27 February 2012

Rwanda: New Course Looks Beyond Patient As a 'Health Issue'

A course on "global health delivery," a method which looks not just at the medical issue on hand but also the entire socioeconomic situation of the patient, is being taught for the first time outside Harvard university, in Rwinkwavu, Kayonza district.

As the Minister of Health, Dr. Agnes Binagwaho explained, the course is not about public health but goes beyond that. "The course is an example of authentic and effective capacity building for the health sector, meant to break the vicious cycle of poverty and disease," she said. "It is in line with the vision of the government to provide quality health care for everyone for the overall development of the country."

"Health delivery is not only a problem of Africa, but a global challenge," pointed out Paul Farmer, chair of Harvard's department of global health and social medicine and one of the course faculty members. "A science of delivery is something we all aspire to, and it is very important to be working with these students from different parts of the world who are also the experts present on the field delivering health services."

While the course has already been taught at Harvard, it is the first time that it is organized outside their main campus in Boston. According to Farmer, the choice of Rwanda is no coincidence.

"Rwanda is a good example in health sector, as they are focused on the outcomes," he said. "It is always great to work with such people who want results."

And with the training having attracted 41 faculty members and students from Burundi, Haiti, Rwanda and the USA, Minister Binagwaho pointed out the obvious advantage of this unique occasion. "It would be very hard and expensive to take around 40 people to Harvard, but bringing their team to teach here is doable," she said.

Another advantage, given that the course is based on practical cases, is that example can be found on the class' doorstep. It's in that context that the participants had a field visit to the Cyarubare health center, in Kayonza district, where they visited the antenatal care department and the section where the mother and new born baby are taken care of to see what is done to prevent the HIV/AIDS transmission from mother to child.

Among the areas addressed in the course, which will take place twice a year, is how to manage chronic diseases such as HIV/AIDS, mental health, diabetes, and the role of health workers in this process. Yet what distinguishes the approach is that the patient is not just looked at as "a medical problem."

"It's about all the things that can affect the health of that patient and the ailment they have," explained Dr. Sabin Nsanzimana who works with the Rwanda Biomedical Center. "For example if it's an HIV patient, consider their lifestyle and financial situation, the environment they live in. It's about considering everything that is likely to affect their well being."

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