Gimme Ten Bucks And A Head Start

I am having one of those days (or one of those slew of days) where you just feel, off.  Where I just want to be left alone.  Where every minor thing somehow is wrong.  Where I don’t feel right in my own skin.  Where I somehow manage to be pissed off by my own damn self, thinking ‘god I wish she would fuck off right now’.  My head doesn’t shut up and my body doesn’t feel right.  Always thinking thinking thinking.  Whining.  Complaining.  Fidgeting.  Uncomfortable.  Irritated and anxious.  Jesus Christ.  This blog is pissing me off.  How is this possible?

Seriously.  What. The. Fuck.

This isn’t actually that unusual.  Well, ok it is, but when I get glimpses of this feeling it can generally be solved by a long run and lack of human interaction.   Which I fully intend to use as treatment tomorrow morning.  But this time it’s a bit more than a bad mood.  My usual PMS bullshit combined with my existing weird mood of late has seemingly formed some sort of turbo-freak of a state of mind.  So what’s the difference?  Hm.  Shall we?  Sure.

Lately (more specifically ever since the clock struck 2011), it’s been lurking.  I suppose the easy thing to say is to admit that I’m freaked out that we are now coming up to the middle of month 5 of a 6 month program.  That I am scared shitless of leaving.  That I’m scared I’ll be going home to a life that I don’t know or care to understand.  That every time I think about the possibility that I might never see the boys again I feel like I could cry and never stop.   I find myself between two worlds.  Two times. The start of this experience – and not just this internship, but the entire experience that encompasses it – and the possibility of the end.  The further I move from the beginning the closer I get to the end.  And I guess I just don’t know what that means. 

I think the other, more difficult reason to admit for my recent peculiar state of mind is that I’ve realized I have absolutely no fucking clue what I want to be when I grow up.  For four years it was “nurse”.  My passions were high and my goals clear.  Even six months ago I knew.  Even one month ago.  And now I feel like I don’t have a clue in the world.  I can do anything.  Anything in the entire world.  And I know it, 100%.  And while most of the time I find this to be a huge rush and one of the most exciting things imaginable, as of late (again, alter ego Caroline emerges) it has felt more daunting than anything.  Because there are so many wonderful things to feel passionate about I find myself without for any of them.  It used to be that there was an end-vision I saw for myself; there were a million and one ways to make it happen, and I was happy to just stumble around and do things as they came – always with faith that it would get me there.  Now the vision is blurry, and I find myself unsure of which path to take to get to where I used to want to be.

Ok. So, I just stopped writing after that paragraph (because I heard how god damn depressing it was) and went and sat for about 30 minutes by myself in the dark (I know, strange girl.) and then came back and re-read what I just wrote.  And you know, I think I had the same freak out before I went away to university.  Haha! So much for growing up! Wow.  Not sure what just happened but I literally just started laughing as I read that and now I don’t really give so much of a fuck.  I can’t believe I’ve been so freaked out.  And I can’t believe I’m still having these brutal anxieties about not knowing where I’m going.  Because that always ends up being the best part.  I mean god damn, imagine if I travelled like this! I would want to absolutely kill myself! 

On a more positive note and hugely less emo note, as painful as it will be to leave, I am getting excited to go home (never thought I would say that).  I Skyped with Billy the other day… he was showing me him and Jensen’s new house (amazing, by the way - I wish I could live there).  When he showed me the deck I saw all the snow on the ground, and to Billy’s serious discomfort (sucker) I started crying – in the middle of the day, at work, by myself, in front of my computer.  I had certainly thought about the snow, at Christmas I thought about my family and all the traditions, on NYE I thought about all my friends and what they’d be doing.  Not once did any of those things get me the slightest bit emotional or sentimental.  But a glimpse of real life (albeit via webcam) Canadian snow got to me.  God damn snow.  Always causing shit.   Getting off this tangent:  Even though I am going to be severely drunk (or hungover, depending on how this master travel-plan goes), it is going to feel so good to step off of that Air Canada flight into the Halifax airport, where the accents are thick and the staff are Nova-Scotia-tartan clad. 

