Riding through town

I had my camera with me today while I was riding across town and decided to take a brief video of one of the main roads in Kigali. This is certainly the largest and longest road, going from the airport all the way downtown. In the video, I'm riding a moto, which is one of the main modes of transportation through Kigali.

Motos are somewhere between a moped and a motorcycle and provide easy, cheap transportation. The most you can pay (even as a muzungu) is about two dollars, and that would be for a trip from the far side of downtown out to the airport. Most rides are around town are less than fifty cents. Amazingly, all the motos are registered with the government, drivers are required to wear official vests with their registration number and both drivers and passengers are required to wear helmets.

We Are The World

For my last Friday night in Kigali, I decided I wanted to return to the talent show at Sky Hotel. The show was amusing as before (see the post from May called 'Talent show') and I caught a video of the performers' grande finale.

For those of you not familiar with this song, it was written in 1985 by Michael Jackson and Lionel Richie. It was recorded by a group of artists called 'U.S.A. for Africa' ('United Support of Artists for Africa') which included numerous famous performers to raise money for famine relief in Ethiopia.

PSF Clinic

I have just a few pictures from the medical clinic at PSF...

'Beyond the Gates'

Last night I watched a movie called 'Beyond the Gates' (it was released as 'Shooting Dogs' outside the U.S.). The film follows the story of the events that took place at the Ecole Technique Officielle in Kigali, Rwanda, during April of 1994. The school served as a base for the Belgian UN peace-keeping troops and, once fighting broke out in the city, became a refuge for two thousand, five hundred Tutsi refugees. However, after ten Belgian soldiers were murdered by Hutu militia, the UN forces were given orders to retreat to the airport. As soon as the soldiers withdrew, the militia who surrounded the school attacked and all within were killed.

While I did not find this to be a particularly impressive film (contrary to reviews, apparently), I did find it incredibly eerie. The film was shot in Kigali in 2004 so the buildings, the hills, the clothing and everything else is familiar. There are a number of scenes in which I recognize specific buildings and specific views. There are lines in Kinyarwanda that I understand (and I can tell that most of the actors are not Rwandan from their accents). There are references to sections of the city and places where I work and that I frequently visit.

Even the details are haunting. The dogs are the same village mutts as the one several of my friends adopted. The bottles of beer are the same as the ones I drank this weekend. The mattresses are the same foam on which I sleep each night.

The most striking aspect, though, may actually come after the film is over. During the credits, faces of Rwandans involved in the making of the film are shown with brief stories of how they were affected by the genocide. For example, "so-and-so lost both her parents and five brothers and sisters", "so-and-so lost twenty-two members of his mother's family", "so-and-so hid in a cess pit for fourteen days and survived", etc. What is most haunting about these pictures and these statements is that, now, I actually know more than one of these so-and-so's. These are individuals who I have met, with whom I have taken lunch, with whom I have spent entire days. And, suddenly, each so-and-so portrayed in the film becomes one of my coworkers or friends - the woman who lost her husband, the boy who lost his parents, the woman who barely escaped across the border and was refused at the hospital because doctors assumed she would die, the girl who lost her brother and so on and so on and so on.

Moto Polo

Some of my friends have invented a new sport called Moto Polo. Basically, it's the game of polo, with all players on the backs of motorcycles instead of horses, using croquet sticks and a ball made of banana tree bark wrapped in duct tape, played on a dirt football field, with not very many rules. Sound like a bad idea? I'm sure it is, but I still went out to watch the second ever match this afternoon.The "professional" video from the first match (which was played a couple months ago) can be seen here.

Lunch

A typical Rwandan meal of rice, beans, mashed bananas and goat is served every day for lunch at work. Occasionally isombe (similar to stewed spinach, only made with cassava leaves), sweet potatoes, cassava or fried potatoes are added to the menu. The meal is always delicious, but it's so heavy that it usually makes it difficult to stay awake for a full afternoon of work.

Charcoal trail

While much of the hike up Nyiragongo is through dense forest, a lot of it passes through areas that have been stripped of the huge, magnificent trees that cover the rest of the park. They call this the Charcoal Trail. I found an article that explains a bit more and have pasted it below. There was also an entire issue of National Geographic magazine in July 2008 that was dedicated to the associations between charcoal, the mountain gorillas, the ongoing guerilla war, Virungas National Park and Nyiragongo. The online version of the magazine can be found here.
Charcoal, Corruption and the DRC's Gorillas
by: Leah Hazard

It was about this time last year when four gorillas were murdered in cold blood in the Virunga National Park in the Democratic Republic of the Congo.

