Shake Hands with the Devil

Gorillas in the Mist… and Mud (Rwanda Part 2)

Sunday April 20, 2014 Easter
Maureen Miruka and I ate a hearty breakfast, which is quite good at the Luxury Hotel
Rwanda in Kigali: scrambled eggs, fresh pineapple, Africa tea (with freshly
ground ginger which gives it a kick). Lucian, our driver, arrived and whisked
us away to see the two famous memorial churches, where thousands were massacred
in the genocide. The Genocide happened 20 years ago, from April 6 through July.
Over 800,000 died in three months, in the most brutal ways possible, Hutu vs.
Tutsi, with the Hutu extremists trying to exterminate the Tutsis, which they
called inyenzi—“cockroaches.”
Laurie Kelley at the Eternal Flame
The first church is Nytarama, where 5,000 died. It is a small brick structure, a
deep red, color of the earth of Rwanda. How can so small a building hold the
sadness of the eternity?
Everything was solemn and respectful of the dead. Our guide was a pretty Rwandan lady, who
was 36 but looked much younger; she was 16 when the genocide took place. We were told not to take photos, but she relented and I tipped her well. The Eternal Flame was slightly pitiful; just a tiki torch that someone fills now and then
with oil. Inside the church it was breathtakingly horrid. The first sense is how small and dark the church is; then the smothering feeling as you see skulls and femurs and pelvises to your right neatly stacked on shelves as you enter, and then the actual clothing of the victims, dried and stiff with their 20-year-old
blood, piled on the rafters, hanging over your head. It feels suffocating.
There is an odd smell, a thickness to the air.
Fresh flowers wrapped in cellophane are placed by relatives on coffins that line the center aisle. At least some of the victims are remembered. What horrors took place in this church; what suffering. And their crime? They were Tutsis.
Children were forced to watch their mothers be raped. Children killed children; pregnant women were disemboweled. On another shelf, some of the victims’
belongings, including one identification document stating that the victim was
I look at the skulls, some of them children. Who were you? A man, a woman? Did
you have a family? Such horrors. Whole families were removed from the face of
the earth and for all time. No one will ever recall them, show videos or photos
of them or build a memorial or scholarship in their name. It’s as though they
never existed.

Grenades blew holes in the wall into which more grenades were thrown. Machetes hacked to death the innocents. In an adjoining building, the children’s Bible study room, a large red stain on the wall was a ghastly memorial to where children were bashed against the brick and left to die. The kitchen was the most terrible as it looked exactly as it had that day when fire decimated it. Everything in it was broken, and covered with the fine red dust of Rwanda. No one disturbed it. People were slaughtered here.

We somberly left and drove to the next church, Nyatama, where thousands more were slaughtered. The physical church is bigger and in better shape but inside…. The inside was completely filled with stacks of caked, moldy clothing of the victims, stiffened with blood. A chipped statue of the Virgin Mary looked down from the brick wall at the scene of carnage, hands outstretched, as though she were crying and asking why?
It was a disturbing, startling contrast. The alter bore the instruments of death: machete, hammer, knife, as well a the artifacts
of the victims: a watch, a wallet, a comb.  The alter cloth was stained red with blood, and left
untouched for 20 years. Downstairs, a glass enclosed display of skulls, with a
glass floor, through which we could see straight through to the cellar. Under
display was a coffin. In the coffin, unseen now, but originally displaying the
body as it was found, a woman with a baby on her back, who had been gang raped, then had a spear shoved through her up towards her neck, and then was stabbed through the heart, which went through the baby. She was
displayed like that, spear and all, for years until finally she was interred.

we exited in shocked silence, a brightly dressed older woman, with strong
features and a scowl, waited outside for us. The sister of the interred woman. Why
was she suddenly here? Maybe because it was Easter, maybe because it was the 20th
anniversary, but something in me somehow said she is here to try to earn a
little cash from sympathetic Americans. We put some Rwandan dollars in the donation box.

