Category Archives: Global Health

UNC Health Care on Ebola

Hospitals across the country are preparing for the possible admission of patients with Ebola. While North Carolina has not had a case of Ebola, UNC Health Care is prepared for the safe care of patients with these types of highly communicable diseases.

The safety of our patients and co-workers will remain, as always, our top priority.

A group of experts at UNC hospitals and the UNC School of Medicine is working to ensure that all appropriate individuals are trained and equipped to protect patients, guests, the community and each other if we do admit a patient with Ebola.

An inpatient location for Ebola care has been designated at UNC Hospitals if needed. This area has space for patient care, point-of-care laboratory testing, equipment storage and separate areas for donning and doffing personal protective equipment.

While Ebola is a serious illness, keep in mind that the disease has not spread through casual contact, air, water or food grown or legally purchased in the United States.  The virus can be spread only via direct contact with bodily fluids, objects contaminated with the virus (e.g., needles, medical equipment) and infected animals (by contact with blood, fluids or infected meat). Ebola outbreaks have occurred primarily in remote villages in Central and West Africa.  Still, it’s important to take precautionary measures to help prevent the spread of infectious diseases including Ebola. As with any other infectious disease, washing your hands frequently is one of the best methods to protect yourself and others from contracting the infection.

Our Ebola Coordinating Group is chaired by Dr. David Weber, medical director of Hospital Epidemiology, and co-chaired by Dr. Billy Fischer, Assistant Professor of Medicine, who treated Ebola patients in West Africa this summer. We are working in close consultation with the State of North Carolina’s Division of Public Health and the Centers for Disease Control and Prevention (CDC).

There is significant and understandable anxiety about this situation. Please rest assured that we have a comprehensive plan in place. We will continue to update our co-workers and the general public with relevant updates as they become available.

To learn more about our Ebola preparedness, click here.

 

Kigali and the Dufataye Cooperative in Nyanza

Over the weekend I had several very worthwhile experiences.

I got some chores done in Kigali, and then had dinner in the home of new friends, Cal and Mimi Wilson.

Cal is a family medicine doctor and a faculty member at the University of Colorado Denver.

He is UCD Director of the Capacity Building Project in Medical Education in Rwanda, which is a consortium of several US med schools working to strengthen medical education here.

He also directs a family medicine residency program in Rwanda — and we have several mutual friends.

Cal and Mimi have done similar work in Jordan and Ecuador in the past.

After church on Sunday, we drove to Nyanza, about two hours south of Kigali, to visit with Godfrey Kalema and his wife Diane.

We had met last year when we were in Rwanda.

Godfrey is a high school teacher who started a non-profit group in 2003 called the Dufatanye Cooperative.

It provides a place to live and some opportunity for income for extremely poor people who are HIV positive.

Currently seventy seven people live there, most of whom are on anti-retroviral therapy.

Will had spent the past two days there — working at the Cooperative.

After lunch at Godfrey and Diane’s house, we went to Dufatanye.

You can see pictures of our visit at www.flickr.com/photos/billroper.

The members of the coop welcomed us with song and dance — and Will and even I got into it!

Then there was some speechmaking and translating, ending with their giving us gifts they had made, woven grass baskets and other items.

We walked around and saw their gardens — and then their brick and roof tile making activities. Will had worked on this and did cabbage planting too.

He had a great time there — and told the group that he looks forward to coming back next year!

We Americans have so much to be grateful for — and so much to learn from others. I was really moved by my time at Dufatanye.

We are now at Butare — a bit further south. It is the third largest city in Rwanda, and the home of the National University of Rwanda, so think of it as the Chapel Hill of this country.

More to come, stay tuned!

Public health and HIV/AIDS in Rwanda

After getting a bit settled this morning (with local currency and cell phones), we set out to learn about the latest in public health here.

We went to the US Embassy, where we were hosted by CDC’s mission chief, Dr. Pratima Raghunathan. We had lunch with some team members — they have nearly 50 CDC staff altogether.

This is a very significantly expanded global health presence by the CDC. They told us that CDC has this kind of staff in over 40 countries worldwide.

The funding for this effort comes principally from PEPFAR, the President’s Emergency Program for AIDS Relief, which was begun in 2002 by President Bush, and now continued by President Obama.

After a very good informal briefing, we went to CHUK, the Central University Hospital in Kigali (the acronym is from the French name), where we toured the pediatric HIV/AIDS unit, and met with children and parents. It was very impressive.

If you wish, you can see some of our pictures at www.flickr.com/photos/billroper.

More to come!

Rwanda 2011

Will and I have embarked on our 2011 international trip, and have returned to Rwanda.

Last year’s trip was so worthwhile that we decided that we should come back to this special place.

We will be visiting friends we made when we were here in the summer of 2010, and making new ones.

If you are interested, you can follow our progress on this blog, and can see some of our pictures here.

All the pictures will be posted at www.Flickr.com/photos/billroper.

We left Chapel Hill two days ago — and flew via Philadelphia and Brussels to Kigali.

We were met here by Theoneste Ndagijimana, the Rwandan student we met last year, and who came to visit us in April.

We were also met by Godfrey Kalema, the leader of the Dufatanye Cooperative, where Will visited last year, and where he will be again in a few days.

Today we are going to spend time with the US Centers for Disease Control and Prevention team, lead by Pratima Raghunathan, seeing the work that they are doing here with Rwandan partners.

And tomorrow we are going to Ruhengeri to visit with Louise and Caleb King, our American friends who have been working in Rwanda for many years.

It promises to be a full, exciting and interesting trip.

For now, I am sitting on the terrace of our hotel in Kigali, drinking coffee and eating fresh fruit, connected wirelessly to the internet.

