Sunday, March 27, 2016

Easter musings

Happy Easter y’all! It is quite the day here in Gisenyi. Perfect weather, woke up somewhat tired from a long day of doing not much and attending a pool party hosted by a bunch of Californians until late night. But it is a holiday, so as a practicing Catholic, I had to find a church to celebrate Easter. More on that in a bit. 

In fact, Catholic mass in general here is an interesting experience. Most masses are in Kinyarwanda, and last for at least 2 hours. It is really difficult to follow when you do not understand anything. So I searched for mass in English. When I initially arrived in Butare (Huye), I had a lot of problems with this. I was told which church to go to by many people for Mass in English, but there was either no mass that day, they no longer offered English mass, or they never had a Mass in English in the first place. After a month of trying, I decided to do mass online, www.thesundaymass.org. It is an awesome, online mass from Upper East side of Manhattan. Great homilies, 30 min in length, indeed, perfect. After a few more months, I finally heard about a mass in English at a Church near the University at 1030 AM. Well, that was only partly true. You see, kids, there are only so many priests that speak English, and they are not always there. So, after another month of going to mass at the appointed time, and there not being mass, I finally got the phone number for someone who was in charge of organizing that mass, and started getting regular information about when it was offered, and I going whenever I was in town. There are more English masses in Kigali, but usually far from where I stay, and difficult logistically. 

It is sparsely attended, mostly University students, but a good mass. The best part is the choir made up of college-aged singers (The main campus of the University of Rwanda is in Huye, and just down the street from the church.) IMHO, they are better any any choir I have heard in the US. I have made some recordings on my phone, and I will try to get them uploaded soon (I know, I know, I also owe you guys some pictures; I am not serious!) 

So, back to Easter mass. I confirmed the place and time with 3 different locals. They all said 10 AM at this one main church. I got up early, got some coffee and a light breakfast, and go for a quick swim in Lake Kivu. I get to the church at 945, and what do I find: church already half over! I guess it started at 9 AM. Ahhh, Africa! Time is a whole different commodity here. So I embraced it, and I stayed for the end. A muzungu attending mass in Rwanda is usually a spectacle, but today I was stared at a lot more than normal. You get used to it: but from someone who hates being stared at, it is tough to get over. Besides that, the best part was the African drumming during communion and after mass. (Again, I will post pics and vids soon.)

As for the rest of the day, not really sure. I will be getting a good dinner tonite (A Conard Easter tradition: some kind of roast or ham, potatoes, and more, if they have?) 

Until next time: Enjoy Life, Love Liberty, and Be Happy!


Craig

Saturday, March 26, 2016

So, yeah, that last post on the Gorillas took a while to do, and get done. But it was worth it! Please read that first before this one...

This is Easter weekend, so I decided to take a trip for a few days to Gisenyi on Northern Lake Kivu, literally on the border with Congo. It is a chill, beach town with some Belgian influence. There are some enormous houses here. I have heard that a lot of the wealthy Congolese have houses here; I haven't yet independently confirmed this! Give me some time...

I was here only briefly in Jan during my Gorilla trekking, and stayed in the more resort-ish town about 6 km south of here at a true resort called Paradise Malahide. From when I got off the 4 hour bus ride from Kigali yesterday, I just knew I was going to like it here. It is divided into an older, suburban town and a true African town with businesses, markets, etc. I was originally going to stay at a hostel near the beach, but the government took over that whole area for an event yesterday and today, so my reservation was cancelled... Ahhh, Africa. No worries, though; I found another hotel in my price range a few blocks away from the Congo Border.

I have been here for a little less than 24 hours, and already love it! It has a cool, beach vibe to it. There is a public beach, with coarse sand. Some say that one should not swim in Lake Kivu because of the risk of Schistosomiasis (aka bilharzia), a parasite that lives in snails that can enter the human body and cause liver and bladder problems. From what I have read, and from what others have told me, there is a low risk here. You can always have your schistosomiasis antibodies checked every few months, and take post-exposure medication (praziquantel) 2 months after exposure. So, I am covered, I think. The water is somehow clear, and perfect temperature. I went for an open water swim this AM, and felt amazing!

