December 15, 2009

by Kelly Tschida

Nyamata, Rwanda

The last few weeks I have been leaving the Nyamata Hospital to work in the community health centers. Getting to the centers often entails a few hours of travel in a four-wheel drive over rough, dirt roads.  There are 11 centers in the Burgessa district and more than 400 in Rwanda

These health centers are the front line healthcare for most Rwandans. Each center is responsible for a population of roughly 20,000 people. Patients using the public hospitals must start at these community based centers. If the case is complicated, they are transferred to a district hospital like Nyamata. The staff care for sick patients, deliver babies, provide vaccinations, distribute food given from the government and non-governmental organizations. They also have daily classes on topics such as family planning, gardening for nutrition, and proper sanitation and food preparation. These centers are truly the best hope the country has in the areas of disease prevention and early intervention. 

Sitting with the nurses to consult the patients has been interesting. The majority of patients have diarrhea caused by intestinal worms or they have malaria. Both are easily treated at the center. I am reminded how different the patients’ lives are from mine every time they leave the room. Because they have lived their whole lives in crudely constructed houses, they have often difficulty figuring out how to use the door handle. 

 I am always amazed by how long patients wait to come to the clinic. I saw one patient who fell down a well. She had a dislocated shoulder and could not see out of one eye because she had hit her head. She told us she was in the well for four days before someone found her. When I asked when it happened, she said 11 years ago! This was the first time she sought treatment. It is common for the patients to try treatment with a traditional healer before coming to the centers. Traditional treatments often involve scarring the body with a red-hot piece of metal. It is sad to see advanced medical cases that could have been avoided if the patient would have come to the center first.  

The centers see 80-160 patients everyday, which means they are usually running at full capacity. I am currently partnering with a member of the Access Project, a non-governmental organization that aids the Rwandan health centers by providing management, training, and infrastructure. Through this collaboration we are searching for a ways to increase the health centers’ capacity without adding more costs.   

The nurses do incredible considering their education and lack of resources, but there is only so much they can do. I feel fortunate to have been able to work with them and teach them some more advanced skills.

 

December 11, 2009

by Jenny Eaton Dyer, Ph.D.

Do you remember the story of Olken Foncime? He was the Haitian orphan who had congenital heart disease and received surgery from Dr. Christian Gilbert in October.

We just received a photo and an update. His doctor reports that since the surgery, he has gained 10 lbs. and has a remarkable increase in activity. He's doing really well.

Thanks to Dr. Gilbert for the update!

Worlds AIDS Day

Vanderbilt University

 

December 1, 2009

by Jenny Dyer, Ph.D.

Last night, Senator Frist spoke at Vanderbilt University's Student Life Center to over 250 friends, students, faculty, and guests in honor of World AIDS Day. The title of the talk: "Celebrating Life, Mourning Death: Continuing the Fight against Global AIDS" focused on where we've come from and where we're going, especially in terms of policy. Recounting his personal experiences in Africa with the AIDS pandemic and how he was able to use those experiences to shape and inform President Bush's decision to move forward to commit historic funding to fight a single virus, the Senator relayed the beginning of the President's Emergency Plan for AIDS Relief (PEPFAR) in 2003.

The Global Fund and the Millennium Challenge Corporation have also been important components to combat HIV/AIDS and other preventable disease.

The good news? Because of these historic initiatives, over 3.5 million people are now on ARVs (in 2002, only 50,000 Africans were on life-saving ARVs).

The bad news? The number of the globally newly infected continues to rise.

We have learned that the "health systems" approach is the best method. We cannot simply confront individual preventable illnesses in isolation. The world is interconnected, and that demands an integrated approach to global health.

Rooted in this principle, President Obama has put forth a comprehensive Global Health Initiative budget request for $63B over 3 years. This plan begins to focus attention on broader global health challenges, including the following: child and maternal health, family planning, neglected tropical diseases, cost effective intervention for HIV/AIDS, and a more integrated approach to fighting diseases, improving health, and strengthening health systems.

We are excited to announce that Hope Through Healing Hands will be sponsoring four Frist Global Health Leaders for 2010-2011 from Vanderbilt's School of Nursing, School of Medicine, Vanderbilt International Anesthesia, and Emergency Medicine.

World AIDS Day reminds us that there is much work to be done in terms of continued awareness, action, and advocacy. We encourage you to join us in the fight.

