Gone Country

Hey all!!

Sorry it has been so long since my last post, but work has been picking up and the project has been sending me all kinds of places and giving me lots to do.  Last week, I went on a trip up-country, and am set to go on another this week, leaving tomorrow.  Here is a picture of me in the office, to prove that I am actually working here:

When the staff is not in the office, which is quite a lot of the time, they are out on field visits. Most of the real work takes place in the rural areas, as opposed to in the capital city of Bujumbura. This makes sense as, the project is called ESD: Extended Service Delivery. The idea is to extend services to people and regions in need.  This means ensuring quality training of staff, adequate provision of equipment, and access to necessary resources such as water and electricity. As you can imagine, this is much easier said than done. 

Last week I was in Kayanza province, which is located about an hour and a half away from Bujumbura, along a curvy mountain road.  There are no paved exits from the road, and it goes from Bujumbura all the way to Rwanda.  

It is amazing how well kept the road is, but I suppose if it is the major transportation route for commercial and government use, it has to be.  I was also shocked by just how green and mountainous the countryside is.  The capital sits in a valley, on the border of the lake, but the rest of the countryside slopes up and away from the capital, thus the term ‘going up-country’.  

 

 

 

Something we saw quite a bit which was funny, but also ridiculously dangerous, is the way many people manage to travel up-country and back.  These men will grab hold of the back of a semi truck, sitting on their bikes, and cruise up hill.  All fine and dandy (I suppose) at a leisurely pace, but the speed of some of these trucks as they go up the hill, it is a wonder that more people aren't flung into oncoming traffic.  We had a couple of close calls on our way up; pretty sure that this picture is my submission for next year's photo contest at the public health school:  What not to do!

Kayanza is an extremely poor (to be fair, more rural areas are in dire straits here) region of the country, where Maternal and Child Health services are far from adequate.  We visited the Kayanza provincial hospital, which serves as a major center for the province.  People are referred here for all conditions that cannot be treated at local health centers, and there is a surgical center, AIDS treatment clinic, and Urgent Care unit.  However, these facilities are far from what we would deem acceptable in the US, and the hospital must operate daily under quite extreme conditions.  There is only one doctor for the entire hospital, who must therefore serve as Medical Director, as well as performing all necessary surgeries and procedures that call for her expertise.  Yes, I said her.  Amazing to see, in this type of patriarchal society, a woman who has managed to achieve so much educational and professional success.  She and I talked at length about differences and similarities in the attitudes of our respective nations regarding women in the workplace.  (Incidentally she also invited me to her wedding, which will be in Bujumbura this July, making it 2 invitations for me thus far!!)  Most of the work is done by ‘nurses’ whose training may be anywhere from that of an NP to a CNA in the US.  Beyond staffing difficulties, there are frequent power outages and the back up generator is in disrepair, there is no running water and standing water is far from guaranteed on a daily basis, the demand for resources like disinfectant and cotton swabs frequently exceeds the supply, there are frequently 2 or 3 patients to a bed, and more still sleeping in the hallways for lack of space, and the one vehicle the hospital can use is in need of new tires and a supply of petrol that is neither easy to procure, nor cheap.  It is amazing that any quality medical care can be delivered given the circumstances.   But they manage it.  And they do the best with what they have. 

We were there to administer a training of a quality improvement strategy known as COPE, which focuses on improving the quality of services through client satisfaction and fulfilling providers’ needs.  Here is a shot of Charlotte (the Head of Pediatrics and Internal Medicine) leading the workshop:

The staff had a lot to say and it was great to see them come up with ways in which they could each take responsibility for ameliorating some of these dire conditions without assuming that responsibility lies in the office of the director.  It was an enlightening experience for me, although I found that I, as the strange white woman, was sometimes an inadvertent distraction to the process.  

Pictured from left to right:

Charlotte (Head of Pediatrics and Internal Medicine)

You know who

Lea (Head of Maternity)

Dr. Pascal (employee of MSH who is instrumental here)

On returning to Buja (as the locals call it) I went back to work in the office and had a meeting to discover more of what I would be doing over the course of the next week or two.  The meeting was a little intimidating, but it was great to see the boss hold everyone to account and ascertain what the will be doing this week.  