There is also a cool coffee shop serving California style food and drinks. They even have their own garden in front of the restaurant. Even the decor is awesome! The two Californians ex-pats that run it get it. I have been looking for a place like this for a while! Kudos to Allie and Stasi for a cool, chill spot.

Being Easter, and a practicing Catholic, I will find time to go to mass tomorrow, likely in French or Kinyarwanda. And find a good Sunday brunch. As far as the rest of the weekend, reading, relaxing, swimming, and, as I am known for saying, "Just chillin'!"

Until next time: Love Life, Enjoy Liberty, and Be Happy!

Craiger


Gorillas in the Mist, literally…

One of the things to do in Rwanda, perhaps the single tourist attraction for which Rwanda is most well known, is trekking to the Mountain Gorillas in the Northwestern part of Rwanda. These same gorillas are what attracted Dian Fossey here in the late 1960s, inspired her to devote her life to and advocate for these majestic animals, and ultimately lead to her death. These are the same gorillas that inspired the book and movie “Gorillas in the Mist.” Needless to say, it was something on my list of must dos while in country, and I took that opportunity in early January. 

First, a little background about the area. Volcanoes National Park lies on the Northern border with Uganda, and a stones throw away from the Democratic Republic of Congo. There are 4 rather large volcanoes there, none “active,” (though one I just heard has had some increased activity, and could erupt at some time soon?) that dominate the skyline of the park. The gorillas live in large family groups, containing anywhere from 8 - 33 members. About 11 are in Uganda, 8 in DRC, and ~ 20 in Rwanda. Since animals do not follow humans rules or boundaries, some migrate between countries. There is one alpha male, the dominant male of the group that sires many of the offspring. He is usually the oldest, and has a gray patch on his back, hence the name “silverback.” The females are his, and the males file suit. Sometimes he allows the males to sire other children. Sometimes there are family squabbles, just like in humans, and there is a dispute, a true fight occurs, and one of the males predominates, usually the silverback. The ousted male leaves, sometimes with some of the females and offspring. Honestly, not unlike many Jerry Springer episodes (is that show even still on?) 

Since this is the main tourist attraction for Rwanda, this is a rather developed, highly organized operation. It is also not cheap. It is $750 for foreign, non-residents (i.e. your average tourist,) $375 for foreign, residents (i.e. yours truly.) Rwandans can see them for less than $100. So, you have to be committed and hope for no catastrophes prior to your trip, as the fees are non-refundable. You also have to apply for a permit, weeks to months in advance, depending on what time of year, for one particular day. And that is the day you go; no transfers, if you miss the day, that is it (I am sure there are exceptions, but from what I am told, they are pretty serious about it.)

My friend Maggie Gilbert from New Orleans is a Monkey Veterinarian at the Tulane Primate Center, located north of Lake Ponchartrain. She had heard that I was in Rwanda (she was already visiting a friend of hers from Vet School in Malawi), and we decided that it would be fun to see the gorillas (I mean, who better to see gorillas with than a Monkey Veterinarian!) We had arranged months in advance, and picked our date: 6 Jan 2016. Incidentally, that was the date 41 years earlier that Dian Fossey started her first major expedition with the Gorillas in neighboring Congo. Fate, you work in mysterious ways! 

We made the trek from Kigali. Now, you could go with one of the many tour operators based out of Kigali or Musanze (the nearest town to the Gorillas) but they are very expensive ($400+ just for 2 days.) We opted for the cheaper route: public transport and find a 4x4 when we got there. The bus ride was awesome, and we stayed the night on Lake Kivu, just outside Gisenyi. Pretty amazing views and food! The next day we went to get our permits on that Tuesday from the office, but the power was out and they had no printer. So, it cost us an extra $30 to get transport to and from the Park headquarters to get our permits. It was worth it just to have that piece of paper!

