Dr. Theonille Mukabagorora does not seek the spotlight, but her work speaks volumes. As Rwanda’s first, and only radiologist with a PhD – she’s breaking new ground in a field often overlooked but absolutely vital. Her journey has been shaped by long hours, tough choices, and a strong belief in the importance of access to quality healthcare. In this Q&A, Dr. Mukabagorora shares what it means to lead in uncharted territory, discusses the current state of radiology in Rwanda, and explains why she is hopeful that more women and diverse voices, will follow in her footsteps. Experts: 1. Could you briefly introduce yourself? When and where were you born, and could you share a bit about your educational background? My name is Theonille Mukabagorora. I’m 40 years old, married, and a mother of two. I was born in Kayonza District, Rwanda, as the youngest and only daughter among four siblings. My father passed away in 2017 at the age of 92, and my mother is now 79. I completed my primary education at Ruramira Primary School, and secondary studies at Groupe Scolaire de Gahini. Afterward, I worked as an executive secretary in the former Rukira sector before enrolling at Kigali Health Institute (now part of the University of Rwanda – CMHS) in 2006, where I earned a diploma in medical imaging in 2009. From 2009 to 2016, I worked as a radiographer at the University Teaching Hospital of Butare (CHUB). I later pursued further studies in Uganda at Ernest Cook Ultrasound Research and Education Institute (ECUREI), earning both a bachelor’s and a master’s degree, completing the latter in 2017. On September 2, 2025, I earned a PhD in Medical Imaging, with a specialisation in vascular sonography, from the University of Pretoria. Since 2016, I have served as an academic at the University of Rwanda, initially coordinating research, and community outreach activities before transitioning to focus on my doctoral studies. Over the past four years, I’ve also contributed to national health policy, strategic planning, and the development of imaging guidelines. My journey has been shaped by perseverance, faith, and a deep commitment to strengthening Rwanda’s healthcare and education systems. 2. What inspired you to pursue a career in radiography and medical imaging? I entered the medical imaging programme at the former Kigali Health Institute (now the University of Rwanda – College of Medicine and Health Sciences) without knowing what the field truly entailed. Coming from a rural background, I was only familiar with nursing and laboratory sciences, and initially hoped to transfer. A registrar encouraged me to stay, highlighting the need for local capacity in imaging. At the time, I had never even seen an X-ray machine and had only heard the phrase guca mu cyuma (going through the machine). But hearing positive experiences from senior students convinced me to give it a chance. I committed fully, developed a deep interest, and ultimately graduated top of my class. This experience, combined with the realization that Rwanda urgently needed imaging professionals, sparked a passion that continues to drive me today. 3. You're the first person in Rwanda to earn a PhD in radiography. What was that journey like? Becoming the first radiographer in the country to earn a PhD in the medical imaging and radiology field has been both challenging and deeply rewarding. This achievement reflects years of hard work, resilience, prayers, and the support of mentors and peers. More than a personal milestone, it represents a commitment to inspiring future generations and advancing the profession. Between 2006 and 2009, only Diploma-level training in medical imaging was available locally. After completing my Diploma in 2009, I was determined to continue studying despite limited opportunities and funding. Together with nine colleagues, we enrolled at Ernest Cook Ultrasound Research and Education Institute (ECUREI) in Uganda – thanks to Jean Baptiste Ndahiriwe, who was pursuing his master's there, and helped secure special arrangements for Rwandan students. We completed an additional two years to earn a bachelor’s degree, building on our three years at KHI. However, the degree was not yet recognised by the Ministry of Health. While working at CHUB, the hospital received a donated CT scanner and funding to train staff. I was allocated $4,500, of which only $500 was used for 45 days of CT training. I used the remaining amount to enroll in ECUREI’s master’s programme. Although I encouraged others to join, only one colleague did, and together we completed the degree in 2017, bringing the total number of master's degree holders in the field in the country to three. Still motivated to advance, I explored PhD opportunities during the 2020 COVID-19 lockdown. South African universities offered affordable options, and with my husband’s support, I self-funded the initial registration. Unexpectedly, I was awarded a bursary I hadn’t even applied for, marking the beginning of my PhD journey in late 2021. My research involved three phases: screening for atherosclerosis in five hospitals (one per province); conducting a scoping review of existing guidelines; and developing a novel screening tool. Engaging 33 experts from nine countries, including several in Africa, as well as the USA and the UK for the Delphi process was challenging, but ultimately successful. Balancing professional duties with academic work was demanding, but the outcomes were deeply fulfilling. The screening tool received positive feedback, and is expected to enhance early detection of carotid atherosclerosis in high-risk patients, potentially reducing stroke incidence through timely intervention. This achievement is not just personal, it sets a precedent for radiographers, sonographers, and radiologists in Rwanda to pursue advanced studies and contribute to a stronger, more informed healthcare system. 