During June 2013, I travelled as a volunteer Dental Nurse with dental charity Bridge2Aid. The charity provides training in emergency dental care for rural based Health Workers in East Africa. In a world where 75% of the population has no access to a dentist, our work as volunteers with Bridge2Aid is vital, and most importantly, wholly sustainable. Having previously taken part in Dental Volunteer Programmes with Bridge2Aid in Tanzania, the charity asked me to take part in its pilot programme as the team move into a second East African country, Rwanda. This is my journey
Day One
The adventure begins, the team meet at Heathrow Terminal One for our transfer flight to Brussels. We greet old friends and meet new ones, have coffee, (lots of, it’s been a very early start), and chat (even more of). We meet Peter at Brussels airport, who has not been out with Bridge2Aid but has worked in Rwanda treating patients over a couple of trips, and fly onto Kigali International Airport, Rwanda.
Tired and weary from travel we arrive into a humid and warm evening and are grateful to be through security and baggage collection relatively quickly. A difference from Tanzania here, we don’t need any visas which really speeds things up. It is a welcome relief to be greeted by Jo (Topley)and taken onto our hotel to get a good night’s sleep after a long journey. The hotel is comfortable and quiet until the security guard decides to move chairs and listen to his radio at 5.30am. No problem for us though, we have Captain Jo, she soon tells him him she has important volunteers from the Uk and they need their rest. Suitably admonished he retreats to his office and all is calm once more!
Day Two
Orientation this morning is comprehensive and informative; we are all experienced DVP’ers so the emphasis is on Rwanda, the structure of its healthcare and government strategies. Rwanda appears to be very strictly governed and as a nation very respectful of authority. I can’t help but wonder is this due to the influences of the previous colonial Belgian rule or is it a product of the Genocide and the need to regain control of its people and rebuild an infrastructure that will be beneficial for generations to come?
This takes us then onto the Genocide Memorial Museum.
It’s so hard to put into words the devastating consequences of a nation quite literally turning in on its self while the world stepped back, the horrors of man’s inhumanity to man, the innocent lives snuffed out in such a cruel, humiliating and dehumanising way. 800,000 people quite literally wiped out. The mass grave sites are all over Rwanda and we drive past a few, prominent at this time of year due to the beautiful flowers adorning the graves in this commemorative period of one hundred days of mourning that takes place each year.
Walking around the centre, looking at the photos of babies, children, young boys and girls with their whole lives ahead of them, men and women, young and old, it is so hard to imagine the horrors they experienced before breathing their last. The continual consequences of such horrors are still evident, how does a nation reconcile and rebuild itself after this? And yet, there is reconciliation, a country working hard to recover and regenerate. An inspirational testament to a community determined to succeed.
And so, onto Kirambi, our home for the next few days. The journey from Kigali to Kirambi is two and a half hours of jaw dropping scenery, the backdrop of the Rwandan hills, lush green foliage, terraces on the hillside cultivated in neat rows with bananas, vegetable and maize. As we approach Kirambi the roads deteriorate to a standard we experienced DVP’ers know and love! Deep rutted and dusty. Peter explains how this road is completely impassable during the rainy season, making Kirambi totally isolated during those times. A very rural area, we are followed by many children running along the rough terrain bare foot and bedraggled, shouting Muzungi!! Muzungi!! (White person, or literally translated, travellers) and laughing and waving as we pass by. It’s a heart-warming sight.
We arrive at Kirambi where Sisters Sekunda and Angela greet us warmly. The house is very basic but clean and welcoming, we each have flowers in our rooms and bottles of water (admittedly this was recycled and ours made us chuckle (it’s the first time I’ve seen a Jonny Walker black label bottle filled with boiled water, hey, this is Africa!!) After a hearty meal of rice, beans, beef and tomatoes, we are certainly not going to be hungry on this trip, a celebration cake was paraded in honour of our arrival, decorated with Bridge2Aid iced on top, the sisters had gone to so much trouble for us. It gave me the sense that we are indeed welcome and the anticipation of the pending training programme is eagerly awaited.