offered to take us to the presidential palace, Habyarimana’s palace. Habyarimana’s death in 1994 sparked the genocide. This was a
boring tour, mostly because we couldn’t understand the guide well. The palace
was not in great shape. There were photos on display from the genocide, which tore at my heart, especially the children with their hollow stares. The most
interesting part was peering out the yard and seeing the actual wreckage of the
plane crash which killed him. On April 6, 1994, someone (to this day no one
claims responsibility) shot Habyarimana down (and the president of Burundi) as
he flew back from attending the Arusha peace accords. His plane landed right in
his own backyard, where his wife could see it. The wreckage is amazing.
Thursday April 24, 20014   Gorilla Trek.
This morning I awoke at 5:30 am, and hastily dressed in the chilly air to
prepare for the gorilla trek. I loved putting on my trekking clothes and gear,
and it made me so content and happy inside to know I could go out exploring. The
road to the gorilla sanctuary on the volcano was brutally ragged, all pitted
magma rocks, mud and stones. A few precarious and narrow wood slat bridges. Out
of the simple homes along the route poured out children, most in dirty clothes,
they themselves dirty wearing a hodgepodge of clothes. All smiling and waving
to us, “Allo!” they cheered!
The countryside was spectacular: heavy mist settling on the rich red earth
upended in clumps in the carefully groomed fields, green trees stretching up
toward a dominating volcano in the background. The Land Rovers pitched back and
forth over the rough terrain. Finally we reached the spot and disembarked. We
hiked about 30 minutes only, through the ploughed fields, through thick bamboo
forests where one guide had to machete his way in, up mud hills, and over
little streams. We met up with our trackers, who had found the “Hirwa” family,
consisting of a nine gorillas: a silverback (“Lucky,” so-called as he gets all
the females), three adult females, two sub-adult females (not able to mate
yet), one one-month old, and three year old twins.
And there they were. Startling to be so close to this endangered animal, which is
so like us. When our guide, Patrick, was telling us about the male gorilla’s
habits— he gets drunk on one of the plants, fights with the other young males
and then cheats with the females— I asked, “We are talking about gorillas, right?”
Laurie Kelley with hikers for gorilla trek

We first spied the mother with the one-month-old, just above our heads on a soft mound of earth. All around us is forest, or perhaps jungle? Thick, green, perfect cover for these gentle giants. We could get in close, and snapped many photos. No flash is allowed as this reminds the gorillas of lightning, of which they are afraid. Then another gorilla appeared, and another.

