthankful”. Well, I am very grateful to the opportunities and the people that have made this experience for me and it goes back a long, long time through the many encounters and times that have made me what I am today. Very grateful.

She presented me with a Rwandan sculpture of a mother feeding her baby as a gesture of her gratitude when she was in the throes of labor pain. I will treasure this. Thank you. As they say in Rwanda, murakoza

So Marcy Tucker, my friend from Duke and her wonderful ophthalmology friend, Karen came to town. And so did So Julie Fritz and and Kristale Privette my nurse anesthesia colleagues also.

Marcy has been phenomenal with her energy and really very touching way she has been teaching my colleagues here.

Concentrating and performing pain relief on a young boy by teaching the concept of using ultrasound and a nerve stimulator.

Success! You can see the Marcy. Nerve blocked. The Local colleagues really loved her. I hope she returns again. pleased look of

She took the young consultant under her wings and its wonderful how she has helped further give of herself. I met Edourd later and he was so pleased. He did not know he could do both nerve blocks using both ultrasound to locate a nerve but at the same time a nerve stimulator to show the nerve at work. Did I tell you Edourd got a fellowship to Nigeria to undertake a 6 month Obstetric anesthesia fellowship. I tell you folks, capacity is being built here in Rwanda. Great progress.

Marcy created a small tray the block resident can move around. Really neat, sustainable and practical.

Dr Jeanne, wonderful anesthesiologist and well respected and Dr Edourd.

Our daily interactions with Karen and Marcy has been very endearing. Julie and Kristal and I spent two days giving a refresher course in anesthesia. I was very proud of them. There was so much energy around the house. And the nurse anesthesia folks of the hospital were so grateful and engaging during the course. Many came to me to express gratitude as it does seem there isn’t too may opportunity to stop and learn. The senior organizer even sent out messages to others outside of our hospital and we had more representations from other facilities, all who wanted to learn. As the saying goes, we put our small drop of water in the ocean of knowledge…..

Ending the course with a subject called Pearls of Intervention when I simply encourage them to practice safely, dedicating themselves to the vulnerable, showing compassion

Julie demonstrating effects of supine positioning in pregnancy. Then she showed the effect of lithotomy position with her legs up in the sky.Hilarious!!

This coming week, Adam and Vincent from Duke and Amy and Jen from Wake Forest arrive to run an ACLS course.

It has also also been so much fun. Visiting friends, hanging out, reminiscing, going for walks, visiting restaurants, shopping…the pictures tell it all.

Shopping of course.

Radiant in her new dress..

Lola continues to be busy with shopping for Exotique. At the market is so much activity and energy and colors. Simply bustling. And eerily quiet. No honking. No loud conversation. No loud music. Its really remarkable how quiet they are, the Rwandese. And boy do they work hard. Sunday morning, they are working. Through the holidays, they work. And late at night , construction continues and workers are out there. Really impressed with their work ethics.

Research has continued as I have now interviewed about 10 subjects who lost their loved one during childbirth. Every interview has left its indelible mark. Its been such a privilege to listen to the people as they experienced and adjusted to the unexpected tragedy that suddenly befell them.

Henry and Lillian are my translators and Transcipters. Phenomenon work they do. Lillian also has worked for Paul Farmer and Partners in Health. How uncanny.

Next month, many have agreed to return to a forum during which they will see they are not alone in their grief and others have also experienced such loss. Who knows? Perhaps by seeing others, some of their hurt and pain will be assuaged.

There has been some down time. The guests and I visited restaurants here in Kigali. Did I tell you Kigali has some of the best restaurants with much variety. Easy to get obese here. But the hills of the city preclude that. Walking uphill burns those fat cells!! Burn baby burn!!