Gisenyi, Rwanda

In Mama Chacura’s guesthouse, it is Robert, Mama’s oldest son who oversees the activities in the house. Robert, who is twenty-six years old, comes to and from the house usually whenever he pleases, most of the time to bring over friends to hang out because it appears that white people are a status symbol inRwanda. Robert is the boss over the staff at Mama Chacura’s guesthouse which includes three “mamas” who are our beloved cook’s and three guards who also act as handymen and janitors.

Of the several employees at the house who are all wonderful people, I have become fascinated by Isadore, the main guard. For one, Isadore does not sleep. He is always keeping guard all night, gardening when I wake up in the morning and does random chores during the day. In my time here, I found him asleep only twice. The first time I saw him asleep, I was woken up in the middle of the night by a terrible thunderstorm. I walked to the backyard patio to see how hard the rain was coming down. When I opened the door, I felt it thud against an immovable soft object. I looked around and I saw a hulk covered by several blankets, protected by the roof, but less than a foot away from a growing puddle. I took a closer look and saw the red hood from a sweatshirt that Isadore wore everyday draped over his sleeping head. This was particularly strange to me because Isadore does in fact have a room in a separate house right next to the compound. But, I did not ask any questions and let him sleep on the ground as the storm beat down on Gisenyi.

Isadore tries to speak English to me. He knows some words, but when he cannot communicate with me he has an interesting way of saying what he wants to me to hear first in Kirwandan, then Swahili, then pantomime and finally when he gives up he sticks out his fists to pound with mine and says, “You and me… friends.”

My friend Isadore is the kind of guy that when there are a large group of people hanging out in the backyard, he stands off to the side and laughs whenever a joke is told, but seems too timid to posit a joke himself. You know, however, in his thoughts there is something brewing, something that he really wants to express.

On Friday night, the six other members of the squad took the evening bus to Kigali, while I decided to stay in Gisenyi with my Rwandese friends because it would be my only Friday here. In the early stages of the night, I planned to go to a local bar to kick back a few Mutzigs (Heineken style beer) with Damas and Robert. As we were leaving the compound, I asked Isadore if he wanted to join us. Robert granted him permission and he left his night post and walked with us down the pitch dark road to Bar La Bamaba.

Now, it is important to note that big Mutzigs are about .75 liters or about 2 beers in size and that they contain about 5.5% alcohol. It is also important to note that Isadore weighs about 130 pounds. So when we drank two Mutzig’s it was not too shocking to discover how wasted Isadore became. What was surprising is that the shell of seriousness cracked open exposing a stumbling partying Isadore. He started bouncing up in down in his seat, dancing and at one point he even tried to get me out of my seat for a little grinding session. And yes, Rwandese men do commonly grind with each other and it freaks me out big time.

So after Isadore became a little out of hand, the four of us exited Bar La Bamba and I was forced to carry him home all the way. As we entered the guesthouse, I laid him down on one of the couches and he soon entered a well deserved sleep.

How do you get Pineapples in Philadelphia?

On Friday, I anticipated having a big night out in Gisenyi, so during the day I attempted to take a nap. This was not successful. I was woken up by Jed who told me there was someone at the gate asking for me. Grumpily, I walked over and saw a short guy, about my age waiting with Isadole, our guard.

He greeted me and introduced himself as Gaston with very soft and slow English words. He then continued, “Samuel, I have a favor to ask you…there is someone who needs you, my sister, who really wants your help.”

I immediately became worried. What could be expected of me? I knew it could not be a request for money because this petition for assistance took on a much more grandiose tone. So, Gaston grabbed my hand and walked with me next door and I entered into a little shed that sold supplies like a local convenience store. Inside was a girl who also appeared to be my age working as the cashier.

I sat down on a stool and Gaston did the same next to me and he began to speak, “Samuel, Sam, you have become very well recognized here in Gisenyi, do you know that? Do you know that so many people here love you because you treat everyone with respect? Do you know this?”