A photo of the 530-pound Senkwekwe, head of the massacred gorilla family, being carried to burial by Congolese villagers, ignited international outrage and garnered the public’s attention, if only for a moment.

Almost a year later, National Geographic has published a magnificent piece examining the gorilla murders in the Virunga National Park. Poachers were quickly dismissed as suspects due to the intact remains of the animals, leaving soldiers from the Congolese military or two other rebel factions as the likely culprits. Soldiers on all sides of the conflict have wreaked havoc on local communities, killing indiscriminately and raping women, including children as young as three years old. Despite such acts, soldiers insist they are under strict instructions not to harm the gorillas.

So who — or what — explains the murders?

"Follow the trail of charcoal," Emmanuel de Merode had said at the WildlifeDirect office. "Charcoal is the biggest threat to the park."

Charcoal, as we discover over the next few days, is the main source of energy, and evil, in North Kivu. Charcoal is used by 98 percent of the households for cooking, boiling water to make it potable, and also for heat. In the city of Goma, a constant pall of charcoal smoke smudges out the sun and makes the rough streets, rumpled with hardened lava from the 2002 eruption of Nyiragongo, appear to be pathways to hell.

Hardwood charcoal is the economic prize in the DRC and it comes from old growth hard wood trees found within Virunga National Park — home to half the world's population of mountain gorillas.

A sack of charcoal sells for $25 on average. Doing the math De Merode estimates that in 2006, when gorilla tourism brought in less than $300,000, the Virunga charcoal industry was worth more than $30 million.

It is estimated that at the rate that charcoal is harvested from the park, the entire southern portion of the park will be gone in ten years. An area considered to be perhaps the most biologically diverse and best of its kind, may soon vanish.

Aware of these facts, and the local implications, neighboring Rwanda has banished the internal production of charcoal. However, this approach does nothing to mitigate Rwanda's own internal demand for the product. They just buy it from the Congolese.

But what does this have to do with the death of four gorillas in July 2007?

Writer Mark Jenkins met with Paulin Ngobobo, chief warden of the Virunga National Park, to hear his story. When Ngobobo worked for the National Parks he quickly realized that all sides were profiting from the charcoal trade, from the Congolese military to Hutu militias and local chiefs — even the park rangers. In a struggle for conservation of the gorilla's home, he realized that the charcoal trade had to be stopped in its tracks.

At this point Paulin Ngobobo was detained and beaten, allegedly by men directed by the former chief park warden, Honoré Mashagiro, who was actively involved in the very trade which was destroying the park he was charged with protecting. To discredit Ngobobo's anti-charcoal trade efforts it is alleged that Mashagiro had the gorillas killed and blamed their murders on Ngobobo. Despite Mashagiro's efforts, Ngobobo has been cleared of the accusations and remains free. Mashagiro, on the other hand, has been imprisoned in Goma and awaits trial for the killings of the Virunga mountain gorillas.

The story of the DRC's illegal charcoal trade is a difficult one. Who is to blame? A culture of corruption which ensures that park rangers and soldiers will smuggle charcoal to supplement a non-existent salary? Citizens of Goma and neighboring Rwanda who demand the charcoal for cooking?

Nyiragongo volcano

After crossing the border and driving through Goma, we headed toward Mount Nyiragongo,one of the only active volcanoes in the world that you can climb. It is over 3,700 meters above sea level and the crater 250 meters deep and two kilometers wide.
The hike up and down Nyiragongo takes two days. The first day is about six hours of hiking across lava rocks that are left from the 2002 eruption of the volcano.
When we were about halfway up the volcano, we turned around and realized we had begun our hike by climbing a smaller, inactive volcano right next to Nyiragongo.The hike is tough, but the view from the top makes it absolutely worth the effort. We arrived at the rim of the crater around five o'clock in the afternoon and had a perfectly clear view of the lava lake within the volcano's crater. Our guide was as amazed by the view as we were - he said it was the clearest he'd seen the crater in fifteen years. We sat just on the edge of the rim for the next several hours, amazed by the bubbling lava below.
While we watched the lava, our porters had set up camp, just a few meters away from the rim of the volcano on a small ledge. When we were frozen from the wind where we were sitting, we walked over to the small camp to sit around the fire and eat some dinner (thank you everyone for the care packages of tuna fish and granola bars!)

