We Make House Calls: A Home Visit in Rwanda

Athanasie Mukamana rises early, walks across the fertile red soil of her town in eastern Rwanda, and knocks on the door of a familiar house before the sun is up.

“Mwaramutse, mwaraye mute,” or “Good morning, how did you sleep?” she greets her neighbor.

Mukamana, 59, is a longtime community health worker—one of 7,200 Partners In Health supports in the three districts we serve. Elected by fellow villagers, she and her colleagues diagnose illnesses that might otherwise go unidentified, such as tuberculosis. They accompany families to the hospital, spread important messages about vaccinations and other health issues, and help patients complete tricky treatment regimens like those for HIV/AIDS.

PIH pays part of their salaries, reducing the amount they need to earn in their primary jobs, and offers advanced trainings. In return, community health workers ensure that everyone can enjoy the benefits of modern medicine.

Today’s pre-dawn visit is, thankfully, routine. Mukamana’s patient, Theresie Yankurise, was sick with HIV and shunned by her family when Mukamana met her in 2005. “I had to take her by the arm and help her walk to the health center,” recalls Mukamana.

But after just a couple weeks of care, Yankurise’s health improved. She married a year later and is now the healthy mother of two boisterous, HIV-free children. Mukamana hands her pills from the hospital, the two chat for a bit, and then she leaves to eat porridge and farm her banana fields.

Mukamana stands in her living room, where she often sees pediatric patients.

 

Later, Mukamana’s house transforms into something like a pediatric ward. With training provided by PIH, she treats young children with malaria and other diseases and provides regular checkups.

 

Mukamana uses a tape measure to confirm that a baby isn’t stunted from malnutrition, slides a digital thermometer under another child’s armpit, and listens for the labored breathing that would signal pneumonia in a third.

All of this and more she logs into a handful of ledgers and patient registries, which are then shared with a nearby hospital. The one for HIV patients—a big grid, with check marks for every time a patient takes his or her medication—looks like a star-filled universe. And for good reason.

“I have been a community health worker with PIH since 2005, and all of my patients are alive and well,” Mukamana says.