Hello from Butaro!

I've been in Rwanda for just under a week now - for those of you who don't know, I finished my internal medicine and pediatrics residency 13 days ago (finally!) and took a job working in Rwanda with Partners in Health with plans to spend 8 months of the year here and 3 months working (and taking board exams!) in Boston. So, last week I moved into a storage container (and left boxes with friends - thanks Michelle and Venee!) and am now one of the 9 pediatricians in the country of Rwanda. I landed in Kigali (imagine a large town in the US) on Tuesday after a nice long flight from Boston to NYC to Brussels and finally to Rwanda. Unfortunately, most of underwear and socks are still somewhere en route (having literally fallen out of my bag when the luggage people ripped open my suitcase) and seem unlikely ever to surface again. I spent my first day at a conference in Kigali (not the best thing to do when you're jet lagged but interesting none the less) and then Wednesday night we took a bumpy 3 hour ride up to Butaro which is where I am going to spend most of my year.

So some brief geography - Rwanda is divided up into districts and I'm in one of the larger northern districts on the border of Uganda. (Uganda is supposedly 9 miles away from where I am living - but with all the hills it takes a bit to get there.) We're up in the mountains here - I think a couple thousand feet (just enough so that I'm particularly winded when walking up hills here - and there are a lot of hills!) - and the hills are terraced and divided into patchwork plots of various shades of green and the roads are a red dirt that seems to cover everything from shoes, to cars, to the leaves on trees, and even the little kids are coated in red dust! The town here (which I can't spell yet) is just one short street with a soccer field (aka Clinton's helicopter landing pad) at one end that is lined with houses that look like they would fit in in Mexico or some Spanish villa and a few tiny shops and a lot of people hanging out on the street.

I live at the top of a hill in between the old hospital - which is a collection of houses with a men's ward, a women's ward, pediatrics, surgery, and a maternity ward in addition to the outpatient area - and the new hospital which is an incredibly beautiful collection of pavilions overlooking the valleys and hills that is still under construction and supposedly opens at the end of August but in reality might need a few more months. My home is half-house and half-administration offices and with that we have people wandering in and out all day most of whom I haven't figured out exactly who they are yet. I live with the program coordinator for the site here, the architect, the carpenter, and a medical student all from the US. The hospital logistician (also American) lives down the road in one of the other PIH houses and spends most of his time with us up here as well (since we have electricity and internet all of the time). There are people who cook for us (bananas that taste more like potatoes, vegetable and meat stews, rice and even crepes for breakfast!) and wash our clothes (albeit a bit too vigourosly and the hem on my pants came undone!) and even make our beds (a bit over the top) and get the red dust off of our shoes (much appreciated). The only hard part is the cold showers! I may be in equatorial Africa, but it's a bit chilly up here in the hills - think somewhere in the mid-to-high 60s in the day and at night it drops to the low 50s - so I heated up some water and took a bucket shower today and I think that'll be my plan. A rat just ran into our house as well - but one of the drivers and the logistician trapped it in the bathroom and killed it. There are a fair number of cockroaches wandering around but we just ignore them.

I only rounded once in the hospital so far - on Friday- and everthing was said in mumbled soft-spoken French, so I can't say I caught all of it and have spent the rest of my time orienting, sleeping, and studying for the medicine board exams! I stayed here in Butaro for the weekend and made cocktails and Bloody Mary's and Mexican food and hung out with the guys. I also went out with one of the guys on his motorcycle to check out the water fall in town which is stunning. Going anywhere here is interesting because you get stared at by pretty much everyone - yesterday I was in a car downtown and had about 10 kids sit down on the lawn next to me and watch me as if I were a movie. Some of the kids are really shockingly poor looking - tattered clothes, big bellies, and no shoes - which really breaks your heart.

Anyway, back to memorizing some more French and then off to watch the World Cup (there is a TV here that the whole hospital staff watches the games on!) Wish me luck rounding tomorrow!