I’m starting to miss my family – especially my big brother.  It’s been a long time since I’ve gotten to spend much time with him.  Growing up we always sort of teamed up on Jensen, we were around the same age, and even though we fought a lot we were always connected.  This is a really strange memory to look back on fondly, but I think about it often when I think about Chris:  A few Christmases ago I came home in the morning super hungover and passed out on the couch.  I was in seriously rough shape.  Chris made me a grilled cheese sandwich and put ketchup on the side, and brought it to me with a glass of water.  I ate a bite, took a sip, and passed back out (to make sure I could stomach it).  Bite, sip, sleep.  Bite, sip, sleep.  This continued for the rest of the day.  He hung out with me in the living room, laughing at my slow progress, but keeping me company and entertaining me nonetheless.  It took me the entire day to eat that grilled cheese.  Really not sure why but that is one of my all time favorite memories of him.  This holiday season he went on an adventure to Australia and New Zealand.  Before he left I talked to him on the phone and he just sounded so different.  He didn’t sound like my brother.  He sounded like a man.  I guess I sometimes worry that we’re growing apart.  We are so different and lead such separate lives.  Neither of us checks in that much with each other or with our parents; we both keep to ourselves and do our own thing.  But I still need him.  And I still feel him. 

I’m also really excited to see Jensen.  We didn’t get along in the conventional sense for most of my life (it started with the ice down the diaper), except those times when we would all cover for each other for a broken window (or kitchen lamp post – god I wish we still had that), but last year I lived in Edmonton and I had never been more thankful to have her around.  She is getting married this April in Cuba and I am jacked for the wedding.  Her and Billy are perfect.  They understand each other and work hard at their relationship because they know it’s worth it.  Call me crazy, but I think that’s actually quite rare and very special.  I’m glad I get to be around for a while before we go our separate ways again.  I want to see her in this time of her life.  Jensen has always been two people – sophisticated city and hometown silly.  I think she will always be both.  But I want to be around to see her grow into the woman she’s been becoming for so long.  I’ve always kind of looked up to her.  Not for her outstanding morals or dedication to society, but Jensen has just always known who she is.  She makes it easy to love her.  She is positive, passionate, and deep down she is extremely kind and empathetic, and she would do anything for her family.  Even when she’s in your face with an irrational mood swing, it doesn’t even phase me (or Billy, he understands her too) because that’s just Jensen.  She has always been upfront about who she is and so even her worst qualities aren’t bad, because it’s her.  And she is letting you see that.  Another admirable quality.  Billy is lucky to marry her.  And she is lucky to marry Billy.  Hence why I’m so jacked for this wedding – two of the people I love most in the world are getting married and celebrating.  Wouldn’t miss it for anything.  

And Billy.  Well.  I’m not even going to say anything about Billy because A) it would make him uncomfortable to be talked about on a blog and B) I just don’t need to, he knows what’s up.  Boom.

So yes.  I am excited to get home next month (and dreading the two week re-entry program).  I start teaching quite intensively this Monday and am getting nervous about it.  But it feels good to be working again.  I will be teaching pretty much all day every day, Monday to Friday, 7am-5pm (except Friday afternoons, like hell I was doing that eesh).  Since Lau and I splurged and flew back from Tanzania instead of another 36 hour bus ride, we’ve decided to make some cuts to ease the financial blow.  Until the last week (when we plan to go ape shit in Kigali) we aren’t going to any of our favorite restaurants (this is pretty much the only cut…but also pretty much our only expense).  We have a final trip to Kampala to plan to white water raft the Nile and bungee jump, and I promised a final visit to Eric and Moha.  The next month and a half are going to fly by.  I can remember when I said those words in November (‘before you know it it’s going to be 2011 and we’ll be on our way out’).   I’m trying to remember to take this experience for what it is.  The ups and the downs (especially the downs, she reminds herself) are all a part of it.  I am learning from all of it.  This is the experience. This is exactly it.  

