GHI’s 4^th Thanksgiving Celebrations. . .

“We are each other’s harvest” and celebrating the essence of community was once again realised at the 4^th Annual Gardens for Health Thanksgiving held on November 8, 2013. Helping coordinate the event and being part of a composite team, including young children, GHI board members and friends from the USA, GHI staff and community friends, was a fantastic experience. I definitely felt that I was in my element!

The preparation process was in full swing the day before when dedicated staff did the predawn trips to the market to purchase 1000 ears of maize and 700 kg. of potatoes, as well as much more produce. Decorating, cleaning, slaughtering and butchering 10 goats were also some of the list items on Thursday.

Cooking and food preparation began in earnest in the night and through the AM on Friday. The amazing cooks working over hot fires magically produced the food: rice, beans, Irish potatoes, sweet potatoes, turkey stew, goat stew, and maize. The delicious salad was prepared by another contingent.  As projected, lunch was served to about 2000 people (including children) right on schedule. An astounding achievement!

The festivities really began when the mamas enrolled in the GHI program from the Musanze District arrived via prearranged transport. These women had been in bus transit for about 2 hours, some walking about two hours before meeting the bus. For many it was their first time to Kigali.  Greeting them and witnessing their elation and excitement was very moving.

Before departure mamas from the eight different health centers sang and danced wholeheartedly, presenting their offerings of food from their own gardens resulting in an enormous cornucopia of food deposited on large mats. These offerings manifest true generosity in the purest form.

                       

Luckily the ominous clouds building throughout the day did not break into downpours until after most of the departures. We were definitely blessed! Continuous music accompanied the work of steadfast dishwashers into the night with intermittent spells of fervent dancing.

Being part of the extraordinary Gardens for Health team for this event was definitely an important goal for me as part of my post-operative recovery and healing. It helps put much of life into perspective in terms of needs and gratitude.

For more photos please see the Gardens for Health Facebook album:

https://www.facebook.com/media/set/?set=a.10151802758973634.1073741834.74617343633&type=1

Helen

Potatoes!

 Salad crew

 One more turkey for the pot

 Kale smoothies

 Julie

 Cooks

 Musanze mamas arrive

 The queue

 Carla serves beans

 Exuberant dancers

 Julie with the offerings from the mamas

Carla & Helen 
Wonderful sharing this time
 with a dear friend from Maine

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

Day of departure Kale drink before
Kamanda's wedding festivities

There's a Rwandan tradition that people hold

their right breasts to transmit strength and

solidarity to others during challenging times.

Turi Kume means "we are all together."

These photos arrived the morning of my surgery.

Helen with pre operation positivity

Helen in list and scheming mode

Marie Claire Ingabire: Exemplifying ‘capacity building’. . .

Marie Claire Ingabire:

Exemplifying ‘capacity building’. . .

The wide use of the phrase ‘capacity building’ has become well established in the lexicon of international development, becoming a catch-all term for multiple entities: individuals, communities, institutions, and societies. One definition summarizes the concept generally and simply, “Capacity and capability building is defined as the empowerment which encompasses the ability, will and skills to initiate, plan, manage, undertake, organize, budget, monitor/supervise and evaluate project activities.”

http://www.adf.gov/SD&PWDch1.htm Chapter 9. The term also relates to individuals in developing societies overcoming the causes of their exclusion and suffering.

At Gardens for Health (GHI), capacity building is an intrinsic part of the organization, giving all staff an opportunity for self-empowerment: learning, adapting to change and offering opportunities to share opinions and perspectives. A recent example includes staff training in health and agriculture topics for ten new field educators participating in an intensive six week training session. (These individuals were hired from a pool of over 200 applicants after a rigorous interview process.) These field educators are at the ‘frontline’ of the work involved around the recent expansion and partnership at four new partner health centers in the Musanze District.

Over my time volunteering at GHI (currently on my fifth stint since 2011), I have had the honor of working with a plethora of extraordinary people, including Marie Claire Ingabire, recently promoted to the new role of Field Supervisor in Gasabo District. Prior to working for GHI, Claire was a community leader and instrumental with HIV/AIDS community education. The power of her expertise stems from her personal story of being diagnosed with HIV when she was pregnant with her third child. Upon joining the GHI team, Claire was one of the original ‘mamas’ learning the health curriculum. She then helped develop health training content. Her input regarding the presentation of the content via pictorial materials and writing scripts for educational skits has been invaluable. Her recent promotion entails planning, management, supervision of three health educators, eight field educators and a team of eight monitoring and evaluation staff. She must also liaise with health center staff and nutritionists in the district.

