The Need and Plans
to bring Cardiac Services to the local level
Rwanda is a small but densely populated country in East Africa, about the size of the State of Maryland, with a population of 10 million people. The capital city, Kigali, is a clean and modern city of one million but is unable to serve its citizens with medical care beyond the basic family medicine level. A dedicated Eye Institute is the only specialty medicine. We plan to add Cardiology as the 2nd Subspecialty available to Rwanda and surrounding countries.
Twenty years ago, Rwanda became the scene of the third genocide of the 20th century, preceded by that carried out against the Armenians and the Holocaust against the Jews. A million people perished in the span of three months. Thanks to current leadership, Rwanda has defied expectations and the process of rebuilding the shattered economy, healing its soul and reconciling its inhabitants have occurred to the amazement of so many observers, both inside and outside the country.
In the area of heath care, tremendous progress has been achieved, with great accomplishments in the fight against HIV, infant and maternal mortality, insurance coverage for the population and improved access to basic heath care throughout most of the country.
However, in the area of advanced medicine and surgery, much remains to be done. There remains a severe shortage of well trained medical personnel, doctors, nurses, and technicians capable of providing the type of advanced medical care which is routine in other countries. There is an unacceptable dearth of medical equipment.
In the field of Cardiology, there is not a single cardiac catheterization lab in the entire country. As a result, the modern life-saving procedures of diagnostic cardiac catheterization and coronary angioplasty and stenting, coronary bypass surgery, pacemaker, or implantable defibrillators are entirely unavailable. There are a few cardiologists, but not one Cardiac Surgeon. All cardiac emergencies must be urgently transported out-of-country, usually to Nairobi, wasting important hours that often make the difference between life and death. Other, more routine catheterizations and heart surgeries become unbearable burdens to patients and their families who must travel great distances to receive treatment.
Teams of specialists from US, Australia, and Belgium rotate through Rwandan hospitals and clinics every few months, doing dozens of cardiac surgical procedures every visit, mainly on children with congenital heart defects, or young adults with rheumatic heart disease. Those disease entities do not require cardiac catheterization for diagnosis, only echocardiography, which is available in a limited basis at a few hospitals.. TEAM HEART from Brigham and Women’s Hospital and Massachusetts General Hospital in Boston has been doing life saving and life enhancing procedures in Rwanda for the past 9 years. Unfortunately, currently, anyone who suffers a heart attack in Rwanda is treated the way we did in the US 30-40 years ago, with pain medication and supportive care. Dr Gakuba spent time in one of the main hospitals in Kigali in 2009 and was very frustrated at the limited care that could be offered. People who would have gone back to worthwhile lifestyles and occupations under similar circumstances in the US either died or were left with incapacitating heart failure, becoming a burden on their families and communities followed by premature death.
The need has become more acute now with recent improvements in nutrition and general standards of living with their attendant increase in diabetes and hypertension followed by increased incidence of heart disease and strokes.
The American College of Cardiology reported in 2013 in the journal Cardiology (Vol.43. no 2) “Cardiovascular disease is a burden shared by every country in the world, however more than 80% of deaths take place in low and middle income countries, with a number projected to grow by 2030 if current trends are allowed to continue.”
Through The Adele Rwanda Heart Foundation, we plan to create a Cardiac Diagnostic and Treatment Center and eventually Centers of Excellence through donations from supporters in the United States, Europe and those Rwandans able to add further financial support, aiming to provide this much needed care. The Center will be equipped with up-to-date equipment including EKG machines and standard X-ray and fluoroscopy, and make echocardiography, the basis of most all modern cardiac diagnosis, fully available throughout the country with mobile units. We will install a cardiac catheterization laboratory capable of doing routine and emergency coronary angioplasty and stenting as soon as finances permit.
We plan to invite physicians and surgeons from US and other countries to spend more time in Rwanda, teaching and training Rwandans. Soon we hope to have enough local well trained Cardiologists and Heart Surgeons to be able to establish and maintain our own cardiac surgical program.
Dr. Gakuba is now in the process of relocating his cardiology practice from Baltimore Maryland to Kigali, Rwanda in order to fulfill his lifelong dream and to guide this project to fruition. Along with his extensive experience in the field of clinical cardiology and years of teaching and administrative responsibilities throughout the Baltimore area hospitals, he will be taking with him a great deal of medical equipment. Dr. Gakuba has also enlisted the financial and administrative support of other US cardiologists to maintain the effort and communication back in the States.
The Adele Rwanda Heart Foundation was incorporated in the State of Maryland in 2012 and will be operating under the regulations of the Rwanda Government. Activities are overseen by a Board of US Governors. Additional Governors will be added in Rwanda.