I awkwardly smiled.

“Now the reason why I came to you, the reason why I woke you up from your nap, the reason why I brought you to our home and to our store is because I have a favor to ask you and I hope you can keep this favor.”

Gaston liked rephrasing ideas in slightly different ways.

“Now Sam, my sister is very shy. She is not like many people here that can just come up to you and say hi. Her English is not that good. Do you understand?”

By the way her sister was sitting right next to me too.

“She told me that she wants to meet you, so that you can you who she is, but she was unable to meet you by herself.”

I shook her hand and asked her name… Myriam.

“So Sam, now that you know my sister, now that you know Myriam, that favor that we have for you the favor we would like is that you remember our name.”

I looked blank.

“Yes, when you return to America and go back to your life, we would like you to think of us and my sister. Maybe even write to us to let us know how things are going in your life.”

I agreed despite my unfettered confusion, so, I did the next best thing, I changed the subject. I asked about their schooling and then I began talking about America and Philadelphia. Gaston soon asked, “In Philadelphia, we have been wondering this question. If a friend comes up to you and asks for a pineapple, how do you get it?”


“How do you get Pineapples in Philadelphia?”

I began to tell him about Supermarkets in America and how it is different than the market place here in Gisenyi. After this he asked, “When you return to Philadelphia, can you get for us a pineapple?”

A small crowd was forming outside the stand and I looked around puzzled. Was he talking about the actual fruit? Is this pineapple a reference to something else? I was totally confused, so I gave him the best scientific answer that I could provide. “In Philadelphia, I can certainly buy a pineapple for you, but if I put it in the box and mailed it to here in Rwanda, by the time that it arrives, it will no longer be a pineapple.”

So we exchanged contact information and before I left I promised both him and Myriam that I will never forget them, but after the pineapple request, how can I not.

Depakote for 80 cents

When Muttesi hugs me, her head reaches my chest, and I am not a tall person. She is a mother of a vibrant seven year old girl and they live next to our group’s guesthouse with their extended family. Muttesi appreciates the work we are doing in the region and even more, the joy we bring to her daughter whenever we play. Even though she cannot speak English, she always expresses her motherly appreciation, especially by giving hugs. One day, after she gave me a hug, the frail, tiny frame of her body became particularly evident. After releasing, a confused look overcame her eyes. She backed up several steps, staggered to her house and in her front lawn, she fell to the ground and began convulsing next to a family of chickens walking about.

Immediately, neighbors, friends, family members and I came to help. She was shaking and foaming from the mouth, but everyone seemed to stay calm, disturbingly calm. My Rwandese friend told me that this was a common occurrence in the country. He claimed that the genocide left many psychologically traumatized and they somehow relive their experiences in moments like these. However, it did not appear that this was a case of Post-traumatic Stress Disorder. So I asked family members several questions about these incidents and I learned that she lived in Uganda during the genocide and that she really never experienced a traumatic event. After Muttesi stopped seizing, I asked another of my Rwandese friends to translate for me and I asked her, “Do you have feelings that you will ‘fall down and shake’ before it happens, such as a premonition?” Her affirmative answer confirmed my suspicions of epilepsy.

She never received treatment her for her chronic illness of twelve years and I soon discovered the reason. Talking to several Rwandese men, they stubbornly insisted that there was no treatment for epilepsy in the country. “It is quite a common occurrence” a man driving a jeep stated, “people fall down and you see it and there is no medicine for it. There is no reason that she should go to the hospital.” Despite this man’s assertion, I was not satisfied. I could not live with myself knowing that I had at least tried to help out. I felt compelled to at least see that if there is no medicine in Gisenyi, then maybe that capital city of Kigali would have some form of treatment. So I marched down the road to the Hospital de Gisenyi ten minutes away. I was able to speak with a pharmacist and I simply asked if they treated epilepsy in Rwanda. His answer astonished me. “Of course we have medication for that. We have Depakote, Carbamazepine, Phenylbarbital, Clonazepam, Diazepam. They are right here on the shelf. Some I do not even need a prescription.”

