African tenacity

Half my teaching time has passed...there is so much material and so little time! Monday we had our third of four "academic" days, with lecture/case presentation/discussion. I have become accumstomed to the individual approaches of the residents--one always questions my explanations, one nods approvingly, one falls asleep when the lights are down. I hope they are retaining what they hear, but more importantly I hope they can apply this new knowledge to patients. A patient in the recovery room developed post-operative acute renal failure just three days after we discussed this problem and how to avoid it in class. We discuss how to approach a particular anesthetic challenge, then a few hours later I watch as a different approach is used. And, I realize that I haven't even scratched the surface of role modeling for them, of getting them to reflect on their strengths and weaknesses, or of creating opportunities for them to practice specific skills.
So, like many experiences in Rwanda, teaching anesthesia is not as easy as I would like. Also not easy are washing clothes, keeping your shoes clean, driving to a remote village, finding a job after graduation, deciding how to deal with a street kid, avoiding traveller's diarrhea, or finding an entree' that doesn't feature goat meat. I am in awe of the Rwandans who deal with these inconveniences, as well as the huge burden of their past, and keep smiling, keep trying, keep putting one foot in front of the other. The least I can do is hang in there.
We had an experience Saturday of African tenacity in action. We were being driven to place where a local Rwandan pastor has organized widows to sew clothing and make jewelery to give themselves an income. The building is about three miles from the main road on a dirt track. Six people crammed into a small Toyota pickup truck, and a heavy rain storm--soon the road was only muddy ruts. Our truck had four wheel drive, but it wasn't working...The truck got stuck, spun its wheels, slid sideways and ended up firmly against a mud wall. People arrived with a shovel and a hoe and began chopping away at the mud. Several more attempts to get out of the ditch ended without success. A group of young men from the market arrived and offered to "lift" the truck out of the ditch, but only after a price had been negotiated. They proceeded to bounce on the bumper, directing the driver to "step on the gas." Finally, our leader proposed that we strike out on foot, and leave the driver and truck to the crowd to deal with. Soon, we heard a cheer from behind, and turned to see the truck sliding down the track with the group of men standing in the back waving and flexing their muscles. The driver actually picked us up, drove another two miles on the muddy, rutted road, and then while we visited the widows he drove back to town to wash the truck inside and out so it would be presentable to drive us home. In Rwanda you wash your truck with a wet rag, because there is no hose. Needless to say, he got a big tip...