Giving healthcare a humble face

Doctors embody the human face of tender loving care. In a sense, they are not only custodians but the true panaceas of health. And if these qualities were used to cut out the men and women in white coats, then Alphonse Umugire would have perfectly fitted on to the examination table. Perhaps it was one of those innocent childhood career dreams, or it was the camaraderie of wearing a white coat and having a stethoscope dangle down one’s chest in the corridors of a hospital. Or it was the accident… whatever really defined and shaped Umugire does not matter much now; the general practitioner at Kibagabaga Hospital has humbled himself to serve and save life. I first got to learn about Dr Umugire from Barbara Margolies, the founder of the International Organisation for Women and Development, who described the 29-year-old doctor as “a very young doctor, but a very efficient and caring human being.” Apparently, a woman had turned up at the hospital with the dreaded Obstetric Fistula case. But with fistula patients being societal rejects and the trauma of leaking endlessly coupled with the acrid smell, the young woman was no longer sure if life still had a meaning. But Dr Umugire had wasted no time in comforting her. Overnight, he became the benefactor of the hapless woman through her referrals to other facilities such as in Butaro for checks on her colon rectal cancer. The journeys between hospitals were many. For a poor young woman without a source of livelihood, it was beyond her. She could not travel to the facilities she was being referred to. “Dr Umugire made sure she had enough money to go back and forth to Butaro in the north, from her home in the south…and into Kigali for the consultations at King Faisal and the CT scan at CHUK (Central University Teaching Hospital, Kigali). Dr Umugire calls her many times a week to be sure she is okay… I wanted her to know that she has people who care about her and that often helps the patient emotionally to know someone cares,” said Margolies. Dr Umugire was born in 1985 in simple background of Kigarama Sector, Kicukiro District. He is the first of two children. He lost his father at the age of nine during the 1994 Genocide against the Tutsi and had to be raised by her mother, Jeanne Mukanyandwi. After primary education at Mburabututo Primary School in Kigali, the young Umugire joined Lycée de Kigali at Rugunga where he excelled in Biology and Chemistry, his choice combination, and was admitted to the then National University of Rwanda (now University of Rwanda following a merger) for human medicine. Dr Umugire said while growing up, he had a dream of becoming a doctor, though there was no possibility since his mother was struggled to find school fees. “Without any hope of attending secondary school, joining university was like a dream too wild dream, but I always had a passion and ambition to be a health professional,” says flamboyant Dr Umugire. “As a child, there was no one who told me about it (studying medicine), or pushed me to do it. There was no doctor in our family, nor a medical person to look up to but I always nursed the wish.” He says he used to look at the future, focused on the past, because his family history would not allow achieving any life goals. “I used to tell myself that I was alive, I can do many things better, no matter where I came from. I used to tell myself that one day I will be a doctor by profession,” he recalls. The dream would later come alive when Umugire acquired a scholarship to study his childhood career dream at the University of Rwanda in 2000. With the white coat and stethoscope earned, Umugire is not stopping there; he has his sights set on using more of his hands to do the healthcare job—surgery. The father of one chooses his words carefully when he speaks, as if searching for the right one all the time from the hidden periphery. But even in this characteristic speak and the repetition of words, Umugire has one mantra: never fail to try. He believes that failure is a character of weak people and he is not one such. Inspiration “Even though there were many challenges I faced in early life, they would stop me from achieving my childhood dream. I was motivated to give my contribution to improve the quality of care at the hospital,” says Umugire, a father of one son. Umugire’s determination to study medicine was reinforced after an accident that left him short of memory and staring at death. But with doctors giving back the life he was on the verge of losing, he had the perfect idea what it means to be a doctor. “That accident pushed and convinced me to study human medicine. I realised that doctors can give someone a life or destroy it,” he says. As a doctor, his joy comes when a patient smiles again after going through the pangs of illness. In a world of fistula Under the auspices of the International Organisation for Women and Development, whose charity in the country has a base at Kibagabaga Hospital where they care for and treat fistula patients, Dr Umugire has found his life closely intertwined the many Obstetric Fistula campaigns brought by Americans in the country. Obstetric fistula is a severe medical condition in women when the wall between the bladder and vagina is damaged and a fistula or hole develops. This means the woman constantly leaks urine and sometimes, if the rectal wall is affected, the ability to control faecal excretion is also lost. “Treatment for fistula varies depending on the cause and extent of the damage caused by the condition, but often involves surgical intervention combined with antibiotic therapy. Some fistulas will close on their own,” Dr Umugire says. He said women who are dismayed and dejected with life are given new hope of living. “After our treatment and care, they return their homes smile and sit with others,” he says. He says simplistically put, the wall between the bladder and vagina is damaged by the prolonged pressure of the baby’s head, and a fistula (a hole) develops. The problem with fistula, Dr Umugire says, is compounded by the perception of society and the human face of sadism that sees people reject fistula sufferers because of bad smell. Such women, he adds, only need care and hospitality.