Finding Inspiration in Rwanda

By Susan Green

When Steve Bensen (’90) talks about the two months he spent in Rwanda earlier this year, you can hear the optimism in his voice. Exhilarated by his first foray into global health, he wants to help others have a similar experience.

Bensen, an associate professor of medicine at Dartmouth’s Geisel School of Medicine and physician at Dartmouth-Hitchcock Medical Center, who specializes in gastroenterology and hematology, is the first gastroenterologist to participate in the Human Resources for Health (HRH) program. A seven-year partnership between the Rwandan Ministry of Health, the Clinton Foundation, and several U.S. medical schools, including Geisel, HRH is committed to rebuilding the medical education and health-care systems in Rwanda.

“I tried for a number of years to do something like this and investigated different avenues,” Bensen says. “But it’s difficult for a gastroenterologist because we are dependent on technology when offering our skills.”

Although there is significant gastrointestinal (GI) disease in Rwanda, physicians lack both the equipment and training to provide specialized care. Armed with hundreds of donated endoscopic devices—biopsy forceps, snares, balloon dilators, PEG kits, and esophageal band ligators—Bensen’s goals were to teach physicians, residents, and interns to perform simple GI procedures and to show hospital managers the importance of providing these devices. “There’s an amazing amount of good to be done with fairly simple instruments,” he says.

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Building Rwanda’s Bright Future

From 1990-1994, Rwanda’s Civil War, and then brutal Genocide, left a path of destruction that claimed more than one million lives.  Many physicians and health care personnel were among those who perished, and Rwanda was left with only 100 physicians to serve the entire country in 1995.   In this video, Jean-Luc Nkurikiyimfura, MD, explains how the groundbreaking Human Resources for Health (HRH) program and the partnership with Dartmouth’s Geisel School of Medicine has helped improve the quality of education for Rwandan physicians, and will help greatly increase the number of doctors and nurses in Rwanda. Continue reading

From Rwanda to Hanover

For the past two years, Dr. Jean-Luc Nkurikiyimfura has been collaborating with faculty at the Geisel School of Medicine despite working and living thousands of miles away. Nkurikiyimfura, who heads the HIV clinic at Kigali University Teaching Hospital in Rwanda’s capital, is part of the Rwandan Human Resources for Health (HRH) program. Funded by the Clinton Health Initiative, HRH is a seven-year program that is helping to build a sustainable, high-quality health-care and medical education system in Rwanda by having U.S. medical school faculty work closely with physicians there. Read more…

Progress and Hope in Rwanda

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Actually, I confess, we drove out of our way to see this little nugget of a roadside attraction. Just north of Queen Elizabeth National Park in Western Uganda, about 70kms from the D.R. Congo border, we crossed back into the northern hemisphere for a few minutes, then hopped back to the south.

I am not a doctor; I don’t even play one on TV. But I am married to Lisa V. Adams, MD (Geisel ’90), the first Geisel School of Medicine faculty member to participate in the Human Resources for Health (HRH) Program in Rwanda when it got underway last summer. She brought her family along (myself and our two kids), and while at times challenging it was most definitely a memorable and thought-provoking experience for us all. While she taught best practices in record keeping to her internal medicine residents, I would negotiate the potholes in Kigali’s roads to get the kids to school, and try to remember the Rwandan word for garlic on a shopping trip (it’s “tungurusumu”).

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Wrapping Up Surgery

Dr. Perencevich performs gall bladder surgery.

Dr. Perencevich and his Rwandan medical partner, Dr. Edmond, putting in a bile duct bypass on a patient with an obstructed gall bladder.

Friday night Dr. Nick Perencevich (Dartmouth ’69) and his wife, Ruth, head back to the States. An (almost) retired general surgeon after two decades of work at Concord Hospital, Dr. Perencevich was the first American surgeon on the ground in Rwanda when the Human Resources for Health program got underway in the summer of 2012. In his role as trailblazer here, he came up against significant structural and institutional problems at the teaching hospital in Rwanda to which he had initially been assigned by the Ministry of Health.

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Changes and Checkboxes in Kigali

Dr. Dorey Glenn, MD, uses a tablet to show some of the medical students and residents at King Faisal Hospital in Kigali, Rwanda how bilitool.com can help quickly assess the health of a jaundiced newborn under their care.]

King Faisal Hospital in Kigali, Rwanda, is one of three tertiary referral hospitals in Rwanda. As the most advanced and well-equipped of them, King Faisal handles most of the referrals for sub-specialties like neuro-surgery. The hospital’s work also involves cases that require mechanical ventilation or where there is concern for potential respiratory failure, explains Dr. Dorey Glenn, who currently works in the pediatric department at King Faisal as a faculty member with the Human Resources for Health program.

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