PIH Breaks Ground on Butaro District Hospital Expansion

On December 10, Partners In Health (PIH), the University of Global Health Equity (UGHE), and the Rwandan government broke ground on the next phase of growth for PIH-supported Butaro District Hospital.

The ambitious, multi-year construction project is set to expand the hospital, located in Burera, from 150 to 240 beds and further establish it as a leading medical institution and teaching hospital in the region.

At the groundbreaking were leaders from PIH, including Dr. Paul Farmer and Dr. Joel Mubiligi; the Rwandan government, including Northern Province Governor Dancille Nyirarugero and Burera District Mayor Marie Chantal Uwanyirigira; and the University of Global Health Equity, including Professor Agnes Binagwaho and Professor Abebe Bekele. Also present were health workers, construction workers, and community members.

Shovels hit the ground at 11:05 am.

“The work we do in Burera demonstrates perfectly what settings like this have been deprived of and what we can do to make a change,” said Dr. Joel Mubiligi, executive director of Inshuti Mu Buzima, as PIH is known in Rwanda. “This hospital will allow us to save more lives, quicker.”

The construction, which begins this month, will take place in two phases and is expected to be completed in August 2023.

Such growth has been years in the making.

PIH has worked in Rwanda since 2005, in partnership with the Ministry of Health, to strengthen the country’s health system. Butaro District Hospital was one of the early fruits of that partnership—built by PIH, the Ministry of Health, and architectural partner MASS Design, with doors opened in January 2011.

Today, the hospital serves 345,893 Rwandans and hosts the country’s Cancer Center of Excellence, in a rural district that once had no hospital.

The expansion project aims to build on that progress.

The hospital’s growth over the years has been striking. In 2012, the oncology ward saw 561 new patients. By 2019, that number had soared to 1,770. Now, the oncology ward is at 120% of capacity.

Adding to its challenges, the hospital currently has no intensive care unit. There is only one operating room for all types of surgery, as is common for district hospitals in Rwanda. There is no CT scanner, despite the diagnostic tool being crucial for more than 75% of cancer patients. And the pediatrics ward is at 130% capacity, with some children forced to share beds.

All that is set to change with the construction.

Phase one will create a 4-bed intensive care unit with room for additional beds if needed, introduce CT scan services, and add an OBGYN-specific operating room for women. The first phase will also increase the pediatrics ward from 28 to 34 beds and the surgical ward from 26 to 44 beds, among other improvements.

The construction will double the number of surgeries the hospital can perform through two new operating rooms as well as add a new 10-bed emergency department with a procedure room.

Phase two will add 54 more beds for oncology patients, create a 16-bed isolation facility, and deliver additional lifesaving medical equipment, among other improvements. It will also improve the hospital’s supply of essential resources such as oxygen, with the installation of a dual-system oxygen plant.

These changes will improve the quality of care and, as a result, will save lives.

Additionally, the project aims to further establish the hospital as a leading medical and scientific institution in the region, paving the way for its accreditation as a teaching hospital and providing a fertile training ground for students from the University of Global Health Equity (UGHE), which sits just across the valley.

“Now that the university is growing, we need to transform this hospital into a teaching hospital,” said Professor Agnes Binagwaho, vice chancellor of UGHE. “Today is the beginning of this transformation.”

Most notable to Dr. Paul Farmer at the groundbreaking ceremony was the spirit of community.

“What today means for me is not just pride and not just nostalgia,” said Farmer, as he reflected on a moment made possible by years of partnership and coalition-building in Rwanda. “It’s that there’s a hope born of having high aspirations—not just on behalf of oneself.”

Those aspirations are shared by many, in Burera and beyond—from patient to doctors, elders to youth, agricultural cooperatives to architectural partners.

“What this moment is for me is not ‘you’re going to be important in the world’ but it’s that, collectively, ‘we’re going to be important in the world,’” Farmer continued. “We can make a difference. It’s not about I. It’s about us.”