Before long, the sun began to set over the crater.
Although the steam adn smoke grew thicker as it got darker, the lava began to glow more and more brightly, and I understood how it could be seen from kilometers and kilometers away.The evening just became more and more amazing when we realized that there was a full moon overhead and, not just a full moon, but a full lunar eclipse.
The next morning we were up early to pack up camp and head down the volcano.
The hike down was much quicker than the hike up but not necessarily much easier. Each step had to be taken cautiously lest we slip in the skree and slide down the side of the volcano. Still, we were back at the base in only three or three and a half hours and not long afterwards were on a bus back to Kigali.

Goma

This weekend I crossed over into the Democratic Republic of Congo for the first time since I've been in Rwanda. The Congolese town of Goma is just across the border from the Rwandan town of Gisenyi. While the two are close enough to perhaps be the very same town, the border between them is divisive enough that it creates two completely separate worlds.

While Gisenyi is considered a holiday town, of sorts, Goma is a disaster area. The guerilla fighting in the area has taken a hiatus for almost two months, but the tension in the air is still thick. It is obvious that life here is much more difficult than in Goma's sister town of Gisenyi.
Almost every single vehicle on the road is labeled and belongs to the United Nations, International Refugee Committee, Red Cross, World Relief, or any of the other dozens of relief organizations in the area. The majority of the residential areas are refugee settlements designed by the United Nations High Commission on Refugees (UNHCR). Plastic tarps covered with the letters 'UNHCR' and 'USAID' are everywhere. Tanks armed by UN peace keepers are scattered along the sides of the road. Even the airport is controlled by the UN.
Aside from the obvious involvement of international non-governmental and United Nations organizations in the area, there is further evidence that life is difficult. Volcanic rock and lava from the 2002 eruption of Nyiragongo still covers the streets and many of the fields. Petrol stations are empty so cars are refueled with siphoned petrol sold in water bottles on the side of the road. The boys at the bus station who, anywhere else, would be selling biscuits and juice instead have boxes of emergency food rations. Economic transactions are conducted in U.S. dollars since the strength of the Congolese franc cannot be trusted.
Goma is not in a good state and, unfortunately, there is little to imply that things may improve any time soon.

Again and again

I just stumbled across this post that I wrote several months ago after returning to Rwanda from a trip over Christmas that included a day in Amsterdam. I had forgotten to finish writing it and post it...

When I visited the national genocide memorial in Kigali several months ago (see 'Kigali Memorial Centre'), I was especially impressed with the fact that the memorial centre included displays not just on the Rwandan genocide but on other genocides that have taken place and are taking place throughout the world. I felt like this showed a true commitment to the fight against genocide by acknowledging that Rwanda is not the only place where a genocide has occurred and the way in which the Rwandan genocide happened is not the only way in which a genocide can take place.

As impressed as I was with this global perspective of the Kigali Memorial Centre, I was disappointed - no, I was angry - with the Anne Frank House in Amsterdam. The majority of the house is fairly and appropriately dedicated to the Holocaust. However, at the end of the tour, there is space for additional displays. This space is filled with exhibition called "Free2choose" which displays "how basic rights can clash: the freedom of speech versus the right to be protected against discrimination." While this display gives insight into how limiting rights such as the freedom of speech can develop into discrimination which can turn to violent attacks and genocide, it does not acknowledge the ways in which this has occurred outside Nazi Germany. In fact, nowhere in the Anne Frank House is there mention of the genocides in Armenia (1915-1917), Cambodia (1975-1977), Bosnia (1992-1995), Rwanda (1994) or any of the other locations and times in the world where genocide has occurred.