Mom’s Rwanda Wrap-Up

Home in Fredericton, after my Tour de Rwanda with Caroline. I am cold, and lonely. Wonder if I will ever wear all the great jewelry I got, as it will seem out of place here. Like an orchid in a cow barn.

I miss the moto’s, African tea, sunshine and heat. Do not miss walking uphill and really dirty feet. I miss Caroline, and her roommate Lauren. Wonderful hosts. They have an impressive lust for food. Surpassed only by their exuberance for life.

Have met some people I will remember for a long time. Peter, Egide, Hilaire, Eric, Mo, and Jonas. They might not have a Visa Gold card, but they have the ability to make you feel welcome, and special. Black is the new gold.

Caroline had her Jurassic Park moments. And I was there to share it with her. That’s what I liked the most – being able to fly half-way around the world to spend time with Cano. The child who took care of me in her adopted country. I got to stand back and watch her. I was humbled.

The sights of Rwanda will stay with me for a long time. I want them to. Their memories will rescue me, when life just gets a bit too foolish here.

Mom's First Blog, written Dec 6th

TIA.

This is Africa.

Last night went to pick up luggage, which did not come with me.  It was open, and yes, the electronics I brought for “the people” were missing.  Yes, that happens in Canada too, however, the paperwork here is a little more challenging. I pretty much had a breakdown.

Rwanda really is the Land of a Thousand Hills. Makes running hills in Fredericton seem rather pointless. Jesus, fill two large jugs with water, and walk up a half-dozen hills to get home, and there’s your workout. 

Cano lives at the end of a very sketchy dirt road. I have to hold hands with her at night walking home. The same situation would be unheard of in Canada. It would be too dangerous.

She has no running water. Well, there was water Saturday morning for a couple of hours. That means the toilet does not flush. Got that? I have been scolded for using three cups of water from the boiled supply per day. Yes, I washed my face, and brushed my teeth three times a day. I have since cutback.

My lungs are sick. Air pollution in Kigali is remarkable.

TIA.

This is Africa.

Peter has his tuition. He is registering for school this week. He is grateful, gentle, and so appreciative of the opportunity to get a degree. Sustainable kindness.

The roads impress me, cleanliness (exception – dreadful air quality), developing infrastructure (exception – water supply), skilled matatu drivers.

As we drive through the countryside on the small, very packed bus; the

children are thrilled to see my white face, and wave and shout. Maybe they think I’m Angelina Jolie.

Tonight is Trivia Night at some Italian Restaurant. I am due for some competition.

Long Is Afternoon Shadows

Mom and I had the pleasure of a three hour bus ride to Kibuye today, and that is not at all intended to be sarcastic.  These hills never fail to move me.  Never fail to bring me back to center, back to what I need.  Because sometimes I forget.  I don’t know why, maybe it’s my task-oriented western culture or maybe it’s my own freakish mind, but I get so wrapped up in things that are or aren’t happening thousands of miles and minutes away from me.  I am unintentionally escaping this experience.  I drift into the future – what will happen, what will I do, where will I be, what is the next thing – and I forget what is going on right in fucking front of me. 

These hills remind me.

It’s so easy to slip into it, so easy to focus on what is to come instead of what is here.   Because yes, I am going to have to find some sort of employment, an apartment, feed myself, and support myself (not to mention repay my debt to my father and the ever-looming government of Canada).  And yes, there are relationships with people that I have back home that I want to keep, or even develop.  And there are things about home that I don’t want to lose or forget about or put on a backburner.  But how can I accomplish all of this without sacrificing the uniqueness and wonder of this opportunity I am living?  

What I really need is balance. 

Libra seeking balance.  What else is new.  Christ.

Slow down. Breathe. Be here. Open your eyes.  

Giver. 

Goodnight, Moon.

I saw Patrick today.

I saw him.

He saw me.

He ran to me.

I saw him.

I felt him.

He was there.

We were there.

His smile.

His heart.

His heart.

His heart has gotten so much worse. 

He is twice the size he was in April.

His liver is twice as big.