We went walking in Musanze town, and I knew there was a group called Gorilla Doctors located there. We walked by, and the door was open. So, we walked in, and met the medical director! We arranged to have dinner later that night. It was pretty cool! Maggie and the medical director are collaborating. 

We stayed overnight a 5 min walk from the Park headquarters. We woke up at 530 to get ready for the day. For some reason, I could not sleep that night, and only got about 3 hours of sleep; anxiety and anticipation I guess. Nevertheless, we arrived at the park headquarters around 7 AM. There were about 100 others there, some to gorilla trek, others to hike to the volcano, others on various treks. There was even a local dance troupe and coffee and tea; very mzunugu! This was also the spot where the rangers decided which people would make the hardest trek. Turns out, they looked at Maggie and I, and decided we were fit? Hmmm. So we were grouped with 4 others (a couple in real estate in New York and a couple working in Embassies in North Africa) to see the Pablo group, one of the largest families, but also the farthest group. We got in our 4x4, and headed out. 

We drove for about 40 minutes, about 20 min on a regular road, and 20 min on something that passed as a “road.” It reminded me of the road I took in Mali to Doneguebougou, the village where I worked on the Malaria vaccine trial. There were multiple ruts, and our 4x4 went side ways a few times (BTW: 4x4 is a must, and they know that, and they know they can charge you for it!)

We reached our letting out point, and started our Epic Journey around 845. We walked through gardens and fields, watching the locals tend their crops. I am sure this is a regular event for them to see every day. What really struck me was the fact that they will probably never get a chance to see these animals on their own. It is a shame really. Anyway, we started at a slow incline until we reached the “trailhead.” There was a small sign, and a narrow path. Initially, it was a slight incline, but as we walked, the incline became more steep as the forest became thicker and thicker. We then had to put on our raincoats and gloves, as it rained, making the journey ever more difficult. There were also stinging neddles, a plant with sharp, thin horns that leave a rash; hence the gloves. I was wondering if this is what I really signed up for?

So, when we started our trek, our guide said it would take a few hours to reach the gorillas. 4 hours later, up and down ravines, thick brush, mud slides, falling down many times, nearly soaking wet, out of breath due to a 5000 feet elevation change, we stopped for a snack and water break. Our guide, with 10 years of experience, was incredulous; the trackers (rangers who track the gorillas before we go on the trek) were supposedly still looking. Just then, we heard a very unique sound, almost like a higher-pitched drum beat. Our guide smiled: that was the sound of the young male gorillas beating their chest! We had arrived! We let our gear with the porters, and started walking with our cameras. After a brief walk, we saw him: THE silverback! He was just sitting there, gazing at us, not making a sound. He doesn’t need to move, gesture, or beat his chest; he is the alpha male. The sounds were coming from the three Adolescents nearest him. Maggie cried, as did I: part joy, part exhaustion, part amaement. We spent some time there, taking pictures, just watching, trying not to stare too long (a sign of aggression.)

So, there were still more than 20 members of this family, but nowhere to be found. Normally, we only have an hour with the gorillas, part for our protection, but mostly to minimize the impact on the gorillas. So, our main guide decided to extend the time we had until we found the rest of the clan. After 20 more minutes hiking through very thick underbrush, we found the rest of the family: females, some adult males, more adolescents, toddlers, and a few babies! It was amazing. We just sat, and watched. At that time, the clouds opened up, and the sun came out. Divine intervention! It was one of the most amazing moments I have ever had. All the blood, sweat and tears (literally, even the blood part!) was worth it just for this 1 hour of interaction with these majestic animals. Sadly, when our hour was up, we had to start the trek back down. 