I found the lack of any such information infuriating. I hate that such a thing tainted my experience of visiting a historical location with such importance of its own, but I walked out of the house feeling more anger than sadness or thoughtfulness or regret or any of the other feelings that are usually associated with visiting a genocide memorial. The world acknowledges the terror of the Holocaust, yet so many are ignorant of the genocides that continue to occur again and again. I feel like the Anne Frank House is such a well-known site that it could be a tremendously effective location to educate people on the dangers of genocide, not just in terms of the Holocaust, but in terms of these continued events that occur again and again around the world. Instead, unfortunately, it supports Samantha Power's cynical, yet insightful, assessment of the UN genocide convention of which she wrote, that in practice it means “never again would the Germans kill Jews in Europe in the 1940s.”

CDC Guidelines for CVCT

At the end of last year, through the President's Emergency Plan for AIDS Relief (PEPFAR), the U.S. Centers for Disease Control and Prevention (CDC) collaborated with the Rwanda Zambia HIV Research Group (RZHRG), the Liverpool School of Tropical Medicine (LSTM), and other national and international partners to develop the Couples HIV Counseling and Testing (CHCT) Intervention and Training Curriculum. Although the CDC is calling this intervention "CHCT", it is the same thing that RZHRG has developed and is using with the name "CVCT". The curriculum was developed in response to increased demand from field partners for interventions and training that would help them address the complex issues related to HIV counseling and testing with couples, who currently constitute the largest risk group in Africa for HIV transmission. The curriculum can be found online here.

Picture day

When clients are enrolled in our studies, we take pictures of both the man and the woman so that we can confirm that the correct person has come for each visit. However, after the couple has been enrolled, we ask them to return with their children so that we can also take pictures of them. These pictures are used to confirm each child's identity if they come to our clinic for treatment or for referral to another clinic and to enroll each child in the national health insurance program called "mutuelle".

The place where the pictures are taken is right in front of my desk, in front of a small section of blank wall. I always love to watch when the children come for picture day. This morning a family of seven came to have their pictures taken. One by one, in order from oldest to youngest, the children took turns standing in front of the wall. Each looked solemnly at the camera without smiling, waiting for the flash of the picture to be taken before allowing their next sibling to take their place.

Something about that solemn pose in front of the camera adds to the maturity of these children who already seem years older than they actually are. Yet somehow, it also adds a child-like quality of confusion and a lack of understanding of this shiny, silver object flashing light in front of their tiny faces. It's so different from children in the U.S., and it's difficult to describe, the combination of such maturity and child-like wonder in the same face, but I think it's the quality that amazes me so much, that whatever these children have experienced or seen or learned, every now and again, you can still catch a glimpse of mischief and wonder and youth in their eyes.

Why Africa is still starving

I don't know that this article really explains why Africa is "still starving", but it does give some insight into one of the dangerous side effects of aid work.

Why Africa Is Still Starving
by: Alex Perry

Paleontologists hunting fossils of early man in the Rift Valley of southern Ethiopia call the area the cradle of mankind. This year it's bursting with life, especially in the fields where local farmers grow barley, potatoes and teff, a cereal used to make the flat, spongy bread injera. As a warm July rain falls on a patchwork of smallholdings half a day's walk from the nearest road, the women harvest yams, the men plow behind sturdy oxen and fat chickens, goats and cows roam outside mud huts. And yet for all the apparent abundance, this area is so short of food that many are dying from starvation.

All morning, the hills above the village of Kersa have echoed with the wails of women walking in from the fields. They gather on a patch of open grass before a stretcher made from freshly cut bamboo, bound and laid with banana leaves. On it is a small bundle wrapped in a red-and-blue blanket. An imam calls the crowd together, asks them to take off their shoes and arranges them in two lines, women behind men, facing east. "Allahu akbar," he says twice. Then four men pick up the bier, easily handling its weight with one arm, and walk a short way to a freshly dug hole, into which they lower the bundle and bury it. Three other small, fresh graves nearby indicate Ayano Gemeda, 6, was not the first child to starve in Kersa this year. The distended bellies and chicken-wing limbs of children looking on suggest he won't be the last.

In the six weeks to mid-July, Médecins Sans Frontières (MSF) treated 11,800 Ethiopian children for severe acute malnutrition. At a tented hospital in the town of Kuyera, 50 out of 1,000 died, double the rate MSF expects for a full-fledged famine. "It's very bizarre," says Jean de Cambry, a Belgian MSF veteran of crises from Sudan to Afghanistan. "It's so green. But you have all these people dying of hunger." The verdure around Kuyera is misleading. It is the product of rains in June, too late for the first of two annual crops. From January to May, the fields were parched and brown. And one failed harvest is enough to turn Ethiopia, a nation of 66 million farmers, into a humanitarian catastrophe.