While we were busy snapping photos, the alpha male, his domed forehead so reminiscent of King Kong, appeared—Munyinya, the silverback. Our guides said he was the biggest silverback in both Uganda and Rwanda, making him the biggest living
mountain gorilla. He issued deep, guttural grunts, and our guides responded. We snapped and videotaped for 15-20 minutes when suddenly Munyinya jumped down, and somehow commanded the entire troop to come to him. Each members obeyed and
lowered themselves to stand next to him. He was only a few feet away from members of our group!
Together, the entire family climbed up to another spot above us, where they proceeded to settle in and eat everything in sight. Munyinya even bent an entire bamboo tree, broke it in half and stripped it of its leaves. His power is immense. The twins appeared and were fuzzy and playful.
Our guide signaled to me that he found another, a young female. She was wandering alone so we tracked her. I got ahead of the guide, and suddenly found myself too close to the gorilla. She stopped, and I stopped. Then she started towards me! “Don’t move!” my guide whispered. I couldn’t, as I was up against bamboo trees. The gorilla came within two feet of me. She looked right into the lens of my lowered camcorder. Then, caught on film, her eyes drifted upwards and looked straight into mine, as though she were checking me out. Then, she simply moved on. Walked ahead, plunked herself down and began eating bamboo shoots. Our group moved in for some great photos!
After one hour we had to leave. The gorillas only tolerate visitors so long. A happy walk back with lots of excitement at having seen these beautiful, intelligent, endangered
Friday April 25, 2014 Dian Fossey’s Gravesite
The African rains pour down but I am in my lovely room, with a space heater on, drying my trekking socks, a cup of spicy African tea, and my laptop. We did a fantastic hike today.
I awoke at 5, and lay in bed enjoying the space heater I was given, and my soft bed. Then up to trek all morning. I washed, donned my trekking clothes, bandana, sunglasses, gaiters, boots, money, Camelback. Love being outside and hiking! I had internet at last and downloaded all the news, of which there was not much. Ate a breakfast of scrambled eggs, roll, mango and passion fruit.
The sky was clear and blue. Ahead of me, the magnificent volcano that has stood for millions of years. Last night I spotted Mars, its intense red light gives it a power that its little size belies.
We set off along the bumpiest road I have ever been on. These were magma rocks, spewed out in 1957, when the little volcano last erupted. The rocks were propped every which way, and our SUV had to maneuver them over a long while.
Going at most 10 miles per hour, Chris navigated us while I enjoyed the pastoral countryside. Mud houses, clean and tidy; people of all descriptions walking everywhere. What’s that, a walking tree? No, a slim older Rwandan man carrying a tree on his back to replant. Mothers with babies tied to their backs with colorful cloth carried massive branches or potato sacks or water jugs on
their head. Little children, dirty runny noses, barefoot, screeched out “Allo!”
and waved frantically. I reciprocate!
And the backdrop behind this daily opening of a play are the Virunga range
volcanoes, over million years old. The big one, Sabinio, is named after an “old man’s teeth” because of its ragged outline. It is stunning. The road we drive on is horrifically pitted with magma rocks: we pitch back and forth, as if we are climbing each rock separately. Our stomachs churn. Our slow speed of 3 mph give the children a chance to run alongside. And everywhere area people walking.
After 45 minutes of that ride, we pull into a small village where the army has men posted. Here’s where the trailhead begins. I meet Lois, our guide, a gorgeous Rwandan woman, and we head out.
We walk up a long “road” of lava rocks, dusty grey now but still pitted like most
lava rocks are. Ahead are the green slopes of the volcano; on either side, the
village. Mud homes, numerous and playful children, laundry laid out on shrubs,
water pouring out of a pipe that comes from the mountains, and children filling
buckets. The children pour out of their little homes to ogle us. I smile at
each one. The adult are not so friendly. I have four army soldiers with me; two
in front and two behind, to watch for wild buffalo, Lois tells me. And a man in
blue, who I ignore at first but I guess he is part of the park service there to
help me. As if I need help!
It’s a long hike that morning. The rocky road cutting through the village, then a
grassy path twisting up the mountain, passing cows and sheep that don’t like
me, then up straight alongside a rocky wall, then into the forest proper. It is
cool but walking makes me hot and I shed my coat. The climb is almost vertical
and slippery. Up past a little footbridge and we are in the forest!
It is primordial, lush, gorgeous. Behind us, downward, spreads the village then
all of Rwanda. Far in the distance are the famous “thousand hills.” Now the
walking is even more treacherous. For the entire time I have to watch my feet.
The path has now been cleared but as it is the rainy season, it’s completely
submerged in mud, covering all the roots and even the white cloth potato sacks
placed there as stepping stones. My boots are able to balance on the roots and
hit the sacks, but every now and then I miss and my feet are engulfed into the
inches thick, black mud. But is feels great! Thick and slimy, it sucks loudly
when I remove my boots or walking stick. Still, I am nimble and surefooted and
keep up with Lois with no problem.
Laurie Kelley hiking to Dian Fossey’ gravesite
For a while you can’t grab onto anything as the stinging nettles are the only thing
lining the path. A few of these microscopic needles get lodged into my hand,
and they sting and itch relentlessly but there’s nothing to be done. I had
gloves with me in my daypack but neglected to put them on. Every so often I
raise my eyes to gaze at the forest; it is magnificent. Every blade, every
tree, every leaf, a miraculous wonder of an intertwined ecosystem. Lois breaks
off a leaf that she says the gorillas love and I taste it. Nothing at first,
then… bitter!
We trek for at least two solid hours, straight up hill, slipping on the rocks,
getting stuck in the mud, avoiding the stinging nettles. Our path weaves in and
out, back and forth to find the best support so we don’t sink in the mud. A few
times my feet miss and I go in over my boots in the mud, and feel water rush
into my socks. By now I have thick mud up to my shins, and a light mist starts
to fall on me. It is glorious. I have never been happier!
Finally we reach the place, where Dian Fossey worked. There’s nothing left; her house
and research station were destroyed. All that’s left of her house are a few
posts; I sit on one and Lois snaps my picture. We see the grave and stand over
it as Lois tells me more about Dian’s vicious death by machete.
The return trip is fast, probably less than one hour. I love the challenge of
hiking. Descending is tricky; gravity pulls, while you are a bit tired and the
rocks are slimy with mud. My boots are completely covered in mud, so I slip
easily. Still, I keep a great pace. I love nature; love it, love it and always
want to be outside.
Coming finally into the clearing, though still having to navigate some steep and rocky passes, I tell Lois, It ain’t over yet, Most accidents happen on the way down.
And sure enough, my ankles are tired; I can feel them give a bit. When we are almost down, already into the cultivated place and alongside the rock wall, I look up to catch the glorious view and slip suddenly, falling to earth in a split second. My right arm hits the rock wall heavily. In a second the man in blue,
who had nothing to do, lurches forward, with “Sorry!” But I hop back up, checking the most important things: my camera lens (which hit hard) and my manicured nails. All’s good. My forearm has an 8-inch superficial gash in it and I have a scraped elbow and my hand has a puncture in it. A bit of blood here and there but I’m good to go.
Finally we are back; I tip everyone well, and we happily climb into the SUV. My guide says I am the first person ever to get back before 2 pm; it is only 12:15! We flew!
We cause a little riot at one street corner, giving away to a small crowd the
soaps, toiletries and toothbrush I confiscated from all the hotels. They are so
grateful for anything they get. I give another little boy who was running
alongside the SUV my chocolate protein bar. When I said “chocolate,” his eyes
Muddy and bloody!
The clouds have now rolled in, and the rain was pelting a while ago. My boots and gaiters
have come back to me clean as can be. My wool hiking socks ran red for 20
minutes—I could not soak them enough to get the mud out. Now I sit, enjoying
tea, a warm room, birds chirping outside, peace and quiet in this rich land of
“In the recycled carbon air of the long flight back, I physically long for Rwanda, its
rich red earth, the smell of its wood fires and its vibrant humanity. “ Shake Hands with the Devil

