Revolutionary Cancer Care in Rwanda

Posted on Jul 18, 2012

The unpleasant truth

  • The World Health Organization expects 16 million new cancer cases worldwide by 2020, with 70 percent in developing countries such as Rwanda.
  • More than 2.4 million cancer deaths could be avoided each year in developing countries by using prevention and treatment interventions that are affordable and available in rich countries.
  • Developing countries account for almost 80 percent of the global cancer burden (loss from death and disability) but only 5 percent of global spending on cancer.
  • In Rwanda, 3,430 cancer cases were registered from 2007-2011; 320 were in children under 15. This doesn't include the great number of cases that go undiagnosed and unreported.
  • A Rwandan child diagnosed with acute lymphoblastic leukemia was assured of a virtual death sentence. This cancer has an 80 percent cure rate in the United States.

Hope for the future

The Butaro Cancer Center of Excellence, in Butaro Hospital in northern rural Rwanda, vastly improves Rwandans' options for diagnosis and treatment. The Center is the first of its kind to bring comprehensive cancer care to rural East Africa.

Patients seeking treatment at the Butaro Cancer Center receive the full spectrum of care, including screening, diagnosis, chemotherapy, surgery, patient follow-up, palliative care, a pathology lab, mental health and social work services, and socioeconomic support, such as food, transportation, home visits, and community health worker accompaniment. Patients needing radiology treatment are referred to Mulago Hospital in Uganda. The Center also is an accredited national referral site for cancer.

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Dr. Lawrence Shulman of Dana-Farber Cancer Institute joins former President Bill Clinton and Chelsea Clinton in an inaugural tour of the new Butaro Cancer Center.

From left: Dr. Lawrence Shulman, the Honorable Dr. Agnes Binagwaho (Rwanda's minister of health), Chelsea Clinton (PIH trustee), former President Bill Clinton, NASCAR driver Jeff Gordon, and Dr. Paul Farmer participate in the Butaro Cancer Center inauguration July 18, 2012.

Center features include:

  • 24 beds for adult and pediatric cancer patients, plus three isolation rooms
  • A patient-centered design—each bed faces a beautiful view
  • Care from trained nurses who are mentored by visiting specialty cancer nurses from Dana-Farber Cancer Institute (DFCI)
  • Care from general practitioner doctors with special training in oncology, and Butaro-based internist and pediatric specialists
  • Visits, conference calls, and frequent email communication with oncology specialists from DFCI and Brigham and Women's Hospital to provide mentorship and guidance
  • Large-radius fans and louvered windows, which ensure frequent air flow and lower the risk of infection
  • Bilingual signage that is color-coded and contextually appropriate for patients of all levels of literacy and mobility
  • The use of local materials, including volcanic stone from the Virunga Mountains

Catalyzing lasting change

The Center also will serve as the first facility to implement standardized cancer training and protocols that align with Rwanda's new national guidelines. The Center's contributions to national cancer care will include:

  • Developing and implementing standardized national cancer protocols to improve the quality of patient care
  • Collaborating with national partners and colleagues to share experiences and strengthen strategies for procuring necessary equipment, consumables, and medications
  • Creating a comprehensive paper chart system and sophisticated electronic medical records to streamline communication and reduce medical errors
  • Developing indicators to facilitate monitoring and evaluation
  • Developing cancer training programs for nurses, doctors, medical and nursing students, medical residents, and pathology support


The Butaro Cancer Center is a critical element of Rwanda's ambitious five-year plan to introduce cancer prevention, screening, and treatment on a national level. It was built and will operate with support from a unique partnership brought together through the Clinton Global Initiative. Key partners include:

  • Rwandan Ministry of Health
  • Partners In Health
  • Dana-Farber Cancer Institute
  • Brigham and Women's Hospital
  • Boston Children's Hospital
  • Jeff Gordon Children's Foundation
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