Day 8: Visit to Partners in Health-Rwanda/Inshuti Mu Buzima

Day 8: Wednesday, February 14, 2007

Kigali is an amazingly beautiful city of rolling hills with lots of housing and farming. It is the rainy season now, so each day usually begins as bright and sunny until the afternoon when it clouds up and then intense lightening-filled thunderstorms rage the sky. Following the rains there is a misty fog that brings in the dusk and fills the air with a sweet and refreshing smell.

My journey through exploring the Rwandan genocide continues. I’m halfway through Dallaire’s book, Shake Hands with the Devil….it is rattling my soul….and it is challenging my awareness and my thinking about life….I’m crying a lot too. I’ve learned more about the society is trying to cope with this relatively recent crisis. For example, they’ve removed history from the primary school curriculum, as they are developing a new curriculum that focuses on unity and reconciliation. After students complete high school, they attend a “solidarity” camp where they get intensive training and education on being a Rwandan first. Some people feel that the government is being too heavy handed in trying to eliminate the notion of tribal identity, rather than trying to say that it is ok that there are different tribes that can live happily together. If you ask someone what there tribe is they won’t answer, except by saying that they are Rwandan. This seems smart to me!

I left Kigali and traveled for about two hours west towards Tanzania on well-paved road to visit Rwinkwavu Hospital which is being rehabilitated by the amazing Dr. Paul Farmer (also a GAA Board member) and his team from Partners in Health (PIH) or Inshuti Mu Buzima (in the Rwandan national language of Kinyarwanda). On our way out of town, we stopped at the airport to pick up a medical student from Boston who was coming to do a rotation. I was pleasantly surprised to meet Vanessa Kerry, the daughter of Senator John Kerry. We had a great chat and I was left incredibly impressed by her intellect, commitment, and passion for global health justice…I have the sense that she is becoming an important leader in our movement.

PIH began operating in Rhinkwavu Hospital and it’s 6 referring health centers in May of 2005. The Ministry of Health assigned them the two most underserved districts in the whole country. Here is a link to get all the details: http://www.pih.org/where/Rwanda/Rwanda.html. It was amazing to learn that in such a short time, PIH has trained over 700 paid community based accompagnateurs (community health workers) who are supporting over 2000 people (including nearly 200 children under 15 months of age) on lifesaving antiretroviral medicines with an adherence rate of over 95%. In classic PIH fashion, a new gold standard of comprehensive health services is steadily being developed to support the nearly 400,000 people in these districts. Already, some of the groundbreaking training approaches and electronic medical records systems are being picked up by the Ministry of Health for national replication. The excellent financial support from the Global Fund to Fight AIDS, TB, & Malaria, UNICEF, and the Clinton HIV/AIDS Initiative is making this possible.

PIH is supporting HIV/AIDS patients by giving them food and nutritional support and job opportunities. They are empowering people to earn a wage by becoming artists, welders, seamstresses, and furniture makers in nearby buildings. One of the major challenges that PIH is facing is the lack of well-trained health care workers. They have recruited and supported some great Rwandan nurses and doctors, but they also have a steady group of expatriates supporting is important program such Dr. Sara Stulac, Melissa, Christian and others. Being committed to finding structural solutions to problems, PIH was recently awarded a small grant from the Bill and Melinda Gates Foundation to construct a new national health worker training center on the hill above Rhinkwavu--scheduled to open later this year. Soon health workers across Rwanda will be able to access world class training.

The powerful hand-to-hand partnerships between the Rwandans and PIH is one of the most powerful demonstrations that I’ve ever seen of the how the African Renaissance is actually underway! and in our time!! now if only we can help it to succeed!!!

Just a short walk from the hospital is a local genocide memorial, which are apparently found commonly throughout the country. There is a small blue and white steel and tall fenced in area that has a small memorial wall in front of a large concrete slab...which means that this was another burial site for thousands. As I stood there, I closed my eyes and tried to absorb the paradox of two realities that humans can create in this one physical place. Just 13 years ago this was a senseless killing field and today it is a vortex of hope in a sea of illness and poverty. I pray that we will all wake up and together make "hope" a new permanent reality.

Happy Valentine's Day to my dear wife who supports me so completely on my journeying!