Land of One Thousand Hills… and Challenges Part I

Traditional Rwandan dancers
A dream come true for me—  Rwanda. This trip happened to coincide with the
twentieth anniversary of the start of the genocide, April 1994. I recall
vividly watching my TV each day, holding my newborn, Mary, and helplessly
comparing her blessed life with the sufferings of the refugees in Goma, and
those trapped in their villages and in the capital, Kigali. The genocide went
on for three months while the world mostly watched, indifferent, unbelieving,
and immobile. It was then and there that I resolved to do something to help those with hemophilia in other countries. Later, Save One Life was born.
Things have changed in Rwanda, which is one of the prettiest and cleanest of all the developing countries I have seen. The country has been reborn, and money is poured into healthcare. But one of the rare disorders that gets no funding or attention is hemophilia. That’s about to change.
First some facts:
Rwanda is one of the smallest African countries, located in eastern
central Africa, about the size of my home state, Massachusetts. Nearly half of
its 11 million people live in Kigali, the capital. Colonized by first the
Germans, then the Belgians after World War I, it is an independent state now
where English and Kinyarwanda are spoken. About 95% of the population is
declared Christian.
“Land of one thousand hills”

The current GDP (“income”) of Rwanda is about $15.7 billion, which ranks it at #141 in the
world. Average income is about $ 600 a year. And about 45% of the population
lives below the poverty line.

Farming impacts 80% of the population. Most crops are for internal consumption, with
only tea and coffee being exported. Thanks to the wild mountain gorilla
population, tourism is the number one industry, with farming a close second.
Life expectancy at birth is 64 years, ranking Rwanda about196th in the world.
Dinner at Dr. Fabien’s House

My first impressions were all positive of this enchanting African land. I looked
at the stunningly beautiful pastoral vista: rolling hills, tiered like a cake
with green frosting, all farms and crops. Patched-worked in were squares of
other crops: banana trees, sugar cane, pineapple, sorghum. And everywhere
people walk, balancing great loads on their heads. Even the children: their
faces disappear under great loads of bamboo, until they resemble huge bails of
greenery with legs. Or small children struggle to haul water jugs back to their
homes. Infants are wrapped and tied onto their mother’s backs, asleep. Women
work hard here. Men push bicycles up hill, with a towering 50-lb sack of
potatoes or yams. The children wave at me and say “Allo!” A huge field in the
foothills is dotted with colorfully clothed Rwandans chopping and turning the
earth with hoes; backbreaking work.