His kidneys are twice as fucked.

His organs will fail soon.

He is so much further, closer.

His smile.

I found out today that Patrick’s mother had 8 children.  Four of them died the same way Patrick is going.  And he knows.  He knows.  He watched them die before him. His regional hospital used to sing with him a song about heaven – about meeting your family and friends, of a better life.  One day he asked why.  Why were they singing this with him?  Was he going to die?  Singing about his own end.  He knows. 

He will die.

The world will never see his smile again. 

He will die.

Leaving the hospital, I have never felt more helpless and useless and ashamed and unskilled and unworthy.  I asked Egide what I should do.  What should I do.  Please.  What should I do.  And he told me this:  We can only do what we can.  You can't pay for what he needs.  But you can come and see him, take care of him, make him laugh, bring him joy.  That is what is going to change the world.

Thank you for getting me out of my own head, and helping me realize what I already knew.  I love you.

Patrick, my man, if you’re going out, you’re going out laughing, going out smiling.  You are taking care of me, making me laugh, bringing me joy.  You are changing the world.

 

In A Perfect World, Ja Rule Would Be Putting Out New Hits.

Thanks to a glorious (and sometimes not so glorious) 9 and 6 hour time difference - depending on which area of Canada I’m wanting to talk to – I find myself in a unique position.   When I get to work in the morning, people are doing one of two things – heading to bed (the non-insomniac ones anyway), or drinking profusely.  Subsequently, when I am indulging in a Primus (or two or three), people back home are usually enjoying a nice quiet afternoon.  Although, I must say, the drunken-incoming-Skype-call-while-I'm-at-work remains a personal favorite.  Keep it up, Canada.

Where is this blog coming from?  Well, its Friday morning.  This means that the Thursday crowd is at the bar or stumbling home.  It’s odd to feel bar-ready first thing in the morning when you get to work.  But, I’m enjoying it. 

Anyway – the club scene in Kigali has been treating me well.  There is always the old option of Cadillac, where I first experienced “real” dancing, where gin and juices glow bright blue, and where finding a dance partner is as easy as looking in the mirror.  Then there are the other, less flamboyant clubs such as One Love, KBC/Planete, Top Tower, Sundowner, Papyrus, tons of other small local spots, and finally, the legendary strip bar (Sky Hotel) for which I doubt I’ll be able to muster up adequate numbness to enter.

Going out in Kigali is a bit of a game.  The night starts off Western enough: You’re at a restaurant or a house of one of your friends, drinking, card games, music, shinanigans.  Then you step outside.  You find a moto (at night its not uncommon to squeeze on two passengers + driver – the one sitting on the back gets to wear the helmet as they tend to fall off – since motos are not as abundant in the wee hours).  This is where you start to notice you are not in Kansas.  Moto drivers can generally weasel higher prices since we are buzzing, giddy, and have pockets full of money intended for drinks. 

For Cadillac, the drive through town is like a calling.  I say this because Cadillac sports a fine flood light that moves across the city beckoning the antsy to its depths.  Either way, you get to the bar and get in line (if there is one).  Here is where you can hear the beats of familiar songs like Letting Go – Sean Kingston ft Nicki Minaj, Baby By Me – 50 Cent, Loose Control – Timbaland ft Jojo, and Say Ahh – Trey Songz and you find yourself almost frustrated to get in there. 

Once you’re at the front, you pay your cover (again, if there is one) and get frisked at your own risk.  Head on in.  Welcome.  Karibu. 

I remember my first time stepping into Cadillac – I was like a kid in a god damn candy store.   The beats. The dancing.  Holy fuck, the dancing.

There is no such thing as lack of rhythm, and less than no such thing as shyness.  Dancing as god intended, as it were.   Often times as a white woman letting loose, there is an overabundance of African-Male-Attention.  It’s usually not a problem, we’re big girls and can take care of ourselves, but it often gets annoying.  However, I would say it’s always been worth the hassle because they just don’t give a shit.  You can dance with whoever, whenever, wherever, however.  Talk about luxury. 