Claire was profiled in the book, The Other Side of War: Women’s Stories of Survival and Hope by Zainab Salbi (National Geographic 2006)  Excerpts from her story include:

“Surviving the genocide, I did not believe that living with HIV/AIDS would be my fate,” she says. ”But I have to live with the consequences of our relationship. It doesn’t help to be angry now. He is dying. We are dying. If I am angry, I will be paralyzed. There is no time for me to be angry. There is too much to do.”

“I have to go on living, despite knowing death is a certainty….Death is a certainty for all of us. My fate is just clearer.”

She is a woman with profound insight and wisdom.

I greeted Claire in Boston in April 2013, as she began a fortnight USA cross-country tour to increase awareness and raise funds with Gardens for Health staff. It was a privilege for me to guide her in Boston during the first two days of her journey. Her excitement and curiosity were infectious as she was introduced to ‘firsts’, including travelling beyond Rwandan borders, travelling by air, going on an escalator, attending a movie (IMAX Deep Sea), eating outdoors at a sidewalk café, seeing horses (and patting them), riding the subway, trying a wide variety of new foods and observing a professional dog walker with a dog bouquet of eight!

At a fundraiser Claire spoke with aplomb and eloquence (in English), sharing her compelling story. Her moxie and resilience, complementing her self-effacing manner, were inspiring for the entire audience.

Claire epitomizes self-empowerment (capacity building) as she expands her confidence and competence. It has been wonderful to witness her personal and professional growth. Being her colleague and friend is one of the reasons why working at GHI is such an honor.

 Claire 2004

 

 Claire 2013

 Claire with Boston Police horses

 

 Claire & Helen

Post Grad. . .

‘Post grad’. . .

Last November when I departed from Gardens for Health International (GHI) after my third stint, I was surprised and touched by the staff having a graduation ceremony (quasi roast) in my honor. I laughed and cried throughout the whole event. In keeping with the GHI graduation tradition, there was a skit, a graduation certificate and the gift of two chickens (which have since been enjoyed by staff for dinner).

Now I have returned for a “post grad” stint and it is heartening to witness the positive changes and progress on the farm over the past five months. Although I am just here for a few weeks this time, I look forward to collaborating with my amazing colleagues on strategic planning for the expansion to a new district with the addition of four new health centers (beginning in September); finessing training materials, and helping with a series of real GHI graduations for mothers who have completed the most recent cycle of trainings.

It’s wonderful to be ‘home’ in this part of the world. Despite jetlag I walked to the office at dawn. How I love the early light filtering through the clouds across the verdant hills, hearing a woman singing as she showers at the back of her home, sharing lunch at the farm table and watching a mini murmuration of gold finches over the gardens. Getting many ‘welcome back’ hugs from staff was especially revitalizing. As always, I am grateful and honored to be part of this special community again.

Helen

Claire as Helen in the skit

Graduation skit for Helen

GHI children doing the skit

 Bravo wearing testimonial statements

 Helen with Cedric and chickens

 Helen's graduation 2012

 Cedric responding to:
'SMILE FOR THE CAMERA!'

 First lunch back at the farm table

 May Day sunset

The full week in Makassar

The full week in Makassar. . .

The week spent in Makassar flew by fast. The pace quickened considerably after the first weekend as we undertook a long list of activities. The team’s preliminary groundwork prior to this trip has been extensive and has streamlined the scheduling of a plethora of meetings in the midst of trainings. (Note that nothing is actually “streamlined” here when challenges abound such as working around the prayers and the traffic!) This means that gears were continuously changing. For example, one day we were in the slums speaking to a woman who lives in a space literally the size of a closet and a few hours later we were being offered tea on the 15^th floor of the snazzy Fajar News office building with 360 degree views of the city prior to TV and newspaper interviews. It was a surreal juxtaposition.

The public relations work is a vital component of any successful program and thanks to Dr. Abidin the team got excellent coverage, providing opportunities to promote the importance of advocacy and health education for the vulnerable populations. Fajar News, Sulawesi’s primary media center, conducted a TV interview as well having two news articles published about the team’s work on successive days. A local radio station, KEZ-FM also did an extensive evening interview with the team.

