Nyamata, Rwanda

The last few weeks I have been leaving the Nyamata Hospital to work in the community health centers. Getting to the centers often entails a few hours of travel in a four-wheel drive over rough, dirt roads.  There are 11 centers in the Burgessa district and more than 400 in Rwanda

These health centers are the front line healthcare for most Rwandans. Each center is responsible for a population of roughly 20,000 people. Patients using the public hospitals must start at these community based centers. If the case is complicated, they are transferred to a district hospital like Nyamata. The staff care for sick patients, deliver babies, provide vaccinations, distribute food given from the government and non-governmental organizations. They also have daily classes on topics such as family planning, gardening for nutrition, and proper sanitation and food preparation. These centers are truly the best hope the country has in the areas of disease prevention and early intervention. 

Sitting with the nurses to consult the patients has been interesting. The majority of patients have diarrhea caused by intestinal worms or they have malaria. Both are easily treated at the center. I am reminded how different the patients’ lives are from mine every time they leave the room. Because they have lived their whole lives in crudely constructed houses, they have often difficulty figuring out how to use the door handle. 

 I am always amazed by how long patients wait to come to the clinic. I saw one patient who fell down a well. She had a dislocated shoulder and could not see out of one eye because she had hit her head. She told us she was in the well for four days before someone found her. When I asked when it happened, she said 11 years ago! This was the first time she sought treatment. It is common for the patients to try treatment with a traditional healer before coming to the centers. Traditional treatments often involve scarring the body with a red-hot piece of metal. It is sad to see advanced medical cases that could have been avoided if the patient would have come to the center first.  

The centers see 80-160 patients everyday, which means they are usually running at full capacity. I am currently partnering with a member of the Access Project, a non-governmental organization that aids the Rwandan health centers by providing management, training, and infrastructure. Through this collaboration we are searching for a ways to increase the health centers’ capacity without adding more costs.   

The nurses do incredible considering their education and lack of resources, but there is only so much they can do. I feel fortunate to have been able to work with them and teach them some more advanced skills.