Hunger has swept East Africa this year, spurred by poor rains and rising food prices. The U.N. estimates that 14 million people urgently need food aid, including 2.6 million in Somalia and more than 1 million in Kenya. In Ethiopia, 4.6 million people are at risk, and 75,000 children have severe acute malnutrition. Nearly a quarter-century ago, an outright famine led to Live Aid, an international fund-raising effort promoted by rock stars, which produced an outpouring of global generosity: millions of tons of food flooded into the country. Yet, ironically, that very generosity may have contributed to today's crisis.

Over time, sustained food aid creates dependence on handouts and shifts focus away from improving agricultural practices to increase local food supplies. Ethiopia exemplifies the consequences of giving a starving man a fish instead of teaching him to catch his own. This year the U.S. will give more than $800 million to Ethiopia: $460 million for food, $350 million for HIV/AIDS treatment — and just $7 million for agricultural development. Western governments are loath to halt programs that create a market for their farm surpluses, but for countries receiving their charity, long-term food aid can become addictive. Why bother with development when shortfalls are met by aid? Ethiopian farmers can't compete with free food, so they stop trying. Over time, there's a loss of key skills, and a country that doesn't have to feed itself soon becomes a country that can't. All too often, its rulers use resources elsewhere — Ethiopia has one of Africa's largest armies.

Why do we get aid so wrong? Because it feels so right. "The American people," says U.S. ambassador to Ethiopia Donald Yamamoto, "are simply not going to sit tight while they see children dying." Nor should they: a starving man needs to be saved first, before he can be taught to fish — or farm. But as the world rallies again to Ethiopia's aid, donors face a dilemma. "We're not getting to the real problem," says Yamamoto.

What would? Ethiopia thought it had found one answer. In 2005 a $1.4 billion five-year program identified 7.3 million Ethiopians unable to live without free food and gave them jobs in rural projects, such as roads and irrigation. The idea was to create livelihoods as well as to save lives. It was working, slowly. By this year, says a Western economist familiar with the effort, "a few thousand" had left the program and were making it on their own. Then came the double blow of drought and soaring food prices. Of the 7.3 million, 5.4 million suddenly needed extra food aid. The sobering lesson: even the best efforts to eliminate hunger are expensive, slow and uncertain of success. Depressing as it may be, this may not be the last time Ethiopia needs help.

Mosquitoes

I had always been under the impression that, when traveling in tropical climates, it was the rainy season during which you had to worry about mosquitoes. The dry season was supposed to be a time of relief, without that pesky buzzing in your ear, without itchy red bumps across your body, without the worry of malaria or dengue fever. But apparently someone forgot to mention all this to the mosquitoes in Kigali.

For the first eight months I was in Rwanda, it was one continuous rainy season (if you ignore the week in January that some would consider the "short dry season"). Almost every day, for at least an hour or two, the skies would burst open and rain would pour down on the nation. There were constant puddles and dampness - the perfect breeding ground for mosquitoes. I expected to see them, to be bit by them, to be driven nuts by them. But during that time, I could count on one hand - less than that even - the number of times I was bit. It wasn't until now, during the first dry season I've experienced in Rwanda, that the mosquitoes have decided to venture out of their nests.

And it is awful.

Every night now, before I go to bed, I follow my usual routine of putting on my pj's, washing my face, brushing my teeth, fixing my mosquito net, crawling into bed, reading for a few minutes and then turning out the lights. Except now, there's an additional task added to the process. Once I turn out the lights, I lay there in bed, as still as possible, and I wait. It's never long before I hear the high-pitched humming of a mosquito that has somehow sneaked inside my net and is now centimeters away from my ear. Then the chase is on. Knowing that it is trapped inside my net, I pull the cord by my bed to turn the lights back on and begin to chase it, slamming my hands against my mattress, my pillows, my headboard, one another. I can't go to sleep until I've smashed my target. Otherwise I'll have an experience like I did a few mornings ago.

