One Meal A Day - SOLID' AFRICA

We are so blessed in the United States to have food readily available; from drive through "fast food" to the hospital cafeteria.  Even while at work, I can have food delivered.  And when patients are admitted to the hospital, we order them a meal tray.  Or the ED patient gets the "dry turkey sandwich" and a Sierra Mist soda.

But imagine having ONE meal a day.  Now imagine being in a hospital bed; sick, healing, post-operation and only having one meal a day. Or even no food available at all.  Health insurance in Rwanda guarantees medical treatment but does not provide meals while hospitalized in the public hospitals.  A family member, friend, etc. should be available to participate in the patient's care while hospitalized.  It involves bathing the patient to changing dressings to providing meals.  Meals are also available for purchase.  If you do not have family or funds to purchase food, you are left vulnerable. 

Solid'Africa NPO/NGO is a non-profit for vulnerable patients in Rwandan public hospitals. 

Mission:
Solid’Africa is a young and dynamic Local NGO that helps vulnerable patients in public hospitals in Rwanda. Working along with social workers, our Six main programs:
1. Gemura: Food for All,
2: Kiza: Medical Expenses,
3:Sukura: Hygiene,
4: Gombora: Hospital Bills & Transport,
5: Menya: Awareness and Advocacy on public health challenges, and promotion of the "Mutuelle de Santé"
6: Kina-U-Kire: Play therapy for kids & educative entertainment, we aim at compensating the lack of financial resources and thus, ease their recovery and accelerate their return back home.

Rwanda, building on its program of access to the mutual healthcare system “Mutuelle pour tous”, has improved access to healthcare. However, misery remains in some layers of the population. For the most helpless ones, paying co-­ pay for medical care, ranging between 5 and 25%, proves difficult or even impossible.
Even when they are affiliated, some find themselves in precarious situations requirin...g food, sanitary products, and means of transportation be made available in order to make their recovery possible.
Our organization is providing a citizen and humane response to contemporary social challenges. The building of Rwandan, African, and world society relies on the involvement of its citizens, solidarity.

It was founded in September, 2010 and we were fortunate to meet the founder.
She invited us to observe the program; we assisted in the feeding on May 1st, their Labor Day.  Solid' Africa provides one meal daily [Lunch on Monday & Breakfast Tues-Sun] to 300 patients at the CHUK, University Teaching Hospital in Kigali, Rwanda.  The patients are identified by the social worker as needing nutritional assistance. Fruit is provided 3 times a week.  Lunch includes rice, vegetables and a meat.  The breakfast is a porridge [gruel like] and bed; milk for children.

 

 

The organization is in need of an industrial kitchen.  The goal is to provide 2 meals per day for 1000 patients.  They are currently working out of 2 personal home kitchens.  They have gardens to provide their own food source.  They have installed a cistern/filter and launched a Portable Water Project at CHUK.

Rwanda Health Care

I learned about the Rwanda medical system while visiting the county; the good and the bad. 

The Rwandan constitution enshrined the "right to health" in 2003.  Mutuelle de Santé — is nearly universal.  Everyone has MANDATORY health insurance.  Mutuelle adopted a sliding scale; the payment is based according to your income.  The yearly rate can be from 1000 to 7000 RWfrancs; or $1.50 to $10 US dollars.  It provides you the opportunity to have medical treatment.  The Health Ministry says that the poorest 25 percent of Rwandans get free care.  In the rural areas, there are district clinics.  The clinics are available for everyone with a co-pay. 

Each visit to a clinic has a co-pay of about 33 cents. [Rural farmers annual income average $150.]  If you need to go to the hospital, you pay a tenth of your hospital bill.  Typically, the consultations are done by nurses and a doctor visits the facility once a week.  There is 0.06 physicians/1000 population; (2013) country population of 12,012,589 has approximately 720 physicians. [In the USA, you can have that many physicians in a university based teaching hospital.] The district clinics sends patients to the district hospitals; district hospitals send patients to the larger public or private hospitals for more advanced care [urban hospitals in Kigali].