This Christmas, consider supporting one of our Frist Global Health Fellows. They are doing amazing work around the world saving lives. We are proud of our students and their care for the world's poorest.

 Sankofa, The Blair School of Music's African Performing Ensemble

December 1, 2009

by Kelly Tschida, Vanderbilt School of Nursing

I have now transitioned to working with the physicians. Each physician is responsible for admitted patients on one of the floors and seeing patients in the outpatient consultation area. This change has been eye-opening.

Each morning starts at 7:00 with prayers, singing, and a short sermon. Watching my colleges sing and dance is an incredible way to start the day. By 7:30 we start rounds. There are usually about 40 patients to see and it has to be finished by 9:30 when the outpatient consulting begins.

Outpatient consulting here is like combining your general practitioner's office and an emergency room. We see seven or eight patients an hour and you never know what will come in next. I've seen snake bites, scurvy, leprosy, severe malnutrition, and even a suspected case of Ebola virus. 

Malaria accounts for probably one-third of the patients. Most are not complicated cases and can be treated easily, but this is not always the case. Malaria patients can come in unconscious, delirious, and in desperate condition. A few days ago a six-year old boy was brought in with malaria. He was unconscious and was barely breathing. We ordered medication and oxygen to improve help him breath. To my horror and dismay, we were told the hospital was out of oxygen.

Probably sixty-percent of the patients have stomach problems, usually due to parasites. Sometimes they come in specifically because their stomach is bothering them, often it is just in addition to another problem.  Sadly, with proper hand washing and food preparation most of these cases could be avoided. The severity of the illness ranges from mildly bothersome to life threatening.

I work with the medical doctors both to learn and to teach. I have been able to see diseases here I might never see in the U.S. I'm also learning how illnesses are treated when there are very few resources. In return, I am able to provide the most current guidelines for treatments, offer diagnoses that are not commonly considered here, and share different assessment techniques.

Perhaps one of my biggest contributions is simply providing a different perspective. For example, an infant with a high fever and having seizures was transferred to us by one of the community centers. The records were unclear as to what medicine had been given already. The physician was torn between risking an overdose and not giving lifesaving medicine. He decided not giving the medicine was safer. When I suggested he call someone at the health center he stared at me blankly for a few seconds before realizing how simple it was. Cell phone coverage in rural Rwanda is relatively new so physicians were unable to contact health centers in the past. In the end the infant received desperately needed medicine and the physician learned a new way to help patients.

 

December 1, 2009

by Danielle Dittrich, Vanderbilt School of Nursing

  

Everyone in Xela is getting geared up for Christmas and consequently the patient load throughout the clinic is winding down. This week marks the last week of women's group meetings for the year. They will start again in January. I lead the closing project with the Tierra Colorada Baja group today. We made fertility necklaces out of brown, black, cream and red wooden beads. The placement of the different colors on the necklace indicate when the woman is most fertile and can be used either for family planning or to help conceive. The project was a big hit, but most importantly it sparked some interesting conversation and important questions.

Women in this conservative, traditional, Mayan, catholic (or evangelical) region have been more open to methods of family planning than I had anticipated. This includes hormonal methods of contraception. You wouldn't think that at first, based on the typical family size; every family has 6-7 children. However, the patients never understand why anyone would only want to have only 2-3 children as is common practice in the US. The only disadvantage is after 5 pregnancies, the woman enters the category of grand-multiparous which puts her at risk for pregnancy and postpartum complications such as placenta previa (when the placenta lies over the opening of the uterus preventing the baby from delivering vaginally without hemorrhaging) and postpartum hemorrhage. I vividly remember when I was working in Nashville with a lot of Latina immigrants, specifically many Guatemalans, a patient recounting her labor story. She had no information to give us about the child's birth on the intake questionnaire. She gave birth at home in her small village. She bled a lot, causing her to go into shock and unconscious. She didn't wake up for over a week and when she finally woke up the baby had passed. Luckily, I have not heard of anything like this with my patients here in the Valley of Palajunoj. However, I will say that this story served as a large motivation to come to Guatemala.

So although many women are willing to use contraception, access to contraception is still controlled by the man. Most of my patients tell me that they have to discuss their treatment plan with their husbands and come back in for a second consult once they decide, even if the plan does not pertain to contraception. Unfortunately, this has hindered some women from getting the treatment that they need.

