Focus on what you have

[wide][/wide]As a student in high school at Onteora several years ago, Nicole Chartrand participated in several sports and took classes in anatomy and physiology, English, history, and health.

She also spent part of each day at Kingston and Benedictine hospitals touring the facilities and becoming well versed in American standards of health care. She witnessed both a live birth and an autopsy.

Shadowing Dr. Richard McNally, medical director of pathology, convinced her she wanted to work with patients rather than in the lab, and it prepared her for her participation in the rigorous New Visions program the following year. In that program, she helped out at local health-care agencies.

This background turned out to be excellent preparation for the four months she spent in Rwanda last year as a junior at Houghton College. The basic standards Chartrand had become used to were lacking in Rwanda, particularly in the impoverished countryside, where she spent a month and a half at a health-care clinic in a small village.

“Wow, these people do not have the resources we have in the States,” she said. “It was hard knowing that while you could possibly save a life in the States, in Rwanda these people were going to die.”

Chartrand, one of 20 students in Rwanda in the highly competitive Go Ed semester-study-abroad program and one of three focused on health care, spent two and a half months taking classes in the capital of Kigali. While the hospitals in Kigali lacked equipment such as machines for CAT scans or MRIs, they were relatively sophisticated compared to the facilities in the clinic in the village of Rwamagana, about an hour’s drive north, where Chartrand was based for the remainder of her time.

The standard of health care in the countryside was abysmally low, with people relying on traditional medicine in many cases based on superstition. For example, practitioners won’t touch somebody having a seizure because they believe the person is possessed by devils, she said. “They wouldn’t let me go near them, either, so I couldn’t treat them. You have to respect the cultural differences.”

Lack of medicine for malaria resulted in many deaths, she said.

People were vulnerable to illness because they didn’t practice basic sanitation, Chartrand’s group discovered when they conducted a survey of conditions in a small village in the north of the country. The survey revealed that people had to walk a great distance to get water — sometimes as long as ten hours — which they then transported in large cans. Though the water might be contaminated with pathogens, nobody boiled it before drinking. (The community health-care workers Chartrand accompanied tried to educate the villagers about such basic practices, distributing picture books showing people boiling water, washing hands, and performing other health-protecting tasks.)

In the Rwamagana clinic, Chartrand assisted in the “little surgery” (as the French term translates). Some of her patients were soldiers getting circumcisions to reduce the risk of AIDS. Others were people receiving treatment for old wounds suffered during the genocide, such as festering machete wounds.

A group of children was once brought in who had been injured from an unexploded grenade they had discovered that had gone off. “They came in gaping in shock,” Chartrand recalled. “It was really sad. I treated four of them, and they were all saved. When the child who was only four years old started to cry, we said, we’re good. When they don’t cry, it’s a bad sign.”

The great distance people have to walk to the hospital to get care was another challenge. “Africans are very reserved,” she said, “They don’t complain about things, and you know if they’re coming to the hospital something is very wrong.”


A heart for people

Chartrand was able to communicate with some Rwandans in French, a language spoken only by those who attended school — which many people can’t afford. She picked up some words in Kinyarwanda, despite its status as the world’s fifth most difficult language. Residing in a nursing school near the clinic, she became friends with the students in the school. One was a young woman who after suffering from debilitating symptoms was moved to the capital and a few weeks after died.

Chartrand said the disease from which she was suffering was never identified, but was probably cancer. “She was only 21, and when her disease began, they didn’t have the tests to diagnose it or the chemotherapy to treat it,” she said. “It was a very hard experience.”

Chartrand returned to the U.S. in May, and later in the year transferred to SUNY-New Paltz, where she is now a senior majoring in molecular and cellular biology. After graduating this December, she plans to apply to medical school. In the meantime she expects to work as an emergency medical technician, having obtained her EMT certification through BOCES last summer.

Chartrand described her experience in Rwanda as invaluable. “It’s given me a heart for people,” she said. “I definitely want to go back, whether it’s Rwanda or some other place hurting for health-care practitioners.” She’s committed to community-based health care, whether abroad or in this country.

“I learned that people will trust you more if you have a relationship with them,” she said. “That’s just as important as what you are doing for them medically.”

Living in Africa also was valuable in testing her values, she added. “Going outside your comfort zone really teaches you what you believe in and why — doing something that’s right, rather than because it’s something everyone else does in your culture.”

She took away many lessons from the Rwandans. “Amidst all the poverty and pain, there’s still so much joy,” she said. “It’s an inexplicable joy, which we don’t see here in the States. We have access to anything we want, yet still we’re so unhappy.”

Learning to appreciate the little things was a big thing she learned. “I’m so appreciative of going to college and being able to afford it,” she said. “It’s such a luxury. Or walking or living in a place where I don’t have to be scared my house is going to get bombed. Even though they [The Rwandans] have so little, they focus on what they have, not on what they don’t have.”


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