Also (!!!!!) got to move into my new apartment! Wooo hoooo.

Pros of new apartment:

·      TV (and satellite to boot!)

• Little living room and larger bedroom.  Can relax a bit, even put my clothes away in the closet!
• Really nice neighbors!  The man is from the US, and the woman is Burundian.  I went to their wedding this weekend! (that makes it 3 that I will attend so far!!)
• Little refrigerator and hot plate; I can have tea and keep some food for breakfast etc…
• Safe and secure neighborhood, closer to town, with more people around.
• Someone comes to clean and change the sheets…nice to not have to do it myself.
• I have a pet!! Lizzie the Lizard, a tiny little gecko, who likes to hang out on the table in the living room.

Cons of new apartment:

• Satellite can only access one channel (CNN) – I suppose this is better than some French melodrama (yes, I watched even that at times)
• Shower gets only cold water brrrrrrrr
• Electricity turns off between midnight and 6 am, rendering little fridge somewhat useless for keeping perishables. 
• Lizzie died….the life of a gecko is short but sweet I suppose...

Phewwwww....what an update.  Hopefully I will be able to be on here a little more regularly this week to update as I go.  This week is bound to be a busy one: I have a meeting today with project-funder USAID and the US embassy to discuss my stay and work here; I leave tomorrow to Muyinga (another province) to complete an assignment on the MCH nutrition project being conducted there; Thursday is the US embassy’s 4^th of July celebration (why Thursday, I have no idea) which my boss has requested I attend with him; finally, I have to have the write up for the Muyinga project done by the end of the week.  This week is very much an instance of them wanting things done yesterday, a nice change of pace from the laid-back attitude of last week, but a little stressful nonetheless.  

Thanks for your interest in what I am doing here, I love hearing from all of you and will try to post more when I can.  

A la prochaine fois,

Amy

xoxo

I found them...the other foreigners that is...

To the left is the view from my apartment.  The hills you see are part of the countryside. Everything outside of Bujumbura appears to slope upwards and away into the countryside.

Good news of the day: I discovered where all of the other foreigners have been hiding!! Last night, after hours of trying to quell my boredom, Raissa (the woman who is coordinating the details of my visit here) and her son Jason (who is super cute) retrieved me from my hotel and took me out and about for a little bit.  I got to change some more money, buy more credits for my phone (amazing how quickly it eats those things up) and went with her to the beach.  Now, remember that Burundi is landlocked, so I am talking here about the beach on Lake Tanganiyka, although by its size, it might as well be the sea.  Burundi shares its Eastern

 border with the Lake, and capital Bujumbura, where I will mostly be working sits right on it.  Really happy to have gotten up and out of the house a bit and get to see the water, and also to discover where Burundi has been hiding all of its foreign visitors.  

At at work today for my first day and ready to get stuck in.  It looks like I will be working quite a bit with a new project that is being developed, on Family Planning.  There isn't much of a program here and so they are trying to institute something that will work in both the city and up-country, in more remote, rural areas.  The details are as yet unclear, but it looks like I will be involved in evaluating the potential for this type of program as well as planning what the program would look like (hello formative evaluation!).  The final report will have to be written in both English and in French, so they would like for me to be the primary author of the English report, and to work closely with a colleague who will be writing the one in French.  I am excited to see how things unfold and to learn more about what the project entails. 

First weekend here...

First things first: my bag has arrived!! So for all of you who were worrying about me, losing sleep over whether or not I had my shampoo, favorite t-shirt, and economics book, worry not. I am now bathed, clothed and, yes, forcing myself to learn introductory economics. Well, the last part, not so much, but definitely the rest! And just to appease your fears, Momma, yes I did pack extra underwear in my pack, so I was not completely without yesterday.