Day three
Waking up in Africa is a unique experience, there is something quite special about hearing a village come to life as the sun rises. The sound of birds, cockerels and cows provide the backing music to children laughing and singing as they prepare for an early morning walk to school or to work in the fields. The smell of the wood fires fills my senses as I watch the mist rising off the hills in the distance. Everywhere I look is green and picturesque. I find it hard to imagine the horrors these hills have seen and the secrets they hold. It’s a stark contrast to the sheer beauty that surrounds me.
The bell from the church at Kirambi calls the villagers to mass at 6am and I think it’s quite safe to say that no one will oversleep whilst we stay here!
Clinic is just a short walk away which is a real treat, no long journeys in 4x4s over dust roads means our training time will be longer, an added bonus. As we approach a small group of buildings we are greeted by the staff of the health centre singing a welcome song to us, their voices the only music, the velvet choral tones are completely harmonious, a spine tingling moment if ever there was one. They come to the end of the greeting and proceed to hand each of us a posy of day lilies and sweet smelling roses wrapped with white paper. It’s just incredible that when someone has so little they can give so much, I feel truly humbled. A very special moment.
We are located in the health centre which is a busy place with vaccination and baby clinics going on around us as well as blood tests and nutrition clinics. Imagine if you will a small cottage hospital without any of the technical equipment, a couple of four bedded wards which consist of just that, four steel framed beds with plastic mattresses in a bare room, a small window the only light. The floors appear to be concrete but I’m not sure if they are hard baked clay/mud. They are certainly kept very clean, constant brushing with a tied bunch of branches proves to be quite efficient in the right hands!!
We quickly set to building our clinic, Dentists Judy, Peter, Barry, Graham and Neil organise the treatment room whilst Janine, Sarah and I organise the decon room and stock the stations with local anaesthetic, bite packs etc. It’s a slick set up made easier by the fact that we’ve all done this before.
The rooms we use for treatment and decontamination are separated by a courtyard and initially I find this challenging. Having the two rooms apart makes it more difficult to assess what is needed in clinic in terms of support and head holding and stocking the stations, but we soon work out a system, carrying clean and dirty boxes of instruments (CQC would be impressed!) between the two rooms whilst keeping an eye on the clinic needs. We work on a rotational basis as scrubbing instruments and putting pressure cookers on kerosene burners in a confined hot space can become intense after a while. Different personalities and high running emotions add to the challenge and we all work hard to achieve a calm working environment and support each other when necessary.
We have many patients registered for treatment and Innocent (a DVP administrator) logs details and takes background information as part of Bridge2Aid’s evaluation process. The difference with this trip as it is a pilot involves us keeping lots of information to provide the government and health ministry officials with details they can use to assess the programme, this all helps towards moving forward with an oral health strategy and planning sustainable oral care for the country.
As part of the training I was asked to deliver a perio seminar to the trainee nurses, this proved to be quite interesting as translation into French, Kinyarwanda and English was necessary! My French is abysmal, my Kinyarwanda non-existent and my Lancashire English accent didn’t do me any favours either! Luckily we have Neil, the Site Clinical Lead, whose French can only be described as fluent and eloquent and we also have a translator. However, my English would have to be spoken slowly and clearly!!
There are many children attending with shocking rates of caries, a three year old with four decayed anteriors, a six year old with ten decayed teeth, the queues are long, the treatment need evident. As one father talked to us his child sucked on a sweet biscuit type snack, sugarcane is widely available and cheap, very few of the community brush their teeth and rarely is toothpaste used. The oral health messages really need to be taught here. It’s so difficult to criticise a parent giving their child sugar water in place of a meal when this is calories that cost less where a meal cannot be provided, and yet it’s heart breaking to see that child in agony and at great risk from infection due to lack of treatment.
It’s imperative that nutrition and education programmes are in place and this area is working very hard to provide such education. The Sisters told us that before they arrived in Kirambi the malnutrition rate was over 70% and through the programmes in farming methods, self-sustenance and the cooperative that is run here that figure is now 0.4%. They run the health centre and their task is endless, their dedication and hard work is truly inspirational.
One legacy of the genocide becomes evident when taking medical histories, Barry saw a patient who told him he was on heart medication, looking at the names of the drugs the medication was not for a heart condition as such but anxiety, the patient explained he was very frightened whenever anyone approached him suddenly from behind. Another woman had serious mental health issues, she had been beaten and raped during the genocide and was lucky to escape with her life, unfortunately none of her family members did and this has had devastating consequences for her.