CHUK - University Teaching Hospital [TOP]
King Faisal Hospital (Private) [BOTTOM]

 In the last decade, improvements and influx of medical development has improved the life expectancy from 50.44 years in 2002 to 62.92 years in 2012.

In the USA, we see all that want to be seen in the Emergency Department whether you can pay or not.  If I think you have a bleed in the brain, I order all the necessary tests [ie.,CAT of the brain]; and if my hospital does not have the services to take care of you, I will transfer you to a "higher level of care" without questions or payment.  In Rwanda, if you are at one hospital that does not have a service or equipment-possibly a CAT scan, then you must be transported to the other hospital [even if it is across town] but you must pay for the transport in advance.  If my family member has a possible stroke and needs a CAT scan of the brain, if the hospital they are at does not have the CT scan then I must PAY for them to be transported.  If I do not have the money, then the doctors will treat my family member with "guestamation" medical treatment.   A cerebral hemorrhage in Rwanda typically is not survivable. 

While we were teaching our ACLS class, one of the nurses had to leave.  He worked at the another hospital.  A patient that was in a multi-car collision trauma needed a procedure [chest tube insertion to re-inflate the lungs].  He was only 1 of 2 persons at that hospital that could perform this procedure; the other person was unreachable.  We were then told about another patient from the same collision was unconscious and needed a CAT scan; but the patient could not be transferred to another hospital because he was unable to pay and the family could not be found.

The health insurance guarantees you the opportunity for medical treatment.  But if you are admitted to the hospital, it does not guarantee you food.  See the next posting "One Meal A Day"

Hmmm.  US healthcare system does not seem so bad now. 

Days 10 & 11 - Kigali, Rwanda; King Faisal Hospital

Two more days of ACLS training - 28 successful candidates.  It has been a good trip and the new skills learned by the staff will improve healthcare delivery.

Thankful for the local instructors and HRH staff.

AHA staff, Local Instructors, HRH staff, GEI staff

 



Our last class -  HOORAY!!!!

 

The local staff gave us gifts - handmade quilts from a women's cooperative.

 

 

 Goodbye to King Faisal Hospital.

Days 8 & 9 - Akagera National Park

Akagera National Park  - sits at the border of Tanzania separated by Lake Ihema and follows the Akagera river.  The park has plains, valleys, hills, wetlands and the savannah.  We were welcomed at the visitor's city by park rangers and the Black Mamba [most venomous snake in the world].

We stayed at the Akagera Lodge, treated to a wonderful lunch watched the baboons play and try to enter the swimming pool.

 

 

The next morning we drove through the park with the fresh, crisp, clean air flowing through the jeep.  A Vervet monkey approached the truck standing behind Linda; I think he wanted to join us.

 

 

7:05 am:  We saw a leopard in the bushes.  I was unable to get a picture and it disappeared quickly.

7:13 am:  A family of blue monkies in the road

 

7:56 am:  McDonald Impala - a "M" on the backside; they walk in a single line.

 

8:09 am:  Hippos in the water, African Fish Eagle

9:00 am:  Waterbuck antelope

9:28 am:  Hippo beach

9:39 am:  Warthog

10:18 am:  Impala, male Waterbuck, Maasai giraffe, Cape Eland, Monitor Lizard, Crocodile, Water Buffalo, Zebra

 10:55 am:  Maasai giraffe, zebra, crown crane of Uganda

 

As we drove from the south park to north park, we only encounter one other car at that was early in the morning.  It is the end of rainy season, and there was very muddy road; we eventually got stuck in the marsh.

11:10 am:  Stuck in the mud

We used a log and mats from the truck for traction; the back wheels were stuck. Since I know how to drive a 5 speed, I attempted to steer us while the men pushed & rocked.  It was not successful.  They placed more substance under the tires [particularly the left].  Cindy, Amie and rocked the truck as Andrew was able to drive it out of the marsh.

11:32 am:  Out of the mud.  Only 22 minutes. We had heard other stories of people being stuck for 3-4 hours.

12:30 pm:  Maasai giraffe

12:40 pm:  Large herd of zebra

12:55 pm:  Lunch at the North entrance point.

1:32 pm:  Leaving the park