INTO AFRICA

There have been a lot of amazing advancements in Rwanda since 1995. A prosperous tea and coffee industry has developed. Tourism is on the upswing thanks to the gorillas. Everywhere you look, there’s new construction, particularly high-rise hotels and beautiful homes.

One industry, however, has fallen far behind the standards of excellence that President Kagame seeks for Rwanda:  the counterfeiting industry. What do you think the chances are for a bill passing as real in the United States or Great Britain if it were a half inch (14mm) too short?Or how about the phrase at the top of the bill running through the not- too-well-rendered silver band, instead of stopping before it? How, then, were we fooled? Except for the hotels and large shops in Kigali, this is a cash society. When we came, we were told to bring $4000 in newer, hundred dollar bills. When you convert that into the Rfr.5000 notes, you get approximately 528 bills, in a rubber-banded stack over 5″ tall. That’s how I missed this bill!

1. We eat a lot of pan-fried, over charcoal, tilapia. Geraldine, our housekeeper, has a limited vocabulary of foods, and Nancy eats no red meat, so we eat a lot of tilapia, rice, potatoes, and mixed vegetables. Once a week, we buy a chicken, which I eat over three days, while Nancy eat more vegetables… we are instructed not to eat any fresh greens and as a result of our salads consists of cold cooked vegetables…but this restricted diet is not the problem.  The problem is—no tartar sauce for the tilapia! I am self-sufficient enough to make my own tartar sauce, and I have found “American mayonnaise”, but no pickle relish. In fact, I have found no pickles at all, unless you include pickled peppers. The delightfully useless cucumber, grown in the USA because it’s easy, does not seem to exist here. Also missing is that staple, the radish, though they do grow parsley here and consume quite a bit, I think. Tonight, we have some Austrian and German medical students joining us for dinner. I have to boil and peel 1 kg of Irish potatoes (Rwandan name) and buy 1 kg flour and 1/2 kg of confectioners sugar (they are cooking  potato poppyseed sweet noodles for us).  They are bringing soup and an avocado, and possibly some Werther’s butterscotches.  We are supplying the burner, and as the number of participants increased, an ever mounting amount of nutritional components.   I bought sausages yesterday in Kigali , and will barbecue them on our cooker (see earlier post) tonight. We have bread and cheese and sliced fruit and two bottles of wine that we do not expect to see again. But next week, back to tilapia without tartar sauce.

2. It is a point of pride among American intellectuals not to watch television. I often wonder how many of these non-watchers have cable in their homes. I was a child of the 40’s and 50’s, and I think this is part of my reason for still loving television. I remember when we finally bought a TV in 1958, the year before I entered my senior year in high school. My father would not have it in the living room, so we painted the walls and the floor in the basement and set up a viewing area. Here in Butare, we have an enormous satellite dish beside the house and a strange antenna on top of the house, belonging, I think, to the StarTimes Vision cable box that sits underneath the TV. Since no one in Einstein House has so far expressed an interest in getting the service working, I am forced to spend the day trying to find the BBC on the radio I bought. What would make me happiest? Someone explaining how StarTimes Vision works, since the office in town seems to have been closed permanently—or answer, for that matter, my life-long questions “What is shortwave radio, how does it work, and is anyone really out there?”.

