Tag Archives: UNC School of Medicine

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.

More at Shyira Hospital

Shyira Hospital


I spent two days at the remote and idyllic Shyira Hospital.

In many respects they lack much of what we take for granted in the US ? for example, they only have electricity for two hours each evening, when the generator is running.

But in other respects, they have so much that we lack ? peacefulness and even solitude. We went to bed shortly after the lights went out at 8:30pm, and got up before 6:00am, fully rested. The hospital starts its day at 7:00am.

Caleb King translating for me

Caleb King translating for me

Today, after morning report, I gave a talk, at the Kings' invitation. Caleb translated ? into French, which the staff understand. They also speak some English and everyone is fluent in Kinyarwanda, the national language.
I used a talk I gave a couple of years ago at Duke ? on spirituality and health. I think it all went fine.

Both yesterday and today we spent time rounding on the wards ? peds, adult medicine and obstetrics.

Will with a kindergarten class

Will with a kindergarten class

Today Will put together home-made Play-Doh, and taught the kindergartners how to make things. He is having a great time at Shyira.

This evening I left him there and returned to Kigali, where I'll spend the next couple of days.

Sunday in Musanze

St. John the Baptist Cathedral

St. John the Baptist Cathedral

Today we are in Musanze (formerly known as Ruhengeri).

We went to the early service (in English) at St. John the Baptist Cathedral. The Anglican service of Morning Prayer was very familiar, and all the songs were ones we knew. There were some other Americans and other non-Rwandans there as well.

After a break, I went back for a portion of the main service, which is in Kinyarwandan, the national language here. I did not understand a single word ? but the vibrant, enthusiastic service was really inspiring.

I was struck by how many young people there were ? in both services, lots of young adults and children. And especially young adult men ? noticeably different from many American churches, that lack them.

Kigali and Gisenyi

Will with people we met on the road

Will with people we met along the roadside

Today was a very good day.

We did several things to get settled ? changed money, got cheap cell phones, got our passes for the mountain gorilla tour (which we will do in a couple of days).

Then we went to the Kigali Genocide Memorial. It tells the incredible story of the 1994 genocide in very effective and moving terms. It is really impossible to do it justice in a short blog posting, but this country has been through horrific trauma, and is now making amazing progress in reconciliation and development.

Then we drove almost three hours to Gisenyi, which is on the shores of Lake Kivu, a huge, beautiful lake. There are a number of resort hotels there, and we went to a very nice one, and had a late lunch. It was magnificent — we sat overlooking the lake as we ate.

We are now in Musanze, where we will spend the next two nights. The town used to be called Ruhengeri.

Our day starts tomorrow with the early English service at the Anglican Cathedral, and then we will spend the rest of the day relaxing. The guesthouse has a pool and the weather here is great.

Then we set out early on Monday to see the gorillas.

Arrived in Rwanda

On the way here via Brussels, we got to spend an unplanned extra day in Belgium. Our plane flight was cancelled, and we had to wait a day for it to go.

Everyone was very kind to us ? they put us up in a hotel at the Brussels Airport, and served us great food.

We got to visit with several of our fellow pilgrims to Rwanda ? a couple from Little Rock on their way to visit their daughter who is working for an non-profit group in Rwanda, three college students who are going there to do volunteer work with another group for several weeks, a lady going home to Congo (she lives a five hour bus ride from Kigali, Rwanda), and an AIDS researcher who works in Rwanda. It turns out we know lots of people in common.

We arrived after dark this evening ? so have not yet seen much, but it is clearly hilly. After all, Rwanda is known as the Land of a Thousand Hills.
Tomorrow we visit the main genocide memorial and then leave the capital city to visit some of the outlying areas.

En route to Rwanda

Greetings from Brussels ? our son, Will, and I are on our way to Rwanda for a long-planned visit.

This will be the fourth of our international visits together, in which we combine our interest in global health with an effort to learn more about the world ? especially those parts which are far away from Chapel Hill.

Will Roper in the Brussels Airport

Will Roper in the Brussels Airport

In 2007, Will and I went to South Africa, Malawi and Zambia. We focused especially on the UNC Institute for Global Health and Infectious Disease work that has long been done in Malawi. We learned a lot, and Will got to work in an AIDS orphanage.

In 2008, he and I went to China, where we again met with UNC collaborators, particularly in the China CDC. And we got to take in some of the Beijing Olympics!

In 2009, Will and I went to Peru, with Drs. Luis Diaz and Doug Morgan, and we saw first-hand the work that they and colleagues are doing to advance our understanding of health and disease. This has direct relevance to our efforts in Latino Health in North Carolina. And we got to see Machu Picchu too!

This year it's Rwanda ? a small country in east central Africa ? with a troubled past, but an exciting present and future. The 1994 genocide in Rwanda is a major part of the history of the country, and we will be visiting genocide memorials and learning of the horror of what happened 16 years ago.

But we will also be learning of the widespread reconciliation work that seems to be bearing much fruit, and the rapid development of the country and its economy.

UNC does not yet have global health work in Rwanda, but I will be visiting with leaders in the Ministry of Health, and in the hospitals and medical school. I look forward to learning much about what others are doing in Rwanda, and to thinking about the further opportunities.

In addition, our church in Chapel Hill has a partnership with the Anglican Church in Rwanda, and our sister parish is St. Paul's Cathedral in Butare, Rwanda. I will be visiting with church leaders there and elsewhere in Rwanda.

All in all, we have much to learn and experience. It promises to be a great trip!

Much more to come.