In the words of three doctors that I met at the PIH facility in Rwinkwavu, Rwanda
Dr. Michael Rich, Director of Research and Quality for PIH. “I have been here for five years I am a medical doctor with a masters in public health. I have been working in global health for more than ten years. I am a native New Englander. I think PIH differs from other organizations in that we take a rights based approach that all people have the right to education, work and good health and to live a decent life. We go to countries and we establish a long term relationship with them and we work with governments to bring those rights to people. My own personal feeling about the areas in which we work is that there is a huge amount of obscene poverty. I think PIH really does break the cycle of poverty and disease. We go beyond just building hospitals and treating people, we work to improve their social conditions, to improve education so that the people we work with have a cycle of better health leading to higher income. We are unique because of the incredible partnership we have with the government that helps them meet their objectives. In Rwanda they care and they want to bring all of these rights to the people. They have specific strategies and are actively moving towards them. When we first came into this area one in ten kids didn’t make it to age five and many diseases weren’t being treated. There are so many moving cases. In the beginning children came with cerebral fever and it was incredible to be able to cure them. Even more rewarding was to work on a program that treated childhood diseases as early as possible. For instance having one of our community health workers treating the child in the early stages. Now I know that we are having fewer cases that are dire. I am particularly interested in seeing all the pathologies and diseases that are at the hospital and trying to treat and prevent them. A very moving case was a young man named Jean Claude. He was diagnosed with HIV and when I first met him he was in dire shape. Once he learned about his disease and learned how to treat it, he joined a neighborhood association and became a community health worker and in turn helps his fellow countrymen and women treat the disease. He is married with three children all of whom are negative – he has turned everything around and is fighting for other’s lives.
My question: Do you think about the genocide? “Everyone thinks about the genocide daily, as an outsider I will never have a full insight into it.”
My question: What do you wish for Rwanda? “My immediate wish in Rwanda is to work with the ministry of health to fully meet the model of care the government has laid out. This would be a comprehensive model of social care and health intervention which includes good governance, and a well trained human resource force that is present in adequate numbers and responsive. I would like sufficient medicines and commodities. I would like to have advanced information technology to help monitor the system. Of course an adequate level of services, including services at the district hospital and the ambulatory hospital as well as sufficient community health workers. To have everything adequately financed here at PIH so that we can accompany the government as they put the building blocks of a good health system in place. My dream would be to see healthcare funded at all levels in these districts. I know that the impact we have assisting the government to meet it’s goals can show others that it’s worth it – we will soon have a public health model to show other governments around the world – to say to them – look this is something that you have a moral imperative to invest in.”
Dr. Jean Bosco, Chief of the Medical Staff, General Medicine at the Rwinkwavu Hospital. Jean Bosco works as a medical doctor employed by the Rwandan Health Ministry in partnership with PIH. “When I was a child I had the inspiration of coming someone great without knowing what kind of person I would become. After primary school I went to minor seminary to prepare for the priesthood encouraged by older brother who was a priest. My parents were agriculturalists – they were deeply Christian. Then came the war. I was in my fifth year when the genocide occurred. I fled to Congo with my family because I was deeply afraid. I was refugee for two years and lived in a refugee camp and worked for a German organization. At that time I was touched by the experience I had gone through, so much mass violence and genocide. My Christian self wondered why there was so much atrocity and why so many innocent people died. This was my response it was bad leadership. Leaders forced Rwandans to kill and poor uneducated people obeyed especially young people….. They were too obedient to the authorities. From understanding that, I said I must be a leader so that I can influence the future. Then I happened to discover Ghandi and I read his book “Tous Les hommes son frères.” I asked myself how can I become like Ghandi? At that time I founded a youth movement for peace – I was twenty three. And then the German congregation I was working for said we want to help you with your studies for the priesthood. But I told them, I don’t want to become a priest, I want to be involved in social change for my country. Then they suggested I become a doctor. At that time I was confused because I wanted to do economics or sociology this would help me to have abroad view of society. Some friends told me it isn’t what you study which determines what kind of person you become, but it’s the person who you are and the person who will act. At that time I didn’t understand this. When the war broke out in Congo I came back and I did my sixth year in seminary and then had to decide whether I would go to university or to seminary. Since I had this idea of becoming a doctor, I thought why not medicine, but I was not seeing the connection between being a doctor and becoming an influential person for social change. I decided to go to medical school, but when I was in the second year I had an existential crisis and I was about to leave medicine. At that time I discovered holistic medicine, I could now make a connection between health and healing and spiritual growth and from that social healing.
I read a lot of things from western philosophies and spiritual healing and when I came here I knew that this was the right place. I feel I am realizing myself. I don’t work for money what I do it’s a calling. I work only to help people.”
My question what do you wish for your country? “I would wish that my country would heal from the trauma because it’s the basis of lasting peace – there has been too much suffering in silence, Poverty is one of the factors that traumatizes people in a chronic way and also the history we have gone through is a big component of this suffering for me. In Rwanda we have gone through a vicious cycle of injustice and violence and with that came a cycle of dehumanization and victimization. When you look at history every time there is a group that is victimized and another group that is a perpetrator. We are in a dual society and with this it’s difficult to transcend duality and ethnicity and to feel as one. We still need mechanisms that can help people to break this cycle and to feel powerful to fully get to reconciliation and healing together.”
Dr. Sara Stulac, Pediatric Medicine PIH. “I’m a pediatrician and also have a public health degree. I have been working and living in Rwanda with PIH since 2005, shortly after the project started here. I am the project’s clinical director, so I support all of the clinical programs, but have especially focused on developing pediatrics programs (pediatric HIV, malnutrition, preventing mother to child HIV transmission, pediatric cancer, etc).
Why I am here: Ever since a visit to Uganda just after I finished college, I had planned to move to Africa when I finished my medical training, because it seemed to obvious that I could do the most good in an underserved setting, where I constantly saw children suffering and dying from preventable and easily treatable illnesses and problems—sometimes only missing an antibiotic, or food. I did a lot of short term work in different Africa countries during my medical training, all of which convinced me that I wanted to work in a place where I could help poor children and families get access to good medical care, education, and jobs. When I learned about PIH, I felt that their work and philosophy were better and more effective than any of the other groups out there, particularly the focus on social justice and right to care. I am really grateful to have been part of building this project and to have the opportunity to make the long-term investment in a country and a community, and to see how peoples’ lives have been affected by PIH’s work here.”