3. You would think that the electricity going off (used to it—actually a problem in Shaker Heights whenever there was a storm), the water pressure sometimes good, sometimes nonexistent (used to it—Shaker Heights and NYC), the dusty dirt roads (getting used to it) the lack of a car, (got used to it in New York City), morning ritual of sunblock and Deet spray (used to it–only a minor variation for Nancy’s skin care)… that all of these things would have bothered me. No, what bothers me most is my confidence that no one understands a word that I am saying, even when they are using English words to respond. It’s nothing new for me–it began 45 years ago in the Amish communities of Ohio, where the children do not learn English until they get to grade school and never speak it at home. I spent most of my life working in these communities, building a successful factory, and supplying to the community the woodworking equipment that brought them into the 20th century. I would hear back from friends what the Amish elders thought I had said the previous week, usually a gross misinterpretation based on their own orthodoxy and assumptions of what I might believe. After repeated corrections of these misunderstandings, I slowly changed people’s perceptions of what I might do, believe, or be saying in a given situation. I despair that two months will not be enough time to reach that level here. I do take great pleasure in visiting with the owner of the Matar Supermarket. He has been here in Butare since 1990, and is Lebanese. He speaks English as well as I, and probably spent some time in the United States, because the snack bar inside his restaurant is called “Cheers Coffee & Fast Food”. The other evening, Nancy and I were picking up water and milk, an almost daily process, when I asked to see a menu for the restaurant… “Ah”, he said “a quiet romantic dinner… if you bring the candles”. Tell me the Kinyarwanda words for “romantic dinner” or “candlelight”.

The weekend was great. We finally had time to do some of the tourist things. The morning started with a car and driver from John and off we went to the Ethnographic Museum – Huye. The museum was finished in 1988, and was a gift of Belgium’s King Baudouin I. It’s 30000 square feet on two levels (connected by a 30° handicap ramp–a real thriller–I couldn’t even walk it) and is made up of 7 rooms with brick walls, parquet teak floors, and tongue and groove pine ceilings. The overall effect is 1970’s California with plenty of light flooding in. The museum covers Rwanda’s geology and geography and the development of its social orders, handcrafts, hunting, fishing, and sports. Two of the more intriguing displays are on how to make banana beer, and on life in full-size hut (the second best from the former mwana’s royal compound, complete with original ceiling portion). It’s exactly the kind of museum that Nancy loves, a literary museum. Glass cases are filled with objects and extensive articles (in tiny print) are posted on the walls covering the general subject matter; then, each specific item has its own descriptive card with even tinier lettering. She read every word…and will remember it. Most of the displays have been updated in English and French–but not in German or Spanish, to the dismay of Nancy’s ever-increasing cluster of Eurozone medical students.

On a Saturday morning, the museum was empty.  This could not be said of the Roman Catholic Cathedral. It is an enormous brick structure built in the 1930s and dedicated to Princess Astrid of Belgium (tragically killed in a car accident while still in her twenties). We arrived in the middle of a solemn high mass: two priests, a deacon, a subdeacon, and five acolytes. Most impressive was the 30 voice choir, supposedly acapella, but I’m sure I heard in the background a wonderful old European pump organ. There were easily over 1000 people inside the church, and hundreds milling around outside. As we stood outside waiting to go in the boy about 2 feet tall, probably three years old, looked up at me and then came over and hugged me around my knees and then turned around and went back to his mother for approval. We stayed about 20 minutes inside the cathedral and felt welcome.  We had arrived in time for the collection and took part, before joining the eddies of parishioners moving freely in and out of the rear.

But no Saturday would be complete without some sort of brunch. The obvious choice was the Hotel Ibis, which has been here since 1942, so almost as old as me. New construction has brought an open snack bar and bar, right on the main street. My only mistake was that I wasn’t wearing a jacket and tie, as were most of the men. Nancy had a croque-madame and I had a croque-monsieur  (a pun not lost on our French speaking waiter), a Guinness export and a Coke. But all good things must come to an end, so we returned home and spent the rest of the evening there, Nancy, working on two more PowerPoint presentations, and I, finishing reading A Thousand Hills, by Stephen Kinzer. (It is essential reading for anyone coming to Rwanda and wanting to know about the genocide, but being sensitive enough to know that this is far too painful for casual conversation.)

Sunday was a different matter; we spent most of the day inside working. Nancy is working on a seemingly infinite number of PowerPoint presentations as part of her teaching mission. As I get to know the residents and the attendings, I realize that the real challenge is the language barrier. All speak Kinyarwanda, and some French and some English. The problem is that the grasp of technical terms in English can be very challenging, especially when your second language was probably French. The perfect nonmedical explanation is this: I had been told, and have been telling people that our dinner each night is cooked on a wood stove. I went out to see this cooker and described to Nancy the parts where the wood was burned it into coals, and then the coals were moved to a grate so that they could fry our fish and boil our vegetables.

