Rwanda is a small country of approximately 12 million people in East Africa whose health care system was decimated by the 1994 genocide.  In 12 weeks, over 1 million Rwandan people died or were displaced at the hands of their friends, relatives and countrymen. Many who died were physicians, nurses and other health care workers that sustained the countries healthcare system. 

 

In the past 15 years, Rwanda has made enormous strides to recreate and reimagine its health care system.  In 2012 the Rwandan government led the Human Resources for Health Program (HRH Program), a bold training initiative to fill the shortage of health professionals.The goal of the HRH Program was to build a large, competent healthcare workforce to sustain a new innovative Rwandan healthcare system.  Over the first 5 years of this program (2012-2017), 99 physicians a year travelled from US teaching hospitals to Rwanda to help in this goal.  The success of the program is inherent in that 22 new training programs were established which graduated over 4600 health professionals by 2019. However, the cost of bringing visiting faculty from the US partner institutions, taking away from their practices at home, was substantial and unsustainable. With the HRH Program winding down, there has yet to be training programs in specialties such as Gastroenterology & Hepatology established in Rwanda. 

Gastroenterology & Hepatology care is very limited in Rwanda, despite liver disease and esophageal, stomach, and liver cancer being in the top 25 causes of death. To address this, the Rwanda Society for Endoscopy (RSE) was formed in 2017 with the goals of providing patient care and training providers in endoscopy.  An important part of accomplishing their mission has been the creation of Rwanda Endoscopy Week (REW) during which gastroenterology faculty from around the world travel to Rwanda to provide high level care to patients while teaching Rwandan physicians endoscopic skills via both lectures and hands-on training.  In 2017, 244 endoscopic procedures were proformed during REW, which increased to 448 in 2018 and 668 in 2019.  Currently there is one gastroenterologist in the country and less than a dozen internists with some expertise in gastroenterologic conditions and endoscopic procedures. 

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To further Gastroenterology & Hepatology care in Rwanda, the US non-governmental organization GI Rising was formed in 2020 with the mission of furthering GI education and care in Rwanda through sustainable methods. As part of this mission, our goal is to start the first Gastroenterology & Hepatology fellowship program in Rwanda, slated to start in 2021. 

 

Such progress has been made through backing from the Rwandan Ministry of Health and U.S. teaching institutions such as Dartmouth Hitchcock Medical Center and Brigham and Women's Hospital, as well as  national and international partnerships.  A great deal more needs to be done as we start on our path to training the first Rwandan gastroenterologists. 

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