Enjoying the Calm While It Lasts

It's a beautiful Summer evening in Kigali. There is neither even a whiff of a breeze nor a cloud in the sky as the Sun heads swiftly for the Horizon, glowing bright red as it does the closer you are to the Equator. Being as close to the Equator as Kigali is (2 degrees south) the days don't vary enormously in length from Summer to Winter. At their longest, as they are now, the Sun sets at around 6.20pm. In Winter closer to 5.30pm. Which means no long, sunny evenings to sit on a terrace having a beer during the Summer (as I recently enjoyed back in New York, London and Toronto) nor does it mean mood-destroyingly short days during the Winter. At the other end of the day, the Sun is always up by 6am and the Rwandan people on the move not long after. This is still a country that walks to work even in Kigali. Only the elite and the taxi drivers have cars. Some can afford to take the little mutatus ("bus" in Swahili lingo, exactly the same little vans were in use in Lima and were called "micros"). Otherwise as you drive to work in the morning or home in the evening you see lines of people walking along the sides of the roads, which are frequently lacking in pavements / sidewalks. The reason that activity starts so early here is that everyone is in bed very early. After darkness descends only 28% of urban residences and a very low 2% of rural ones have electricity to make use of. What else is one to do but sleep? Or that other activity which the Rwandan government is actively discouraging in order to bring down the 5.5 fertility rate amongst Rwandan women.

In case anyone happens to be interested in further stats on Rwanda, mostly related to health, check out the newly released Interim Demographic and Health Survey (http://www.measuredhs.com/pubs/pub_details.cfm?id=936&srchTp=home). If you're a geek like me, it makes for fascinating reading. It has its drawbacks as a survey (much of the data is self-reported and impervious to verification and there is little comparison to previous years for trend analysis) however it's still for the most part pretty good as an indication.

As for work it never sits still. When I arrived three new people had been hired all starting the same day as me who would form the team I would manage. Two of those have now left, one to do a masters in Belgium and the other on loan to our sister organisation Partners in Health. What's more we're on the verge of hiring nine or ten additional people who will all have the misfortune to be managed by yours truly. It's exciting. I'm engaged in three broad areas: advising the Ministry of Health in Kigali on policy and planning; working in one of the 30 districts of Rwanda to help them manage their health system, consisting of a district hospital and thirteen health centres; perhaps most interestingly of all developing a large-scale data collection, storage and analysis tool/engine which will collect several hundred data points on every health facility in the country (450 and rising) every six months and allow every level of the health system (from rural, isolated health centres to the Ministry of Health in Kigali) to manage their investment and operational decision-making. This last piece of work is all the more fun because it's probably one of the first to be developed on the continent and is being built with one eye on other countries where we could deploy it. Right now we're going through a certain lull as most CHAI (Clinton HIV/AIDS Initiative, just one of several initiatives run by the Clinton Foundation) staff are out on vacation. However the storm clouds are clearly visible and due to arrive in the first couple weeks of August. From then until Christmas, and beyond, work is going to be wild. Our donors and the Ministry expect.