The Charbon

Nancy and Geraldine, our cook, conversed in French and today in French we got the list for groceries that she needs for the next couple days including charbon. Charbon (French for charcoal), I thought we cooked with wood.

We went out at 4 PM to get more water and dishwashing soap. I suddenly realized that the entire main road had a meter-deep trench dug for as far as I could see.  It had happened sometime between 4 PM Saturday, when we had left the Hotel Ibis, and 4pm Sunday.  The sign proclaimed a major infrastructure improvement being done by CHICO, a Chinese company.  At that moment, I saw a Chinese engineer crossing the street in fluorescent Day-Glo green vest and hardhat. They were laying new electrical cable for the entire city of Butare, which would improve the service by six times, he said. I asked him when they would be done—and he answered that they hope to have it finished by January—not just Butare–the entire country! An idle boast, I hope not. We really need better electric power here. By the way, his English was perfect, Nancy said he probably learned it at Caltech!

I read once that Bill Gates has almost every Great Courses that has ever been published. I’ve bought my fair share, on sale, but have never had the time to watch them—there was always something better on TV. Well, I started the 48 session on History of European Art, and it’s fascinating. I’m up to High Renaissance in Venice. Since my new vocation is Fine Arts Appraisal, it would help if I knew all the stuff, or at least sounded like I knew all this stuff. Well… back to the DVD’s.

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Rwanda lives up to its name, “The Land of a Thousand Hills”. It becomes clearest when you watch a group of kids trying to play soccer (football) and not having enough level land for a pitch. In the southern province, the only one that I’ve seen, people tend to live on the tops and sides of the hills. The bottoms are where the water is and where most of the crops are grown, including rice. A full-time occupation of the kids, when they are not in school, seems to be carrying  5 gallon jerry-cans from the water sources up the hills to their houses, a trip of 1K to 5K. The look is not unlike northern coastal California, except there is no ocean—but we do have eucalyptus trees.

When I was 16 years old, the school bus from my Catholic prep school would drop me off a mile away from my house. The walk started through a small shopping strip, where I got to know a shoemaker, Morry Malcmacher, who had been operating there for years. He tried to convince me that it would be much smarter to learn his trade then to go on to college,”[ he] had seen during the Second World War what good an education did you”. Even at this age, I was greatly intrigued by retail, and I convinced him that he should begin selling shoes—because people weren’t going to pay to have shoes remade in the future. When I came back from college Morry had opened two retail stores. What little I learned came in handy on the streets of Butare. This man’s shop is on the porch of a condemned building.          

If I had learned French, or more importantly Kinyarwandan, maybe I could’ve convinced him to go into retail. But the language barrier spared this man. There are three official languages in Rwanda: English, French, and Kinyarwandan, and perhaps this is true in the capital, but when you come to a city like Butare, the command of both English and French is, at best, minimal. Don’t accept a nod and a smile as understanding or agreement, gentle repetition is the best approach. (Or you could learn Kinyarwandan).

P.S. Only in the world of Blogs can this happen… Morry’s daughter Sylvia got in touch with me, she and her brother are now dentists… Morry did need me for shoemaking.

