Inshuti Mu Buzima update, January 2007

During our second year in Rwanda, PIH and our Rwandan partner organization Inshuti Mu Buzima (IMB) continued to renovate and expand our clinical facilities, scaled up our comprehensive HIV care program dramatically, more than doubling the number of patients on antiretroviral therapy, and expanded our support for nutrition, housing and other social and economic needs.

Highlights of 2006 included:

Renovation of Rwinkwavu District Hospital: During 2005, PIH had succeeded in transforming the broken-down facility in Rwinkwavu from a collection of crumbling buildings with no electricity, no doctors, few medicines and only a handful of overworked nurses into a functioning district hospital. In 2006, we continued to improve facilities and services at the hospital with the addition of a new pediatric ward and a functioning operating room.

Improving staffing and facilities at other sites: In addition to Rwinkwavu Hospital, PIH works at five other sites in southeastern Rwanda, including four health centers in Kirehe health district serving a population of more than 350,000 people. After initiating HIV testing and treatment at these facilities in 2005, PIH took steps in 2006 to establish the staffing and facilities needed to implement our full model of comprehensive community-based care. A clinical team headed by the PIH Rwanda Project's medical director, Henry Epino, took up residence at the Kirehe health center. Clinical and laboratory facilities in Kirehe have been expanded, pending construction of a new district hospital in 2007 by PIH and the Rwandan Ministry of Health.

	The new pediatric ward at Rwinkwavu Hospital

Building infrastructure to support children’s health: Rwinkwavu Hospital opened its pediatric ward and inpatient malnutrition center in February 2006, with support from the Clinton Foundation and UNICEF. The 30-bed pediatric care center serves as a referral facility for complicated pediatric cases from all six PIH Rwanda sites.

Inauguration of Rwinkwavu Hospital operating suite: In October 2006, Rwinkwavu Hospital officially opened its fully renovated operating room. Prior to renovations, emergency obstetrical cases had to be transferred to the closest hospital—more than an hour away.  Doctors at Rwinkwavu Hospital can now perform emergency obstetrical Cesarean sections, and hope to expand surgical services in 2007. 

Expanding access to ART: The HIV treatment program continues to expand, with more than 2,000 patients enrolled on antiretroviral therapy (ART). Patients are visited daily by more than 800 community health workers, trained by Inshuti Mu Buzima to distribute medications and provide social support.  

Providing comprehensive care for children with HIV/AIDS: PIH Rwanda enrolled over 150 children living with AIDS on lifesaving ART and instituted comprehensive prevention of mother-to-child transmission (PMTCT) programs at all six clinical sites in 2006.  Children living with AIDS and their families meet for monthly pediatric counseling groups, where PIH Rwanda staff provide education and psychosocial support.  Around Rwinkwavu, PIH Rwanda staff and patients conduct HIV education programs at local primary and secondary schools, with plans for expansion in 2007.

Nutritional support for patients with HIV and TB: Food security and proper nutrition are essential to successful HIV treatment.  In 2006, PIH Rwanda distributed more than 1,500 food packages per month to HIV and TB patients and their families, and signed an agreement with the World Food Program for another 1,000 per month. To improve food security and nutritional status community-wide, our partners in the Clinton Hunter Development Initiative launched agriculture programs in the area around Rwinkwavu to distribute maize and bean seeds and cassava cuttings while providing education to local farmers.

	One of dozens of new houses contructed in Rwanda during 2006

Supporting social and economic rights: Inshuti Mu Buzima’s Program on Social and Economic Rights continued and expanded its work to improve access to decent housing, schooling and opportunities to earn a living. During the course of 2006, IMB built more than 35 houses, paid secondary school fees for almost 400 students who would otherwise have lbeen unable to go to school, established a carpentry and welding workshop that provides both jobs for local residents and furnishings for IMB clinical facilities. In addition, IMB dispersed 40 microcredit loans to income-generating projects for associations of HIV patients in Rwinkwavu and Kirehe.

[posted January 2007]