Health trainings for women community leaders from the slums have been gratifying. They all seem eager for knowledge and have an innate motivation to help others. They only have basic knowledge, but ask good questions and are open to discussing some of their challenges. Very basic ‘take home’ messages were reinforced: hand washing, coughing into one’s elbow, not touching blood from open wounds. All women were given bars of soap, a kilo of rice and a certificate of participation. Like any mothers or grandmothers, they want their children and grandchildren to be healthy. Empowerment for women, especially in this culture, is provided through education, expressions of hope and compassion. Pure and simple. . .

Jane Goodall, one of the most admired women, says it best:

“And if we dare to look into those eyes, then we shall feel their suffering in our hearts. More and more people have seen that appeal and felt it in their hearts. All around the world there is an awakening of understanding and compassion, and understanding that reaches out to help the suffering animals in their vanishing homelands. That embraces hungry, sick, and desperate human beings, people who are starving while the fortunate among us have so much more than we need. And if, one by one, we help them, the hurting animals, the desperate humans, then together we shall alleviate so much of the hunger, fear, and pain in the world. Together we can bring change to the world, gradually replacing fear and hatred with compassion and love. Love for all living beings.”

Helen

Community leaders come

to LPTM for TB training

  Helen with community leaders

 Helen with young girl

 Helen blowing out birthday candles

  Helen

Sulawesi Introductions. . .

Sulawesi Introductions. . .

It’s been a few days since I arrived in Indonesia for my initial visit. The first two days were spent in the highlands of Bali, quite a dramatic contrast to where I am currently based in Makassar, Sulawesi. Makassar, is a port city, the provincial capital of Southern Sulawesi with a predominantly Muslim population of about 1.4 million.

In the midst of trying to acclimate to the extreme equatorial heat, humidity and intensity of

such a large city, I am beginning to gain some familiarity with this conservative Muslim culture. This involves learning about social protocol and customs in order to get work accomplished. My colleague Karen has been working in Sulawesi for 4 years and as a result has learned the ropes and acquired basic, but vital Bahasa Indonesia language skills. She has been a strong advocate for community health education in the vulnerable slum communities, helping them to gain health services access. This access has been painstakingly established by working with the whole spectrum of leaders, from local to national level. While Karen’s extensive professional knowledge and experience have helped with her achievements, her personal qualities of infinite patience, flexibility, compassion, sensitivity and humor have played a large role in her success. 

One of the highlights of these first few days has been meeting Dr. Baharuddin Abidin, an entrepreneurial visionary, who has been collaborating with a US based NGO since 2009. He acquired his PhD in naval engineering in Germany, but has a wide variety of interests and projects to help Indonesia’s people. Dr. Abidin is the director of LPTM, the Sulawesi partner NGO affiliated with USA based Medical Exchange International, Inc. LPTM has involvements with community health and advocacy primarily focused on TB. (Dr. Abidin is a recovered TB patient so he is especially committed to helping others and empowering people with proper health education and dispelling stigma.) His other projects include training excavator operators, solar power, nature conservation and eco tourism with the underlying objective to promote and develop public/global health with direct and indirect strategies. Throughout my time in Sulawesi I will begin to work with the LPTM and Dr. Abidin in achieving these goals. I will elaborate further as the days pass as to how this unfolds.

Upon meeting Dr. Abidin one becomes immediately aware of his extreme affability. The glint in his eye and smile gives him almost elfin qualities. His physical fitness (we have bonded over our mutual love of swimming!) gives him the appearance of being a couple decades younger than his 69 years. His devout Muslim faith and devotion to his wife and family (father of 6 and grandfather of 6), is paramount, but he is extremely committed to leading his community. It has been wonderful to be introduced to his wife and family and welcomed to Sulawesi with such warmth and concern.

Going into a Makassar slum my first day here, accompanied by Karen and our faithful translator Kasman, I was able to get an ‘in-the-trenches’ snapshot perspective of the challenges faced by the people residing there. We met with formerly identified women community leaders who have had previous health training and scheduled more training for the coming week. In the process, I did basic health assessments on their children. Despite their obvious struggle with the provision of basic shelter, clean water, food and garbage disposal, these people exude cheerfulness and hospitality. As always, I feel honored to have the opportunity to help these women and their families.

Helen

 Helen doing child assessment.

Photo used in local newspaper

Helen meets Dr. Abidin

 

Helen with  baby

Helen with Abidins

 Makassar canal

On the road to Sulawesi. . .

Helen has arrived in Sulawesi after a couple days in Bali. 
She will get to updating the blog when she gets a chance.

Helen on Balinese steps

 Balinese statue