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This is my forth trip to Rwanda and as I get ready, I'm filled with excitement and trepidation. I'm excited knowing I will see fellow team members that I haven't seen for two years and to see some of the patients we helped on previous trips. The trepidation is there before every trip, even after 22 years in the military and more deployments than I can count, dozens of medical missions during those years and those that I have done after I retired.  The trepidation is the unknown; did I pack the enough anesthesia equipment, will I anesthetize more pediatric patient than adults or will I anesthetize any patients at all, or will my checked bags be lost and none of the anesthesia supplies and equipment arrive?  All this runs through your head as you try to finish up the those daily tasks at work that you know can't wait until you return. 

The trip starts early, 4am, throw the bags into the truck drive to DIA while thinking of what I may have forgotten. Once at the airport we find out they had us ticketed but no seats were assigned. Luckily Susan, my significant other and fellow anesthetist, insisted we leave Summit County early so we had plenty of tIme between arrival and departure. After lots of calls, and running between airline ticketing agents we get to the gate three hours later, but still with lots of time to make the eighteen hour flight to Rwanda. Yes, connections were just barely made and one special anesthesia monitor was lost or stolen but walking out of the airport in Kigali and seeing someone holding a paper sign with our names, I know the trip will be okay.

The next day we meet up with Dr. Janes who had been in Ralemia teaching a two day class on the poinsettia technique, serial casting for club foot deformities, and the rest of the team which has  just finished a trek to view the mountain gorillas.  The biggest surprise  during the four hour drive  to Muganero  Hospital is the huge amount of road construction being done to widen and straighten the road. The amount  of progress, development and improvement found in Rwanda is just astounding.  Most of these infrastructure improvements are being funded by the Chinese.

The surgery week successfully ends, we  are thanked many times and told that we give the people of Rwanda hope. But as I sit here next to Lake Kivu I reminisce on the many patients who life's we have impacted and hopefully improved. As I leave Rwanda I wonder if the change that is happening throughout the region and around Lake Kevu will make a much bigger impact on their lives than their  surgery?

Matthew Cowell