There was torrential rain last night so this morning the air was clear and fresh as we arrived on the tidy grounds of the Butare Hospital campus.

Allie and I made pain management ward rounds again with another team member, Emmanuel. It is heartwarming to see the skill and care with which the pain team operates. They are knowledgeable and compassionate. We rounded today on the obstetrical ward. There were 6 postpartum women in one room with their neonates but the atmosphere was calm and serene. One woman had twins!

One of the twins

We were reminded once again of how risky pregnancy and delivery is in this setting. One lady had an eclamptic seizure a few days ago and was just recovering. Another middle aged woman had had multiple C-sections. Despite the challenges, it was obvious that patient care is improving.

Allie had to borrow Gaston's spare lab coat for rounds, so we had to Dr. Gastons.

Following ward rounds, we had a highly productive meeting with the hospital leaders. They are committed to palliative care, a chronic pain outpatient service, and delivery of the VAST Course in Butare. We left the meeting feeling quite elated. As we were leaving, Gaston introduced us to a 92 year old ENT surgeon who continued to practice well into his late 80s. He was actually the very first student at the University of Rwanda (student number 001). There is an inspiring piece about his work ethic:

http://allafrica.com/stories/201603010145.html

Prof Venant Ntabomvura, a Rwandan leggend

Allie and I celebrated a great morning with lunch at Inzozi Nziza. She got coffee ice cream with cookies and sprinkles topping.