Category Archives: International Health

In my previous post I mentioned an emotional visit to Kigali’s public hospital – that actually doesn’t even begin to do justice to the intensity of our experience. Mardge Cohen arranged the visit for us, to give us a better sense of the Rwandan health care system. Until this visit, we had only seen privately funded clinics, not actual hospitals used by large numbers of Rwandans.

A local doctor gave us a tour of different wards, including the pediatric care unit. For privileged Westerners socialized who take a certain standard of medical care for granted, it was a sobering experience to say the least: beds crowded together, patients and family members thrown together in a jumble in decrepit room after room. Most of us like to talk about the ways our own American medical system is broken, but the brokenness of public health system in Rwanda is truly difficult to fathom. The public hospital doesn’t supply patients with food or bedding; these items must be provided by individual families. We also learned that when hospital stays are completed, patients are expected to pay in full. Unbelievably, those who cannot pay must stay in the hospital until they are able to pay their hospital bills.

Private medical insurance is available in Rwanda, but it is obviously beyond the means of most Rwandans. There is also a national system known as “Mutuelle,” which is less expensive, but the social safety net system here overall is close to non-existent. It’s just so overwhelming to see the sheer number of people holding on for dear life or simply falling through the cracks.

On Friday our group split up into groups. One visited a WE-ACTx supported maternity clinic in rural Nyacyonga and the rest of us accompanied WE-ACTx social workers on their home visits to families. Our group visited the home of Beatrice and her 14 year old daughter, Leontine, both of whom are infected with HIV. We visited with them for close to two hours, sharing our stories and learning as much as we were able about one another.

Beatrice was infected by her husband, who later died – and she passed the HIV on to Leontine when she was pregnant. With disarming frankness, Beatrice told about how angry and depressed Leontine became when she first learned how she contracted her illness. She was near suicidal when they discovered the children’s program at WE-ACTx. Today Beatrice is a happy and confident teenager and a leader in the program. (We’ll get to see her perform with the children’s dance troupe this Sunday).

Our final visit of the day was an excursion to Nyamata – a rural village which is home to an infamous genocide site. In April 1994, a mass of Tutsis attempted to find sanctuary inside the church. 2,000 were eventually slaughtered inside and 10,000 were killed in the surrounding area.

The inside of the church remains much as it was during the actual genocide – the sanctuary itself is filled with the bloodied and torn clothing of the victims. The basement of the church and an underground crypt outside essentially serve as mass graves, filled with row upon row of human skulls and bones.

Incongruously enough, as we emerged from the crypt, the air was filled with the joyous sounds of Afro-Pop filling the air. A local church was celebrating a “Festival of Hope” just down the road. For many of us, the paradox of the moment was just right: in a sense we were experiencing both the horror of recent Rwandan history as well as the hope of the Rwandan present.

Even so, the visit shook our group to the core. Before leaving for Kigali, we gathered together for Kaddish (above). During the drive back, the sun set over the green hilly countryside. Rwanda is just such a beautiful country in so many ways. Looking out at this gorgeous, tranquil landscape, it is impossible to comprehend the sheer hell that was unleashed just fourteen short years ago.

PS: Our visit to the Kigali Genocide Museum was featured on the Rwandan news yesterday…