On The Job
After our first day on the job (that you can read about in my last blog post), the rest the week was spent trying to get us accustomed to work in Ruhengeri hospital. Our first week of work was not actually a full week. There were Rwandan holidays on Friday the first of July and another on Monday, the fourth of July making our first workweek only four days long. On the four-day weekend we traveled to Kibuye to visit Lake Kivu, but I will write more about that in my next post.
As young women technicians in a hospital with a large amount of male leaders, we wanted to make an impression on the staff, especially the four technicians in the maintenance department. So we set off to work right away.
As young women technicians in a hospital with a large amount of male leaders, we wanted to make an impression on the staff, especially the four technicians in the maintenance department. So we set off to work right away.
On our second day, we fixed our first machine! We worked on the patient monitor with the power supply problem that I had mentioned in my last blog post from the start of the day. After disassembling it and examining its contents, I had found two blown fuses on one of the circuit boards. The fuses we found were not common, so we had to use our imagination while replacing them. The same problem was occurring after the fuse replacement. Since we were not sure what caused the fuses to blow in the first place, we thought it would be best to replace the entire circuit board. Using a board from another broken monitor of the same model, we swapped the boards. Once we plugged the monitor in and let it charge for a few minuets, it worked!
We went up to our Biomedical Equipment Technician (BMET), Jean Claude, to tell him the good news and he offered to buy us drinks after work to celebrate!
We went up to our Biomedical Equipment Technician (BMET), Jean Claude, to tell him the good news and he offered to buy us drinks after work to celebrate!
The next day Jean Claude asked us to take a look at a large collection of oxygen concentrators that were sitting in out workshop. Some of the machines had a few notes written on them, but we were unsure of what most of the problems were. We worked on three different types of oxygen concentrators, each with their own manual that we had to research. I had honestly thought that researching manuals would not be a problem. I was wrong.
I strongly suggest that any medical equipment company should place a link of their machine’s manuals on their website. Otherwise, when hospitals are unable to keep track of each and every manual for all their equipment, it is very difficult to find the necessary information. Thankfully, in this instance, we were able to find the service manuals.
Parts of Wednesday, Thursday, and the Tuesday after were spent hours testing, inspecting, and trying to determine the percentage of oxygen being outputted by the oxygen concentrators. One particular make and model was giving us some trouble. The Weinmann Oxymatt3 was not only the most difficult to disassemble, but it also had a very strange alarm system to decode. During testing, we would start the machine and wait a few minuets to see if any alarms sounded. A blinking red light along with a set of beeps would go off on each of the four Wienmann models. The manual has a unique system with many combinations of beeps and light flashes that correlate with different problems that was not easy to follow. On multiple occasions we would receive a leak alarm and an overpressure alarm, which seemed very confusing to our team.
In order to test that amount of oxygen exiting the concentrators, we needed a type of oxygen analyzer. At first, we did a very simple test of holding a flame to the exit point and observing whether the flame grew or not. But of course, that was no proper way to test oxygen percentage. Jean Claude later surprised us a with a brand new oxygen calibration device.
Since we were the first to use the oxygen analyzer, we had to calibrate it. Once we read the instruction manual, we were concerned with its many limitations. For example, it needs to be calibrated when the temperature changes more than two degrees. In Musanze, the temperature fluctuates daily by at least 10F. In order to calibrate the device, we also needed a source out 100% oxygen. Our hospital is fortunate enough to have a working oxygen plant on the grounds that can fill up about 60 large canisters of oxygen tanks a day with around 94% pure oxygen. It was the closest we would get.
Using the analyzer we were able to diagnose some problems and rule out others. We would start out by opening the machines, and cleaning out filters and other components in the hopes of making it run smoother. However, one of the main problems of the 8 or 10 oxygen concentrators we looked at was that the zeolite, which is a type of chemical used to clean out the air into pure oxygen, was at the end of its life. After 20,000 hours of use, that chemical loses its ability and the machine does not work.