However, despite the women's reluctance to participate in family planning by themselves we were able to discuss some important points. There are many myths circulating in the community about miscarriages. I have devastated patients come to me after miscarrying stating my auntie told me it was because I ate X or my mother-in-law told me it was because I looked at Y while I was pregnant. Whatever the reason they give ends up being, it always puts full blame on the pregnant women. Ridden with guilt, the patient usually tries to get pregnant again immediately. However, it is advisable that after a miscarriage that the pregnant woman waits a few cycles to get pregnant allowing the endometrial lining (where the fertilized egg will implant) to replenish so it can sustain a healthy pregnancy. The reality is that 1 out of 4 pregnancies end in miscarriage. This is the body's way of preventing the birth of babies with genetic defects that are not compatible with life outside of the womb. I am trying to turn around some of these notions of guilt and blame as women in the community are always held accountable for the child's health even when the child contracts a simple cold virus.

Although my time with the women's group is coming to a close, this is not just a time to tie up loose ends. With a month remaining in my time in Xela there is still time for new beginnings. Today the new group of medical students from San Carlos University arrived and I led a two hour discussion on the basics of obstetrics and gynecology. It is amazing to me that the last group of med students have already come and gone. This new group is very tentative, as is only natural in the first few days. The last group of medical served as a good practice run. But with only 3 weeks until the clinic closes for Christmas, I will have to teach the new medical students in 3 weeks what I taught the last group of students in 2 months. These medical students will serve as the future of the women's clinic in the month of January at least until we figure out how to stabilize the women's health program after I leave at the end of December (too soon).

By far the most exciting new thing that has happened is my collaboration with one of the community midwives (comadronas). After knocking on a few doors we came upon her house. She is well respected in the community as a traditional healer. She is the president of the association of comadronas in the Valley. In addition to being a midwife she also treats children. She specializes in illnesses such as the evil and uses only herbal remedies. Despite the image that this may conjure, she is very well trained and I respect her work as a health practitioner. She received training at the local hospital and rotated on the labor and delivery floor for some time. She is also a certified provider of APROFAM, a great women's health organization in Guatemala with very progressive ideas and projects. Through APROFAM, she is provided with and certified to administer contraceptive injections.  However, she insists that her patients get a pap smear and bring her the results before she will administer the injection. Though she does not perform pap smears herself, it is her way of incentivizing the women to seek a women's health service that she knows to be important in the prevention of cervical cancer.

When the women's group meetings pick up again in January, she will be coming to speak to the women about her work during the segment on leadership, as she is a recognized leader in the community. The collaboration is very important as there are some things that she can't heal with traditional medicine and there are some things that we can't heal with western medicine. I have no idea what to do with a return patient who is not getting better because she is convinced that she must first be cured of the evil eye. I have really come to understand how much faith plays into the idea of wellness, or at least alleviation from pain and suffering.

The commadrona works with some western equipment. She showed me her fetoscope, blood pressure cuff, etc. She understands how important high blood pressure can be for a woman in labor (signs of pre-eclampsia/eclampsia) and knows that with high blood pressures she needs to bring her patients to the hospital in the city. At the end of last week I dropped off some few remaining supplies that she needed replaced including a stethoscope, sterile gloves and drapes and new scissors for the umbilical cord. She will be attending the birth of a patient that I have been providing prenatal care. I have been invited to come to the birth. Her due date is December 15th so hopefully she will give birth before I leave on the 18th. This partnership will hopefully allow us to perform better prenatal care in the valley with a more fluid transition to the birthing process which currently is very disjointed.

November 22, 2009

by Jenny Dyer, Ph.D.

Belmont University: From right to left--Senator Bob Corker, Dan Haseltine, Bill Hearn, Dave Barnes

Belmont University hosted an event today with Senator Bob Corker announcing his co-sponsorship of the Paul Simon Water for the World Act of 2009. Joining Senator Corker included water activists Dan Haseltine and Jars of Clay with Blood: Water Mission, Dave Barnes with Mocha Club, and Bill Hearns of EMI for Healing Water International.

Global Health Activists, students, media, and others came out for the event to celebrate all the great work on global water issues being done and supported out of Tennessee.

On behalf of the Global Health Coaligion, we are proud of Senator Corker's leadership on Clean Water issues and Child Survival around the world.

For more on the event: Click Here.

