Rwanda Revisited

Rwanda is an optimist’s paradise.  Naysayers and cynics move along.  This post is rife with inspiration, innovation and resilience in a country that 19 years ago was in unimaginable turmoil.

Continual controlled panic was the way I described my visit to Rwanda in October 1994, just months after a brutal genocide saw the massacre of a million people in 100 days.  On that visit I slept on the floor of the destroyed Ministry of Health office in Kibungo, eerily listening to dogs howl as they raided shallow graves for sustenance.  Tufts of hair and pools of blood still stained the floors of the new office space under consideration, and we’d speed up as we passed churches still full of the remains of those who’d fatally reasoned that the church would be a refuge rather than a mass grave during the worst of it.  I never saw a dead body that trip, but empty villages and the smell were enough to connect the dots in my imagination.  I never thought I would return.  Ever.

Yet last week that’s precisely what I did.  Invited as a strategic advisor to Vision for a Nation, a registered UK charity with a mission to make vision assessments and affordable eyeglasses available to all, I traveled to Rwanda and spent three remarkable days consistently impressed and inspired by what I saw and experienced.

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With 11 million people in Rwanda, Vision for a Nation’s goal to give every person (over 8) in the country an eye exam and provide relief for correctable refractive error is ambitious, but now that I have been there and seen their approach, I believe it is possible. VFAN was born from a simple adjustable lens technology and ‘train the trainer’ model that enables nurses to diagnose and correct refractive error in the 45 health centers throughout the country.  The adjustable glasses have dials on the sides which, when rotated, slide one lens in front of the other until the unique prescription is achieved.  Those with refractive error walk into a health center and walk out with glasses completely eliminating the need to return to the center to pick up custom glasses or the inefficiencies of pairing donated glasses from the developed world with end recipients.  It’s inexpensive, efficient and instant gratification.  Other benefits include diagnosis and treatment of cataracts, conjunctivitis and other easily treatable eye ailments.  Working in partnership with the Ministry of Health, VFAN will soon launch a public awareness campaign through a highly organized communication system in the country to educate and inform the public about vision care.  Eye care is generally not a life saving intervention, but it certainly improves quality of life.  This is one of many public health initiatives the MOH has embraced to improve the lives of those in Rwanda.

http://www.visionforanation.org

Speaking of the Ministry of Health, we were fortunate to have a private dinner with the remarkable Minister of Health, Agnes Binagwaho one night in Kigali.  The list of health initiatives she has implemented to improve the lives of Rwandans is impressive.  She is entrepreneurial, philosophical and pragmatic with a “can do” attitude I’ve never seen before in Africa.  She’s a total pro.  Dinner conversation included great one-liners like, “The best idea on the table is the one I take.”  “Money will come.  Good strategy is the important thing.”  “I want to die happy of what I have achieved.  I don’t want to be the richest in the cemetery.”   Her initiatives include the 80/40/20 plan to reduce non-communicable diseases (NCDs) by 80% for those under 40 by 2020.  To do this she began by implementing very concrete public health changes including mandating helmets for motorbikes, seatbelts, banning smoking in public places, cooking stove improvements and other initiatives that didn’t cost much, but had a huge impact.  She was the first to offer the HPV vaccine, countrywide, to schoolgirls of a certain age.  Her work in reducing HIV AIDS in the country is legendary.  Her entire staff has all gone to graduate school at the expense of the ministry and many are beginning PhDs now.  Government workers are mandated to do an exercise of their choice on Fridays during the workday and pay a fine if they do not.   She regularly tweets (as does the President) and responds to every tweet she receives.  She has 10,000 followers and has a regular Monday with the Minister show two times a month to address public health issues.  The Honorable Minister is a global health leader, not only for Rwanda.  I was honored to share a meal with her. 

Rwanda has two unique programs that contribute to its continued growth and improvement.  If I understand correctly, the Muganda is a compulsory gathering the last Saturday of every month at which time the entire country, divided into local communities, comes together to work from 7-10 on an improvement project and then from 10-12 to meet and share information.  They will paint a house that has fallen into disrepair, collect trash, build a road, or anything that the community deems as an improvement.  As a result, the country is tidy, fresh and continually improving.  Similarly, the Urunana radio programs reach an unprecedented percentage of the country with a soap opera-like ongoing storyline.  Intertwined in the programs are community health and agricultural messages.  This is one of the primary vehicles for spreading information throughout the country.  So radio that was once used for inciting violence is now used in a similar way for improving lives.

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Beyond health initiatives, last spring, in preparation for the TEDxHappyValley “Radical Resilience” event in Hong Kong, I was teamed up as a speech coach for a remarkable 27-year-old entrepreneur Elizabeth Dearborn Hughes, founder of the Akilah Institute for Women in Kigali.  Elizabeth taught me more than I her during the process.  When I agreed to go to Kigali, I knew that a visit to see Akilah would be important.   Akilah Institute for Women is a three-year training program for women.  Women apply, take an entrance exam, provide references and interview for spaces at Akilah.  Those selected do a foundational year of math and English language as well as leadership training and then embark on a two-year program in one of three disciplines, entrepreneurship, information management or tourism.  Women receive career counseling, do internships, and continue with leadership training and practical skills development throughout their studies.  The first graduating class in 2012 had 100% job placement.    I had the honor of having lunch with four of their current students.  I was completely inspired and humbled by their poise, intelligence, determination and vision for their futures.  I can’t say enough good things about Akilah!  If you’re looking for a good place to invest in women’s education, this would be my top recommendation.

http://www.akilahinstitute.org

Above and beyond these formal gatherings, I was inspired to meet others who are consciously building businesses in Rwanda.  A friend of a friend has launched an organic coffee farm on his family’s heritage land after having fled Rwanda in 1959.  Upon returning, he was given back his family land and is now gently learning the coffee business, producing some of the world’s finest artisenal products.  I can’t wait to try some.

A dear friend of mine, Rachel Radcliffe, made the effort to fly all the way from Nairobi to visit me during my short stay in Rwanda.  I was so touched and happy to see her!  We worked together 20 years before at OFDA and have both led circuitous international lives since then.  Reconnecting with an old friend from those formative years was grounding and inspiring.  I feel so blessed.

Returning to Rwanda under much better circumstances was cathartic.  I know it isn’t perfect.  I’ve read the articles and heard the naysayers about Rwanda, but in this post I choose to see the country as it should be, celebrating those things that are working and truly inspired by earnest, innovative efforts on the parts of so many people to make things good in a place that hasn’t always been so.

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