Last night I went out with one of the women I met at work, named Diane. I was sitting in my room, having woken up from a 2 hour jet-lag induced nap, when the front-desk dude (more on him later) came upstairs to let me know that there was someone there to visit me. Clearly, I wasn't expecting anyone, but there she was, a visitor!! She invited me to come out with some friends of hers so that I could see the town at night and get out of my room a bit. Of course I jumped on the invitation; as all of you can probably guess, I don't do particularly well alone without other humans for very long. First we went to the future home of two friends who are going to be married in July, and then on to the bar! Only coca-cola for me, but I did eat the local special - beef on a stick served on a bed of bananas. Was pretty good to tell you the truth and I am not paying for it today (knock on wood). I had a great time and discovered half way through that about half of them spoke English to some degree, however don't think that they let up, because they were definitely still making me speak French with them. On that note, speaking French all of the time is tiring! You forget how easy it is to think and speak in your native language and it really takes effort to speak (and think) in French all of the time. I have started a vocab list in my journal to try and remember the words that I would like to have used and their translations (thank you Webster's pocket dictionary!) We hung out there for a while and then came home relatively early (around 11 or so). An extra special moment: I was invited to the wedding of two of the people there! It will be in July and will be AMAZING to get to go to a real Burundian wedding - whatever will I wear? :)

I promised you more on front desk dude: I have been talking to him quite a bit, mostly because there do not appear to be any other guests at my hotel. I am told that they are there and that all of the rooms are occupied, but you rarely see anyone coming and going. Also, the 'hotel' appears to be more of a missionary hostel, so I am getting a lot of questions and invitations to church (hence the reason that I have been holed up in my room and at the internet cafe all day). On that note, the connection here is really cheap! It is 10F (10 Burundian Francs) per minute. So...to translate...if I spent an hour on here, and wracked up a bill of 600F, I would pay about 55 cents for the time. Not half bad! Anyway, this front desk dude seemed nice at first, then as he appeared to get more comfortable with me, the barrage of questions began. He wanted to know about my religion, my marital status, my relationship status, and that is when I had to put a stop to things. Sure, it is nice to have someone to talk to, but this guy is just weird! Unfortunately, I feel that I may have opened pandora's box and found myself a buddy whe all I want to do is read my book.

Before I go, I would like to mention that I have never been more aware of the color of my skin. In Tanzania, I was travelling with other wazungu (the Swahili word for foreigners or white people) and so perhaps didn't notice being looked at like I didn't belong. However, I am very aware of the looks I am getting here. Most can be appeased with a smile or a simple 'Bonjour', the people here are so friendly and helpful, but I am still aware of being very different. Since I have been here, I have seen 5 other white people (seen mind you, not met) and all have been men. Are the other wazungu hiding out somewhere? Maybe there just aren't that many here at all...I dunno.

All in all, the experience is shaping up to be amazing. I am supposed to be moving hotels soon (the one I am at is for short stays only) and there are supposed to be more people around at the next. Also, tomorrow I begin work and will be making trips à l'intérieure, or up-country, to see the project in action, which I am really excited for....

Last thing: I have a phone!! My number is: + 257 797 88 463. Please give me a call if you'd like (skype is relatively cheap I think), just remember that I am 9 hours ahead for you Californians, and 6 hours ahead for those of you on the East Coast.

A la prochaine fois (until next time)
Amy xoxo

Je me suis arrivee!

Got in last night, safe and sound, and am excited to say that I am finally in Burundi. At the office right now as our boss, Tanou, is going 'up-country' (meaning anywhere but capital city Bujumbura) on Monday, so wanted to meet me today. I am getting right into the swing of things and feel like I am actually going to be helpful with a lot of the projects that they have in mind. Also, French is kicking in and coming back to me, and I can already tell that most of the communitcation will be in French, which is precisely what I was hoping for.

Unfortunately, the one downer so far is that my suitcase hasn't made it. I am not thoroughly surprised as the woman who checked me in in Boston told me that there was a slight issue with my ticketting whereby it appeared that I wasn't booked all the way through to Bujumbura. She seemed to have been able to remedy things, and clearly I got here ok, but apprently my bag didn't quite follow the same instructions. Heading to the airport in a bit to see what can be done. Filled out a declaration last night, so they should be trying to wrangle it in from Nairobi. As my boss said (albeit in French) "sometimes you just have to find someone and put a pistol to his head". I'll keep that in mind.....

Here we go....

Hey all, thanks for taking a look at my blog. There isn't much up here yet, but I have every intention of inundating this page with photos and stories of my adventures this summer. Off to Burundi tonight...I'll update as soon as I can.
Amy xoxo