“I have a dream that one day every valley shall be exalted, Every hill and mountain shall be made low, The rough places will be made plain, And the crooked places will be made straight And the glory of the lord shall be revealed, and all flesh shall see it together. This is our hope.... “ Martin Luther King Jr. Reading these words touched me deeply and in spite of difference in place and time, they resonate with me today. Living in the Land of a Thousand Hills, I often wonder about the million other unseen hills, valleys, and mountains in the world. After 25 years, I now look back and remember the Genocide against the Tutsi that changed the history of Rwanda. I was very young at that time so all of the memories that float through my mind are actually tales told to me by surviving members of my family and liberators. Although I have no real memories of what happened, the stories are so vivid they bring the events to life for me every time they are told. The brutality of the Genocide is a non-negotiable fact in our history. What makes it more horrifying is the impact of that brutality on the lives of every single person I know. I see it in the eyes of the crippled, the emotionally disturbed, the orphaned, the widowed struggling to raise children. It is evident in the many transformations that have taken place to overcome that crisis. This April Rwanda commemorates the 25th anniversary of the last century’s greatest human tragic, the 1994 Genocide against Tutsi. This tragic event shaped millions of lives in just a couple of days. Its ripple effect is still strongly felt in our day-to-day lives. Yet today Rwanda is radically different than it was 25 years ago; we have embarked on a remarkable journey of transformation toward prosperity. We have come a long way; with strong leadership, fruitful partnerships and innovative programmes, Rwanda is now stable, prosperous, and progressing rapidly. Rwanda’s economy is currently one of the fastest growing in Africa, with a growth rate averaging 8% every year since 2001 given its tatters following Genocide. This had lead to substantial improvement in living standards, meeting some of the Millennium Development Goals (MDGs). Rwanda has also recorded the sharpest decline in maternal mortality in the world ever, between 2000 and 2011, as highlighted in the British Medical Journal, with a two-thirds drop in child mortality and near-universal primary school enrollment, poverty rate dropping from 44% in 2011 to 39% in 2014, while inequality measured by the Gini coefficient stood at 0.45 and life expectancy has doubled since 1994. Rwanda is among few countries that have exceeded the Abuja commitment to invest at least 15% of the domestic budget on Health and Education. Moreover, Rwanda has kept pace with renewed commitment toward the Sustainable Development Goals (SDGs) for 2030. Given Rwanda’s experience in 1994, this growth and achievement is remarkable. As a result, Rwanda has improved in key health indicators and other health outcomes, serving as an example for the region. This improvement in Healthcare delivery has attracted global attention. Community Health Workers and health insurance stand out as the drivers of this success and has led to increased access to healthcare services. Progress is immense, but these services must continue if the improved collective health of Rwandans is fully to be realised. The 1994 Genocide against the Tutsi not only destroyed our social and economic fabric but also our healthcare infrastructure and human resources for health. Training of healthcare providers to advanced levels has taken time and has just begun to keep pace with meeting our needs. My university, the University of Global Health Equity, has joined the league of other higher learning institutions in the world to advance global health delivery by training a new generation of global health leaders who are equipped to not only build but also sustain the effective and equitable healthcare systems in the country and the world. As a trained health professional and as a social justice agent, it is heartwarming to be part of this great effort and transformation impacting my country. Looking ahead, many challenges remain in Rwanda; an increasing non-communicable diseases epidemic, addressing new HIV infections, teenage pregnancy rates, and malnutrition among others. Additionally, there has been less private sector investment in healthcare, and over 38.2% population still live in poverty. A shortage of trained healthcare professionals poses a challenge as the country faces an epidemiological transition. For Rwanda to tackle these challenges, strong partnership, results-driven governance, new innovation and social justice must be put forward as a solutions on the table. Though our thousand hills’ and their winding roads are some of the most visually stunning in the world, they must never be excuses to shy away from addressing health challenges. Inequalities and challenges are hills we struggle to climb and these crooked roads take extratime and resources to negotiate. We not only seek to flatten the hills of injustices but to raise the valley of despair, to lift people out of poverty and hopelessness. A universal and fair healthcare system is one that restores healing, wholeness and hope, and so my training at my University has gone beyond equipping me with state-of-the-art knowledge and skills, it must teach me to bring hope to those I serve. Let us Remember and Re-unite. God bless Rwanda’s Liberators who could not make it home and those who are part of this transformation. The writer is a Global Health Scholar. The views expressed in this article are of the author.
