Kigali - Afternoon

Rene and I met up with the rest of the shopping team. The others had had more success than use, finding shower rods and curtains.

Gabby pointed out the place where he’d bought the power strips before. We crossed the street. Amber and I stood outside while Rene and Gabby went inside.

For a few minutes we waited and tried to talk to some children. Of course, they really only wanted “Agafaranga”, which means “give me money”. Around the Health Center, the children still wave and yell “Muzungu” at us, but they also yell “Muzungu Karuhu”, which means “European by skin only”, indicating that we will not give them money. These kids did not yet know that we weren’t tourists. “Oya,” I said in broken Kinyarwanda, “Yitqua muzungu karuhu.” (“No, my name is European by skin only.”

Amber turned to me, “I need to go meet my friend. I guess I’ll just take a moto-taxi.”

“Uh, there’s a couple over there,” I pointed across the street, distracted by the children and not expecting what came next.

“Ok, later,” she said. She walked across the street, into the crowd, and she was gone.

My jaw dropped. She’s just going to hop on a moto-taxi and be gone? Woah. Amber is setting up CCHIPs’ mental health program. She’s also lived in East Africa on and off for the last decade. So getting on the back of a moto-taxi in Kigali, saying “Serena Hotel” and hoping to make it there is no big thing to her.

Impressed but now alone with the street children eyeing me, I crossed the street. Elie knows basically everyone in Rwanda, and he stood with a handful of friends that he had run into. I climbed into Gertie and waited with Consolate.

A few minutes later Gabby and Rene returned with the extension cords.

“I only got two because I’m not sure of the quality,” Rene reported.

…

We rejoined Zack, Ro, and Jean D’Arc after their lunch meeting. They had another meeting scheduled for now o’clock at Global Fund.

…

For Team Mutuelle, Elie had scheduled a meeting at Gitega health center in Kigali. I put on The Strokes as we wound through Kigali. We only got lost twice on the way.

The Health Center was on a normal city block, with a screen fence and a covered open-air waiting area pushed up to the sidewalk. There were a number of people waiting to be seen, but Elie led us down a hallway and into the Mutuelle office.

We sat down with the Section Head and began to ask questions…

• “What’s the population of the catchment area?”

About 35,000.

• “What’s the Mutuelle enrollment %?”

We are actually over-enrolled, at about 120%, we have people coming to us from other catchment areas because we are very conveniently located.

• “How much financial support do you receive for indigents?”

We receive support for about 15% of our population.

• “How far of a walk is it for most people to the Health Center?”

Most people take moto-taxis. They are not expensive.

• “What sensitization strategies do you use?”

We conduct a census of all the households of the catchment area. Because people live close together, it only takes the community health workers about week for each village (~500-1000 people). We also hand out flyers to inform people that they have to enroll.

• “Wait, you are confident people can read the flyers? What is the literacy rate in the catchment area?”

The literacy rate is high enough that at least one person per household will be able to read.

• “How prevalent are traditional healers?”

There are not too many of those in the City of Kigali.

I took in what the Mutuelle Section Head was telling us. So this is what it’s like to have all of the demographic variables line up in favor of actually getting people to use the health center. The Gitega health center is urban, has relatively high income, has a high literacy rate, has stronger cultural attitudes toward formal healthcare, and it is readily accessible via low-cost transportation.

I was frustrated. It’s so easy here! But, there is a reason we work at Shingiro and not Gitega. There is an extraordinary need at Shingiro, because of the demographic factors on the ground.

Still, the census idea had merit. And the meeting helped me think about the demographic challenges we face at Shingiro. And what we can do to address them.

…

When we returned to the Global Fund office, Zack, Jean D’Arc, Rene, and Ro were still in their meeting. We settled in to wait in Gertie out front. I threw on George Clinton’s Greatest Hits. Somehow I wasn’t finding “We Got the Funk”, so I settled into “Atomic Dog”.

Soon teenage street vendors came up to the car, apparently attracted by the music. Among the items I was offered were ladies shoes, a belt, and blue jeans.

…

The team came out of their meeting, and, after an excruciatingly long, hot day, we set off for the hotel.