When Selva Nesar arrived with her family in Rwanda from Afghanistan, she was unable to hear and unsure of her future. Today, her story has helped launch a cochlear implant programme that is transforming lives and positioning Rwanda as a leader in inclusive hearing healthcare. Silence shaped Selva’s first five years of life. Not the peaceful silence of a quiet morning, but the isolating silence of complete deafness. When her family fled the Taliban regime in Afghanistan and found asylum in Rwanda in 2021, Selva arrived carrying trauma, resilience, and a future that, without intervention, would have remained silent. Today, Selva’s story is changing Rwanda’s hearing-healthcare history. Born bilaterally deaf, she became the first child to receive cochlear implant surgery in Rwanda, marking the beginning of a national conversation: not just about one child’s access to sound, but about Rwanda taking up the responsibility – and opportunity – to establish a sustainable cochlear implant programme for its people. Cochlear implants are not hearing aids; they are used when conventional hearing aids provide little or no benefit. These sophisticated devices bypass damaged parts of the inner ear and directly stimulate the auditory nerve, enabling individuals with severe to profound hearing loss to perceive sound. For children, access to sound is not merely medical – it determines language development, cognitive growth, education, and lifelong participation in society and the economy. The global need is substantial. According to the World Health Organisation, more than 34 million children worldwide live with disabling hearing loss, with the majority in low- and middle-income countries. In sub-Saharan Africa, childhood hearing loss remains underdiagnosed and undertreated, often due to infections, birth complications, and limited early screening. Without timely intervention, hearing loss can permanently restrict educational and social outcomes. Selva’s surgery became possible through an extraordinary collaboration. With the support of the Ministry of Health, and funding from the Crocker Catalyst Foundation, a plan was developed to bring internationally renowned ENT surgeon Prof. Dr. Richard Gurgel from the University of Utah to Rwanda. The aim was to surgically place two cochlear implants – one for each of Selva’s ears – offering her the possibility of hearing, communication, and opportunity. But then a powerful idea emerged: “Why stop at one child? If expertise, technology, and infrastructure were already mobilized, why not extend the impact?”, Michael Fairbanks, the CEO of Akagera Medicines, says. Fairbanks is also a member of the President Paul Kagame’s Presidential Advisory Council. That question gave birth to “Operation Selva” – transforming a single humanitarian intervention into a national catalyst. Instead of one surgery, ten deaf children received cochlear implants, creating momentum to change hearing healthcare in Rwanda as a whole. The cochlear implant surgeries by Prof. Gurgel were successfully conducted at King Faisal Hospital and its surgical team, under the leadership of Dr. Augustin Sendegeya and Dr. Jean-Marie Vianney Dushimiyimana, with support from Dr. Kaitesi Mukara, as well as surgeons from Rwanda Military Hospital and CHUK. The joint effort ensured high clinical standards while building local surgical capacity. For families, the impact was deeply personal. Parents of the ten implanted children began referring to Prof. Gurgel simply as “Muganga” – healer – when their children’s silence broke. Yet surgery alone does not create hearing. Long-term audiological care and rehabilitation are essential to success. This work is being delivered at Rwanda Military Hospital by a multidisciplinary team under the leadership of ENT specialist Dr. John Bukuru. In parallel, the hospital offers Newborn Hearing Screening. This early detection enables timely intervention, and prevents irreversible delays in language development, and improves long-term educational outcomes. Industry partnership has been equally important. The cochlear implant manufacturer MED-EL is reinvesting revenues into supporting the establishment of a sustainable cochlear implant programme in Rwanda, including comprehensive training for surgeons, audiologists, and rehabilitation specialists, strengthening national capacity across all stages of care. Public hospitals, international partners, and local professionals share the same long-term goal of an All-Rwanda approach: Rwandan citizens implanted in Rwanda, by Rwandan surgeons, receiving lifelong aftercare from Rwandan audiologists and rehabilitationists. Enabled by the President’s visionary support and the government’s decision of including assistive hearing technologies like cochlear implants into the Community-Based Health Insurance, Rwanda is demonstrating how political will and coordinated action can translate advanced medical innovation into public good – positioning Rwanda as a lighthouse for hearing healthcare in Africa and beyond. Selva once lived in a world without sound. “Today, she is learning to listen, to speak – and she dreams about becoming a doctor herself, inspired by those who changed her life”, Selva’s mother says. And who knows, one day she may return to the operating theatre as an ENT surgeon – perhaps even as a fellow of Dr. Gurgel – and becoming herself a “Muganga” treating Rwandans with hearing loss and breaking their silence to hear life. The writer is the Regional Manager Africa, MED-EL
