Dr. Subira Manzi’s story is one of roots, exile, dedication, and ultimately, a return home with a mission that transcends medicine. Born in Rwanda many decades ago, his journey took him across borders, languages, and healthcare systems — only to bring him back to the country of his birth, where he now pioneers a cause too often overlooked: menopause care.

Today, the senior gynaecologist and obstetrician sits in one of the many new buildings at King Faisal Hospital (KFH), where, with a fulfilled heart, he hopes to make a difference in his country of birth before he calls time on his lengthy career.

A childhood beyond borders

"I was born in Rwanda, but I didn’t live here for long,” Dr. Subira begins, reflecting on the paradox of identity that many in the Rwandan diaspora share. "I left this country at the age of two, following my father, who was an evangelist across the border.”

Raised outside Rwanda in a French-speaking system, Dr. Subira grew up deeply connected to his Rwandan heritage, even though his surroundings were foreign. "I was raised as Rwandan but outside the borders of Rwanda, because of the political turmoil that scattered many Rwandans abroad.”

His formative years were shaped by his family and faith. "We were many in my family — eight children originally, now seven — and I’m privileged to be the only medical doctor,” he shares.

His father’s role as an evangelist deeply influenced his early worldview. He attended missionary schools affiliated with the Seventh-Day Adventist Church and initially envisioned following in his father’s footsteps.

"Actually, I wanted to be a lawyer,” Dr. Subira reveals, describing his university days in Kinshasa. "But I was aware of the environment around me, and personally, I thought being a lawyer would be miserable for me. I wanted to be close to people like my father — but in a different way. Not defending them in court, but helping them directly. That’s why I chose medicine.”

ALSO READ: From periods to post-menopause: A look at challenges, strategies for a better transition

His medical training began in Kinshasa, then Zaire, now DR Congo (DRC), where he qualified as a medical doctor and specialised in gynaecology and obstetrics. The choice of specialty came somewhat unexpectedly but soon proved to be a perfect fit.

"Gynaecology and obstetrics are in the middle of everything—internal medicine, paediatrics, surgery, psychology,” he explains. "It was fulfilling to work in such a multidisciplinary field, where I could make a tangible difference in women’s lives.”

For the next three decades, Dr. Subira worked primarily in Southern Africa, spending 22 years in Eswatini (formerly Swaziland). "I was a medical doctor for four decades and dealt with everything in gynaecology and obstetrics,” he says with pride.

The call to come home

Despite a prosperous practice and a comfortable life in different countries, surrounded by his family—including his wife and four children—Dr. Subira felt a profound pull to return to Rwanda.

"Almost 11 years ago, I was running a small but prosperous gynaecological clinic,” he recalls. "My wife and I sat down and said: our countrymen are back home, many died fighting for our freedom. Somehow, we contributed to the liberation struggle as Rwandans abroad, but it was not enough.”

The decision was not easy. "Before I came, I was sitting in front of somebody extremely influential, who knew that my clinic was contributing to the welfare of the country. When they heard that I was leaving, I was summoned to explain why I should leave the country.”

His answer was simple and heartfelt: "You don’t know where I got educated. I came here and wholeheartedly served this nation before, but I felt I still owed my country what they hadn’t yet received from me.”

Dr. Subira returned in 2013, realising that retirement age was fast approaching without using his skills and experience to serve his country of birth. "I wanted to retire into something profitable for the nation and personally fulfilling,” he says. That ‘something’ would become his mission to improve menopause care in Rwanda.

Dr. Subira says that during his travels, he became increasingly interested in what he should be doing for his country ahead of retirement.

ALSO READ: Menopause: The burden of womanhood

"I realized that Rwanda is advancing rapidly in many ways, and women are central to that development,” he says. "So, I thought, why not come close to them and help with a common problem related to menopause?” he says, explaining his mission to return home.

When Dr. Subira returned to Rwanda, he did not immediately become a permanent staff member at King Faisal Hospital.