Too many troubled souls, those living with the consequences of their actions and the surviving victims living and working side by side. The government has set up counselling programmes and encourages reconciliation between the communities, its yet more inspirational evidence from a nation striving to recover and rebuild.
So we end a busy day training and working in clinic and walk back up to the mission house as the sun starts to set. We sit on the veranda for a detailed debrief which is vitally important when we are experiencing such a tapestry of sights, sounds and emotions during teaching and treating throughout the day. This gives us all chance to individually discuss our day and any problems we might be experiencing.
The sisters had prepared hot water for us on charcoal stoves at the back of the house and we help ourselves to buckets full for a refreshing wash, camp style, before another wonderful meal of rice and beans, stew and vegetables is served, most of which are grown in the gardens here and lovingly prepared for us by Tdayo, the chef.
A competitive game of Jenga rounds off the evening before retiring to our little wooden beds with foam mattresses. Sarah and I are sharing a room and we have a nightly ritual of tucking in mosquito nets and checking for wildlife that might also want to share with us! Life here is physically demanding, emotionally draining and wonderfully challenging all at the same time. We are here for a short time and I contemplate the sisters’ perseverance and strength once more as we settle down to sleep.
Day four
I wake at 5.30 to the sounds of a beautiful dawn chorus and sat outside enjoying the view as the light came up, the Rwandan hills a stunning backdrop. It is so peaceful and as the church bell rings I decide to walk over to the church for mass at 6.30am. The church is a simple but large brick building, very plainly furnished with low wooden benches and fabric bunting hung along the pillars to commemorate the hundred day mourning period. The singing fills the room as I enter the cool building, it is amazing to listen to with the beat played out on a single African drum. The priest, Fr. Pancras said mass in Kinyarwanda but even so it is easy to follow the familiar pattern. It is a lovely start to the day.
After breakfast and the usual “is everyone well this morning? Have you remembered your anti malarials?” we walk to clinic and greet the trainee nurses, the number of patients waiting in the shaded area of the health centre is a good indication that word has spread. We are in for a busy day!
Everything runs like clockwork, Sarah, Janine and I have a good routine in place and clinic is kept well stocked with clean instruments. The dentists and trainees work so hard, I am always in awe of the teaching skills implemented by the volunteer dentists, breaking down all language barriers to train under often challenging circumstances, and the keen enthusiasm evident in their students.
One of our patients has elephantitis (podoconiosis) and the growths on his legs are so huge just walking must be excruciating and yet his toothache was so bad he walked the distance to the clinic with the aid of iron crutches to be treated. There are no electric scooters or advanced treatment centres here and life is obviously very hard for this guy.
I particularly enjoy holding a three week old baby whilst mum has to sit her twelve year old daughter on her knee for two necessary extractions. Judy managed to demonstrate great technique through the child’s cries and afterwards the little girl shook Judy’s hand and thanked her!!
Important visitors from the government visit, the senior dental officer of Rwanda and distinguished guests. We talk through the practicalities of DVP and I demonstrate the sterilising procedures to them.
The senior dental officer is concerned that our pressure cookers are not big enough (he sees 400 patients a day in his clinic). I explain that hopefully with more nurses and health workers trained in basic extraction techniques across Rwanda the rural communities will have access to pain relief more regularly and the nurses will not need to see so many at once. He seems impressed with this and I breathed a sigh of relief when they moved on to the next part of the health centre!
Bridge2Aid’s founder, Dr Ian (Wilson) had orchestrated the visit and it’s been lovely to have his presence on DVP. He’s such a a charismatic person and his enthusiasm is infectious.
Day five
Sarah and Peter joined me for mass this morning and afterwards we take a walk along the road before breakfast. We meet many villagers, children on their way to school giggling alongside us and calling Mzungi and we stop to watch a man forming bricks from the clay soil to build his house. We walk along a row of three houses made from the same clay bricks and rendered with mud, the roofs are made of clay tiles and it becomes evident that one of the little buildings is a shop selling everything from toothpaste to beer and also houses a little bank. Not exactly Tescos but a multi-purpose business none the less!