4. Were there individuals who supported or inspired you throughout your studies and career? How did they influence your path? Absolutely! Throughout my academic and professional journey, I’ve been fortunate to receive guidance and inspiration from remarkable individuals who have shaped both my path and perspective. One such person is Jean Baptiste Ndahiriwe, who served as our Head of Department during my diploma studies at the former Kigali Health Institute. His efforts to connect us with study opportunities in Uganda had a lasting impact on my career. I had the privilege to study under Prof. Michael Grace Kawooya at ECUREI, whose leadership advanced medical imaging education, and earned him recognition as a pioneer of radiology in Africa. Another profound influence was Dr. Zeridah Muyinda, particularly as a woman in academia, she remains a powerful role model. The support of Rwandan radiologists during my clinical training was invaluable, as was the mentorship of my PhD supervisors at the University of Pretoria, who played a pivotal role in shaping my academic journey. I also want to acknowledge Prof. Kirk from the University of Washington. His ground-breaking work in Duplex ultrasound and guidance during my research were invaluable to my journey. My husband and children have been my greatest source of strength. Their love and unwavering support, particularly my husband’s constant encouragement, have carried me through every stage of this journey. 5. From your perspective, how has the field of radiology evolved in Rwanda? Radiology in Rwanda has made significant progress over the past two decades. Initially limited to diploma-level training, and a few radiologists mostly trained abroad and based in Kigali, the field has since expanded. The Radiology Residency Programme, launched in 2016, has graduated 11 radiologists, with more in training. Radiographer training has advanced to the bachelor’s level, enabling graduates to perform ultrasound, and interpret general radiographic images – key to addressing the shortage of imaging professionals. In 2005, Rwanda had only one CT scanner, which was located at King Faisal Hospital. The hospital later enhanced its diagnostic capabilities by acquiring a single advanced 128-slice CT scanner in March 2017, currently the only one of its kind in Rwanda. Today, there are 14 CT units, including in private facilities. MRI access has increased from one to five machines, all in the private sector, reflecting growing private investment. Ultrasound equipment distribution to district hospitals, and some health centres has further strengthened diagnostic services nationwide. Overall, Rwanda’s radiology sector has evolved into a more specialised and integrated system, enhancing healthcare delivery and working toward ensuring qualified professionals serve both urban and rural populations. ALSO READ: Rwanda gets largest medical diagnostic equipment-delivery under new strategy 6. Are there specific health issues or challenges in Rwanda where sonography plays a critical role? Sonography is vital for diagnosing and screening non-communicable diseases like cancers, heart conditions, vascular disorders, and internal organ issues such as liver cirrhosis, liver masses, and pancreatic diseases. ALSO READ: Young people questioned on reluctance to take NCD screenings It is also crucial in managing abdominal trauma, especially splenic rupture, a common cause of internal bleeding after blunt injury. In maternal healthcare, sonography monitors pregnancies and detects complications early, including ectopic pregnancies, placental abnormalities, and congenital anomalies. Ideally, every pregnant woman should have at least one ultrasound per trimester. The World Health Organisation (WHO) recommends at least one scan before 24 weeks to determine gestational age, detect anomalies and multiple pregnancies, reduce unnecessary inductions, and improve pregnancy outcomes. Sonography supports timely diagnosis, guides treatment, and improves outcomes across many conditions. When available at all healthcare levels, including primary health centres, ultrasound machines and trained sonographers enhance early disease detection and expand access to diagnostics. This plays a significant role in advancing universal health coverage. ALSO READ: Health ministry mulls major changes as NCDs surge in Rwanda 7. What do you envision for the future of radiology education in Rwanda? We’re working toward launching master’s programmes for radiographers and sonographers. Eight Rwandan students are currently completing master’s degrees at ECUREI – thanks to partnerships that make tuition more affordable. Expanding such programmes locally, and creating pathways to PhD-level training, is vital. With time and commitment, I believe Rwanda will become a regional leader in radiology education. 8. Can you share more details about your research, and how it aims to improve patient care or medical imaging in Rwanda? My research journey began in 2019 with a community outreach programme at Nyabugogo car park, organised by the Department of Medical Imaging Sciences, the College of Medicine and Health Sciences, and Nyarugenge District to raise awareness about medical imaging and radiation safety. We screened 86 individuals, and 22 (25.5 per cent) showed one or more abnormalities. A memorable case was a woman who discovered she was 24 weeks pregnant during the outreach. The full article is available here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8572265 More recently, my PhD research started with a scoping review of existing carotid ultrasound protocols to assess their relevance locally. We identified 17 validated protocols, all developed outside Africa in the UK, USA, and Europe – highlighting a lack of standardised, region-specific guidelines and causing confusion in local practice. As part of this research, I developed a screening tool, currently under copyright review, to help medical imaging professionals and clinicians detect carotid atherosclerosis early. Designed for decentralised healthcare levels, the tool aims to support timely diagnosis and reduce stroke risk through early intervention. 