With this whole visa thing I’ve been in need of some serious stress relief. 

So, pretty much wrote this to torture myself – I am just itching to go out tonight – but there is another 12 hours to go in this damn day and I’ve already started the playlist designed for these nights. 

That’s it for me.   For those of you who are lucky enough to be on the receiving end of my drunk dials, well, you’re welcome for tonight’s conversation.

I Really Don't Know Clouds, At All.

I’ve been meaning to write about clinical for a long time.

I’ve been waiting until I didn’t feel so much about it to post. 

Clinical is fucked.  At the very least it is a huge shit mix of emotions.  Because it’s so hard to describe how I actually feel about it, I’ve taken three separate posts and put them into one. 

In my heart, clinical here is so many things.  It is terrible, it is beautiful, and it is real.

The terrible.

Sometimes things here hit you. 

Some days, you just really see it.

Some moments, you are so aware.  So aware of where you find yourself.  The reality of this place.  The reality of this life.  The reality of their lives.

Some days, Rwanda breaks me. 

And I see you standing there, wanting more from me, and all I can do is try. 

And I see you standing there, I’m all I’ll ever be, but all I can do is try.

Looking around the room.  Every single patient.  Every single one.

You deserve better.   You deserve the life I had.  Have.  You are deserving.  You are deserving.  You are beautiful.  You are better than this.  You are better than me.  I know what you think about me.  I think it too.  I don’t know what to do.  One step towards you, one step away from them.  There are so many.  You deserve. 

Sometimes it just feels like you are falling.  Some days, you are just waiting to hit the ground. 

The beautiful.

I remember the first day I met Patrick.

I remember my first day in the hospital. 

I remember the first time I cried here.

I remember the first person whose hand I held.

I remember the first time I really saw this place.

I remember feeling like I needed to run and never stop.

I remember looking again.

I remember seeing it again.

I remember the beauty of Rwanda.

I remember the way it makes me feel.

I remember the most painful kind of wonder.

I remember laughing.

I remember when she gave her last.

I remember the mystery she held in her smile.  

I remember the indescribable feeling of my patients.

Their eyes. Their hands.

I remember sitting on his bed.

I remember looking at each other.

I remember feeling so privileged to be allowed into their lives.  To be invited.  To be there.  To be only there. 

I remember knowing that this was it.

I remember feeling love.

I remember feeling my heart beat.

I remember feeling the walls come down.

Rwanda saved me.

My patients saved me.

They let me out.

The real. 

(I wrote this article for New Brunswick Nurses Association)

In April 2010, I completed a one month consolidation in Butare, Rwanda, working in various sectors of the regional hospital.  When I got home in May, the reality of what I had seen and the things that I had done truly sunk in.  Despite the emotional stress caused by practicing my chosen profession in a ‘developing’ country, I fell in love with Rwanda, ‘pays des milles collines’.

As a result, I am now back in-country on a six month internship with the Coady International Institute, as funded by the Canadian International Development Agency (CIDA).  I have been given the daunting task of teaching nursing students, supervising clinical placements, and participating in community outreach programs.  On paper, this sounds simply peachy.  In reality, it is quite the opposite – neither simple nor peachy.

Teaching students here is, challenging.  Everything from preparing a two week course (that should be taught in three months) with hit-or-miss power and internet accessibility to trying to explain the mechanism of heart failure to students in what is their third (and sometimes fourth) language is taxing.  But this is the least of my stress.

My great strain and my great love: Clinical.  I am realizing and appreciating more and more everyday how wonderful our education system is in Canada.  Over four years, our professors manage to instil in us an unfailing sense of responsibility and accountability, coach us through endless skills and the theory necessary to perform them, and finally by some miracle they teach us how to think critically.  These values are seemingly non existent in the majority of nurses here, and consequently my students are on the same bleak path.  This is the foundation of my stress, and of my efforts. 