Hope Through Healing Hands (HTHH) and Soles4Souls

Join Forces to Create "Hope4Schools"

Senator-Doctor Bill Frist's Hope Through Healing Hands joins Soles4Souls to provide shoes for

Central American, South American, and Caribbean children living in extreme poverty.

Nashville, TN -- Hope Through Healing Hands (HTHH), a nonprofit founded by former U.S. Senate Majority Leader Bill Frist, M.D., has announced a partnership with Nashville-based Soles4Souls to bring aid children living in extreme poverty in Central America, South America, and the Carribbean. 

Soles4Souls, an international charity that has distributed over 6 million pairs of new and gently worn shoes to people in need, both in the United States and around the world, has set up a website: www.hopeshoes.org to provide more information and to reserve sponsorships for new shoes.

"Shoes are integral to combating neglected tropical diseases, like podoconiosis and other soil-transmitted diseases, which disable, disfigure, and cause death to over 1.4 billion people around the world. Shoes are also necessary as a part of the school uniform in many countries. When a child living in extreme poverty receives a pair of shoes, you are offering her the opportunity for better health and an education," states Dr. Frist.

"We are honored to partner with Hope Through Healing Hands to benefit thousands of needy children in Central and South America," said Wayne Elsey, Founder and CEO of Soles4Souls. "Hope4School is a program that aims to give needy children the attire needed to attend public schools. A pair of new shoes is a simple way to provide access to an education and a better life for so many children," he said.

One out of five people living in the world today survive on less than $1 per day.  Over 20% of our fellow human beings are categorized as living in extreme poverty -- without electricity, running water or adequate clothing.  This includes footwear, which is a luxury item in many parts of the world.

Many diseases, infections and injuries are caused through cuts, abrasions and bacteria accumulated through the feet.  In many developing nations, the difference between receiving an education or being refused is simply a pair of shoes, the final hurdle to gain access to school because it qualifies the child as having an adequate school uniform.

In this way, a pair of shoes is much more than a covering for one's feet -- they are a ticket to a better future. 

About Hope Through Healing Hands

Hope Through Healing Hands is a Nashville-based 501(c) (3) that promotes improved quality of life for citizens and communities around the world using health as a currency for peace. HTHH supports health students and residents to do service and training in underserved clinics around the world. For more information, go to www.hopethroughhealinghands.org.

About Soles4Souls®

Soles4Souls is a Nashville-based charity that collects shoes from the warehouses of footwear companies and the closets of people like you.  The charity distributes these shoes free of charge to people in need, regardless of race, religion, class, or any other criteria. Since 2005, Soles4Souls has given away over 6 million pairs of new and gently worn shoes (currently distributing one pair every 9 seconds). The shoes have been distributed in 125 countries, including Kenya, Thailand, Nepal and the United States.  Soles4Souls has been featured in Runner's World, Ladies' Home Journal, National Geographic's Green Guide and The New York Times. It has appeared on CBS, ABC, NBC, FOX, BBC, CNN and thousands of regional news outlets across North America. Soles4Souls is a 501(c)(3) recognized by the IRS and donating parties are eligible for tax advantages. Visit www.giveshoes.org to offer help and receive more information.

Contact:

Elizabeth Kirk, Soles4Souls, 615-391-5723, elizabethk@giveshoes.org

Jenny Dyer, Hope Through Healing Hands, 615-818-5579, jenny@hopethroughhealinghands.org

 

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Hope Through Healing Hands (HTHH) and Soles4Souls

Partner to Create "Step Up Tennessee"

Senator-Doctor Bill Frist's Hope Through Healing Hands joins Soles4Souls to benefit over 100,000 Tennessee children in need of athletic shoes.

Nashville, TN -- Hope Through Healing Hands (HTHH), a nonprofit founded by former U.S. Senate Majority Leader Bill Frist, M.D., has announced a partnership with Nashville-based Soles4Souls to benefit over 100,000 Tennessee children who are in need of a good pair of athletic shoes. This number, based upon a random sample analysis conducted by the Department of Sociology at Vanderbilt University, represents a need in over 16% of Tennessee children in elementary and middle schools. The study was initiated and funded by both organizations.

Soles4Souls, the international charity that has distributed over 6 million pairs of new and gently worn shoes to people in need worldwide, has set up a fundraising website: www.hopeshoes.org to provide more information and to reserve sponsorships for new shoes.