As always, it is easier to go down. But the slick mud trail and my poor balance made this part a rather muddy trek down. I fell down, a lot. It was hard on this 39 year old frame. When we reached the cars a few hours later, around 430, we were all exhausted. We said our goodbyes to our cast and crew, and made the trek back to Musanze to gather our gear. We gave our main guide a ride back, and even he said this was one of the hardest, longest treks he has lead in a while. He was even going to recommend to not have anyone trek to see this family the next few days! Made me feel proud that I did it. 

We got a bus back to Kigali, arriving later than expected. I never slept better!

All in all, it was an amazing, arduous, fun, exhausting journey, one I will never forget! I will not look at a gorilla in a zoo the same way every again! I highly recommend it to anyone, whether it be in Rwanda, Uganda, or Congo. It is truly a once in a lifetime experience.

Pictures coming soon, I promise.

Happy Easter!

Until next time: Love Life, Enjoy Liberty, Be Happy,


Craiger

Sunday, March 13, 2016

Updates, Updates.

Wow, what a busy few months it has been.

Since I returned to Rwanda on Jan 3, I have been traveling or hosting various medical trainees or doctors from the USA, including:

- My friend, Kevin Hachey, a 4th year medical student from Ohio State, who I have worked with in Honduras with an OSU medical student-run group called PODEMOS. He spent a month with me in Butare, rounding for 2 weeks in Pediatrics, and 2 weeks in Internal Medicine. He finds out where he matches for Internal Medicine-Pediatrics residency in 4 days, so, please, wish him luck!
- Dr. Una Mulale, a Pediatric Intensive Care MD from Boston Children's Hospital. She is originally from Botswana, but has spent a significant portion of her time in the US for training. She was an amazing springboard for innovation to change the educational curriculum at CHUB, the hospital where I work.
- Dr. Will Rosenblatt, an Internal Medicine Resident from Dartmouth. He spent 2 weeks at my house, working in Internal Medicine. He is originally from Mississippi, but you would never know it. It was cool to reminisce about the Deep South!
- Dr. Andrew Wilkins, a Pediatric Rheumatologist (aka auto-immune/arthritis) from New Hampshire. He spent 25+ years at the Baylor College of Medicine and is an expert in medical education. He provided some amazing ideas on how to improve our teaching.
- Dr. Archana Patel, a Pediatric Neurologist from Harvard/Boston's Children's Hospital, who has had significant global health experience. She and I worked on some innovative, low impact, high yield improvements for our patients with cerebral malaria, and we have a few potential collaborations planned. Did I mention that she has been working with the WHO on its Zika Virus Guidelines?

So, it has been a rather busy time here. I seem to be getting into the groove here, and I have some great ideas on improving education, and for research. I don't want to get ahead of myself, but I have some cool ideas. The only issue is time, which is partly why I hardly every post anymore to this blog.

I have also seemed to be in Kigali a lot the past few months for meetings, other work, and some fun things. It really makes me appreciate my slow weekends here in Butare, when I can.

What the future brings?

- Another week of fun with Dr. Andrew and Dr. Una this coming week.
- Departmental meeting on Friday in Kigali, followed by a weekend in Kigali to spend time with a good friend of mine and his family, who will be leaving shortly to return to the USA.
- Then Easter weekend, most likely at Gisenyi Beach (Northern Lake Kivu)
- Then yet another visiting physician (a Pediatric Endocrinologist) for a week
- Then somber time in Rwanda (Genocide Memorial starts 7 April, and goes for about a month)
- Then my birthday 13 April, to be spent in Kenya with some good friends of mine from Mali. Believe it or not folks, I turn 40. Gulp...

Anyway, hope all is well on your side of the woods. Looks like Spring has sprung in some parts of Ohio? The Green Thumb/Farmer's Almanac guy in me predicts a warm Spring, and a HOT Summer for my Northern Coast friends, the usual for the Left Coasters, and a HOT summer for the Gulf Coast!

A bientót,

Love life, Enjoy liberty, Be happy,

Craig

P.S. I just downloaded Picasa, so expect some pictures or a link to pictures soon (as soon as I figure out how the hell to use it!)