One of the most remarkable achievements Rwanda has witnessed since its liberation has been the transformation of its health sector. Three decades ago, the country faced the enormous task of rebuilding a healthcare system that had been left in ruins by the 1994 Genocide against the Tutsi. ALSO READ: A preventable genocide, a denied responsibility: What ‘Corridors of Power’ reveals about Rwanda Today, Rwandans have far better access to healthcare, life expectancy has risen dramatically, and the country is setting its sights on becoming a regional medical hub. Protecting these gains is now one of the biggest responsibilities of healthcare workers. ALSO READ: For one genocide survivor, liberation began with a walk In 1993, life expectancy stood at about 42 years. In 1994, after the genocide, it dropped to around 23–27 years. Hospitals were destroyed, medicines were scarce, and much of the health workforce had been killed, displaced, or forced into exile. What remained was a system that could barely function. ALSO READ: What does Rwanda's rising life expectancy mean? Even before liberation, healthcare workers were already working under extreme pressure. Between 1990 and 1994, doctors and nurses treated wounded soldiers in forests and hills, often without proper equipment or reliable supplies. When the war ended, many of them moved into rebuilding services and training new professionals who would take over the system. ALSO READ: Community health workers to start screening high blood pressure Rebuilding health services involved reopening facilities, restoring basic care, and gradually rebuilding trust in health institutions. People had to regain confidence that a visit to a hospital or health centre would make a difference. ALSO READ: Community health workers: Facilitating the growth of Rwanda’s health sector Today, the situation is very different as investment in the health sector has expanded training, improved service delivery, and pushed life expectancy to about 70 years. The focus is no longer only on survival, but on longer and healthier lives. One of the major changes has been primary healthcare. Rwanda has built a system that reaches communities through nearly 60,000 Community Health Workers across villages. They are supported by health posts, health centres, district hospitals, and referral hospitals. This network has made healthcare more accessible and immediate for many families. ALSO READ: Elevating midwifery: A transformative journey to reach zero preventable maternal deaths in Rwanda The impact is evident in people’s daily lives. More women now give birth safely in health facilities. Malaria, once a leading cause of hospital admissions, has declined, although recent increases show the fight is far from over. More children are growing up healthy and free from many preventable diseases. The Community-Based Health Insurance scheme (Mutuelle de Santé) has transformed how people seek medical care. Many now visit health facilities earlier because they can afford treatment. However, access alone is not enough. The care patients receive must also be timely, respectful, and of high quality. This is where the responsibility of healthcare workers becomes especially important. Treatment involves more than diagnosis and medication; it is also about how patients are welcomed and treated with dignity. A patient may recover physically but still leave feeling ignored or disrespected. That experience shapes how people view the entire health system. There are still structural challenges as the country has about one skilled health professional for every 1,000 people. The World Health Organization benchmark usually refers to 4.45 doctors, nurses and midwives per 1,000 population. The 4x4 Reform is meant to address this gap by increasing the number of health workers within four years. As staffing improves, expectations on service quality will rise as well. The sector is also expanding into areas of specialised care that were previously unavailable within the country. Since 2023, King Faisal Hospital has expanded advanced services, including kidney transplantation and open-heart surgery. Kigali Health City, IRCAD Africa, and the BioNTech vaccine manufacturing facility are expanding capacity in specialised care, training, and medical innovation. These developments are inspiring a new generation of healthcare professionals. More students are enrolling in medical and nursing schools, and young practitioners are joining a health system that continues to grow while expanding access to advanced medical care. I urge fellow healthcare workers to remember the history behind our profession. It is a daily responsibility to make sure care is delivered with competence, dignity, and consistency for every patient. I urge my fellow healthcare workers to remember the history behind our profession. We have a responsibility to ensure that care is delivered with competence, dignity, and consistency to every patient, every day. The author is a medical doctor and a passionate public health advocate.