We walk by many people, some of the victims of the genocide are easy to spot here with dreadful scars and amputations. Peter explained that just half an hour away there is a big refugee camp that still houses 50,000 displaced people. This beautiful country has such sad stories within its hills.
Clinic is a busy place today with many men, women and children sat patiently waiting in the heat, some wear colourful outfits, their Sunday best to visit the doctors in town! The children play on the hard mud floor whilst their parents sit on the hard benches for hours, one little boy spends a while competing with his playmate for the long walking stick he acquired from under the seat of an elderly lady, it’s hilarious to watch them dual with a branch three times longer than them! They can be no more than a year or so old.
It was my turn to do some teaching today and being the hygienist the general consensus is that I should teach the oral health education section to the trainees after which they would deliver a talk to the waiting patients. It goes well and I’m so proud of the speed at which the nurses learn, they deliver the talk and one lady stepped forward to say something. I asked Innocent to translate, she said “we like this education very much, it is so good, now we can go and tell the others how they can avoid the painful teeth.” I felt so elated.
The afternoon is really hard, many, many, instruments to scrub, the heat is getting to me and the kerosene fumes make my nostrils sting. We try to rotate but clinic becomes so busy we all get stuck, everyone is hot and fractious this afternoon, the early mornings and hot, difficult hours begin to affect me, I feel homesick today, a low point for me.
We had debrief sat on a bench at the little shop and it lifts my spirits watching the children watching us! One little guy has a football made from banana leaves wrapped with string, he’s really quite skilful with it, again I am reminded of the privileges back home, this fellow is really happy with his little homemade footy.
We returned to the house for the night and I managed to call home, it was really wonderful to hear everyone’s voices and I felt refreshed and ready to carry on with the rest of our programme.
I had been given some children’s and baby Everton football shirts to bring out so I give these to Sr Sekunda this evening and she is delighted, she explains that she will distribute them to the most needy families, actually I would say that accounts for all who live in this village but there are definitely some who really have nothing.
There is a child who hangs around the centre every day and he has the same pyjama pants and ragged t shirt on each day, he wears no shoes and the terrain underfoot is extremely rough and stony. Sister explains that his mum has mental health issues and they do what they can to support them but it is so difficult, there are so many. I walked past the maternity ward this morning on the way to the long drop and it was full of women who had just delivered babies, tomorrow I will try and go inside!
Day number? – I’ve absolutely no idea, completely lost track, Sunday I think!
A couple of days have passed and I couldn’t find time to write my diary, so a catch up; we finished another very busy clinic day on Saturday, more oral health education lectures which we needed to finish off, the pressure is on to get all aspects of the training completed so the nurses will all hopefully pass. I decided to teach one in the morning and let him give the talk before lunch and then another just after lunch so completing this part of the training for all four nurses before they embark on the sterilisation sessions with Janine and Sarah. (The oral health and sterilising units are the responsibility of the volunteer nursing team to deliver.)
It was particularly challenging due to the first trainee nurse, Jean Dieu only speaking French and the second nurse, Jean Mari only speaking Kinyarwandan! Interpreters at the ready they gave the talks, however, because one was given before lunch and one after the second trainee nurse decided he would do a question and answer session of the same group of people to assess what they had learnt from the first trainee nurse earlier that day. I was speechless but couldn’t help being impressed at his innovation!!
There was a lovely group of kids hanging around today and we enjoyed making use of the balloons I had brought with me, the boys were so proud of their cherished gift, I hadn’t the heart to tell them it won’t last forever, just as well though as the other kids can be quite brutal in their methods of re distribution!!
Due to the teaching the pressure was on for Sarah and Janine to turn the instruments over and support on clinic and they coped admirably well, I finished the last session in the decon room and we tidied away on time before leaving for the hotel in Nyanza that would be the location for our day off and give the sisters at Kirambi a rest.
The journey to Nyanza is very pretty and everyone along the ways stops to wave and smile. Its worlds apart from home!! The road surface is really terrible and only passable in vehicles with four wheel drive, it snakes along the side of the hill and I find it quite hair raising at times!