I woke up, looked in my mirror, and noticed three red dogs spaced along my left eyebrow. I looked closer and saw two more on my forehead. It wasn't a problem that my skin was breaking out; it was a problem that a mosquito had been inside the net that surrounds my bed my net while I slept and tortured one of the only parts of my body not covered with a sheet. A little while later I noticed more bites - on my wrists, my feet, my arms.

It's just ridiculous, so much so, that I think now I may be a little paranoid.

Tonight, while getting ready for bed, I heard a high-pitched, humming sound, so I immediately began swatting the air around my ears, declaring war against that tiny insect. But my swatting did nothing. When the sound didn't disappear, I paused for a minute, and I finally realized that what I was hearing was not in fact a mosquito within centimeters of my skin, but a kitten meowing outside my window.

Airport crashes

This afternoon I received a text message from a friend who was supposed to be flying out from the Kigali airport about an hour before the text came through:

"Computer system @ airport crashed and they can't get it back up. The supervisor is literally buying phone credit to call a technician."

I chuckled to myself while picturing the scene. I can see lines of people waiting to check in for the flight while airport employees have no idea what to do with the computers down. I can imagine a supervisor who finally suggests they call a technician, only to realize no one has any credit on their phones to make a call. He then walks past the lines, out the front door of the airport and toward the street where he can buy a few francs worth of phone credit from a street vendor before he returns to the airport to call the technician. Of course, whether the technician answers the phone, whether the phone credit lasts long enough to explain the situation, whether the technician is available and whether he can do anything to remedy the situation are all entirely separate stories.

Trashy magazines

I don't know what it is, but there's something about living in Africa that makes trashy, American, celebrity gossip magazines much, much more interesting than they ever would be anywhere else. I received five in the mail from my mom last week, and even though they were a couple months old by the time they made it to Kigali, they were a big hit when I had friends over for dinner this past weekend.
Even the guys couldn't be disturbed once they started reading (even though they might kill me for mentioning that!).

Grey's Anatomy & HIV

This weekend I rewatched a couple episodes from this season of Grey’s Anatomy (yes, I patiently downloaded the entire season on iTunes, week by week) and was reminded of two posts that I meant to write the first time I saw these episodes. The first is from an episode called ‘Piece of My Heart’.

In this show, a young, married couple comes into the clinic and requests a pregnancy test. After performing the test, Izzie (Katherine Heigel) tells the couple that they are indeed pregnant, congratulates them and offers some free samples of prenatal vitamins. However, the couple does not respond with joy. The woman begins to cry and tells Izzie that they need to schedule an abortion. Izzie suggests they take some time to think before making such a decision and the woman responds that there is no decision to make, that she has been HIV-positive since the age of nineteen and a condom had broken and now she is pregnant. She refuses to risk having an HIV-positive baby.

The couple continue to insist that they want an abortion, until Izzie comes through with the following speech:

“If you want to have an abortion because you want to have an abortion, then that’s between you and whatever god you believe in. But if you want to have an abortion because you think that’s what medicine’s telling you to do, then that’s between you and me…I wasn’t tell you there was some chance your baby might not be born sick. I was telling you there is a 98 percent chance your baby could be born perfectly healthy. A 98 percent chance. There’s a higher chance of your baby being born with down syndrome than there is of you passing HIV on to your child.”

Thank you, Grey’s Anatomy, not just for providing me with my weekly dose of McDreamy and drama at Seattle Grace, but for presenting HIV in such a way – showing that this disease affects not only homosexuals and intravenous drug users and Africans, but also young, white, heterosexual, American women, and showing that drugs exist that can basically eliminate mother-to-child transmission.

Care package dinner

I really enjoy cooking for groups of friends, and, as I found out recently, have developed something of a reputation for doing so, particularly on the holidays.

Tonight was no holiday, but I still decided to invite a few people over for dinner and was particularly excited to do so since I had received a care package earlier in the week that was filled with delicious foodstuffs - drink mix, instant sauces, spices, packets of flavored mashed potatoes and rice, salad dressings, chocolates, tuna, and so much more. So tonight for dinner I was able to make things I'd never been able to make in Rwanda - pasta with pesto sauce, Parmesan-crusted tilapia, salad with real salad dressing, peach tea and, for dessert, banana fritters with chocolate sauce. I'm pretty sure we all overate our share, but it sure was delicious!
(Thank you, Nicole, for making this possible!!)