What in the World is Timo doing....

This is a question that I've been asked quite a bit. Before leaving, during my trip to Goma, and even while I've been here. So, I thought I would give a list of the things that I've started working on during my 3 weeks here and which I will plan to expand on when I return in April.

New Clinic:
There is a new clinic that is being built at the Hospital and I've started discussing the project with the construction forman here in Goma, the architect in Sacramento, and Dick Anderson one of the directors on the US side of HEAL Africa. I'll be doing the interface between the architect in Sacramento and the people doing the work here, as well as working with the forman when trouble shooting is needed and with the actual location and construction of the clinic. Plans should be here by the 3rd of March and by the time I get back in April I think the preparation for the foundation should be completed.

Waste disposal:
Right now the hospital has a small incinerator that they use to burn all of the waste that comes out of the hospital. This includes needles, rubber gloves, bandages, biological waste, etc. You name it, coming out of the hospital, and they are burning it. This is obviously not the best practice for a hospital, although it is common practice in nearly all hospitals here from what I understand. So, I've got 2 projects that I'd like to tackle. One is designing a waste disposal program for the various medical departments at the hospital with separate containers for different classes of waste and implementation/training of the doctors, nurses, and lab technicians working in the hospital.
The second project is a redesign of the incinerator. It's basically a small open air fire place that's sitting in the far corner of the property. I'm taking a wild guess and saying that they smoke coming out of the 10' tall smoke stack is pretty toxic, and if the wind is blowing the wrong way it heads straight at the technical services buildings and towards the ward where women recovering from VVF surgery are staying. (although the smoke is pretty thinned out by that point)

Water Supply:
It's a novel idea to have a reliable supply of running water at a hospital.... Unfortunately they don't here. There are a couple of water tanks that are supposed to be a back up for when the city water stops working, which happens from time to time and can last a week or more, but I'm not convinced that they are filling up, or that they can really be helpful during a prolong water shortage because of the small pipe size leading to and from the tank. So, there are a couple of ideas I'm working on for fixing this situation. The first of which is to design a way to measure how much water is in the tank, which would be a good thing to know for starters. This will be a longer term project because ultimately we need to design a system of water storage and distribution that could supply the hospital for up to a week if the city water supply cuts out.

Nutrition project:
Global Strategies is planning to start a small manufacturing process for a generic version of "Plumpy Nut" which is basically a fortified peanut butter. The "Plumpy Nut" will be distributed to malnurished children who have HIV and are on ARV treatment. It will also be sold to local NGO's to make the program self sustainable. At this point we have been visiting local vendors to find out where and how we can get the ingredients and equipment and how much it will cost, as well as where it will be located. The people doing the work will be caretakers of Orphans here in Goma so we're not just providing much needed food to kids, but also much needed jobs and income for these caretakers.

English Lessons:
We are starting english conversation classes twice a week for several of the doctors and hope to expand it to include any of the staff who are interested in improving their english. For the two doctors that we are focusing on at first it is critical for them to improve their english as they are slated to attend a training course in Israel.
There is also a translator at the hospital who teaches ESL to some of the students from a local university and I've started helping him with those classes once a week. While I'm back in the US during March I will be getting some better reference materials for both of these classes.

So, those are the things that are keeping me busy at the moment and will be my focus when I return for 3 months from April to July. "Now you know...... and knowing is half the battle..."

(sorry- no pictures at this point because my internet connection is way to slow. I'll try to update with photo's when I get back to the states.)

The lost Key

This is a quick story of how I greatly underestimate the goodness of people at times. I'm in Kigali Rwanda, and for some reason I just can't help but think that everyone is out to get the Muzungu (white person, as they call us). Not outwardly, but inwardly I admit that I was having a hard time completely trusting the bus drivers and taxi cabs especially. So, when we got back to the hotel and I realized my key had fallen out of my pocket at some point. I thought that it was lost for sure. Who is going to return a key. Anyone who finds it is going to just keep it and use it for something.... what, I don't really know, but that's how I was thinking. When I returned to the bus station the next day (think 15 passenger vans leaving from a mechanics shop - not greyhound bus terminal), I thought I was grasping for straws. But they said to come back after noon and they would let us know. So 4pm we stopped by the bus station and much to my surprise the lady behind the counter, who has 10 people talking to her at once and waving money for bus tickets in front of her face, looks up with a smile. She reaches under the desk and pulls out not only the key, but also a dinner receipt that had fallen out of my pocket with the key.... When will I learn my lesson and have more faith!

Gikongora Memorial

Second day in Rwanda was a bus ride to Gikongora. On the way there, I asked the guy next to me where to worst of the genocide in Rwanda took place. He looked at me with an awkward smile and said "where you are going was the worst.." It was silence for a while after that and then he told me he would point out the place where his uncle, aunt, and cousin once lived. They had been killed and the house burned to the ground. A lot more silence. I really didn't know what to say, and I could tell that this had brought up some painful memories, as he told me that he lives only with his sister now. I did not need to ask what happened to his parents. We finally arrived in Gikongora and took bike cabbies down the hill to the memorial. The lady at the front of the memorial building lead us around the back, which I thought was strange because only old school buildings stood out back, while the memorial building looked very new and attractive and I was sure it had what I really wanted to see. Especially since there was a clear language barrier between us and the tour lady. I later learned that the school buildings are the memorial and the nice new building has never been finished. So it is empty. Out guide, the only person on the entire site, started unlocking rooms of the school buildings, and left the doors open for us. As I walked in the first room, I was caught off guard at the sight of about 30 bodies lying on wooden tables.