For this blog I’ll write about our meetings with the hemophilia team. In Part 2 I
will cover the visits to the Genocide Museum, churches and then the Mountain
Gorillas. Because to know Rwanda, you must know more about the Genocide, and its natural wonders which attract people from around the world.
The lone machine at the lab
On Sunday night, April 20, Maureen Miruka and I were invited to dinner with Dr. Fabien Ntaganda and his family at his home. Dr. Fabien
is a young hematologist and the only hematologist in a country of 11 million.
He had just recently returned from training in South Africa. His daughters
Alegra and Farley were charming and we enjoyed conversing with them.

Dr. Fabien with Laurie Kelley
Maureen is president and founder of the Jose Memorial Haemophilia Society-Kenya. She has a son, Ethan, with hemophilia, and was compelled to found this
patient-centric organization after her other son Jose died. After knowing her
and working with her for several years, I asked her to accompany me on this
trip to create a bridge between the two countries. To me, it’s silly to have
African nations reaching out to the West constantly, and for us to help
unilaterally, when Africans can share and should share with one another.
Maureen would have much wisdom and experience to share with the patient group the next day.
On Monday April 21, we met at the Rwandan Military Hospital, where Dr. Fabien
works, to meet with many doctors of different disciplines. I gave a talk about
the need for leadership in starting a hemophilia foundation and also in
changing history—here, to create a hemophilia program that addresses problems medically and socially.
Maureen gave a presentation of her own story that led her to create the JMHS-K, and how nit is impacting lives there now.
Afterwards we toured the pediatrics ward, meeting two pediatricians who told us about their encounters with hemophilia patients. Treatment? Fresh frozen plasma. Not even cryo. The first use of factor concentrate was December 2012, when a
donation from the World Federation of Hemophilia was received! December 2012!
Maureen Miruka with Dr. Fabien and pediatricians
This fact jars remarkably in a country where The Clinton Foundation
is deeply involved, where health expenditures are 10.8% of GDP, placing Rwanda at 17th in the
world, where HIV prevalence is 3%, one of the lowest rates in Africa.
The government views healthcare as a human right. With over 400 health care facilities, 42
district hospitals, and 45,000 community health workers providing care are the
village level, Rwanda has created a system to bring health care to both its
urban and rural populations. Yet, life expectancy is only 64 years (and lower
for men).
Hemophilia most certainly contributes to this low life expectancy.
And with a
population of 11 million, there should be about 400-500 with hemophilia. Yet
only 27 have been identified. Dr. Fabien showed us the blood lab, where a one
humble machine stood. Rwanda needs a proper diagnostic facility, in order to
test those with factor VII and factor IX, those with inhibitors or von
Willebrand disease.

The pediatric wards were bright and cheery, with beautiful beds (so remarkable not to see chipped paint, stained walls, overcrowded facilities) and clean floors and walkways.

Our driver, Lucian, took Maureen and I back to the hotel after this, where we had
lunch together, and then waited for the parents/patients to show up at 2 pm for
our first meeting of the Rwanda Federation of Hemophilia. This group was formed
in February 2013, but in actuality, nothing has been implemented or become
official. The group is not registered as a proper nonprofit with the
government, which then prevents it from participating with the WFH and
receiving the resources it needs and deserves. Our mission is to get the group
together, sort out why it has not been registered, get it registered, and get
it moving, according to the tenets of my book, Success as a Hemophilia Leader.