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Our days rapidly settled into a mildly dysfunctional routine.  The alarm rings at 0600.  We get up and stare at the hot water heater to confirm that it’s not only plugged in but has the red light of power shining happily at us (more later on this).  The shower is thoroughly enjoyable and gets rid of residual layers of DEET and sunblock, as well as the omnipresent red dust. A variety of orphaned shampoos ring the sink and the towel sits on the toilet seat; there are no other flat surfaces in the bathroom.  Geraldine has arrived and is heating water for cafe presse.  David heads toward the kitchen.  I, in my role as keeper of the Malarone ($3 per dose) arrive in the dining room shortly thereafter, having taken my BP meds.  Now, dried and dressed, in freshly polished shoes, I have also re-anointed myself with protective chemicals of truly frightening toxic potential, particularly given the motley combinations of lotions, sprays, creams, and concentrations available in our bathroom cupboard.  Breakfast, Malarone, and grocery/menu negotiations with Geraldine completed, we next attempt to contact the 0700 ambulance driver (our official transport) who is 0 for 3 for timely arrival, with Jean-Claude, as designated petitioner.  My predecessor made a mimed display of “no never, no more””returning to the USA” as I vainly attempted to reassure the baffled Kinarwandan-only gentleman that “no, actually, nothing has changed” in Franglais.  It is totally unclear if this—or some other event— has resulted in interruption of service.  Today, we were informed that since it was Eid, he was not coming at all.  David and I had a brisk, dusty walk to the hospital in time for 0730 morning report “Staff” meeting with a skeleton crew. My day is then occupied with lecture prep, tea break, ward rounds, lunch, ICU or ultrasound visit, lecture (not happening on Fridays, Eid—and maybe Feast of the Conception, Kigali HRH days, etc.).  I gather up my things, call David, who meets me en route, and we head home to dinner by Geraldine and more lecture prep, provided the power stays on (so far, nightly, half or all the house goes dark, right after dinner and stays that way until bedtime).  David has spent his days exploring the shops with Jean-Claude, sorting expenses, reading and getting household repairs accomplished (toilet seat, light bulbs).  More ambitious projects (plumber to stop eternal toilet) and electrician (in case this isn’t a government initiative—plus we both get mild, but painful shocks from our computers) await.   Images, from top, are water heater (note lack of happy red light of power), shower and hospital cafeteria, site of chai/water breaks (coffee can take up to 45 minutes to arrive) and carb-loaded luncheon: fluffy rice, wooden cassava, deep fried potatoes, couscous, boiled bananas, boiled–well past al dente–spaghetti, as well as creamed spinach-like cassava greens, watery tomato sauce (to be poured on everything), boiled eggs (extra 200f), some chicken parts and oddly shaped chunks of (allegedly) beef, although it looks more like goat to a piscaterian like me.

Jean Claude and I had walked to the Airtel shop to buy a modem for my Apple and buy data time for both of the computers. It turns out there are 3 million cell phones in Rwanda and the government has no record of who owns them, so they dictated that by August 1st everyone had to bring in their phones and modems with their identity papers or their passports, and register their devices .When we got to the shop we found that their network was down and there was no way to get registered. What had I walked a mile for? Not to worry, the shop assistant said, we will give you one of the modems that are for “the people cannot be registered”. It made me feel very special.

It’s time to play catch-up. We’ve been here 10 days, unbelievably, and so much has happened. We flew from JFK to Amsterdam on a Delta 9318 flown by KLM left at 6 PM and arrived into Amsterdam at 7 AM. The entertainment system was impossible, but the food was above average (with free alcohol to prevent complaints about the movies) and the flight crew was more than attentive—and pleasant in at least four languages. The three hour layover was spent in the Starbuck’s, of course, and at the Rijksmuseum and gift store including 12 carefully selected, not so valuable paintings but a really fine Karel Appel. Then on KL0535, eight hours to Kigali, Rwanda where we were greeted with flowers by Cindy Chazotte (whom Nancy is relieving) and then off to the Umubano Hotel for the night. Have you ever stayed at an middle class businessman’s hotel in Eastern Europe or in Leeds, England (remember Trusthouse Forte)? Imagine that building in ochre stucco with maroon accents, add a beautifully inviting swimming pool(ignoring the potential for death by mosquito, sunstroke, water-borne dysentery and altitude-assisted  drowning (3.5 meter deep end) and a red clay championship tennis court.  Now throw in the saddest miniature golf course in the world—think cracked turquoise cement with unlined holes situated unpromisingly 20 feet from a margin–then you know this hotel complete with a good dinner and a better breakfast buffet. In the morning we had paperwork to do, lunch with the HRH people, some shopping, and then off on our three hour drive with “Flat Right Car, LTD.”, $75 one way or $75 plus $30 for the hotel per night for a round trip, Jean Paul Hitimana, managing director, always on time and a very conservative driver. We arrived at 6pm and met Jean Claude our houseman, Geraldine our cook and housekeeper, and Higaro our night guard.

