Doctor Jean de Dieu Nsanzimana is a Rwandan general surgeon undergoing specialised training in Israel and could become Rwanda’s first known paediatric cardiac surgeon.

Last week, he was among specialists who took part in a Rwanda-Israel medical mission that provided free treatment to 25 children with heart conditions at King Faisal Hospital. The interventions included catheterisation, a minimally invasive procedure used to diagnose and treat certain congenital heart defects without open-heart surgery.

After the mission, Nsanzimana returned to Israel, where he is pursuing a five-year fellowship in congenital and paediatric cardiac surgery at Wolfson Medical Center under Tel Aviv University.

He began the programme in March 2025, three years after graduating from the University of Rwanda in 2022.

Nsanzimana said his decision to specialise was shaped by seeing many cardiac patients referred abroad for surgery, with only a small number able to access treatment due to high costs and strict selection criteria.

"It is a big sacrifice to leave your family and go abroad for five years of training. In healthcare, you do not focus on yourself; you accept it for a greater purpose,” he said.

Despite the sacrifices, he remains hopeful that the long-term impact will be worth it.

"It is a process, but one thing I am sure of is that the results will show. Cardiac care will be accessible locally in a timely, affordable, and convenient way,” he said.

Building capacity

Congenital heart defects are conditions present at birth affecting a baby’s heart structure and function. Rwanda is currently building capacity in managing the disease.

"Since Rwanda does not yet have a fully trained specialist in paediatric congenital heart surgery, many patients are referred abroad for treatment, where some do not survive due to delayed access to care,” he said.

Nsanzimana said his goal is to perform specialised procedures after training and also train Rwandan doctors to strengthen local capacity and reduce reliance on treatment abroad.

According to estimates from the World Health Organization and global health studies, congenital heart defects affect roughly one in every 100 children worldwide.

"In Rwanda, we don’t have national statistics because many people do not have access to screening and care, but there are more than 400 children who have already been diagnosed and are still waiting for surgery,” Nsanzimana said.

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Consequences

For many children, delays in treatment are life-threatening. Nsanzimana said that among the more than 400 patients awaiting surgery, the condition often continues to worsen while they wait, and in some cases becomes too advanced for successful operation.

He noted that some children die before they can undergo surgery, mainly due to the long waiting times and limited surgical capacity.

Nsanzimana said congenital heart conditions should ideally be treated within the first year of life, but delays mean many patients present when the disease has already advanced, leading to higher risks of complications, disability, and death.

"We have very few specialised personnel. At the moment, there is one Ethiopian and one Rwandan specialist, and we still rely heavily on visiting medical missions from abroad,” he said.

He added that the challenge also includes limited equipment, gaps in training, and the high cost of treatment, in addition to a shortage of specialised staff and a growing number of patients needing cardiac care.

Even when they survive, children who miss timely surgery often live with long-term complications and disabilities. Many do not grow and develop as expected, face difficulties in school, and suffer from failure to thrive.

According to different scientific studies, most congenital heart defects are genetic. However, there are also a few contributing factors during pregnancy, including untreated illnesses such as diabetes and hypertension, as well as alcohol use, smoking, and conditions linked to poverty.

These account for a small proportion of cases, while the majority are genetic in origin.

Cardiac care improvements

Despite the challenges, the medical expert noted that Rwanda has made stable progress in cardiac care, particularly since King Faisal Hospital began performing heart surgeries more regularly.

He noted that over the past three to four years, operations were not performed consistently, and the country relied heavily on visiting medical missions.

Nsanzimana observed that increased government attention has since strengthened the programme, attracting more foreign specialists to conduct surgeries at King Faisal Hospital while also training local medical teams.

Visiting specialists have strengthened both treatment and training capacity by supporting local teams, offering guidance, and working alongside professionals at King Faisal Hospital and other hospitals to improve service delivery.

The international medical missions have increased, with two to three visits now taking place annually, allowing more patients to access care.

The medic said the long-term goal is to establish a self-sustaining programme led by local specialists.

"We expect that in the coming years we will have fully local capacity, without relying on foreign experts. The aim is to build our own teams and sustain a programme that provides regular and continuous medical and surgical care,” he said.