Fred and Prince
included: Emmanuel, Alyos, and Sylvestre, all fathers of children with
hemophilia; young people Fred and Prince, brothers, and their mother. Prince, age 15, was on
crutches and needs to have x-rays to determine if surgery is possible to fix
his patella, which was knocked loose during an accident. Dr. Fabien, in spite
of all the work he has to do, had done his part and got this community
together, bless him. We met for over an hour, talking about what needs to get
done to get this new initiative moving. We ordered soft drinks and African tea
for everyone. Maureen’s lecture on what she has accomplished with JMHS was
superb and opened their eyes to possibilities—what they as a group of patients
and parents can accomplish. As an African, she can communicate with them as I
cannot; she has that credibility that I don’t.
Right then we discussed their
constitution (It needs reviewing as it’s been a year); temporary elections were
needed today, now, to get leaders in place (done!); priorities need to be
established (blood diagnostic lab and registering the society). We accomplished
all that. Fred, only age 21, took the Minutes. We were having our first proper
It was a good meeting, and maybe even a bit intimating, as we contemplated all
that needs to be done.
On Tuesday, Maureen headed back for Kenya, and I had a day off to read and organize notes from my hotel room. Later that day, Dr. Fabien and I met with the Health Minister, the Honorable Dr. Agnes Binagwaho, who was appointed in May 2011. The Health Ministry is located in a commercial building, and we waited about an hour until she was done with her
other guests. A pediatrician, the Minister of Health understood about hemophilia. I showed her photos on my laptops of some severe cases. And then we  cut to the chase.
Emmanuel, new president
Incredibly, Rwanda
offers health care for all individuals to access medical services, currently
95% of the population have access to insurance (current annual insurance cost
is approximately $5). Medicine is sold at pharmacies, and patients get reimbursed
about 80% through the government. Could this be done with factor?
No, she said.
It would overwhelm the system and is too expensive. And honestly, I thought,
asking parents and patients to pay just 20% of the costs would wipe them out.
So there is no easy solution for treatment of hemophilia in Rwanda. Yet,
Barbados, a small Caribbean country, purchases factor; Honduras, one of the
poorest countries in the Western Hemisphere, purchases factor. How can we move
other countries in the same direction?
It takes a
structure fortified by the patients, families and physicians (the Rwanda
Federation of Hemophilia; it takes help from the outside world (the WFH and
entities like us and the JMHS-K); and it takes time. And over time, Rwanda will
achieve self-sufficiency.
Our meeting was pleasant and gave me a better picture of the challenges we were up against. But as I watched in later days, the women walking miles carrying heavy burdens on their heads to market, the children who were dwarfed by the huge bundle of sticks they carted about on their backs, I know that this is a country ready to work for its daily bread, its dose of factor. It has overcome much already, and will over come the new challenges too.
Laurie Kelley with the Hon. Dr. Agnes Binagwaho 
To quote the country’s president, Paul Kagame, who led the revolt against the government during the civil war/ genocide, from an article he wrote in the Wall Street Journal recently, “As we pay tribute to the victims, both the living and those who have passed on, we also salute the
unbreakable Rwandan spirit, to which we owe the survival and renewal of our
country…” Think of the victims as those with hemophilia, and you can parallel
that we will succeed one day in providing hemophilia care to a nation that has
already suffered enough.
Great Book I Just Read
Shake Hands with the Devil by Roméo Dallaire
Dallaire was
the head of a UN peacekeeping mission during the 1994 civil war/genocide, in
which 800,000 Rwandans were slaughtered in three months. The book is not a
reporter’s eye-witness account of atrocities: it is a moment by moment, blow by
blow, insider leader’s view of the events leading up to the April 6, 1994
assassination of Rwanda’s president, the internal struggle to get the Arusha
Peace Accord finalized, the mobilizing of anti-governmental forces, the power
struggles between the Tutsi and Hutu tribes, the political players, and more. Dallaire
gives an exhaustively detailed account of what went on politically before
during and after the Genocide, both inside the country and globally; how the UN
on the ground reacted and the indifference of the world. It is a scathing
indictment of the bureaucratically hampered United Nations, the hesitant United
States and the self-serving Belgians. While the world watched, hundreds of
thousands of Tutsis and moderate Hutus were macheted and mutilated. How
Dallaire coped with the lack of resources, the suffering of his own troops,
constant gamesmanship of the players involved, death threats, lies from
politicians, and being surrounded by death and suffering of women and children
is nothing but heroic. He is a hero, and did his best. It is an exhausting book
to read in many ways, yet must-reading for anyone involved in charity work, war
time missions, history, the military, and huge international bodies like the
UN. So many lessons to be learned; Dallaire has done the world, history and
future citizens a vital service in providing this book. It should be a military/humanitarian
classic. God bless him. Five/five stars.
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