Information About: Rwanda

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MMI  first traveled to Rwanda with Dr. Pete & Judy Obregon leading the surgical teams over many years.  Today, Peta-Ann Schmidt, is the Project Director and plans for the project from her home base in Southern Africa. Dr. Pete & Judy Obregon continue to provide leadership.  Our short-term teams in Rwanda have partnered with Kibogora Hospital, which was initiated in the 1940s by American missionary Reverend Frank Adamson. Throughout the 1960's, the Medical Director Dr. Al Snyder expanded the hospital to resemble what it is today. 

Kibogora Hospital provides surgical, general medical, paediatric,  maternity and neonatal services, as well as an outpatient department. The support facilities include an X-RAY laboratory, HIV/AIDS testing, treatment facilities, dentistry, ophthalmology, physiotherapy and family planning clinics. In addition to these medical services, the Social Affairs Department and Chaplaincy team provide for the spiritual needs of patients and staff. 

                        Peta-Ann Schmidt, Project Director

                        Peta-Ann Schmidt, Project Director

 MMI Canada teams provides medical and surgical expertise and support in coopertation with the medical staff at the hospital.  A variety of surgeries are performed including obstetric and gynecological care to young women. In addition, MMI Canada participants conduct informal & formal teaching and training sessions, bed-side visits and prayers, kids club, supply sorting, chart filing, chapel time, and devotional time to create an impact on the community of Kibogora

Project Sites

  • Kibogora

General Overview

Projects will work with the Kibogora Hospital community to provide obstetrical and gynecological care, including surgical care. The patients will include a portion of the 1628 infants delivered at the hospital annually, over 45% of which have complications.

Many projects also provide a training opportunity for the locals serving in the medical field. In the past, these training opportunities have been well received by the medical personnel in the area.

Project Details

About Kibogora

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Kibogora Hospital was started by missionary nurses in the early 1960’s and is located on the shores of Lake Kivu, about five hours from the capital Kigali in the centre of Rwanda. A population of approximately 250,000 persons are serviced here, adn the hospital is a referral centre for twelve outlying health centres. Rwanda’s economy is primarily based on agriculture, particularly: coffee, tea, bananas, sorghum, and potatoes. Kinyarwanda, English and French are all official languages. A lack of access to healthcare and a lack of appropriately trained health care workers has meant that Rwanda has one of the highest infant mortality rates, and only 40% of the population has access to health care. Rwanda is  currently in the process of decentralizing health care, however rural areas are still under-serviced. Rwanda has made much progress in the field of maternal, newborn, and child health.  Lake Kivu is one the African Great Lakes, and is a centre for tectonic activity which results in unique water overturns. Rwanda is known as the "Land of the Thousand Hills", and is one of the few places in teh world today where Mountain Gorillas can be seen in the wild. 

Elevation

1463 m (4800 ft)

Climate

Subtropical highland.
Dry season: June - September; December - February. Dry and temperate.
Wet season: March - May; October - November. Wet and temperate.
Average High: 23° (73°F)
Average Low: 15°(59°F)

Quick Facts

COUNTRY BACKGROUND:

Ethiopia has a population of 87.9 million with over 80 ethnic groups, the two largest of which are the Oromo (35%) and the Amhara (27%). Ethiopia underwent a restructuring of the political system in the early 1990s, and since 1996 has remained a federal democratic republic with a division of nine ethnically based autonomous states called kililoch, which are subdivided into woredas responsible for the day-to-day health systems. The economy of Ethiopia was one of the fastest growing in the world, however since severe droughts in 2009, agriculture has been severely impacted, specifically the main exports of coffee and maize. Inflation rates as high as 40% led to subsequent difficulty with debt repayments and slowdown of growth. About 16% of the population in Ethiopia are living on less than one dollar per day. 

Major droughts  have also affected the health status of the country: only 65% of rural households in Ethiopia consume the minimum standard of food per day (2,200 kilocalories), with 42% of children under 5 years old being underweight. This has led to high amounts of infectious disease that are exacerbated by poor sanitation, malnutrition, and co-habitation with livestock. Emigration of skilled professionals has resulted in a 'brain drain' in the country, and a severe shortage of skilled health professionals. It is estimated to have 1 physician for every 100, 000 persons, with most professionals concentrated in the capital.  Despite this, infant mortality continues to decrease and rests at 8%, while life expectancy continues to increase: it is currently 58 years. 

School enrollment is at approximately 69% of urban individuals in primary school, while secondary school has 35% enrollment; this places Ethiopia as one of the highest among African countries. Literacy rate continued to increase, and currently stands at 82%. 