"Providing shoes for children in need promotes wellness, physical education, and play; all key components for a strong, successful foundation in health and education. Fun exercise is one critical factor in combating childhood obesity and encouraging a healthier lifestyle," says Dr. Frist.

"We are honored to partner with Hope Through Healing Hands and work together to benefit needy children in Tennessee," said Wayne Elsey, Founder and CEO of Soles4Souls.  "Step Up Tennessee is designed to provide a simple yet effective way for people to assist a child right here in our own state.  It's important that we offer real solutions to our neighbors at the same time we are reaching out to people around the world," he said.

A sponsorship of $20 from an individual or company will guarantee that an at-risk child in Tennessee will receive a new pair of athletic shoes.

About Hope Through Healing Hands

Hope Through Healing Hands is a Nashville-based 501(c) (3) that promotes improved quality of life for citizens and communities around the world using health as a currency for peace. HTHH supports health students and residents to do service and training in underserved clinics around the world. For more information, go to www.hopethroughhealinghands.org.

About Soles4Souls®

Soles4Souls is a Nashville-based charity that collects shoes from the warehouses of footwear companies and the closets of people like you.  The charity distributes these shoes free of charge to people in need, regardless of race, religion, class, or any other criteria. Since 2005, Soles4Souls has given away over 6 million pairs of new and gently worn shoes (currently distributing one pair every 9 seconds). The shoes have been distributed in 125 countries, including Kenya, Thailand, Nepal and the United States.  Soles4Souls has been featured in Runner's World, Ladies' Home Journal, National Geographic's Green Guide and The New York Times. It has appeared on CBS, ABC, NBC, FOX, BBC, CNN and thousands of regional news outlets across North America. Soles4Souls is a 501(c)(3) recognized by the IRS and donating parties are eligible for tax advantages. Visit www.giveshoes.org to offer help and receive more information.

Contact:

Elizabeth Kirk, Soles4Souls, 615-391-5723, elizabethk@giveshoes.org

Jenny Dyer, Hope Through Healing Hands, 615-818-5579, jenny@hopethroughhealinghands.org

 

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For immediate release: Laura Lefler Herzog, 202-224-3467
November 12, 2009

MEDIA ADVISORY

Senator Corker, Jars of Clay, Nashville Music Community Lead Efforts to Deliver Clean Water to the World

WASHINGTON - U.S. Senator Bob Corker, R-Tenn., second-ranking Republican on the Senate Foreign Relations Committee, will hold an event at Belmont University on Monday, November 23 to highlight efforts to give millions around the world access to clean water and improved sanitation. Corker and Sen. Richard Durbin, D-Illinois, are sponsors of the Water for the World Act, S. 624, which sets a goal of reaching 100 million people with first-time, sustainable access to safe drinking water and sanitation by 2015. (See more on the bill below.)

Corker will be joined by Dr. Bob Fisher, President of Belmont University, as well as:

Jars of Clay, the Grammy award winning band which has launched Blood:Water Mission, a non-profit organization promoting clean blood and water in Africa.

Dave Barnes, a Nashville singer/songwriter involved with Mocha Club, an on-line community of people giving up the cost of two mochas a month - or $7 - to fund relief and development projects in Africa, including clean water.

Bill Hearn, the President and CEO of EMI Christian Music Group involved with Healing Waters International, a non-profit organization working to reduce water-related illness and death in developing countries.


WHO: U.S. SENATOR BOB CORKER, member of Senate Foreign Relations Committee
DR. BOB FISHER, President of Belmont University
JARS OF CLAY, Grammy award winning band who has launched Blood:Water Mission
DAVE BARNES, Nashville singer/songwriter involved with Mocha Club
BILL HEARN, President/CEO of EMI Christian Music Group involved with Healing Waters

WHAT: Water for the World Event
WHEN: Monday, November 23 at 10:30 a.m. CT
WHERE: Belmont University, lobby of the Gordon E. Inman Center

RSVP: Members of the media with questions and interest in attending the event should contact Laura Herzog at Laura_Herzog@corker.senate.gov or 202-224-3467.

All other individuals and organizations interested in attending should RSVP to Hallie Williams at Hallie_Williams@corker.senate.gov or 202-228-5515 by Friday, Nov. 20.


The Senator Paul Simon Water for the World Act of 2009, S.624

Sponsored by U.S. Senators Bob Corker (R-TN) and Richard Durbin (D-IL)

Ten years ago the late Senator Paul Simon wrote the book "Tapped Out," which warned of the world's looming clean water crisis. His call for greater U.S. leadership on this issue led to the passage of the Water for the Poor Act of 2005, which has given millions of people access to clean water and improved sanitation. Yet our impact could be much greater.

