Allison's thoughts

Allie here…I am Stew’s wife (he’s the Anesthesia PGY-4 with Patty), and a Palliative Care fellow. I have been fortunate enough to be able to come along for this incredible adventure!

Rwanda is amazing. As my husband will tell you, I am rarely speechless; but it’s happened many times since we’ve been here.

What a privilege to have such an incredible opportunity – to be exposed to healthcare in the developing world, to educate, to share experiences, to learn from, to bond with, and to change for the better as a result.

Providing palliative care in Canada makes you feel humbled and simply human on a daily basis. It results in significant self-reflection and encourages you to appreciate the bigger picture. Palliative care in Rwanda is all of this and more. I have been fortunate to be involved in home visits throughout Kigali (picture below), and it has exposed me to a side of Rwanda that I otherwise would not have seen. Resilience, stoicism, and innovation are words that come to mind.

We visited a young woman with breast cancer the likes of which we would never, ever see in North America (due to effective screening and aggressive treatment). We did a dressing change and taught her sister the basics of wound care. The cancer had created a grapefruit size wound that had essentially replaced her left breast. Part of the dressing involved cutting a maxi pad in half – talk about improvising. This all occurred in a home with no door and pieces of fabric to divide the room. The mattress was a piece of foam. Another patient was a survivor of the genocide, and during that time had been raped and had a child as a result. Palliative care provides the unique

opportunity to truly get to know your patients and their life story, which invariably affects their illness experience and the approach to their care.

Stew and I have spent quite a bit of time reflecting on the medical education and healthcare standards in Rwanda. They manage to do a remarkable amount with very limited resources and education; and it’s an interesting balance between educating them while recognizing the constraints as a result of these day-to-day, on-the-ground limitations. Of course, cultural differences also have a significant impact on the provision of care.

 We are both excited to continue to share knowledge with and learn from the people of Rwanda. I am absolutely touched by how welcomed we’ve been in Kigali – I already can’t wait to return!

Allie

Stew and Allie in the OR

Allie making home visits with the palliative care team