Our trip to Rwanda with Partners In Health
January 12 - 19, 2008
Jody Adams
What took my breath away immediately about Rwanda was its beauty.
My son Oliver and I had left Boston on a cold, rainy night, and 24 hours later we were met at the Kigali airport by Margaret Butler of Partners in Health and The Clinton Foundation. Standing in a sleeveless shirt and a cotton skirt in the bright Rwandan sun, Margaret gave us a warm welcome followed by a prompt apology: there was no time to stop at the hotel and freshen up because Paul had insisted that we head straight for Rwinkwavu, a village about an hour and a half to the East of the capital. He was excited to show us the hospital there, which was the first PIH project in the country. If you know Dr. Paul Farmer, co-founder and Executive Vice President of Partners in Health, you know this is how things work in his world. He is truly and sincerely sorry, but sleeping and showering will have to wait given all there is to see, hear, taste, and smell. We’ll sleep when we’re dead. In the meantime there is just so much to learn, so much to tell, and ultimately so much to do.
In 2005 the Rwandan government invited Partners In Health to bring their model of comprehensive, community-based, HIV prevention and treatment programs to rural regions of the country. In January of this year, Oliver and I were invited by Ophelia Dahl, Executive Director of Partners In Health, to learn about the work they’d accomplished in the last three years in partnership with the Rwandan Ministry of Health, the Clinton HIV/AIDS Initiative, and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
We drove to Rwinkwavu along a main road lined with houses made of red mud bricks from the region’s iron rich soil. They were picturesque. In some the brick was left exposed and it made them seem unfinished, while others were painted white, blue or yellow and had wooden doors in bright, contrasting colors. The houses came right up to the edge of the road and were surrounded by a rich green landscape: flowers, vines, small kitchen gardens, small trees and tall clumps of grass, some planted purposefully in rows to form natural fences. Lots and lots of banana trees. It was lunchtime, and we kept passing groups of smiling, laughing, running children in their school uniforms, the girls in royal blue dresses and the boys in khaki shorts and shirts. They were walking home for lunch or carrying yellow Jerry jugs to the water pump. We saw women in skirts and wraps of brightly patterned batik fabric carrying full baskets on their heads, and men in suit jackets pushing decorated bicycles laden with bananas. It was so visually compelling it was almost surreal: wave after wave of bright color.
Rwanda is a place of contrasts. The landscape is spectacular, with volcanic mountain ranges and lakes in the north of the country easing into a savannah to the east. Throughout the week, as we travelled to PIH sites in Rwinkwavu, Burera, and Kirehe, I was struck by the beauty and variety of the land: the hills dotted with a patchwork of farms, the valleys of tea and rice fields, the walls covered in garish shades of bougainvillea, the rows of corn, the daisy-like pyrenthrum. I had been told that this tiny, land-locked country in the middle of sub-Saharan Africa was a beautiful country, and I also had in the back of my mind all those far-removed newspaper accounts of genocide, malnutrition, and horrible suffering. As we drove, the actual rise and fall of the rich Rwandan landscape wove these painful images into a present reality. One full of hope, change, progress, and the conviction that keeping the memory of the genocide alive is critical so it may never happen again.
After six days of hospital, clinic, and home visits, and after meeting many doctors, patients, politicians, and program leaders, Oliver and I travelled back to Kigali on the very same road that had taken us there. It was the first leg of our 27-hour journey back to Boston. I saw the same scenes. The same beauty and bougainvillea, the same abundance of bananas of all kinds, the same school children jumping, waving and yelling Muzungu! (Which we now knew meant “white person”). What had changed was the depth of what I saw. I knew to look farther than the stunning blue front of a house, allowing my eyes to follow instead the adjacent dirt path into the small village behind. There I would find a family gathered in front of their home—a hut just nine feet long, six feet wide, and seven feet tall, covered with only a roof of dried banana leaves. I knew that there might be six people living in that hut, the children sleeping on a dirt floor and living without heat, running water, or electricity. Perhaps they would have a tiny plot of land to farm, but too little rainfall and low soil fertility would mean that they would sometimes still go without food. It was more than likely that some of the children were suffering from acute or chronic malnutrition, and that members of the family had been affected either by a food and water-borne disease like Hepatitis A, or by major infectious disease like HIV/AIDS. If they were lucky, and the family did have access to food, I knew they were probably cooking a single pot of bananas and beans in questionable water on an open flame inside that house. The heat would keep the family warm, but it could also cause terrible respiratory problems.
Six days in Rwanda was not enough for me to understand this beautiful and complicated country. It was not enough to fully understand the problems of poverty, malnutrition, disease and a country healing from national genocide. It was, however, just enough time for Rwanda to settle firmly in my heart. It was enough time to learn that what happens in Rwanda happens not just to these people in this country but happens to all of us. Just as what happens in Kenya happens to us. What happens in Iraq happens to us. What happens in Pakistan happens to us. What happens in Darfur happens to us.
The tragedies of war, genocide, and poverty are our tragedies. They are ours to see, hear, taste and smell. Most importantly, they are ours to do something about.
I thank Paul, Ophelia, and all the folks at PIH for sharing Rwanda with Oliver and me and for teaching me these lessons. To find out more about Partners In Health, their work and how you can help, visit www.pih.org.
Partners In Health - www.pih.org
Rialto Restaurant - rialto-restaurant.com
Official website of Government of Rwanda - www.gov.rw