We drive past women washing their clothes along the river and men and children hoeing in the fields, the terraces that adorn the side of the hills are well tended. There are neat furrows where water is channelled into and this is scooped out and thrown over the crops, it looks like back breaking work and once again I think of home, how easy to get the hose pipe out!
We come across a large group of people building a compost pile; the government have an initiative whereby villagers are paid a small amount to provide compost for the terracing. They all stop to shout and wave as we drive past. There is also another government initiative in Rwanda called Umaganda, it is an obligatory day of volunteering (an oxymoron I know!!). Every man, woman and child must dedicate the first or last Sunday of the month to assisting with community projects, I wonder if this would ever catch on in the UK, what a difference it might make. Somehow I don’t think it would be too popular! It re-emphasises the country is being run in a very structured manner.
We arrived in Nyanza at sunset, looking forward to charging phones and using WI-FI. Just after we checked in the whole town was plunged into darkness as the electricity failed. Africa!! Can you imagine if the whole of your home town suddenly had a black out? Everyone would panic; here it is just a way of life.
The electricity returned eventually and it was lovely to catch up with home. We had a lovely dinner, wine and great conversation with lots of giggles which was just what the doctor ordered after the past few emotional roller coaster days.
Sarah and I were awoken very early to the sound of the community radio being blasted over loud speakers from the building down the road, in a town like this it’s a vital service however I can say it was not so welcome at that hour of day on our one day of relaxation!! There was nothing else for it, we might as well get up and go for a walk, we had coffee first which took the usual 40 minutes to make (African time) but when it did arrive it was beautifully presented with a plate of carved fruit. We went along to the local church of St Christopher, Sunday mass isn’t just a service here, it’s a celebration of dance, music, drums, gospel choir and literally thousands of people clapping. What an experience! We both had a wonderful time.
The hotel receptionist had walked with us to direct us to the church and later on took us all to the local market. Sarah wanted traditional material to make a scrubs tunic and Graham spent some time haggling for the kanga material, he ended up with enough for both Sarah and Janine who decided they would try and get them sewn by the tailor in Kirambi village which would make them really authentic.
We drove onto the national museum at Butare which was really fascinating and everyone was able to purchase gifts for home, a bit of retail therapy always makes us smile. There was a beautiful statue of Our Lady of Kibeho which Neil suggested we purchase as a thank you for the nuns at Kirambi, I was so delighted as I knew they would be thrilled. (It is reported that Our lady appeared to visionaries in 1983 and Kibeho is a shrine for Catholics to visit, similar to Lourdes but on a much less commercial scale). I had been talking of the significance of Kibeho to the team and I thought it was such a kind and thoughtful suggestion I became overwhelmed with emotion (must have been the heat!!).
We loaded up our packages and our 4 foot statue of Mary into the 4x4s and continued our journey back to Kirambi.
Back to clinic, day ?? It’s all a blur!! Monday, I think, but I’ve lost count.
Today started in a very serene manner. Barry, Sarah and I walk down the road to the community project office where each morning they hold “Capacita”. It is similar to Tai chi, gentle movements to meditative music but with an emphasis on recovery and positive thoughts. It was developed to help the survivors of the genocide, releasing hurt, upset and tension and drawing in peace and good feelings. It is a moving experience, humbling and inspirational.
We arrive at clinic and the dentists are doing a tutorial first thing so I take the opportunity to ask Sr Sekunda to give us a tour the health centre. She is delighted to show us around. We walk around the little bare rooms lit by just one bulb in the centre of the ceiling, the sterilising room is so dark that the nurses clean their instruments sat outside and then take them in to place them in two very large pressure cookers on kerosene burners. There is also a large freezer for cold sterilisation, though how that could work I have no idea. We walk through a covered area outside where people are being weighed as part of the malnutrition programme and we meet Tdayo, the chef’s wife. She works as a receptionist but is actually a qualified nurse. She suffered horrifically during the genocide, Sr Sekunda tells us her story;
“During the height of the killings the Interhamwe came to the house, they had already killed all of Alphonsine’s family and were searching for her. Tdayo, a Hutu, tried to protect his fiancée to no avail; they cut her with machetes and threw her in the cess pit. Later Tdayo went to retrieve her body but found by some miracle she was still alive, he cleaned and dressed her wounds and hid her in the roof of the house for some time. His brother returned with an angry group insisting Tdayo tells them where he has taken her. As Tdayo refused his brother told him ‘we will find her and when we do will kill her and then kill you too’. This was Tdayo’s own brother; the whole place had gone mad.
