A hospital fit for a President

My weekend started in Kigali, with the discovery the local drink of choice, Waraje (Rwandan gin), and an exploration of the city on the back of a moto.  Then early on Sunday morning, I set off with several colleagues on a road trip to the Northern Province.  We stopped along the way for a table football competition, a trip to “MacDonalds” (a small but very popular roadside bbq stall, which sells fried sweet potatoes and goat brochettes), a hike in Parc National des Volcans, and finally to enjoy an evening of wine and cheese by a log fire (given the altitude, it is surprisingly cold up in the north).

On Monday morning, we headed (rather indirectly) to Butaro for the opening of a new hospital by Paul Kagame, the President of Rwanda.  

PIH has been working in partnership with the Ministry of Health and the local community to build the hospital for the past two years, following a request by the Rwandan Government for help to bring health care facilities to Burera, the last district in Rwanda which did not have access to a hospital.

Luckily, the President was two hours late, so our detour meant we missed nothing more than an hour or so of sitting and waiting for things to kick off.  When they finally did, there was the token ribbon cutting, followed by speeches by the President, the Minister of Health and Dr Paul Farmer (founder of PIH).  The president then lead a rally down in the community, and the day ended with traditional drumming and dancing back at the hospital.

Since PIH started working in the district in 2008, in a temporary make-shift hospital, the rate of infant mortality in under 5s has more than halved and malnutrition has been cut by over 60%.  The project has also created over 3000 jobs for the population of Burera.  So there was such a buzz of excitement at what can be achieved now the new facilities have opened.  

The hospital really is impressive.  It is situated on top of a mountain, close to Lake Burera.

And rather than looking in at a room full of sick patients, every bed looks out at the wonderful views: 

In terms of facilities, the hospital hopes to become a model of how to deliver health care in rural Africa.  It features an innovative design intended to harmonise with the local environment and reduce the risk of hospital-acquired infections.  It has an emergency department, a full surgery ward with two operating rooms, a neonatal intensive care unit, the list goes on...  It will even be making use of the impressive hills to supply hydro-electricity.

 

I am certainly looking forward to spending some more time up in Burera in the coming months, but for the rest of the week at least, I’m back in Rwinkwavu, as the stock take started today!

Oh, and of course, no official opening celebration would be complete without a huge cake, with a photo of the new hospital on the top...

Week one at work - settling into an office outdoors

It is 6.30pm on Monday here, and I have just watched my first proper sunset since arriving, a nice treat before settling in for an evening of work (the mid-year budget reviews started today). 

I spent most of my first week settling in, getting to know the people and the organisation, and setting works objectives.

The offices are based around an open air quadrant, and there is a large working area which has a roof and one wall but is otherwise open to the environment.  Spending so much time outside is awesome.

We conducted our interviews for the position of Internal Auditor last Monday.  We used video-conferencing to enable the Boston-based team to participate, but to be heard clearly in Boston the candidates had to sit right in front of the monitor, with the rest of us circling them.  Not exactly an easy environment for an interview.  Unfortunately, we didn’t end up recruiting, so we are back on the hunt...

In the meantime, there is plenty to keep me busy, including: performing financial “healthcheck” audits on each of the 3 districts in which PIH operates (Kayonza, Kirehe and Burera), and then working with those teams to help strengthen controls over newly expanded and decentralised operations; reviewing the procurement and stock management systems for medical and non-medical supplies; and setting up a risk assessment process.

One afternoon a week the Finance Advisor delivers excel training in Kigali to the whole finance team.  Having had some practice of delivering training over the past 12 months, I was interested to attend and help out, so went along on Friday afternoon.  It was pretty tough given the range of abilities in the class and various distractions (sodas and snacks arrived so they didn’t have two free hands to learn shortcuts, phones rang, and were answered, people joined the class at various points right up until 20 minutes before the end).  Going forward, we have agreed to split them up into two smaller groups, and work with a group each.  Hopefully that will make the training more effective, and more manageable.  There is a strong culture of exams here, and so when we suggested a game to check their learning, they seemed disappointed and have willing opted for an old fashioned test!

