A New Medical School Will Transform Care in Rwanda—and Beyond
Filed under Social Justice
Posted April 2019
The new campus at Rwanda’s University of Global Health Equity won’t just train the next generation of doctors in East Africa—it will advance the community health care model throughout Africa and across the world.
The global shortage and unequal distribution of trained health care workers have profound negative impacts on human health, and particularly on the health of the world’s most vulnerable populations. The World Health Organization forecasts a shortfall of six million health care workers by 2030 in East Africa alone.
That’s why the grand opening of the University of Global Health Equity campus in Butaro, Rwanda, on January 25 took on symbolic weight. There, next to the district’s sole reference hospital, a new cohort of health care practitioners-to-be will train to provide and lead health care delivery—in Rwanda, across East Africa, and beyond. For those living nearby, the newly finished medical school—the first health sciences institution in any rural area of the country—is a beacon of the enormous progress made over the past decade. As recently as 2008, Burera, the district encompassing Butaro, lacked a reference hospital and it didn’t have a single doctor to care for its 800,000 residents.
With the campus unveiling, the university opens its doors to a new generation of doctors, nurses, and other practitioners who will work to transform the culture of health care delivery across the region and around the world. Though Rwanda provides universal access to health care—and has recorded remarkable rates of childhood immunization, access to treatment for HIV and tuberculosis, and other gains—some services, like specialized surgery, remain scarce or unavailable.
Nicole Jabo, UGHE master's of science student
If you’re just focusing on what drugs to give them to treat malaria, you’re not solving the bigger problem, and you won’t prevent that patient’s brother or sister from coming back, too.
Enter the University of Global Health Equity, a major initiative of the nonprofit Partners In Health, which in 2011 joined with the government of Rwanda to launch the first teaching hospital in Butaro. The new UGHE campus, situated on a neighboring hilltop, comprises six buildings over 250 acres, including classrooms, conference rooms, offices, dormitories and other amenities for 200 students, and a dining hall. Courses are taught by a team of permanent and visiting faculty drawn from Rwanda and around the world.
The university application process privileges refugees and other underrepresented groups and has designated 70 percent of the admissions in its first cohort of medical students for women. On average, the university provides scholarships covering 91 percent of students’ tuition.
UGHE aims to fill key gaps in health care delivery, especially in rural settings, by employing community health workers as faculty and embedding first- and second-year students with on-the-ground health teams that are attuned to the realities of delivery challenges away from large hospitals. (Third-year students transition to hospital residencies.) According to Cassia van der Hoof Holstein, Emerson Collective’s Director of Global Health Equity, this focus on community-based care is significant: “As trusted members of the communities they serve, community health workers (CHWs) play an essential role in care delivery in much of the world,” she explains. CHWs provide care and support in patients’ homes and communities, including first-line diagnosis and treatment, family planning, support for the treatment of chronic conditions like HIV and hypertension, and accompaniment for pregnant women. They serve as living links between communities and health systems.
Cassia van der Hoof Holstein, Emerson Collective director of Global Health Equity
As trusted members of the communities they serve, community health workers play an integral role in the delivery of care in much of the world.
In addition to its focus on community-based care, UGHE is the first university in the world focused entirely on advancing health equity—pairing human rights and social justice education with medical training. The UGHE curriculum combines lessons learned in community health settings with leadership and management skills training that’s often lacking in medical schools around the world. “Some of the key lessons learned in the delivery of equitable care have been learned right here in rural Rwanda, and some of these lessons are broadly applicable in cities, and many disparate settings,” says Dr. Paul Farmer, Co-Founder and Chief Strategist at Partners In Health, and Chair of the Department of Global Health and Social Medicine at Harvard Medical School.
For Nicole Jabo, a 25-year-old Rwandan student pursuing a Master of Science in Global Health Delivery, being exposed to community health delivery included visiting malarial hotspots in the eastern Rwanda town of Rwinkwavu, one of the poorest regions in the country. Despite Rwanda’s universal health care, Jabo says, it was clear that people living in such areas faced tremendous obstacles to receiving care. “They can’t afford transportation, or can’t leave work, or afford meals away from home,” she says. “You can see how all of this can disempower someone from going to the hospital, which is very far away. If you’re just focusing on what drugs to give them to treat malaria, you’re not solving the bigger problem, and you won’t prevent that patient’s brother or sister from coming back, too.”
Jabo is precisely the type of student UGHE was created for. After receiving her bachelor’s degree at the University of Texas at Tyler, she decided to pursue a career in health care back home in Rwanda. “The country has a lot of promise,” she explains. “When people see Rwanda, I want them to see something other than the genocide. That’s the image people have. But we’re trying to create a new image in the world’s eyes, and I want to be a part of that.”