friday

Our final day in Africa is a warm and sunny one , the nicest by a long way , but then last days often are !
We visited one of Kigalis district hospitals to meet the pall care team there, the doctor  had played for the Rwandad national rugby team , fly half ?,  the country only started  a nat team in 2001 and in spite of the final score vs S Africa losing 110-2  he gave us a blow by blow account of a magnificent run he made un challenged after he recieved a 'massive impact' so he took people by surprise , with great enthusiasm and pride !!  he made John Motsom seem laid back !!
We went to the ministry where the minister was delayed so we set off in search of a wheel chair. we had been told these were made at a charity orthopaed clinic but after 20 min drive across toen were told they no longer do them but that we could import one from Dubai!
we found another supplier ( the only other one) which was in a park connected to some African heritage charity. They had imported them  but they were quite rigid and we got a call that the minister was ready for us !
We returned, he was a very fierce and scary imposing man and im not sure he really grasps pall care or understands what is happening , but he had a very good strategic plan he told us !  We were a little down cast so took  the team here at the comm centre out for a buffet lunch
This afternoon I am . as you can see trying to write the report while Ruth contiues to look into a few things here at the centre.
Airport in a couple of hours

Thursd

We presented at the 7 am hospital meeting today showing a DVD of the Kenyan hospice that Ruth started  which was well received. My lovely pink lap top has done sterling work and fortunately the volume was just about ok for so many people as the Rwandanese speak so quietly they are use to low volume.  We had several emotional farewells from the clinical director and 'our team', they were terribly excited by the self timer group photo and I was quite relieved I worked out how to do it with out my trusty off spring to set it up! Everyone felt the trip had been a great success and I think so too although we still haven't persuaded John Baptiste to try his wheel chair but at least he's been moved from pall care to rehabilitation status and the staff have a plan! we were asked to see one of the prisoners before we left, all the prisoners wear baby pink 'scrubs' and there are heavily armed guards at the doors , i have to say the prison ward has done nothing to lessen my fear of prisons. The prisoners are allowed visitors in prison but not on the hospital wing ? fear of escape apparently but this chap wasn't running anywhere
We came up to Kigali this afternoon and then I went out on a home visit
Tonight we had supper with Ruth Evans who writes for the Guardian and is out here doing a documentary for the BBC, we had a lovely evening and she asked me to be in a series of debates she is doing on the 145 slot on radio 4 (thats how you refer to it apparently !!) in the new year , i think she was joking but Daddy would smile as it follows on from his favourite '40 mins of news and comments' that I hated at Vicarage lunches ! Tomorrow its 8 am at local hospital and then 11 am at ministry of health and then starting to tackle the report we have to submit of our trip. My Christmas cards have had a wasted trip I haven't even done the As!!
I'm completely out of comfort zone as the only way we could do on line check in was to receive the boarding pass to text on phone , I like a PAPER TICKET!!
Home via Nairobi , touch down for an hour, then change plane in Brussels

wednesday

We set off on our visit in the hospital transport as no private taxi would take us, only 1 hour later than planned, not bad for African time . We are going to use the money the taxi would have cost us to have Joseph's (the hospital soc worker) motor bike repaired as he has been unable to do visits for 2 mths waiting for it to be repaired! The journey started off smoothly enough and we had with us the physio, soc worker , Dr Alphonse ( who didnt want to miss out on the team outing!) , driver and a 'chap who knew the way', Rwamagana's answer to a sat nav! however this small counrty is not called the land of a 1000 hills for nothing  and as we left the main road we were soon  up and down with steep gradients on red earth pot holed tracks, side sitting in the back of the ambulance . The scenary was beautiful, views of the lake , contrasting foliage , smell of eucalyptus trees, goats , mud houses and groups of Africans sat under trees. On route we crossed into another district and had to stop and get paperwork permission to take a working vehicle through! Our destination was to 23 year old  Agnes. She lives in a mud house with her father and step mother. 3 years ago she had a caesarean section from which she woke up paralysed from the waist down , doubly incontinent and unable to sit other than for a few minutes to eat. her husband left and has a new wife but he does let the 3 year old daughter visit. For 3 years Agnes has lain on the floor being cared for by her stepmother and has not moved from there. Her smile was amazing , she was so pleased to see us and loved the English sweets I had and the perfume stick I gave her that was in my bag ,we took the food  for her parents. We were able to check that all her pressure sores were healed and managed to pull her to a sitting position although her waist and hips are v stiff. we asked her if she would like a wheel chair to be pushed outside her eyes lit up. A wheel chair is too expensive for the family. Ruth has some money that has been donated and I measured the door frome and while we are in Kigali we are going to the church firm that makes wheel chairs and hopefully buy one. This afternoon was an entertaining if not exhausting session on communication skills. at one point I was lying on the table in role play !

Tuesday

I gather a more cheerful post is required today ! Our presentation was well received and 1 doctor asked me to e mail her the slides and another asked to come to our afternoon session.
Hermon the german ( he's not german , congolese ) who is the deputy director of the hospital is rather shy and I think is probably hypothyroid , either that or he goes to bed far too late as he as a tendency to nod off- anywhere, so this afternoon I sorted  him , I gave him the pen to write things up on the flip chart , it was painfully slow but he didn't nod off once !! I think the box of miniature heros Ruth took helped, we have been sneaking one out at night and re sealing the box so no one would notice but thought we should take them today as the box was getting  suspiciously low, we still have my box for the last session!
Just flipped onto generator again !
Anyway, todays pictures are on the theme of  resourcefullness, 2 successes , wheelchair  from garden chair and man with oes cancer who has tied  his gastric feeding tube up with  shoe laces, the third is my shower apparently one has to stand in the washing up bowel which then wanders off round the shower tray at will and as the water spray is very small ones body often misses the water completely - polite helpful  suggestions only please
Last night Joseph the social worker joined us for supper and he is very useful for a potted history of Africa, unbiased of course. He was born in Congo , came to Rwanda to work for save the children  after the genocide
Off on a long drive tomorrow to visit a health centre and home visit so early start!

monday