Ethiopian cuisine is quite different than Western cuisine: popular dishes include: wat, a thick meat stew and injera, a sourdough flatbread. Dishes are served family style, and utensils are not used - instead injera is used as a form of spoon. Long-distance running is the most popular sport, and E
thiopian athletes have won many Olympic gold medals in track and field.

Ethiopia has a diverse climate due to varying elevations, thus is home to over 31 endemic mammalins species and 20 endemic avian species. Many of these species are endangered due to habitat loss through deforestation, including the Ethiopian Wolf. Ethiopia is also the origin of the coffee bean, the mouth of the Nile River, and the sight of the largest cave in Africa at Sof Omar. 

The population is young and predominantly rural, with a density among the highest in Africa. Rwandans are composed of three ethnic groups: the Hutu, Tutsi and Twa. The Twa are a forest-dwelling pygmy people descended from Rwanda's earliest inhabitants.
Rwanda is one of the poorest countries and has great health care needs. According to Rwanda’s Ministry of Health there is only one doctor for every 50,000 people and 103 children out of 1000 die before they reach the age of five.

there are five provinces delineated by borders drawn in 2006. he current constitution divides Rwanda into provinces (intara), districts (uturere), cities, municipalities, towns, sectors (imirenge), cells (utugari), and villages (imidugudu)
The districts are responsible for coordinating public service delivery and economic development.The present borders were drawn in 2006 with the aim of decentralising power and removing associations with the old system and the genocide. 
Rwanda has the world's highest proportion of females in government positions in proportion to the population.
Rwanda's economy suffered heavily during the 1994 Rwandan Genocide, but has since strengthened. The economy is based mostly on subsistence agriculture. Coffee and tea are the major cash crops for export. Tourism is a fast-growing sector and is now the country's leading foreign exchange earner. Rwanda is one of only two countries in which mountain gorillas can be visited safely, and visitors are prepared to pay high prices for gorilla tracking permits.Rwanda is a country of few natural resources,[95] and the economy is based mostly on subsistence agriculture by local farmers using simple tools.[141] An estimated 90% of the working population farms, and agriculture constituted an estimated 42.1% of GDP in 2010.[77] Since the mid-1980s, farm sizes and food production have been decreasing, due in part to the resettlement of displaced people.[142][143] Despite Rwanda's fertile ecosystem, food production often does not keep pace with population growth, and food imports are required.

The Rwandan government prioritised funding of water supply development during the 2000s, significantly increasing its share of the national budget.[165] This funding, along with donor support, caused a rapid increase in access to safe water; in 2008, 73% of the population had access to safe water, up from about 55% in 2005.ccess to sanitation remains low; the United Nations estimates that in 2006, 34% of urban and 20% of rural dwellers had access to improved sanitation.[167] Government policy measures to improve sanitation are limited, focusing only on urban areas.[167] The majority of the population, both urban and rural, use public shared pit latrines for sanitation.[167]
n 2012, estimates place Rwanda's population at 11,689,696.[77] The population is young: an estimated 42.7% are under the age of 15, and 97.5% are under 65. The annual birth rate is estimated at 40.2 births per 1,000 inhabitants, and the death rate at 14.9.[77] The life expectancy is 58.02 years (59.52 years for females and 56.57 years for males), which is the 30th lowest out of 221 countries and territories.[77][176] The sex ratio of the country is relatively even.[77]The population is predominantly rural, with a few large towns; dwellings are evenly spread throughout the country. 

Only 40% of the population have access to adequate health care. Malaria has been the biggest cause of illness and death. An ongoing health education program has reduced the incidence of malaria but it remains a major cause of death, particularly in children.
In 2011 the total number of staff at Kibogora was 216 including 12 Doctors, 97 nurses and 17 technicians. The hospital admitted 6312 patients and treated 23119 as outpatients. The maternity unit delivered 1628 babies, over 45% of which had complications. The laboratory conducted 96500 tests. There were 1998 major surgeries performed and 1064 minor surgeries. The bed occupancy was 70%.

 

The HIV/Aids unit at the hospital has treated 1918 patients since the programme started in 2006. Of these, 621 were transfered for treatment to the  health centres. The Health Centres are supported and supervised by the HIV/Aids team of Doctors and technicians from Kibogora Hospital.