Apart from the abysmal conditions, lack of basic resources, and intense diseases for which patients resist seeking medical attention until absolutely necessary, the health care system is in distress. The medical model is highly engrained into their practice, and most nurses would never think to perform any task that was not outlined by a physician, and are flabbergasted when I question an order.  Furthermore, there seems to be no connection made between nursing interventions and the disease process.  For example, it would be rare to find an upperclassman able to link the diagnosis of ‘diabetes’ to peripheral vascular disease, amputations, confusion, coma, neuropathy, or any of the associated assessments and interventions. Wounds on the foot of a diabetic are not attributable to diabetes, that patient simply has wounds for no other reason than they are just there.  It is more frustrating than I can say. The discrepancy between their standard of care and that of Canada is monumental.  To have the lives of patients under their locus of responsibility makes me extremely uncomfortable.  So, I am working to try and ease this discomfort. 

In Rwanda, progress seems slow. And that’s probably because it is.  Change takes time, and real change takes a long time.  It took Canada half a century just to move away from the medical model.  Let us not dismiss what has been done here. Yes, Rwanda has problems, big ones.  They can not be conquered easily, quickly, or simply.   But it is worthwhile to recognize the reality of where these changes had to come from. Following the devastation of 1994, the country – which was ‘third world’ to begin with – had to be rebuilt from scratch.  It means starting some semblance of an economy from scratch when your country is millions in debt and all productive land and infrastructure has been destroyed, dealing with the ongoing struggle of refugees and rebel groups, gaining the trust of a population who just witnessed one of the most gruesome genocides in history, trying those responsible in a fair way, and reintegrating killers with family of the killed, in a country so small that it is inevitable they will have to see each other and work together.  To build peace in a country of war, to build love in a country torn apart by hate, and to build trust in a place where it is long gone.

While these tasks may not seem directly linked to the delivery of health care, we must realize that each and every item destroyed – whether it be a building, a piece of land, or a life – it all relates to the social determinants of health of the population, and the ability of the country to provide optimal care and education.  Every aspect of health care had to restart in 1994, so this entire system is only 16 years old.  Furthermore, the sheer weight of demand is more than any country could cope with. In a country roughly half the size of PEI, they have managed to fit over ten million people.  Ten million. In half the size of PEI, they have squeezed almost one third of the entire population of Canada, the second largest country in the world.  The thought alone is unfathomable.  Unsurprisingly, Rwanda has the highest population density in sub-Saharan Africa.  Furthermore, over 75% of the population lives under a dollar a day, and 90% of the population lives under two dollars a day (Human Development Report, 2009). The same report has ranked Rwanda 167^th out of 203 countries on the development scale. 

As a nurse, and generally as a human being, I know that a high population density coupled with high poverty rates present a seemingly insurmountable struggle.   Health suffers, happiness suffers. The apparentness of this struggle is not lost on the people of Rwanda, but you will never see them stop fighting the uphill battle.  There are wonderful things happening in this country everyday.  I have so often seen families with nothing give what they have to other families who have nothing.  That is rare in this world, and that is something of greatness.  That is something that shows the power of this place.

Rwanda has made incomprehensible progress as a people.  I feel confident that most other nations could not have done what Rwanda has done given the same circumstances.  There is something here.  There is a spirit and a strength here that I have never experienced before.  You can feel it in the hills, and you can see it in the people.  There is much to be done, but the catalyst for change is already in place – it is in the hearts of the Rwandese people.  The change is possible, and they are able. 

Rwanda is so many things.  And I have not even scraped the surface.  Rwanda is not simply my emotional experience.  This is a real place doing real things.  It isn’t a figment of my imagination.  It is not here solely for me to experience.  This place is actually happening.  These people actually live here.  They actually live here.  This is real.  I have to remind myself of this so often. 

I’m always looking at this country and these people through my own eyes.  Everything is affected by my life’s experiences and by what I’ve known and done and thought and not thought.  Rwanda is not mine.  It is not anyone’s.  The longer I spend here the more I realize that I am not here, not really.  So, please take my stupid blog posts for what they are – some random 22 year olds half-assed impressions and lack of impressions about a place she completely misunderstands.