Voice of America (Washington, DC)

28 March 2014

Rwanda: In Rwanda, Reform Progressing On Many Fronts

In a checkout line at Kigali's Nakumatt shopping center, employees pack groceries in paper bags.

After non-biodegradable polythene bags were banned in 2008, owners found that stocking plastic in their stores carried a risk of going to jail.

The ban is part of an environmental campaign that has earned Rwanda the reputation as the cleanest country in Africa.

Another hallmark initiative is "Umuganda," a mandatory day of community service held on the last Saturday of every month.

Adan Ramata, the store manager, comes from neighboring Kenya.

"When Kenyans will visit Rwanda, and you tell them tomorrow is national cleaning day and that you have to clean, they will ask you how much do they pay?" he said. "No, no, no. This is just a national cleaning day, you have to sacrifice it. You have to clean."

Twenty years after a genocide that killed an estimated 800,000 people, Rwanda is often cited as a model country when it comes to improvements in the environment and economic development.

Rwanda's government has also made sweeping reforms in the healthcare sector. Facing a healthcare system that, like those in many African nations, was heavily centralized in urban areas, Rwanda's Ministry of Health has recently pushed to establish district hospitals for its rural citizens, around 80 percent of the population.

The country is also widely recognized for a national health insurance plan that covers nearly all Rwandans.

"When patients are insured, they consult earlier," said Dr. Bwiza Muhire Hippolyte, a general practitioner at Butaro Hospital in northern Rwanda. "They don't come when they are severely ill. Many times ago people were delivering at home, and if the delivery is not attended there is a very high risk of complication. Even some mothers can die."

Dr. Hippolyte says that nearly all deliveries today are attended to by healthcare professionals. Universal health insurance, he believes, has brought down infant and maternal mortality rates.

Rwanda's healthcare successes were largely made possible by foreign aid money, which covers half the cost of the national health insurance program.

Rwanda's rapid development is not without its critics, who say the government is heavy-handed and does not stand for opposition.

But there is no denying Rwanda's economic growth stands out in the region. GDP growth has averaged 8 percent per year over the past decade.

Poverty reduction has been a top priority of President Paul Kagame, who says he wants to push Rwanda to middle-income status by 2020.

"In the past there is always a term used, we called it 'reducing poverty,' as if the aim is to remain with some poverty," he said.

At the time of the genocide, 78 percent of Rwandans lived in poverty. Today, that figure has fallen to less than 50 percent.

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