Written by Dr Zenira Elbasheer, ST4 Emergency Medicine, North West deanery
Edited by Anisa Jafar
Rwanda is a relatively small, landlocked country in East Africa. Known affectionately as Le Pays des Mille Collines or ‘land of a thousand hills’, the country boasts breathtaking landscapes including rolling hills, and volcanic mountains. Kigali, its capital, and where I was based for 6 weeks, is a progressive, safe city that reminds you of how far this country has come in the past 30 years and gives me a much-needed feeling of hope about the state of my own.
Coming to Rwanda was not just a professional opportunity but also a deeply personal one. Being Sudanese, the irony of being based here as my country goes through one of the toughest periods in its history was not lost on me. I had planned to spend the majority of my break in emergency medicine (EM) training in Sudan itself- a plan that would suddenly change on April 2023 when war broke out in Khartoum, where my family and home were.
Teaching at the University of Medical Sciences and Technology (UMST)
The most meaningful aspect of time here was spent at UMST where I had the honour of being a guest lecturer, clinical educator, and former student. Having witnessed the university I was teaching in – and had graduated from only 7 years earlier – relocate from Sudan to Rwanda gave me a special connection with my students.
Knowing all too well what it feels like to have to continue to work and study while home is unstable and feels very distant added a personal layer of responsibility to my role here. Their added resilience was to be admired- to travel through war, move to an unknown country and to pick up their studies through all of the uncertainty is no small endeavor.
Though I also taught other year groups, most of my time at the institution was spent developing and running a course on EM for the 5th year medical students. Through lectures, simulation training and skills lab teaching, I was given the opportunity to make a real difference in their clinical learning, as until now there had been no dedicated programme for the specialty on the university course. The gratitude and positive feedback from these students was heartwarming. Seeing them so motivated to attend sessions (sometimes even outside their year groups) and ask about how to get into and excel in EM was probably the most gratifying part of the experience, especially knowing the importance of developing EM in Sudan, where the specialty is still in its early years. It was a reminder of the value of investing time into teaching and reinforced my passion for medical education.
Volunteering at Centre Hospitalier Universitaire de Kigali (CHUK)
When not at the university, my time was spent gaining exposure to the country’s emergency care system in the emergency and paediatric emergency departments at CHUK (also known as University Teaching Hospital of Kigali), the largest hospital in Rwanda. EM is a relatively new medical specialty in the country with the residency program only being developed in 2015 and the first dedicated physicians graduating in the past few years. The introduction of this training programme demonstrated significant impact on mortality since its inception and confirms the importance of the specialty as a whole. Of course, there remain challenges to EM in Rwanda, including availability of resources, equipment and consumables. What was impressive, however, was that despite these limitations, the hospital staff demonstrated how to breed innovation, resourcefulness and a unique and inspiring approach to emergency care. This version of EM that does not compromise care despite the resources – is something we can learn from the world over.
I was also fortunate to see firsthand how the entire health system responded to the sudden and unexpected outbreak of Marburg virus, a deadly haemorrhagic fever similar to Ebola. Immediately, systems were put in place to control and contact trace, and impressively, within a couple of weeks, the outbreak was under control according to CDC Africa.
Rwanda’s journey of reconciliation
Understanding more about Rwanda’s road to reconciliation provided some profound lessons. After the horrific genocide of 1994, the country and its people were left broken and traumatized. Rwanda’s progress in only 30 years has led it to be considered a symbol of healing, unity and resilience . Undoubtedly many deep-rooted challenges remain, however the ability of this nation to unite towards a common goal of national development is to be admired.
This path of resolution resonated with me immensely, as I reflect on current struggles in Sudan. The Rwandan population’s capacity to rebuild, relearn and reconcile after a period of darkness and unspeakable atrocities gave me hope that my own country may one day also find its own path toward peace and healing.
Reflection on global health
My time in Rwanda felt deeply transformative. It is a country defined by resilience, community and hope and these traits shaped the whole experience. Teaching and volunteering has enriched my perspective on global health. I was able to appreciate how the Rwandans have built a setting which allowed its health system to grow, through community cooperation, economy building, and strong education systems. Thinking of, and comparing to, settings like Sudan, and my practice here in the UK, I am reminded how we all have so much to learn from each other.
The experience is also a reminder of the power of education to change lives and improve health outcomes. The eager students I taught will be the future leaders who will contribute to strengthening emergency care, bringing us closer to bridging those remaining gaps in global healthcare.
I leave Rwanda with immense gratitude for the students, colleagues and patients who welcomed me amongst them and I hope to one day return and to continue the work we started together.