Rwanda trip 2009
Sharon Foster, MD
I was privileged to go on a ZOE Medical mission trip to Rwanda in 2009, fifteen years after the genocide. There were 16 members of the team lead by Susan Graebe. This was my first trip to Africa and it began a love affair with this beautiful continent and its courageous, gentle and hardworking people.
In 2009, Rwanda was still suffering from the genocide that occurred in l994. In the course of three months, ethnic cleansing caused the death of over one million citizens leaving many children as orphans. The AIDS epidemic was also raging across the African continent, killing thousands of parents, and leaving their children orphans. (The retro viral medications had not yet made it to Africa.) As part of my Pediatrician duties I examined many of the children cared for by the ZOE organization. By and large these children were doing physically well but many still suffered mentally from years of loneliness, grief, and neglect. ZOE was doing an admirable job helping to heal these wounds by placing the children in work groups which became their family and having local churches nurture them spiritually. Poor children in the surrounding villages, even those with parents struggled as well.
One morning, I was seeing patients in a make-shift clinic and a young mother brought her very robust 12 month old twins for me to examine. Both of the twins were growing appropriately and meeting their developmental milestones. The mother was still breast feeding and the babies were being supplemented two to three times/day with the standard diet of rice and beans. I complemented the mom on what a great job she was doing parenting her children. She kept repeating the question, are you sure they are ok? Finally, I asked her why she was so concerned about the health of her children. The mother explained that she was HIV positive and she knew that there was a 15% chance that she would transmit the virus through her breast milk. However, she could not afford the baby formula and the twins would starve without her. I reassured the mom that she was doing the right thing (this was the WHO’s advice at the time) and I saw no physical or developmental evidence that her robust active twins were infected with HIV. I thought to myself, however, no mother should have to make this choice!!!
Another mom brought her 12 year old son in for me to examine. He otherwise was a healthy young boy but in a freak accident had injured his left lower leg and developed a leg infection that had persisted for 6 months. Pus was oozing from 3-4 different sites from the lower leg. I was quite sure that the infection had spread to the underlying bone. I explained to the mom, that her son would need an operation to remove the dead and underlying infected bone followed by 4-6 weeks of I V antibiotics. The bone would regenerate and he would be a healthy boy once again. She told me the Rwandan doctors had given her the same advice but she could not leave her five other children to go with this son and cook his meals while he recovered in the hospital. Food was not provided for hospitalized patients and their families were expected to cook and bring fresh food daily to their family throughout the hospitalization. I gave this boy two weeks of a strong antibiotic to buy some time but pleaded with the mother to make some type of arrangement for this young boy to go to the hospital so he could be cured. Again, no mother should be asked to make this choice!!!!
Finally, our group wanted to go to a local church for a Sunday morning worship service. We had seen the Pavilion like structure several days earlier with its corrugated steel roof and open at the sides. I started thinking about the three-hour service, with the songs and sermon all spoken in the local dialect, but mostly the extreme heat which would occur under the steel roof as we approached the noon hour. I must confess, I had a bad attitude and told our leader that I would leave after an hour and walk back to the hotel. Forty-five minutes into the service, the pastor in perfect English asked our leader to introduce our group. Through an interpreter, our leader explained that we were from the ZOE organization and our mission was to bring financial help and hope to children orphaned by HIV and the genocide. The minister and congregation knew well the work that ZOE does and we became instant rock stars. The minister preached the sermon in Kinyarwanda, the local dialect, but had a young women studying at the University come up front next to him and interpret his entire sermon to English so we could understand. Needless to say, I stayed the entire three hour worship service and felt honored and blessed.