As a white person in a black country, a "muzungu" you get used to being different, special, and privileged. Things which are expensive luxuries for locals you buy without a second thought. You get driven everywhere and can get your clothes washed and folded for $6. Its sad to lose that status, and just be an ordinary member of the crowd.
It was a fascinating experience. I am already beginning to look at the photos and think "Was I really there?"
I will have to spend a fair while talking to other people and thinking about things before I can work out how worthwhile the medical part of the trip was. Clearly there is much which could be done to improve the safety and efficiency of perioperative care in Rwanda, its just a question of who can do what, and what is really feasible in an African setting. Its easy to get pessimistic: Standard sayings are "You don't change Africa, Africa changes you"; "TIA - This is Africa" - meaning don't expect things to work - and "AWA - Africa wins again" - when the wheels fall off something.
But things can change, and Rwanda is certainly changing fast, albeit with the aid of vast amounts of donor money. The roads are good, there is little crime or corruption, the buses and planes depart on time, the Eco Bank is starting to accept foreign Visa cards, and the anesthesia equipment is improving dramatically in some hospitals. It is slow and frustrating to work within the system, slowly trying to get the local residents to understand what quality anesthesia care is, but perhaps there are no real short-cuts.
Going to see about adding some pictures to the blog now I have a faster connection. Look for them on Flickr at http://www.flickr.com/photos/jpoyston/