Today almost 1 billion people lack access to safe drinking water, and two of every five people do not have access to basic sanitation. These conditions contribute to nearly 10 percent of the world's disease.

Each year 1.8 million people-90 percent of them children under the age of five-die from preventable diarrheal diseases. Diarrheal diseases and related malnutrition account for virtually all of the deaths and nearly 90 percent of the overall disease burden associated with unsafe water supply, sanitation, and hygiene.

Water scarcity hinders economic growth, limits the opportunities of women and girls to work or go to school, and has contributed to political unrest in Sudan and elsewhere. Water and poverty are inextricably linked.

According to the United Nations Development Program, every $1 invested in safe drinking water and sanitation produces an $8 return in costs averted and productivity gained. Water is the right place to invest in these difficult economic times.

In fiscal year 2007, the U.S. obligated more than $900 million for water- and sanitation-related activities in developing countries. As a result, millions of people gained improved access to safe drinking water and sanitation, water resources are being managed more wisely and productively, and many communities are enjoying greater water security. In addition, nearly 2 million people gained first-time access to an improved water source, and more than 1.5 million gained first-time access to basic sanitation. We can do more.

To strengthen U.S. leadership on this critical issue, U.S. Sens. Bob Corker, R-Tenn., and Richard Durbin, D-Ill., have introduced the Senator Paul Simon Water for the World Act of 2009, S.624, which sets a goal of reaching 100 million people with first-time, sustainable access to safe drinking water and sanitation by 2015.

The bill implements recommendations made by the Center for Strategic & International Studies in their recently released report, "Global Water Futures." The bill would expand safe water and sanitation efforts in priority countries, promote research and technology development, and improve training and technical assistance to help meet the water needs of the world's poor. It would also increase capacity and sharpens the focus at USAID and the U.S. state department to implement these activities.

Corker and Durbin introduced the Water for the World Act on March 17, 2009 and it has been referred to the Senate Foreign Relations Committee. Specifically, the bill would:
-Establish an Office of Water within USAID,
-Establish the Bureau of International Water under the Under Secretary for Democracy and Global Affairs,
-Require a revisit of or the development of a strategy to meet water security goals,
-Establish a water and sanitation managers program in every priority country to train local leaders in best practices,
-Provide grants for low cost and sustainable technologies suitable for high priority countries, and
-Require an assessment of current and future political tensions over water resources and the expected impacts of climate change on water accessibility.


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Todd Womack
Chief of Staff
U. S. Senator Bob Corker

by Kelly Tschida

November 18, 2009

Nyamata, Rwanda: Today

Although the Rwandan genocide occurred fifteen years ago, I see its impacts everyday in the hospital. The region I live in was an area of great violence. There is a memorial site here in Nyamata were 10,000 people crammed into a small church seeking refuge, only to be killed. It is hard to believe that the reserved, kind spirited people I know went through such a horrible event.

I never ask about peoples' experiences, but the genocide is brought up many times a day. Medical histories are incomplete for many young adults because they are orphans. Patients come in with disfiguring scars, old bullet wounds, and HIV as a result of the violence they experienced during that time. Sometimes they say it happened during the genocide, mostly they say it happened "15 years ago". I have been told the mental health floor gets very busy with post traumatic stress disorder during the same months that the genocide occurred. Other stress related illnesses, such as stomach ulcers are common complaints of our patients.

One consequence of the genocide that has made a big impression on me is how the Rwandan people react to death. I noticed when patients die the family members never show outward emotion. There is no crying, no awkward silence or loud outbreaks, and no consoling of one another. They seem to concentrate on packing up the belongings and taking care of business. When I asked one of the nurses about it, she said that is the way Rwandans are. I thought she meant it was cultural, so I said "So it is normal?" She replied "No, it's not normal. It's because we saw too many things in the genocide."

The hospital staff deals with genocide related problems the way they would for anything else; no sorrow is shown or empathy given and no further questions are asked. They take note of the history in a professional manner and together we all simply move on to find the best treatment.

 

 Inside the Nyamata Church Genocide Memorial. Each bundle of clothes belongs to a victim.

Milles Collines, the real Hotel Rwanda.

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