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General Information on Elective

Kibogora Hospital, nestled in the verdant hills of western Rwanda, is a place where the beauty of nature harmonizes with the warmth and determination of its people. The hospital’s red-brick buildings, with their distinct sloping roofs, stand as steadfast guardians of hope and health. Surrounding them, vibrant gardens bloom with life, lovingly tended and offering bursts of color against the backdrop of misty green hills. Beyond the hospital, clotheslines strung across grassy terraces flutter with brightly hued fabrics, and the air carries the mingling scents of cooking fires and fresh earth, creating a sensory mosaic of the community’s daily rhythm. Just 200 meters from the hospital lies the stunning Lake Kivu, its clear waters dotted with islands, inlets, and small wooden fishing boats that glide across the surface, completing this picturesque setting.

At the heart of this unique setting are the people, each contributing their own energy and dedication to the hospital’s mission. Emmanuel, the chief nurse and head of sponsorships for Kibogora, is a dapper, always well-dressed Rwandan man with a vibrant personality and a cool, calm, collected way of doing things. His wife, Rachel, an American missionary nurse, met Emmanuel on an outreach in 2015 and stayed, bringing her expertise and compassion to Kibogora. Together, they’ve created a life filled with purpose and love, raising their three children in this hillside haven. Noella and Mateo, aged five and three, are beautiful, curious, and inquisitive, their laughter echoing through the compound where they live just across the road. Their youngest, Luca, a six-month-old bundle of warmth and wonder, completes this idyllic family.

The mission compound, our home during the elective, is cared for by David, a youth pastor and university student who faithfully and tirelessly brings us delicious, simple Rwandan food each morning, afternoon, and evening. His dedication and hospitality make him an unforgettable host.

Within the hospital, a dynamic team of medical officers rotates through the wards, each bringing their own expertise and flair. Solange, Aliya, Liba, and Solomon, all dressed in crisp white lab coats paired with fashionable attire, navigate the challenges of their roles with dedication and style. Supporting them is a collection of specialists, drawn from neighboring countries through Rwanda’s ingenious ‘4x4’ system. This system—born from the necessity of rebuilding after the genocide in 1994, when many educated professionals were lost—invites specialists from politically unstable neighboring countries to serve in Rwanda in exchange for safety, security, and a salary, while teaching four specialist registrars every four years.

Among these specialists is Yimal, a short, stocky, highly knowledgeable Ethiopian pediatrician whose calm wisdom reassures patients and staff alike. Kyros, a passionate, loud, and friendly fetal medicine specialist, fills every room he enters with energy and expertise. Addis, a calm, collected, and humorous obstetrician and gynecologist, balances his sharp clinical skills with a light-hearted approach that puts everyone at ease. During our first week, we were also joined by Miriam, a visiting cardiologist from Germany. Friendly and warm, her English was limited, but her knowledge seemed unlimited, leaving a lasting impression on all who worked with her.

Another striking feature of the hospital is the presence of its nursing students, forty in total, dressed in their blue uniforms with white overcoats. Each morning, they can be seen neatly lined up, their front rows highly attentive while some in the back rows occasionally drift into daydreams. Their dedication to learning and their vibrant energy bring a youthful vitality to the hospital, promising a brighter future for healthcare in the region.

Rwanda’s history is a poignant backdrop to this vibrant setting. The genocide of 1994 left a devastating impact, with many educated professionals among the lives lost. Under the leadership of the Kagame regime, Rwanda has made remarkable strides toward national unity and development. One of the most inspiring aspects of this transformation has been the focus on public health, led by visionaries like Professor Agnes Binagwaho, a former Minister of Health who has been instrumental in shaping policies that prioritize access to quality healthcare for all.

Our decision to undertake this elective in Kibogora was fueled by a desire to explore a new healthcare system, learn about diseases uncommon in our home context, and witness firsthand how Rwanda’s innovative approaches—showcased in documentaries like Bending the Arc—work within the African setting. We aimed to immerse ourselves in a system renowned for its emphasis on equitable healthcare delivery and its ability to overcome immense challenges.

Operational and Cultural Highlights

Daily 7 AM Chapel Services One of the most striking operational routines here is the daily chapel service at 7 a.m. Every morning, all hospital staff—doctors, nurses, social workers, administrative staff, and students—pack into a repurposed room that serves as a chapel. There is a small electric keyboard, 1m-long benches for a dedicated choir, and an infectious spirit of unity. The service includes worship songs, a brief sermon, and practical reflections on how to serve patients better. This daily gathering does more than provide spiritual nourishment: it unifies everyone around a shared purpose of alleviating suffering and working together as a compassionate team.

Robust Online Record-Keeping System Despite its rural setting, Kibogora Hospital boasts an exceptionally well-organized EMR system. Lab results, X-rays, patient notes, and administrative updates are all stored in one place, facilitating efficient continuity of care. Their servers also allow staff to access email easily. During our stay, we created safe email addresses for several doctors and integrated a medical note-taking AI tool (using WhatsApp for dictation) so they could have their notes automatically emailed back to them and then pasted into the EMR. This focus on “getting the basics right” created a strong foundation on which to build innovative approaches, and it undoubtedly underpins the remarkable efficiency Kibogora has achieved for a rural hospital.

This intricate tapestry of individuals—local and international, seasoned professionals and young learners—is what makes Kibogora Hospital so extraordinary. Together, they create a space where challenges are met with innovation and determination, where care extends beyond the wards and into the heart of the community. In this hillside Eden, every day brings a new story of resilience, compassion, and connection, making Kibogora not just a place of healing but a living testament to the power of humanity.

A Memoir Beyond the Rubric

This project, more than just a portfolio, has been crafted as a memoir—a catalogue of photos, videos, and memories to inspire future generations of doctors. It adheres to the rubric’s structure while offering much more: a glimpse into the daily journal entries we shared on a WhatsApp group with friends and family. What began as updates for a small circle soon grew into a group of 165 supporters, praying for and encouraging us throughout our journey. These journal entries capture the essence of our experiences and the spirit of Kibogora, making this project a living, breathing testament to our time in this extraordinary place.

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