He managed to move her from hiding place to hiding place sneaking bread and water at great risk to his own life until the violence settled. They were married shortly after her recovery and due to this Tdayo’s family disowned him, they were completely alone, the Tutsi community including all of Alphonsine’s family were wiped out. Alphonsine knew the mass grave her family were buried in except for one of her sisters, just last year digging was being done on the terraces and they found the bones of the sister she had been searching for, identified by the cloth wrapped around them. Alphonsine can no longer work as a nurse as most of the community are Hutu and if anything went wrong during her treating somebody it might be seen as revenge, we can only employ her as administration”. A very sad story that is evidence of the problems still being encountered nineteen years later.
We walk onto the antenatal room with six beds and a door to through to a very small room with two of the same beds for delivery. No gas and air cylinders or oxygen here, they do have pain relief for labour however, we are told paracetemol is available!! We meet two new born babies in the next room which is lovely, just hours old.
All in all it is a comprehensive tour and a lovely half hour before the start of clinic.
Clinic today is extremely busy, we have an additional staff member today, Peter’s wife Pam who has worked at Kirambi on previous trips, has joined us, which is a welcome extra pair of hands. Janine and Sarah teach the sterilisation techniques today and again we are all impressed at the speed at which the trainees learn.
Due to the teaching the instruments pile up and it takes all hands on deck to catch up whilst busily restocking the clinic tables and giving head support where needed. We see a sad case of a lady with an advanced lesion of some sort, possibly a sarcoma and maybe related to her HIV status, the lesion has created a large cleft in her palate. There is little or no treatment options available for this lady and it’s very sad to see.
It’s an exhausting afternoon in the heat, and been quite an emotional day so I decide we all need to have a little fun. We blow up balloons for the kids hanging around which thrills them all and we blow bubbles to the sound of squeals of delight, they have so much fun chasing the bubbles and playing with the balloons, we all feel so much better after!
As the sun sets over Kirambi we head up to the house for supper, safe in the knowledge that our laundry has kindly been done by Francoise who works for the mission, she says she is so happy to do it because the job means her son can go to school and they can live a good life. I feel very humbled once more.
Tuesday
Today is a day of two halves. I arrive at clinic to be greeted by a young woman who has seen me in church and she asks if she can tell me about her difficulties. She lived in Uganda and her parents wanted to send her to school, they had to work very hard in the fields to grow vegetables and sell them at market. They could afford the first few years but now the money has run out, would it be possible for me to fund the rest of her education?
I was so sad, I tried hard to explain that it costs us money to come here to volunteer and train the nurses, that we don’t get paid and of course we have lots of bills to pay at home, but all the time I kept thinking, my girls are so well blessed, their lives as women is so much easier, they have so many more opportunities, they live where education is a given and all have the same chances.
What chance does this young woman have? I reassured her that she was doing well and to keep working hard, that I would pray for her and she thanked me for this. I then walked away and burst into tears!!
The morning on clinic is very difficult and one very distraught lady in particular really gets to me, she has been in pain for three years. However, soon she was so grateful to be relieved from her pain and kept hugging and thanking us following her extraction.
The afternoon is a lot lighter on the heart and emotions, that rollercoaster we are all on showing itself in full today. Ian also sets up a workstation and this helps us get through the patient numbers, his original style of treatment and charismatic nature has us all laughing. I am thrilled when he hands a patient over to me with a periodontal abcess and I get to be hands on for a little while.
Teaching is going great, the dentists are all happy with the level that their trainees are at and it looks like they will all definitely pass.
We finish on clinic and head up into the hills to meet the Twa tribe; they are a marginalised pygmy people who over the course of history have been pushed further up into the hills where the soil is infertile. They make pots from the clay to earn a meagre living. They are all so excited to see us and show us how they make their pots, we watch for a while and then are encouraged to walk on further, they have a surprise for us.