9. In your view, what are the most pressing gaps in radiology expertise in Rwanda and the region, and what steps do you believe are needed to close them? Rwanda has made significant strides in advancing medical imaging, and radiology through government investment in modern equipment, and training programmes to address the shortage of skilled professionals. ALSO READ: Gov’t scales up advanced healthcare training to meet growing demand However, a key gap remains: the absence of a centralised coordination unit within the Ministry of Health to oversee imaging services. Radiology requires more than equipment and trained staff; it needs clear standards, guidelines, and regulatory oversight to ensure consistent, high-quality service delivery across the country. Regionally, countries like Tanzania, Kenya, and Uganda have established radiology units within their health ministries, led by imaging professionals. These structures streamline services, regulate practice, and promote quality. For Rwanda, creating a similar coordination body would be a crucial step toward harmonising imaging services nationwide, improving quality control, and ensuring efficient use of resources – essential for building a more equitable and sustainable healthcare system. ALSO READ: NCDs account for 44% annual mortality in Rwanda – Minister Mpunga 10. What exciting innovations in sonography or radiology do you hope to introduce in Rwanda? There are several exciting new technologies and techniques in sonography that I am eager to introduce in Rwanda, especially to improve vascular sonography, which is currently limited to urban centres. One promising advancement is the integration of artificial intelligence (AI) into ultrasound systems, automating measurements and detecting vascular abnormalities with greater accuracy and consistency while reducing operator dependency. I plan to collaborate with IT specialists to develop software that enhances detection. Innovative techniques like hybrid imaging, combining ultrasound with CT or MRI – provide better visualisation of complex vascular structures, aiding diagnosis and treatment planning. Advanced modalities such as elastography, which measures tissue stiffness, and contrast-enhanced ultrasound offer detailed tissue and vessel assessment. Portable, high-resolution ultrasound devices supported by AI can expand access in remote areas, enabling early disease detection and management. Incorporating these technologies into training programs will improve diagnostic accuracy, patient outcomes, and overall healthcare delivery. ALSO READ: Rwandan scientist wants to use AI to deepen radiology services 11. How can universities, hospitals, and policymakers better support professionals like yourself and others in the field? Universities, hospitals, and policymakers can support radiology professionals by investing in sustainable education with skilled faculty and modern infrastructure. Expanding specialised training and continuous development builds a competent, motivated workforce. Coordinating academic institutions, training sites, and healthcare facilities ensures practical skills are integrated into education. Policymakers should establish strong regulatory frameworks and promote policies that improve working conditions, career advancement, and service quality in medical imaging and radiology. ALSO READ: Inside Rwanda’s progress on reform to quadruple healthcare workforce 12. Radiology is still a male-dominated field. How have you navigated the challenges related to gender throughout your career? Radiology remains a male-dominated field, and my journey has been challenging, especially as a married woman with children. Leaving my five-year-old child was emotionally difficult, but I had made up my mind and sought strength through faith. What carried me through was a clear vision, passion, perseverance, and discipline. Balancing professional demands with family responsibilities required careful time management, including many late nights and long hours. The journey was tough, but with determination and God's guidance, I made it. 13. What advice would you give to young Rwandans pursuing radiography or sonography? For young Rwandans considering advanced studies in radiography or sonography, my advice is to approach the journey with dedication and a passion for patient care. These fields offer meaningful opportunities to make a lasting impact in healthcare. Focus on building a strong foundation in both theory and practice. Since radiography and sonography are highly operator-dependent, precision and continuous learning are essential. Stay patient-centred and open to growth. Medical imaging offers diverse career paths, including subspecialties like nuclear medicine, radiotherapy, and radiation sciences. Radiography is a solid starting point that opens many doors. I encourage women, in particular, to aim high and consider pursuing a PhD. It’s an achievable goal, I’ve lived it myself, and I’m proud that two of my colleagues are already on their own PhD journeys. With determination and support, these possibilities are well within reach. ALSO READ: Girls, be the difference the country’s healthcare is looking for - Rwanda’s youngest neurosurgeon
