By Peter Drobac, PIH Country Director for Rwanda


Dr. Peter Drobac (right) with Dr. Tharcisse Mpunga, the Director of Butaro Hospital (left).

In nearly a decade with Partners In Health, I have been party to some wonderful achievements and countless small victories. But Monday, January 24th was my best day.

On a stunning, remote mountaintop in northern Rwanda, scores of government leaders, PIH staff, friends and supporters, and community health workers looked on as Butaro Hospital opened its doors to the world. This 150-bed, world-class teaching hospital features two operating theatres; an intensive care unit; a dedicated neonatal unit; and state-of-the-art medical equipment. Its innovative design employs natural ventilation techniques to prevent the transmission of dangerous diseases, such as tuberculosis and H1N1, while creating a tranquil, dignified environment. And yes, there are fish ponds.

I watched with pride as the men and women who had built the hospital, and those who would soon provide care there, led the President of Rwanda on a tour of the facility. Paul Kagame nodded approvingly—high praise from such a strong man. Paul Farmer cried a little—he’s strong in a different way.

Three years ago this month, we stood on the very same mountaintop, appreciating the breathtaking setting and surveying the work to be done. After two years of successful collaboration with the Government of Rwanda and the Clinton Health Access Initiative—having built two public hospitals, training scores of doctors, nurses and community health workers, and providing care to hundreds of thousands—our Government partners invited PIH to help them implement an ambitious new model of rights-based, primary health care in the remote Burera District. They chose Burera because its desperately poor health care infrastructure was most deserving of attention. Difficult roads. No electricity. One doctor serving nearly 350,000 souls. Women dying in childbirth on boats trying to reach the nearest hospital. If we succeed in Burera, they told us, we can succeed anywhere.

The mountaintop on which we stood housed a military camp. It had been an important battleground in the war that ended the 1994 genocide and decades of conflict. Rwanda was moving forward. It was time to replace soldiers with doctors. President Kagame had promised the people a hospital on this very site—and he keeps his promises.

Two years ago this month, we launched construction on this very same mountaintop. In the preceding year, a series of abandoned buildings—some of them used to confront and reconcile the perpetrators and victims of the 1994 tragedy—had been transformed into a temporary hospital staffed by seven doctors and more than 50 nurses, providing desperately needed care.

In the meantime, our collective ambitions for a permanent hospital grew. Originally, we had intended to build a modest district hospital. But here in Rwanda, the country that was beginning to teach the world how to break the cycle of poverty and disease, why not create a flagship teaching hospital?

One year ago this month, a massive earthquake rocked Haiti, killing hundreds of thousands and displacing millions in just a few seconds. The government of Rwanda, the people of Rwanda, and the staff of Inshuti Mu Buzima responded with a tremendous outpouring of support. Community health workers donated portions of their modest pay to the relief effort. Once the shock abated, it became evident that Rwanda provided Haiti with perhaps the finest example of how to Build Back Better in the wake of devastation and tragedy. And so we accelerated construction, adding a third shift of local construction workers. Many nights I would be awakened at two or three in the morning to the sounds of hammers, saws and the music of hundreds of men and women singing as they worked tirelessly under flood lamps.

More than 3,500 good jobs were created during the construction. Every window, every door and most of the furniture was made on site by local craftsmen in vocational training programs. More kids are in school because of this hospital. People are healthier, and communities are stronger because of this hospital. And all this before the first patient even arrived. Butaro is a powerful example of the “virtuous social cycle” that is created when smart investments in health infrastructure transform communities by catalyzing economic development and social change.


Dr. Peter Drobac shows Rwandan President Paul Kagame around the new Butaro Hospital.

On Monday, President Kagame said, "Butaro is more than a hospital. It is a unique story of exceptional people with the desire to see positive change in the world and in communities like the one hosting us today... It is also a story about strong and mutually benefiting partnerships and the fact that when we come together and join forces, commendable results can be achieved."

On behalf of the thousands of people who built this hospital, and the hundreds of thousands who will benefit, I want to thank you for your partnership, which made all of this possible. Now, of course, the real work begins. Caring for patients, teaching, striving to deliver ever-higher standards of equity and quality, all of which will ensure that Butaro Hospital fulfills its immense promise.

In other words, it’s time for the fun part.