 

There are currently 384 children in the community malnutrition program where they are supervised in their own homes. There are many hundreds of others treated at the health centres with only the most serious cases being transferred to Kibogora Hospital. Among the most serious cases are children with Aids related illnesses who are severly malnourished. Unless the child is well nourished the anti retroviral medications will not be effective.

he Rwandan government provides free education in state-run schools for nine years: six years in primary and three years following a common secondary programme.[252] President Kagame announced during his 2010 re-election campaign that he plans to extend this free education to cover the final three secondary years.[253] Many poorer children still fail to attend school because of the necessity of purchasing uniforms and books and commitments at home.[254] There are many private schools across the country, some church-run, which follow the same syllabus but charge fees.[254] From 1994 until 2009, secondary education was offered in either French or English; because of the country's increasing ties with the East African Community and the Commonwealth, only the English syllabi are now offered
The country's literacy rate, defined as those aged 15 or over who can read and write, was 71% in 2009
In 2008, the government spent 9.7% of national expenditure on healthcare, compared with 3.2% in 1996.[265] Health insurance became mandatory for all individuals in 2008;[266] in 2010 over 90% of the population was covered.[267] The health insurance is mainly delivered by the Community-Based Health Insurance Scheme, which consists primarily of a social health insurance program called Mutuelles de Santé. Due to a variety of reasons such as poverty, poor roads due to the hilly terrain in the rural areas, misleading traditional beliefs and inadequate knowledge on pregnancy related issues, 31 percent of the women end up delivering at home despite having a public health insurance scheme. Some of the solutions which have been sought to the challenges include the training of more community health workers (village health teams) to sensitize the community,on top of providing them with mobile phones to contact the health facilities in emergency situations such as haemorrhage. The number of ambulances to some of the rural health centres have also been increased.[he number of malnurished children in Rwanda stil poses as a challenge. The percentage of children under 5 years who were moderately or severely underweight decreased from 24 percent in 1992 to 18% in 2005 to 12% in 2012. Stunting reduced slightly from 57% in 1990 to 44% in 2010
The cuisine of Rwanda is based on local staple foods produced by subsistence agriculture such as bananas, plantains (known as ibitoke), pulses, sweet potatoes, beans, and cassava (manioc).[214] Many Rwandans do not eat meat more than a few times a month.[214] For those who live near lakes and have access to fish, tilapia is popular.[214]

 

GEOGRAPHY

LOCATION:

Eastern Africa, west of Democratic Republic of the Congo

GEOGRAPHIC COORDINATES:

2 00 S, 30 00 E

MAP REFERENCES:

Africa

LAND BOUNDARIES:

TOTAL:

930 km

BORDER COUNTRIES:

Burundi 315 km

Democratic Republic of the Congo 221 km

Tanzania 222 km

Uganda 172 km

COASTLINE:

0 km (landlocked)

MARITIME CLAIMS:

None (landlocked)

 

CLIMATE:

Temperate; two rainy seasons (February to April, November to January); mild in mountains with frost and snow possible

TERRAIN:

Mostly grassy uplands and hills; relief is mountainous with altitude declining from west to east

ELEVATION EXTREMES:

LOWEST POINT:

Rusizi River 950 m

HIGHEST POINT:

Volcan Karisimbi 4,519 m

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Country Entry Requirements

Travelers must present a passport, which must be valid for at least six months beyond the date of expected departure. Tourist visa is required. Proof of yellow fever vaccination is required.

Canadians: Travel visa is required at a cost of $50 USD, and must be obtained prior to travel. Visas are not available at points of entry. For more information on the visa application process, please check this website: https://www.migration.gov.rw/index.php?id=216.Please check the following website for the most current entry/exit requirements: http://travel.gc.ca/destinations/rwanda

Americans: Travel visa is required at a cost of $30 USD, and can be obtained at Rwandan ports of entry (i.e. airports). For more information see the US State Department website: http://travel.state.gov/content/passports/english/country/rwanda.html

 

Medical/Dental Professionals

Please send a copy of the following to the MMI Canada office:

  • Current license
  • Current diploma 
  • CV for MD, DDS, DMD, RN/LN, RPN/LPN, NP, PA, and surgeons
  • Surgeons - Surgical privileges list  

Travel:

Once you have been accepted on the project, we will provide our designated travel agent information so that you can arrange your travel in order to coordinate logistics of the team.

Canadian Applicants: Donations for travel are in addition to the Participant Project Donation.

US Applicants: Travel costs are arranged individually and are in addition to the Participant Project Donation.

Airport

Kigali International Airport (KGL), Kigali

Lodging and Accommodations

The team will stay at guest house facilities while on project in Rwanda. 

Bed Linens/Sleeping Bag: provided
Bath Towels: bring your own
Mosquito Netting: bring your own
Laundry Service: available for additional fee
Hot Water: available
AC: not available
Phone Service: check with your cell phone provider
Wifi: available at the hospital, but not at the guest house
Voltage: 220V (transformers and adaptors required)  - Electricity is often limited
Meals: Meals are provided by partners in Kibogora. Be sure to bring your own re-usable water bottle with a wide mouth for refilling. Purified water is supplied.

Culture

Language: Kinyarwanda, French, and English

Religion: 

  • Catholic: 60%
  • Protestant: 26%
  • Other: 14%

Government: Republic

Currency

Currency is the Rwandan franc.

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