Stay tuned — more to come!

Weekend in Rwanda

I had a very pleasant weekend in Kigali and beyond.

One of the places I saw was the Hotel des Milles Collines, which was featured in the film Hotel Rwanda.

Hotel Rwanda

On Saturday evening, I had a dinner meeting with the leader of the Anglican Church in Rwanda, Archbishop Emmanuel Kolini and several others. Our church in Chapel Hill is under his jurisdiction.

Dinner Saturday, Archbishop Emmanuel Kolini is far left

Dinner Saturday, Archbishop Emmanuel Kolini is far left

On Sunday morning, I went to the English service at the Anglican cathedral, St. Etienne, and heard the dean preach. He is Rev. Antoine Rutayisire. After the service, he introduced me to Dr. Richard Sezibera, one of the members at St. Etienne, who is the minister of health of Rwanda. We had a short visit and he invited me to meet with him in a couple of days.

left: Rev. (Dean) Antoine Rutayisire, Dr. Richard Sezibera

left: Rev. (Dean) Antoine Rutayisire, Dr. Richard Sezibera

Sunday afternoon, Will and I went to Nyanza, and visited the Dufatanye Cooperative, which is a local NGO that supports and provides opportunity for a number of people who are living with HIV infection. It was founded and now run by my new friend, Godfrey Kalema.

The people at Dufatanye are very poor, but they have done truly impressive things together they raise a number of crops, tend goats, rabbits, cows, raise fish in ponds, and make bricks and roof tiles.

Dufantanye Cooperative

Dufantanye Cooperative

Godfrey with finished tiles and bricks

Godfrey Kalema with finished tiles and bricks

Bricks air drying

Bricks air drying

Bricks awaiting the kiln

Bricks awaiting the kiln

Godfrey with finished bricks

Godfrey with finished bricks

Cows at the Dufatanye Cooperative

Cows at the Dufatanye Cooperative


Will is working at Dufatanye, helping the workers and learning how to make bricks!

I have gone on to Butare, where the National University of Rwanda is located, including the med school. I am visiting there today.

Another beautiful day in Rwanda!

The NUR Med School and the CDC

Today I had a very helpful meeting with Dr. Patrick Kyamanywa, the dean of the Faculty of Medicine of the National University of Rwanda. The med school is in Butare, where I will be in a few days, but he and I met in Kigali.

Patrick is a surgeon, with an active medical practice, who is now the acting dean of the med school. We shared insights about the opportunities and challenges of managing a school of medicine at a public university. He is very much a leader in the health sector of Rwanda, and works closely with the Minister of Health and others.

From him, as from others I have met, I gained important insights about Rwanda ? its past, present and future. He is a very impressive person in every respect.

Lunch with CDC Rwanda team

Lunch with CDC Rwanda team


Later I went to the US Embassy, where I met with the CDC team based there. About 30 CDC employees are assigned to Rwanda, and I got the chance to have lunch with a number of them, especially the Country Director for CDC-Rwanda, Dr. Pratima Raghunathan. She is a former EIS officer, who has been with CDC for more than ten years in a number of different assignments. She has been in Rwanda for two years.

CDC's global health mission has grown and developed very substantially since the time I was director (1990-93). In those days we had a global focus, and world-wide reach and impact, but it is now so much greater. With PEPFAR (The President's Emergency Fund for AIDS/HIV Relief) and other US government programs, CDC now has many more people and much more resources on the ground around the world, including here in Rwanda.

Ambassador Stuart Symington

Ambassador Stuart Symington

I was also able to see the US Ambassador, Stuart Symington, and to visit briefly with him. I am very proud of what CDC and the US Government more generally are doing in Rwanda.

Public Health and Health Care in Rwanda

Neonatal unit in CHUK

Neonatal unit in CHUK

Today I had the privilege of meeting with several health leaders here in Kigali.

I was introduced to them via my friend, Nathan Thielman, MD, who is a faculty member at Duke Med School. Nathan is an internist who does work in infectious diseases, HIV/AIDS, and global health.

I visited with two Ob/Gyn physicians with whom he is collaborating here in a project to lower Rwanda's maternal mortality rate. It is currently about 350 maternal deaths per 100,000 live births.

I met Dr. Stephen Rusila, who is head of research at the Central Teaching Hospital of Kigali. It goes by its French acronym, CHUK.

The med school in Rwanda is in Butare, where it is a part of the National University of Rwanda. In North Carolina terms, Butare is the smallish university town ? the Chapel Hill, and Kigali is the large, capital city ? the Raleigh, or even Charlotte. All med students get their basic science teaching in Butare, but a sizeable number get clinical training at the Central Teaching Hospital in Kigali, much like we send students for clinical rotations to AHEC sites across North Carolina.

I also met Dr. Janvier Rwamwejo, who is on the staff of King Faisal Hospital ? it is widely said to be the finest hospital in the country.

We talked about their project ? and the efforts to train mid-wives and other health workers to recognize problem pregnancies and to manage them or refer them.

The infant mortality rate in Rwanda is estimated to be 65 per 1000 live births this year. That is in the middle of the range of the various African countries' rates. By contrast, the US rate this year is between 6 and 7 deaths, before one year of age, per 1000 live births.

P1010969 Tomorrow I am meeting with the dean of the Faculty of Medicine of the National University of Rwanda, and the next day with the Minister of Health. This is proving to be a very enlightening and very pleasant visit.

I added some local beauty to my hotel room today ? I bought some flowers from the shop in the hotel lobby ? the arrangement is not nearly as attractive as those my wife does ? but it still brightens up the room!

I am now also posting photos to my Flickr page. You can see them here.