Innovation in Medical Care Brings Access to Rural Areas in Rwanda
Simple medical attention can be hard to come by in rural areas of many developing countries. For instance, “just a few years ago the Burera district [of Rwanda] only had one doctor for its 350,000 population.” This has serious consequences for those in need and can cause what should be low risk exercises, like routine childbirth, to turn deadly. However, the inability to provide care for women has caused “childbirth [to be] the number-one killer of young to middle-aged women in developing countries.” In Rwanda, where maternal mortality is extremely high, government officials are relying on innovation to aid in the fight against this humanitarian crisis.
A cooperative effort between the Rwandan government and a variety of foundations and non-profit organizations has allowed Rwanda to begin constructing community health centers in rural areas of the country. A major donor, Partners in Health, not only provided funding but the expertise for a state of the art medical facility in Rwanda’s Burera district. Dr. Peter Drobac, the Rwanda project director for the organization explained that their purpose is to “help support the government implement their roadmap and do it effectively, and [the government] gave us the space to try new things and to innovate." The innovations are “effective but inexpensive design features” which can make a major difference in patient care. Ultraviolet lights are used because they kill many disease carrying airborne microbes, smooth resins are spread over floors for easy sterilization and high ceilings are vaulted to flow through windows to improve ventilation.
Innovations are not only being explored in the physical design of the medical centers but logistically as well. The Rwandan government has set up a pyramid structure in order to realistically provide medical care with the financial and human resources at hand. At the base of the pyramid each village has at least two “community health workers,” in the middle are community health centers and at the top are district hospitals. With this system, the community health workers are able to quickly identify serious medical complications, monitor patient progress, and send patients to medical centers or district hospitals when necessary. This system has had perhaps the most notable impact on decreasing maternal mortality. Instead of unattended home births, women have access to community health workers, a short distance to travel to community health centers and if the staff identifies a complication, they can send the patient to a district hospital.
The innovative processes which are taking root in Rwanda’s medical care systems are both realistic and effective. The design of the new health centers provides cost effective ways to reduce infection and contamination while the pyramid system allows for the greatest amount of care without overwhelming the most advanced hospitals. Rwanda’s attempt to improve access and quality of medical care is another example of how innovative thinking can overcome seemingly insurmountable price tags.
Reference: Strieker, Gary. "Rwanda Saving Lives of Mothers and Babies." Inside Africa. CNN, 6 Apr. 2011. <http://edition.cnn.com/2011/WORLD/africa/04/06/rwanda.child.birth/>.
An article from The World Bank on healthcare in rural areas of Africa: http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/AFRICAEXT/0,,contentMDK:21661891~pagePK:146736~piPK:146830~theSitePK:258644,00.html
A video on using adapted bicycles to transport patients to healthcare centers in rural Africa: http://vimeo.com/5014906
A link to the website for a Virgin Mobile program which seeks to bring healthcare workers to rural areas of Africa: http://www.virginunite.com/Templates/News.aspx?nid=baa433fb-a751-4914-8258-0781487ed291&cid=b2cc3b54-5e68-49a0-b662-9611ee4ef7d5&id=b442957f-c09b-4d81-8a94-5a55ae35873f
A video on the “Phelophepa Train” in South Africa which brings healthcare to rural areas: http://www.5min.com/Video/Learn-About-the-Phelophepa-Train-in-South-Africa-516895092
An article about improving healthcare in rural South Africa: http://www.sagoodnews.co.za/newsletter_archive/mission_possible_quality_healthcare_in_rural_sa.html
1. Do you think the pyramid system is effective enough to provide suitable medical care in the rural areas of Rwanda? How could it be improved?
2. What are the challenges to providing services for the residents who live in rural area of developing countries? How can they be overcome?
3. Can you think of any new simple design innovations that hospitals in developing countries could use to improve their service?