I'm not sure if the bodies are real...although I've been told they are and they sure smelled and looked it! Room after room, 25 in all are filled with these memories of the genocide. On the school grounds that we were at, several mass graves had been found. 50,000 people in total had been killed in this town... It was very moving. As we left, a man with a large indentation in his forehead escorted us out and in broken french and english discussion he told us that he was one of 4 survivors of this area and that the indentation was from a bullet wound. He had been left to die. He smelled of alcohol and softly begged for food as we left. He may be an alcoholic, but I can't even imagine the horrible memories that must still haunt him, and the pain he may be trying to numb....

Rwandan Development....

I was in Kigali before but didn't stay down town. This time, however, we stayed in a downtown hotel. Rwanda seems to be developing a lot and either benefiting from, or catering to, the money coming in from the Western world. It is likely both. Much of this money is what some call guilt money. Aide that has been sent into Rwanda for the past 10-years because of the guilt of failing to act during the Rwanda Genocide in 1994.

A couple of high-rise construction projects and newly finished developments are the biggest signs of this increased economic development in Kigali's "business district" which seemed to be about 4 blocks around. They still need to make some improvements thought. When trying to use the ATM, the machine would choke, as if it was cutting my card in to shreds, and then spit my card back out, fortunately still in one piece. But with no money. So, I went into a bank and asked them about the ATM machines. "Oh, they don't work....". me-"where can I find one that works?" "none of the ATM's in Rwanda work" All of Rwanda!? I had heard of local machines not working for some reason, but the entire ATM network in a country not working... Wow. (I later found out that they do work for local cards, but have not been set up yet for international transactions)

Quick Kigali Day 1 summary: After arriving early in the morning from Kampala, I was beat. I was afraid that Ashley would want to tackle the day in Kigali since she got a bit more sleep than I had on the bus ride, but was relieved when nap was on the top of her list as well. So, first day in Kigali started with a long nap, which was rudely interrupted by some pretty big swaying from an earthquake that we later heard had struck the Bukavu area on the south side of Lake Kivu along the border of DRC and Rwanda. No structural problems in Kigali however. Then we were both itching for some different food, which after two weeks in Uganda for me and 1 month for her, meant Italian food! Found a great place with PIzza!

Kampala

After leaving Jinja, we said our goodbye's to the Uganda team on the corner of one of the busiest streets in Kampala, which has traffic that would make New York City feel like a stroll through the countryside. Ashley Johnson, a student at Whitworth University, was part of our Uganda team and is studying genocide. Since there really is no better way to learn about it than in the field, she decided to join me to Kigali to see the Genocide Memorial there. Which was great because traveling solo is never quite as much fun.
Kampala, I found, is an extremely busy city. It is how I imagine some of the cities in India and Asia to be, with no traffic lights and what seems to be complete chaos everywhere. However, once you get used to it, it's not to hard to learn how to walk into traffic, stop as a van and moto pass on both sides with about 6 inches to spare, and then calmly continue across the street repeating the process as needed until reaching the other side. The picture is of the taxi park in the center of town and is not far from what the traffic in the streets looks like during rush hour.
Besides serviving the city streets, we also checked out the newly built Mosque, which is the second biggest in Africa and was paid for by the president of Liberia. It is a beautiful building and got a tour of the entire grounds, inside and out. I would say that the Mosque was one of the neat things to see in Kampala, but if I ever go back it will probably only as a stopping point on my way to somewhere else.

If you're ever in Kampala though and looking for a cheap place to stay, the Hotel Fiancee had warm water and good security (an armed guard at the front door). It was about $15/night and not far from a cool little outdoor eating area. Think strip mall, lined with restaurants, and everyone sitting out in the parking lot on plastic chairs and small plastic tables, with waiters giving the options of ordering from any of the establishments. Then add music and "miming" to the mix, and you have a truly unique experience. Miming is basically lipsinking on steroids. This is just a block or two from the central bus station in Kampala.

After 2 nights in Kampala, we were off on the night bus to Kigali. The bus left at 1am. The bus was full size, like a greyhound, except that most of the luggage had to be kept in the aisle or somewhere on the top of the bus since the bottom compartments are used almost entirely for commercial goods. So, if you ever plan to bus travel around Africa, I would recommend keeping luggage to a minimum. I don't have a lot, but I still feel like the bag I have is pretty large. The bus ride was pretty uneventful, except that I got very little sleep and two stops included a roadside bathroom stop..... which meant guys lining up 5 ft from the bus to pee and women going around the corner of the nearby buildings (homes, or shops, I have no idea what they were), and the other stop was for a women and a guy who loaded up into the bus from the side of the road in the middle of nowhere, and then they got off together about 30 minutes down the road. I'm guessing he was protecting her somehow, since as he sat down right in front of me, I noticed the barrel of a shotgun slung around his neck...

10 hours later, we were in Kigali.

Rafting the Nile

The day after camp, about 12 people in our group went for a white water rafting trip down the Nile. To say the least it was an awesome adventure. A bunch of class V rapids and several flipped boats. one of the best rafting experiences I've been on. We'll be leaving tonight for Kampala where I'll be staying the night and then catching a night bus tomorrow evening to Kigali, Rwanda. A couple days in Kigali and then on to Goma, DRC. I hope to update when I get there.