For thousands of Rwandans gradually losing their sight to cataracts (the leading cause of avoidable blindness), many remain unaware that their vision loss can be reversed. A new wave of support is now bringing screening, surgery, and renewed hope closer to home.

On February 18, four provincial hospitals received the second phase of ophthalmic equipment in an initiative expected to significantly expand access to sight‑saving treatment.

The support targets underserved communities and addresses the reality that 31.4 per cent of people living with cataracts do not know the condition is treatable, according to published data.

The equipment was provided by The Fred Hollows Foundation (FHF) in partnership with the Ministry of Health (MoH), the Australian NGO Cooperation Program (ANCP), and The Church of Jesus Christ of Latter‑day Saints (LDS). The initiative aims to tackle preventable blindness and vision impairment and to ease the heavy economic burden vision loss places on families and communities.

Cataracts account for nearly 56 per cent of all blindness cases in Rwanda. Yet the condition is largely avoidable or treatable through a relatively simple surgical procedure.

Despite this, access to care remains uneven. As of 2022, five of the seven hospitals providing continuous cataract surgery services were located in or near Kigali, leaving significant unmet need in the Western, Eastern, and Northern provinces.

The newly equipped facilities—Kibagabaga Level Two Teaching Hospital, Ruhengeri Level Two Hospital, Rwamagana Level Two Teaching Hospital, and Kibuye Referral Hospital—were jointly prioritised with the Ministry of Health based on service demand, geographic equity, and alignment with national eye health priorities.

Four ophthalmologists sponsored by The Fred Hollows Foundation and ANCP, who graduated from the Rwanda International Institute of Ophthalmology (RIIO) in 2022, were deployed to these hospitals.

The Foundation has worked closely with the Ministry of Health and hospital leadership to strengthen eye care systems within these facilities, improving productivity, quality of care, and the effectiveness of the ophthalmologists serving in the eye units.

"The Fred Hollows Foundation took our priorities as their own because they invest in areas that we feel are very sensitive,” said Dr. Jean Baptiste Ntihumbya, Director General of Health Quality Services Standards and Regulation, at the Ministry of Health.

"I appreciate the way they invest in the workforce. Hospitals are celebrating because they don’t often talk about how they are struggling to invest in the workforce. This is a good thing on the side of our partners, who always take our orientation into consideration as their own.” he added.

Procurement of the equipment was channelled through national systems to ensure alignment with government accountability frameworks. Through a strong partnership with Rwanda Medical Supply (RMS), The Foundation successfully transitioned eye health equipment procurement to RMS.

This shift reinforces sustainable, government‑led supply systems by replacing external international sourcing with a centralised, government‑owned mechanism. The approach ensures competitive supplier selection, manufacturer warranties, proper installation, and on‑site user training—reducing the risks of non‑functional equipment, weak maintenance support, and parallel supply chains.

A timely intervention

The need for strengthened eye care services remains urgent. Rwanda has just one surgeon per one million people, far below the World Health Organization’s recommendation of four per million.

About 10 per cent of the population requires eye care services to prevent vision loss, while poor vision continues to cost the country significantly in lost productivity, according to data. In addition, nearly one in two cataract surgeries has previously resulted in poor outcomes, often due to gaps in equipment, workforce, training, and outreach services.

Tiva Kananura, Country Director of The Fred Hollows Foundation, said the equipment was selected based on observed service delivery needs and clinical recommendations, with the shared goal of reducing avoidable referrals to tertiary hospitals.

"By strengthening capacity at referral and teaching hospitals, this investment promotes more timely, efficient, and patient‑centred care closer to where patients live,” she said.

Kananura added that a long‑term objective is for these hospitals to be established as Secondary Eye Units (SEUs) delivering equitable, high‑quality, integrated, people‑centred eye care that meets demand, improves access, and actively engages communities—particularly in areas with high unmet need for eye care services.

"We want to continue supporting ophthalmologists to grow professionally so they can effectively serve their catchment populations and ensure continuous, integrated eye care services,” she noted.

Over the past decade, The Fred Hollows Foundation has supported the integration of eye health services into Rwanda’s national Performance‑Based Financing (PBF) framework, contributing to an 80 per cent increase in the Cataract Surgery Rate.

"By 2035, FHF, in collaboration with other stakeholders, aims to close the cataract gap by building a sustainable system in which every person has equitable access to high‑quality, affordable, and integrated eye care services,” Kananura said.

The initiative targets screening 9.4 million people, training 25 ophthalmologists and 58,567 community health workers, upgrading infrastructure and equipment, and establishing 14 secondary‑level eye care units over the next decade. These efforts are expected to eliminate the cataract backlog and enable more than 100,000 people to receive sight‑saving surgery.

Hospitals welcome the equipment

Ruhengeri Level Two Teaching Hospital received a B‑scan, A‑scan, trial lens set, five cataract sets with Simcoe cannulas, an auto‑kerato refractometer, slit‑lamp microscope, operating table, and a 24‑litre autoclave.

Kibuye Referral Hospital received a B‑scan, trial lens set, direct ophthalmoscope, direct retinoscope, indirect ophthalmoscope, five cataract sets with Simcoe cannulas, slit‑lamp microscope, operating table, and 90D and 78D lenses.

Kibagabaga Level Two Teaching Hospital received a B‑scan, five cataract sets with Simcoe cannulas, a portable surgical microscope, an auto‑kerato refractometer, and 90D and 78D lenses.

Rwamagana Level Two Teaching Hospital received five cataract sets with Simcoe cannulas, an auto‑kerato refractometer, and a 24‑litre autoclave. In addition, the Rwanda Ophthalmology Society (ROS) received 16 cataract sets with Simcoe cannulas.

"They’re good‑quality equipment, and we are ready to use them to serve patients,” said Dr Philbert Muhire, Director General of Ruhengeri Level Two Teaching Hospital. "We are committed to meeting Ministry of Health performance indicators and ensuring the equipment is well maintained and used for its intended purpose.”

Emmanuel Nsengiyumva, an ophthalmologist at Kibuye Referral Hospital, said the equipment would significantly reduce avoidable blindness.

"As an eye surgeon, the instruments we received will help us perform surgeries more effectively, including an operating table that was lacking in our eye unit. We also thank The Fred Hollows Foundation and ANCP for sponsoring our training programmes and for continuing to support our work even after graduation,” he said.