I strongly suggest that any medical equipment company should place a link of their machine’s manuals on their website. Otherwise, when hospitals are unable to keep track of each and every manual for all their equipment, it is very difficult to find the necessary information. Thankfully, in this instance, we were able to find the service manuals.
Parts of Wednesday, Thursday, and the Tuesday after were spent hours testing, inspecting, and trying to determine the percentage of oxygen being outputted by the oxygen concentrators. One particular make and model was giving us some trouble. The Weinmann Oxymatt3 was not only the most difficult to disassemble, but it also had a very strange alarm system to decode. During testing, we would start the machine and wait a few minuets to see if any alarms sounded. A blinking red light along with a set of beeps would go off on each of the four Wienmann models. The manual has a unique system with many combinations of beeps and light flashes that correlate with different problems that was not easy to follow. On multiple occasions we would receive a leak alarm and an overpressure alarm, which seemed very confusing to our team.
In order to test that amount of oxygen exiting the concentrators, we needed a type of oxygen analyzer. At first, we did a very simple test of holding a flame to the exit point and observing whether the flame grew or not. But of course, that was no proper way to test oxygen percentage. Jean Claude later surprised us a with a brand new oxygen calibration device.
Since we were the first to use the oxygen analyzer, we had to calibrate it. Once we read the instruction manual, we were concerned with its many limitations. For example, it needs to be calibrated when the temperature changes more than two degrees. In Musanze, the temperature fluctuates daily by at least 10F. In order to calibrate the device, we also needed a source out 100% oxygen. Our hospital is fortunate enough to have a working oxygen plant on the grounds that can fill up about 60 large canisters of oxygen tanks a day with around 94% pure oxygen. It was the closest we would get.
Using the analyzer we were able to diagnose some problems and rule out others. We would start out by opening the machines, and cleaning out filters and other components in the hopes of making it run smoother. However, one of the main problems of the 8 or 10 oxygen concentrators we looked at was that the zeolite, which is a type of chemical used to clean out the air into pure oxygen, was at the end of its life. After 20,000 hours of use, that chemical loses its ability and the machine does not work.
Jean Claude gave us a break from the oxygen concentrators on Wednesday and we traveled about thirty minuets out of town to a Clinic near the famous volcanoes. In years past, volunteers have visited this same clinic and conducted inventory on lab equipment. We were there to update that list and assist Jean Claude with a water purifier. The only equipment that this clinic had was related to machines that ran blood work, and sterilization. What surprised me was that there was a pile of slides with different samples testing for HIV on the counter top. To me it seemed a little unsanitary and dangerous to maneuver around. Other than that the clinic was well managed.
Jean Claude got to work on the water purifier with another technician. It was very difficult to help since the area that they were working in was very small and cramped with not enough room for all of us and they were speaking in entirely Kinyarwanda. But we did what we could in the short amount of time we had and soon we had to return home.
The next day, Thursday, was our last day of work for the week. In the morning we spent more time working of different oxygen concentrators with may of the same problems as the day before. Later in the day, Jean Claude took us to the sterilization room where there are two large autoclaves that clean all surgical equipment. One of these machines was broken and Jean Claude spent some time explaining the inner workings of the machine and brainstorming the possible problem that was causing the machine to stay in one phase of the cycle for too long. While we were running a test on the machine, the power went out. That has not happened to often, but when it does, some serious issues arise. So after the power went out, Jean Claude decided it was time for our lunch break.
Our coordinator for the Rwanda Summer Institute, Inca Johnson, made a visit to our hospital at lunch and gave us some advice on working in this environment. We shared with her any concerns that we had and she was quick to offer some tips of how to better our situation. She put emphasis on aggressively searching for equipment throughout the hospital and talking with the staff members about any concerns that they had regarding equipment. A few days into our job we realized that we were going to have to go out and look for things to work on. We would need to take the initiative.
