helen weld public health

Rwanda

Boomerang. . .

“You can plan all you want to. You can lie in your morning bed and fill whole notebooks with schemes and intentions. But within a single afternoon, within hours or minutes, everything you plan and everything you have fought to make yourself can be undone as a slug is undone when salt is poured on him. And right up to the moment when you find yourself dissolving into foam you can still believe you are doing fine.”
― Wallace Stegner, Crossing to Safety

Stegner’s quote has always hit a deep chord with me, but minus the “dissolving” aspect, because I am doing fine! Over the past month I have had an opportunity to fully realize the rest of his words in a powerful and personal experience.

I was five days into my fifth time at Gardens for Health (a planned two month stint with a definite agenda of projects) when out of the blue I awoke from a great sleep having significant discomfort with basic breathing accompanied by a sharp pain in my posterior chest wall. Intuitively, I felt that this was not a pulmonary embolus, but most likely related to bronchiectasis, a chronic pulmonary condition I have dealt with for the past thirty years. Coincidentally, this also happened to be the exact 20^th anniversary when I had the lower lobe of my left lung surgically removed in 1993.

Without wanting to be an alarmist or go into “freak out” mode, I observed my signs and symptoms for 36 hours and started my ‘usual’ regimen of antibiotics. I felt in control, not feeling as though I was experiencing a medical emergency. I felt safe and trusted my mind and body. When it became obvious that this was not a transient situation I decided to enter into the Rwandan medical system and went to the emergency room at King Faisal Hospital, the best Kigali has to offer. It was the beginning of a ten day long swirl spending many hours at King Faisal as an outpatient; including visits to the emergency room (twice), radiology (chest x-ray and CT scan) laboratory and having a consultation with the only pulmonologist in Kigali. He was an avuncular type who I intuitively trusted and respected and South African trained. His diagnosis was a significant abscess on my lung, which would require surgery “sooner than later”. This set the ball in motion to return to the

USA

as soon as possible for further evaluation and culminating with thoracic surgery on 10/10 in Portland, Maine with the same thoracic surgeon as 20 years ago.

In Kigali it was humbling to realize how fortunate I was to have the capability (both financial and self advocacy) to readily access these medical services. It was enlightening to experience the medical system in

Rwanda

first hand. “Pay-as-you go-in-cash” was a new approach for me. (An emergency room visits was ~$8 USD, the CT scan with contrast ~$145 USD, and the specialist visit ~$16 USD.) Throughout my dealings with the staff in all areas, I was impressed with their caring and professional manner which was not just due to my “muzungu” status, as I had plenty of opportunity to observe their interactions with Rwandans while waiting. Some of their professional training still needs finessing such as implementing the rudimentary and crucial name and MD order match up.

Once I was ‘in the system’ back in Maine, the advanced computerized technology and systems were mind boggling, especially since I have not worked nor been a patient in a hospital for many years. (Despite, these systems, I was ALWAYS asked my name and date of birth before any medication or procedure.) Similar to Rwandan health care workers, compassion and care were characteristics of all

those I encountered.

I am convinced that my baseline good health, a positive attitude, terrific medical/surgical and nursing care, and a global abundance of support and love, has helped my healing process tremendously. As a result, I was given medical clearance by my surgeon and infectious disease specialist to return to

Rwanda

within three weeks of my surgery.

I am very grateful to be back amidst the Gardens for Health community. I am pacing myself as I try to pick up from my surprise month hiatus in Maine and feeling really well as I gain strength each day. Helping coordinate and prepare for the 4^th annual Gardens for Health Thanksgiving preparations (anticipate 1500-2000 people) has been my main focus. I am back in major list mode, but always mindful of Stegner’s words!

Helen