"I started as an outside consultant on a revenue-sharing basis, similar to the system I’d seen working in South Africa,” he explains. He also played a key role in founding Legacy Clinics and served as Chief Medical Officer there before eventually settling into his role as Head of the Department of Obstetrics and Gynaecology at King Faisal Hospital.

"I never expected to focus on menopause care,” he admits. "In Rwanda, when people think of obstetrics and gynaecology, they think about pregnancy and deliveries. But after reproductive age, many women are left alone and unattended.”

Recognising a gap in care, Dr. Subira took the initiative. "I spoke to hospital leadership, and they encouraged me to start a menopause clinic.”

The clinic officially opened on February 27, 2025, though Dr. Subira had been "dealing with it timidly” since his arrival. The clinic now addresses a widespread and urgent need in Rwanda.

Why menopause matters

"Menopause is often misunderstood,” Dr. Subira explains. "It’s not a catastrophe; it’s a natural continuation of life. But many women experience difficult symptoms and are left isolated without help.”

Dr. Subira is passionate about educating the public on menopause as a medical condition with wide-reaching effects. "Menopause means the stopping of menstruation,” he clarifies. "The ovaries stop producing hormones, especially estrogen, which affects everything from hair and skin to bones and the brain.”

He emphasises the numerous health risks that arise from declining estrogen levels—osteoporosis, cardiovascular disease, memory loss, mood disorders—and the psychosocial impact on women. "Some women experience hot flashes, insomnia, forgetfulness, and depression. Many think these are just part of aging, but they are medical issues that can be treated.”

ALSO READ: World Menopause Day: Identifying the signs

Dr. Subira’s mission extends beyond women to include men. "Menopause can strain relationships because men don’t understand what women go through. They also experience hormonal changes—called andropause—but more gradually.”

"I’ve seen cases where marriages have broken down due to menopause. Irritability, emotional changes, low libido—these things can deeply affect relationships,” he says. "If men are unaware of what’s going on with their wives or partners, how can they offer support? This lack of understanding can lead to frustration and even divorce. But with a supportive partner, the results are different.”

A growing movement

Dr. Subira draws attention to the global evolution of menopause care. "The International Society for Menopause started in England in 1978, and today, in Rwanda, we are just starting—47 years later,” he says.

He advocates for multi-sector engagement—through schools, churches, media, and healthcare—to foster open conversations.

"Menopause should not be taboo.” Even medically, managing menopause isn’t just the job of gynaecologists and obstetricians. "It involves other specialists,” he explains. "We collaborate with orthopaedic surgeons for bone health, psychologists for mental health, and endocrinologists for hormone-related issues. It’s a multi-disciplinary effort.”

The clinic provides hormone replacement therapy, counselling, and comprehensive care, but Dr. Subira stresses the importance of expanding services and training.

"Health providers in Rwanda have little formal training on menopause,” he says. "As life expectancy rises, we must prepare for 25 years or more of post-menopause life.” He emphasises the need to increase awareness, starting with dispelling misconceptions.

ALSO READ: Why older men are healthier than older women: Lack of menopause leaves men feeling better

He dreams of a dedicated Menopause Centre in Rwanda—a place where women can access all services in one location: labs, imaging, counselling, treatment, and multi-disciplinary support. "Before I retire, I would love to see the creation of a standalone Menopause Centre—a comprehensive care facility, ideally with branches across Rwanda. It would offer everything in one place,” he says.

Legacy and Future

For Dr. Subira, this mission is deeply personal, combining professional fulfillment with national service.

"My reward is not financial or comfort. It’s the satisfaction of serving my people, many of whom never saw me growing up, but now see me contributing before I retire.”

His story embodies a full circle—from a Rwandan child raised in exile to a pioneering doctor returning home to fill a critical healthcare gap.

"I came home with a mission,” he says simply. "To change perceptions on menopause and improve the lives of Rwandan women.”

He thanks the Government of Rwanda and King Faisal Hospital for granting him the opportunity to do something he hopes will impact the nation.

"I’m very grateful to King Faisal Hospital for supporting this work and for giving us this platform,” he says, commending the holistic approach, which involves other medical disciplines.