I rushed back to Muttessi and informed everyone that indeed there was a treatment for her problem in the city and she agreed to go to the hospital after regaining the strength to walk, on the condition that I accompany her. Early the next morning, before the group’s departure to the village, I walked with Muttessi first to the crowded corridors of the clinic. There we met with a nurse and she wrote us a referral to see a doctor in the hospital. We left the clinic and walked to the hospital that was organized like a campus, with the waiting rooms outside and separate buildings for different wards. Both visits each required a thirty cent “co-pay” thanks to her solidarity card (insurance card that costs $2 a year).

In the hospital, the extent of her illness devastated me. She looked to be in her late 30’s, but according to the birth date on her card, she was really 22 years old… younger than I! When she stepped on the hospital scale, the arrow tipped to 27 kilograms… 60 pounds! Evidently, her seizures came several times a week, making her too ill to feed herself. She was wasting away and I worried her beautiful daughter followed in this line of neglect.

There were forty people lined up to see the doctor. I sat with Muttessi as long as I possibly could, but since I needed to catch the Red Cross vehicle to the village at 9am, I had to leave before she was seen. After spending a day in the village, where I was noticeably distracted from the group’s work, I returned to the guesthouse and saw Muttessi, limping down the dirt road. She had been in the hospital all day. When I met her, she showed me a prescription for Depakote. It cost 80 cents. In the US, this medication costs about $150 a month. I felt a sense of justice in pharmaceutical companies allowing the production of cheap generic drugs, but when she complained that the price was still too much, all notions of justice withered away. How can she afford 80 cents a month if she has no income? I could easily give her several dollars to cover the medication prescription for the year, but I refrained. This would violate the group’s value of sustainability. Yet, I felt criminal withholding money.

The Rwandese do not uphold the ideal of self-reliance like Americans do. Instead, family and social support networks play a much greater role in the care for individuals. I witnessed this phenomenon first hand when I gathered her family together. With the help of a translator, I described the pathophysiology of epilepsy as best I could. I told them that the medicine would not cure Muttessi’s epilepsy, but it would at least help, and allow her to eat, gain weight and maybe even work. I insisted that everyone in the family help to continually pay for her medicine and to monitor if she improves. Everyone agreed and promised to ensure that she receive the attention her condition deserved. I finally felt comfortable that I did everything I could possibly do for this wonderful mother. This is what it must feel like to be a doctor.

First impressions of Kigali

Two days of traveling in the airport feels like you are horizontally passing through time. We flew overnight from JFK to London Heathrow, waited around for twelve slowly moving hours and then another overnight flight to Nairobi for a short layover to our final destination in Kigali, the capital of Rwanda.

In Kigali, the road outside the airport looks like the clean manicured streets of Switzerland, but superimposed onto the landscape of a poor urban setting. While green grass and flower gardens decorated the median, women balancing fruit baskets on their heads and children running around in hand-me-down clothes several sizes too large rummaged around the sides of the streets, which I must point out lacked the sidewalk space needed to allow pedestrians to comfortably walk a good distance from maniac drivers. You really needed three eyes on the back of your head to truly feel safe walking.

It is important to note , that traffic is the number one killer of tourists in Rwanda.

After checking our bags into the hotel and freshening up, we walked around the small downtown region and there was not one significant moment that the group felt threatened or overwhelmingly harassed. We walked by a never-ending flock of children many holding hands as they ogled at us like they were tourists at a zoo looking at us strange creatures.

There is this benign energy here that I am unable to fully comprehend. Beyond the friendly faces that I find everywhere, the limbless street sellers, probably victims of the genocide reminded me that Rwanda is not teeming in innocence. There is a kindness here that I know hides its brutal past. Whether this is a type of unhealthy repression or moving on with life, it remains a puzzle that I will have to sort through many pieces just to understand its form.