With our talk with Inka fresh in our mind, we went back to the hospital and spoke to Jean Claude asking if we could attend the staff meeting the next Tuesday. He agreed to let the director know that we were attending and thanked us for our work this week.
Our coordinator for the Rwanda Summer Institute, Inca Johnson, made a visit to our hospital at lunch and gave us some advice on working in this environment. We shared with her any concerns that we had and she was quick to offer some tips of how to better our situation. She put emphasis on aggressively searching for equipment throughout the hospital and talking with the staff members about any concerns that they had regarding equipment. A few days into our job we realized that we were going to have to go out and look for things to work on. We would need to take the initiative.
With our talk with Inka fresh in our mind, we went back to the hospital and spoke to Jean Claude asking if we could attend the staff meeting the next Tuesday. He agreed to let the director know that we were attending and thanked us for our work this week.
After Hours
As I mentioned earlier, Jean Claude had offered to take us out for drinks after we fixed our first machine on Tuesday. We joined him after work at a bar called New Northern Star that is very close to the agricultural market. We sat with him, ordered a few beers and learned more about him and his family. Soon, Herbert, a young man who works with Jean Claude in administration, was also able to join us. Jean Claude was kind enough to order two whole rabbits for our little group.
Now I have had rabbit before, but there is nothing like trying it in a different country in the dark (since the bar setting is outside and lights are rare). It was really good and I was enjoying it. Then Jean Claude handed me another piece of rabbit and told me to try it. He had handed me the head. I was holding the head of a rabbit (but again it was okay because I could barely see it in the dark). So after pumping myself up, I grabbed a bit of brains, or what I thought was brains, and ate it. This is exciting stuff there folks.
Now I have had rabbit before, but there is nothing like trying it in a different country in the dark (since the bar setting is outside and lights are rare). It was really good and I was enjoying it. Then Jean Claude handed me another piece of rabbit and told me to try it. He had handed me the head. I was holding the head of a rabbit (but again it was okay because I could barely see it in the dark). So after pumping myself up, I grabbed a bit of brains, or what I thought was brains, and ate it. This is exciting stuff there folks.
The next day, I was able to wash my own laundry all by myself! Did you hear that mom? I will definitely never complain about doing it back in Texas, where we have washing machines. I had to wake up extra early so that I could wash and hang up my clothes so that they would be dry by the time we got out of work.
After work that night, the girls and I went out into town to by dinner at a restaurant called La Pillote, known as the place where the muzungu people go. It is a cozy place with coffee and good pizza.
The night before our four-day weekend, Jean Claude invited us for dinner at the bar. This time we were treated to a local delicacy, akabensi. It sounds like something really exotic, but it’s really just the term for pork. However, I have never had pork that tasted this good before. Now of course we always start off by ordering a few beers first, then we wait the appropriate amount of time for our food, while talking and enjoying each other’s company.
The akabensi is unlike any other meat I have had. It is usually cut up into chunks and served with some form of potatoes. That night we had roasted potatoes. The akabensi has a great seasoning but can be a real challenge to chew. I can say with complete and utter honestly that my jaw has never been worked out that much in my life. I was so hungry but my jaw was so overworked and I was only half way done. I had to take numerous breaks while eating. Once I had finished my meal I was satisfied.
The morning after Katie, Megan, and I set out on our journey to Kibuye, a small town on Lake Kivu. Be on the look out for my next post to learn more!
Thanks, y’all!
The akabensi is unlike any other meat I have had. It is usually cut up into chunks and served with some form of potatoes. That night we had roasted potatoes. The akabensi has a great seasoning but can be a real challenge to chew. I can say with complete and utter honestly that my jaw has never been worked out that much in my life. I was so hungry but my jaw was so overworked and I was only half way done. I had to take numerous breaks while eating. Once I had finished my meal I was satisfied.
The morning after Katie, Megan, and I set out on our journey to Kibuye, a small town on Lake Kivu. Be on the look out for my next post to learn more!
Thanks, y’all!