I glance at the mud houses as we pass by, walking further up the hillside , the terrain is very hard and dry, quartz stone glints from under the scrub, obviously unsuitable for growing anything here. None of the children here wear any type of footwear. The people here truly do live in poverty and yet they are so happy. One lady is drying grain tossing it high from a flat shaped basket and smiles warmly as we pass by.
I notice a cow kept in a pen cobbled together from sticks and she stands patiently chewing on dry grass watching us walk by. One of the doors we pass has numbers on, obviously a maths lesson for the children who do not attend school. One lady greets us with a wide smile, proudly showing us her mouth where one of the trainees had extracted her tooth earlier that day. This is where I realise the Bridge2Aid programmes work so well, reaching those who really would have no other option than to live a life of pain.
We reach the top of the hill and the singing and dancing begins! The children put on a colourful display of beautiful rhythmic dance to the voices and clapping of the adults. They are wearing little floral dresses, boys and girls alike! Pam explains that these were donated to the community last year.
It was a truly amazing experience and I feel so privileged to have been given a little glimpse into their humble way of life.
At debrief I became emotional describing my day of two halves and received a lovely cuddle from Judy and a very empathetic response from the team. The Bridge2Aid family support felt so warm and strong tonight.
Wednesday
As the training comes to an end we have a really busy morning at clinic ahead. Lots of patients that the trainees treat with very little help from the dentists, it’s a really lovely thing to see, the hard work really paying off, knowing that these nurses will soon be in their own health centres reducing the pain of thousands of people.
Over lunchtime an official ceremony is held to celebrate the success of the programme. Speeches, clapping, singing and traditional dancing make for a very enjoyable time and we are presented with gifts in gratitude. One lady asks to approach the table of dignitaries and explains that she had been in pain for many years. She attended the clinic and one of the trainee nurses extracted her tooth and her pain has now gone. She tells them that following her treatment she went back to her village and shared the good news and many of her community then came to attend for treatment!
The afternoon continues with the remaining patients being treated and the trainee nurses really beginning to look like pros!!
After debrief we all walked down to the market in the village, down a steep hilly road that’s very dusty. I am concerned we may get separated in the throng of people, there are literally thousands, but Innocent reassures us that we stand out somewhat and will be easily recognisable. I have to agree looking around me; we do look like the typical Mzungi tourist at this point!! We spend ages just walking through the crowds; I know now how celebrities must feel!
Barry decides to entertain the children by starting a line doing the Conga dance and they quickly pick up the moves and follow us all singing their hearts out. Definitely one of the most amazing experiences of my life and I was laughing and crying all the way back to the house as we looked like the Pied Piper of Hamlyn.
Thursday
Exam day! More patients receive treatment this morning prior to the trainee nurses taking their final written exam. As the papers are marked us nurses set too with the final sterilisation and packing away of instruments, counting and monitoring the condition of each so they can be readily identified for future trips. The pressure cookers are scrubbed of soot for the last time and the group of children that have been watching us all week help to carry the water. I will miss them all so much.
The results are in and each of the trainee nurses have successfully passed the course. Shouts of excitement echo around us, hugs and tears of joy! They are each presented with a kit of instruments including the pressure cooker and kerosene burners for sterilising and beam with huge smiles, delighted in their achievement. The four nurses are responsible for more than 25,000 patients each, that’s a lot of people with access to emergency dental treatment and pain relief.
Four clinicians trained and 600 patients treated!
Leaving Kirambi
Awaking for mass at 5.30 am, sitting on hard benches, walking on hard dusty roads and sleeping on a cot with a foam mattress listening to flying termites buzzing in the room. Fighting with the mosquito net and taking it in turns to wash in buckets of water. Using the long drop loo when on clinic, breathing the unique odours, coping with kerosene fumes and steaming pressure cookers in intense heat. Riding the emotional rollercoaster that is DVP.
I would have it no other way, I have relished every minute.
Bridge2Aid, I thank you.
For more information about dental charity Bridge2Aid visit http://www.bridge2aid.org.
If, like me, you are a dental professional wishing to volunteer with Bridge2Aid contact the Visits Team on 0845 8509877 | visits@bridge2aid.org
http://www.facebook.com/bridge2aid
http://www.twitter.com/bridge2aid
Ramblings from Rwanda, by Jeanette Grimley 