Bringing Care Closer: Expanding Care and Medical Training in Rwanda

At the Ruhengeri Hospital in Musanze, Rwanda, the tables in the surgical rooms are more than beds where patients receive crucial medical care. They are also training tools for surgical residents and hospital staff, a gathering spot to observe plastic surgery procedures and receive hands-on experience to further enhance their own skills. With an ICU that has six beds, four operating rooms and a teaching room, Ruhengeri is an example of a spoke hospital that brings essential surgeries and care closer to communities. “Until now patients would have to travel to Kigali to have plastic surgery,” explains surgeon Dr. Charles Furaha. “That is not only far, but also costly for patients.”  

This facility is more than a building; it is a catalyst for lasting impact in access to care and training. As Dr. Faustin said during the inauguration ceremony of this hospital: “You can’t teach a person how to swim if you don’t have a swimming pool.” It represents a broader initiative by Operation Smile, a global nonprofit dedicated to strengthening access to essential surgeries and health care not only in this region of Africa, but in 37 countries around the globe. Our work in Rwanda demonstrates how education and training can create a ripple of care that can positively impact an entire country.  

As Dr. Faustin Ntirenganya, plastic surgeon and associate professor at the University of Rwanda explains, “We are building that hub and spoke model, with a central a hub in Kigali. Then we are reaching out to the periphery,” he says. “In the end, we will have six spokes dispatched all over the country, and each Rwandan will be at least 75 kilometers from plastic and constructive services. Not only we will be able to treat patients near their homes, but also, we will staff those hospitals with the newly graduating plastic surgeons trained here.” 

Furaha and Faustin were the first two plastic surgeons in Rwanda. Today, with the support and partnership Operation Smile, University of Rwanda, the College of Surgeons of East, Central and Southern Africa (COSECSA) and the Ministry of Health in Rwanda, there are now five certified plastic surgeons in Rwanda with six more in training. Dr. Fidel Simba is one of the trainees. “It feels really great to be working this new facility. All the equipment is new. It’s a big, big contribution to the development of the country and in particular this city,” he says. 

The search for solutions to improve the global shortage of surgical care providers will be the focus of the first Pan-African Surgical Conference later this month in Kigali. Bringing together academic leaders, policymakers, global surgery experts and other stakeholders, it will address critical challenges and opportunities in plastic and reconstructive surgery on the continent.  

Dr. Billy Magee, Operation Smile’s chief medical officer, is working with Ntirenganya on the agenda for that historic gathering. “We’ll be talking about the state of global surgery, the state of health care and how we can work together towards a more comprehensive system,” he says of the conference taking place February 24 – 28. “By prioritizing capacity building, infrastructure development and policy advocacy, our goal is to secure access to essential surgical services for all communities, supported by the plastic and reconstructive surgical community.” 

While each country is unique, by working with local leaders, partners, ministries of health and governments to understand the needs, locally led and globally supported impact is possible. Agustino Hellar, regional director of east Africa for Operation Smile, sees both the conference and bringing care closer to patients as important initiatives. “Once this is built locally, it can be expanded within the country to provide care to everyone. It shows us that this will be sustainable for a long time.”  
 

Learn more about how Operation Smile is strengthening health care workforces around the world.