Non-clinician staff aren’t allowed to just wander around the hospital, and I still haven’t arranged a proper tour with Dr Felix.  As soon as I have, I’ll describe what it is like.  I will start taking a few more photos and loading them to share my surroundings too.

Welcome to Rwanda

Thank you for all your messages and well wishes.  I have been in Rwanda for 3 days now, so thought I’d share a few of my first experiences on the eve of my first day at work.

The country is absolutely stunning.  There is a perpetual backdrop of (often mist covered) hills and mountains, and the red African soil contrasts beautifully with the lush green vegetation.  The rain storms that sustain such plant life are pretty intense.  When it rains, it POURS, the tin roofs pound, the thunder and lightning sound worryingly close to said metal right above your head, and every pathway turns to a muddy water flow.  It is quite exciting!

On first arriving in Kigali on Friday morning, a guard at the Partners In Health (PIH) house took me on a tour of the city.  We walked up a massive hill (I’m so unfit) to his main attraction... a supermarket!  Not quite what I imagined my first Rwandan adventure to be but apparently it was so I could see how Rwandans do business.  It was huge (two stories) and sold everything from English football team doormats to Chinese banquet tables, and of course all of the usual more conventional supermarket products...

I am now at my main base for the next 4 months, Rwinkwavu, in rural Rwanda (about 3 hours from Kigali, including a bumpy 45 minutes drive down a dirt track).  Having only been here for a couple of days, I have already become:

-          Fish-eating – I hate fish so when a plate was put in front of me with 2 barbecued fish smiling up at me and I was told “we eat it with our hands” I was a little worried, but it was actually yummy and eating it with your fingers takes away any fish bone worries;

-          Football watching - the first few days were a little lonely, so when I was invited to the local bar for the Man U/Liverpool game (and a beer), I jumped at the chance;

-          Spider-saving (sort of) - a massive spider appeared in my bedroom this morning and usually I’m scared and kill them, but today I caught it, put it outside, and minutes later watched a bird eat it!  A satisfying triumph for the circle of life.  The critters in Rwinkwavu are BIG.  When I turned the (very cold) shower on yesterday, a flying creature that must have been more than 2 inches long came back up the plug hole.

Today, I went on a great walk, up (another) big hill, all along the ridge between our valley and the next, and through an umudugudu (favourite word I’ve learnt, it means village).  As I left the village, I turned around to find 10-15 kids following, one or two who wanted to practice their English and asked surprisingly difficult trivia questions.

So now I'm waiting to start work, a little nervous but also quite excited.  I am being thrown straight into the deep end with interviewing local candidates on Monday for the position of Internal Auditor...

Introducing my adventure

So, this is my very first experience of blogging… I guess a good place to start is to introduce the author…

My name is Emma (or Robbo), I’m 26 years old, and am just starting a 12 month career break from my job as a Chartered Accountant in London.

I am off to Africa on Thursday to work with Partners in Health (PIH), a charity based in Rwinkwavu, Rwanda. PIH provides primary health care services to rural Rwandans, as well as works to alleviate the root causes of disease in local communities.

Many people have been surprised to hear that I am not off building hospitals or digging wells (although this is perhaps not such a surprise given my poorly defined guns…) Instead, I am hoping to use my professional skills to help improve the financial management and internal control systems of an NGO that has recently undergone significant expansion.

Having spent 4 and a half years as an auditor, reviewing financial systems and controls developed by others, I am eager to experience the other side, and to take on the challenge of actually implementing some practical processes that will help to support PIH’s operations.

I am really excited at the prospect of all the people I will encounter over the next year, and what I can learn from them (I hope this includes at least a little Kinyarwanda).

My biggest concern is not having the right knowledge or expertise to assist PIH. Given my track-record, holding on to all my belongings while I’m away is at least a minor worry too…

Following my 4 month placement with PIH, which I arranged through a British organisation called Accounting for International Development (AfID), I have an auditing assignment in Nairobi, and I am planning to return to the UK in June, lean and mean (and parasite-free), for a cycling trip around the UK with my dad. And then, who knows...