We had barely settled in, complete with a Hello Nancy-Goodbye Cindy and Rebekkah banquet, evenings out at two of the few restaurants with “safe” food and an evening spent protein supplementing two German medical students chez nous, apparently randomly dropped in Butare as part of a global medicine rotation, when it was time to retrace our steps to Kigali, or more accurately, pile into Jean-the-driver’s car for a 2.5 hour ride back to a promised session with former President William Clinton, the philosophical driving force behind the Clinton Health Initiatives, with a vision (and some structural elements) shared by HRH (Human Resources for Health). our program.  

Security was crazy—we weren’t told where or when the session would be held—and we soon discovered why!  President Paul Kagame and Clinton were to meet (as it turned out, for 2 hours of our planned session), against a backdrop of multiple embassy closures—including Kigali—after an Al-Queda-Africa Yemeni alert.  A six foot palisade and tent were constructed as a decoy, we were given hourly changes of time and place and agenda.  Finally, after 4 hours, a talk announcing a child feeding farm program and a photo op, spouses pointedly NOT invited.  Nancy did get a protocol-defying word or two in edgewise! We discovered that Chelsea was being shadowed by Glamour Magazine as she demonstrates her serious altruistic side, that it is easy to confused Jesse Eisenberg with Mark Zuckerberg and Dakota with Elle Fanning and that nobody really knew if Martin Scorsese was there (I don’t think he was).  A wonderful spicy curry dinner (“Mongolian Hot Pot”) certainly helped compensate for the lack of substance.

Say you’re going to Africa for two months, fairly confident that you will find nothing to buy there—what do you pack? First, you buy from Walmart Online four of the largest airline-acceptable suitcases, that weigh under 9 pounds and cost less than $60, because you despair of ever seeing them again. Your arms have almost recovered from last month’s inoculations (typhoid, hepatitis A, tDAP, and initial round of yellow fever, in spite of dire warnings, necessary for entry into Rwanda).  Your Hep B was already in place, and you have formulated an escape plan if bitten by something rabid.You start packing (a week in advance, so as not to crowd the NYC apartment for longer)Malarone (for malaria), Cipro (for the stomach), 3 month supply of all your prescriptions in pharmacy bottles, 30 to 40% Deet spray (for mosquitoes),  55 to 110 sunblock (Neutrogena, the latter implausible strength for the truly pallid), hand sanitizers and your special hair and skin care products. Things you wouldn’t think about are Woolite for hand washing clothes, tissue packs for paperless bathrooms, a drugstore bottle of 90% alcohol and a good supply of pens (because none appear to be available when you try to sign a bill). There are a number of Pyrethrin sprays that are effective repellents for up to 6 washings when sprayed directly on clothes (but not skin). You should do this before packing (they  have to dry thoroughly). As for food, packaged meals prepared with hot water, protein bars, and trail mixes (all more or less available in Africa except the protein bars) are welcome changes from cassava and tilapia. Now comes the easy part, the clothing. Go to websites about your country and observe how people dress: professional dress,white, blue or patterned business shirts and dark slacks for men and dresses or tops (long sleeve) and pants for women: casual dress, collared tee shirts and any color slacks or jeans, preferably dark color and in good condition. Your skin tone will make you stand out enough, don’t add to it with shorts, printed tee shirts, or sandals (surprise… men don’t wear them on the street).  I always think of the French tourists on the subway in NYC dressed like 1980 Midwest movie characters, complete with cargo shorts on 50 year old dads. All of this is for Rwanda.