In case anyone here ever had a burning desire to know all about the inside of a rural Rwanda hospital, today is your lucky day…
Yup, we somehow managed to survive 3 months in 22 countries with barely a cold, AND we trekked to the farthest gorilla family and back today with only a few aches and pains to speak of, but somehow still found ourselves speeding down the dirt mountain roads after dark tonight in search of a doctor.
I should probably rewind. The Boy is a Type 1 Diabetic, which means he is dependent on 2 kinds of insulin daily to keep at his bad decision making ways. [Ed. note: This is true. It hasn’t stopped me yet though!] Over all the continents, we have managed to travel with an ample supply safely; keeping it cold in the Sahara and warm on Antarctica without fail. We’ve even entrusted our “stash” to hotels in many languages to store in the general fridge…until Rwanda. When we asked reception for our bag of medicine back tonight to take a dose, they seemed to have trouble locating it. We waited in the lobby a few minutes, but when the hotel manager told us it would be brought to our room shortly, we didn’t worry too much and headed on down. But when the porter delivered a solid, frosty ziplock bag, we entered panic mode. In less than 24 hours, our hotel had managed to freeze and ruin a month’s supply of insulin…while we were 2 weeks and 8,000 miles from home. [Ed. note: panic mode doesn’t really begin to describe my mindset when looking at a frozen block of life-sustaining medicine that should never ever ever be frozen.]
Thus, we found ourselves in the back of a safari jeep, careening down the unlit, unpaved side of a mountain to the nearest hospital 30+ minutes away. The driver (who just met us in our panicked state) was trying to assure us that this would be fixed quickly, however our confidence in locating the right medications and enough of it in basically a third world country that we were leaving the following evening was low…or rather non-existent. On top of this, neither of us could get our cell phone to pick up reception (because we are on the side of a mountain in Rwanda and don’t have coverage through the annoying “Can you hear me now” guy…[Ed. note: who is he with again? It doesn’t matter, the cell phones weren’t reception-ing.]), so we couldn’t initiate our go to world travel emergency plan: call Boy’s dad…(This man is the true hero of this story by the way, as well as the hero when we got stuck on the continent of Antarctica for an extra day and almost couldn’t find a flight to Easter Island; and the on-call hero when we were unsure if we would make it out of North Korea without lots and lots of bribery money…although for that one we just left his cell phone number with our friends in Hong Kong and said to call him first if we didn’t confirm a safe arrival in China, and only after speaking to him to then call the US Embassy…) [Ed note: I got reception once on the entire drive, long enough for the automated voice to say something in some language and then hang up. Great.]
A Rwandan hospital…is open air. There was a basic roof that almost enclosed all the walls and internal doors for exam rooms 1 and 2, but no external doors to speak of (or keep anyone/thing in or out…including the stray cats). HIPAA laws also have no place here. The exam room was a revolving door of spectators. Granted, this might have had a partial correlation to us not speaking the language, however the doctor was fluent in English so the need for our normal driver, our tour company’s other employee (who was at our lodge and actually drove us), and the third unnamed participant (who I believe drove our driver from their lodge…) to be in the room with us as we explained the problem eluded me. The doctor started examining the 7 damaged insulin pens [Ed note: completely rendered non-usable] while I showed him a PDF of an expired prescription on my phone as “proof” we should have this…
The Boy finally grabbed cell signal and got his Dad on the line. Dad, cheerful and ready for a chat on what was his Memorial Day mid-morning, answered the call with a “hey, how’s the trip going?!” The Boy calmly [Ed. note: Maybe “calmly” isn’t the descriptor I’d use…serious and with suppressed panic?] reminded Dad that this call was costing $10 per minute and he needed to listen closely then pull up the itinerary we e-mailed and call the emergency number listed at the bottom (which I thankfully told the Boy to include when all he wanted to list was “Find Gorillas” or “Find Lemurs” next to a country…) With the bat-signal deployed and Dad mobilized to get someone in America (and the UK…our travel company was based in both countries so why not call everyone?!) on board to find a full resupply in Kigali or Nairobi, we returned to the imminent need: the Boy had no insulin to take tonight and only one pen of the main insulin when we were traveling with 6…[Ed. Note: one shot at night, the other when I eat. Easy and simple regime to follow…until you don’t have anymore available.]
The doctor couldn’t replace the main insulin, or match the nighttime insulin exactly, however he wrote out a prescription for some other nighttime insulin and told our driver to go down the road and collect it. I offered Boy’s passport for identification and they said no need…then I saw the Rx was simply written for “Boy” and decided I would go along to confirm what was actually being dispensed. The pharmacy was, unsurprisingly, open air, however there was a mini fridge from which the medicine vial came so I felt slightly relieved from that fact. [Ed. note: because insulin must be kept cold. Not frozen.] The next problem was this medicine is in a vial and the boy uses pens with screw on needle tips. No problem, a little English to Swahili translation and I am handed a sheet of syringes…yup, nothing can go wrong now that we will be traveling with unknown medication, a bunch of loose needles, and a handwritten prescription paper (in French, so honestly who knows what it really says!) as we have to cross customs 3 times in the next 36 hours…[Ed. Note: we got this. It couldn’t be too hard, right?]

Back at the hospital, the Boy has calmed down and is showing the doctor photos on his phone (because apparently this is his favorite way to pass time in Rwanda?) [Ed. note: yeah, this one was a way to take my mind off of things. Plus the guy was interested in penguins!] I hand over the tiny vial and the imminent danger is behind us. We still have to solve the bigger issue at hand before we board a flight from Nairobi to Madagascar in 48 hours (because no wifi, little electricity and running water means we’re not risking the hope that we can find medicine in that country…), but our Rwandan hospital visit was basically a success.
However, when the receipt came back for our payment for the hospital visit, he was registered in the official Rwanda computer as “Boy Boy”…and Boy is in fact a nickname so wish us luck if we ever try to obtain a full copy of his medical records in the future…especially since these were also in French. The final puzzling part of this encounter was the payment. I have been to a hospital in a foreign country before thanks to a very klutzy year and a broken arm in rural Ireland. Therefore I understand that America’s astronomical healthcare system isn’t the norm elsewhere. Be that as it may, when I was told to pay 7,000 francs and the receipt showed a charge and payment of only 1,014 francs, I couldn’t help but feel a little ripped off. Luckily, my anxiety addled mind did manage some simple math and I decided not to fight for the equivalent of $7. This means our receipt to claim this back from travel insurance amounts to $1.50. Think it’s worth the deductible?
