September 2008 by The Access Project

ACCESS NEWS September 2008 Volume 1, Number 1

said it is crucial that school-aged children are in good health, which is why they will receive drugs for intestinal worms and schistosomiasis. “If you need good performance at school, to have a better future and participate in the development of your country, you have to be in good health” he concluded. In partnership with the Access Project, the Ministry of Health administered albendazole and praziquantel drugs against intestinal worms and schistosomiasis to more than five million people in its national de-worming campaign. This was part of the Mother-Child Health week in August. According to recent research conducted by TRAC Plus in partnership with the Access Project, the highest overall prevalence of intestinal worms is in the Northern Province (83.1%) and the highest schistosomiasis prevalence was found in Gicumbi District at 69.5%. At the end of his

Thompson with school children at Rwesero Primary School

Tommy Thompson to support Rwanda in fighting NTDs

four day visit to Rwanda, Thompson met with

President Kagame at Urugwiro Village on

the Access Project staff, thanking them for

Aug. 20, 2008, Thompson stated that im-

the tremendous efforts they are making in

provement in the health of a country’s popu-

fighting NTDs.

lation automatically leads to economic development. He also acknowledged the re-

by Malick Kayumba markable efforts by President Kagame and the Government of Rwanda in reviving

Tommy G. Thompson, the former U.S. health services for all Rwandans after the Health and Human Services Secretary and 1994 genocide. four-term Governor of Wisconsin recently

While in Rwanda, Thompson attended in the

concluded a four-day visit to Rwanda.

official launch of the National Mother-Child

Having recently assumed his new role as

Health Week in Nyaruguru District on August

Global Ambassador of the Global Network

19, 2008. Thompson also paid a visit to

for Neglected Tropical Diseases (NTDs),

Rwesero Primary School and Health Center

Thompson has pledged to support Rwanda

in Gicumbi District for the de-worming cam-

in promoting the health sector, especially by

paign against intestinal worms and schisto-

fighting NTDs. After his meeting with H.E. somiasis. During the school visit, Thompson

INSIDE

Thompson in Rwanda .................................. 1 What is the Access Project? ........................ 2 Farewell........................................................ 2

Thompson administering albendazole tablets to children

Word from the Editor in Chief ...................... 2 Community Health Insurance ...................... 3 Meet the Access team ................................. 4

www.theaccessproject.com | Kiyovu, Rue du lac Mpanga, No 2106. PO BOX: 7393 Kigali-Rwanda

A WORD FROM THE EDITOR IN CHIEF

I would like to personally introduce the first volume of Access News, our new project newsletter. This is a great way for us to share recent events, success stories, and news with our partners, authorities, and government leaders. I encourage you all to read Access News regularly, and to contact the editor regarding recent events and stories that you would like to be included. This way, you can remain up to date on our work and successes out in the field and in the head office.

Executive Editor:

Josh Ruxin Editor in Chief:

Dr. Blaise Karibushi Editors:

Dr Blaise Karibushi

Sonia Ntukanyagwe Dr. Denise Mupfasoni Dr. David Kamugundu Dr. Eugene Ruberanziza Malick Kayumba Dorine Kayirebwa

ABOUT US

Reporters:

Bertin Gakombe Francois Kiboko Dr. Zimy Wansaula Dr. J. M. Rukanikigitero Dr. Paul de Rire Habineza

Access is a Columbia University project that began its work in Rwanda in 2003. It works to expand the capacity and quality of health services in Rwanda by strengthening health system management at the local level. Access uses a bottom-up approach and works directly with local health centers, where 85% of medical consultations take place, in order to reach those most in need: Rwandaâ&#x20AC;&#x2122;s poor. Access project also works directly with the Ministry of Health through its Neglected Tropical Diseases program to fight 5 neglected tropical diseases namely Soil transmitted helminths, Trachoma, Schistosomiasis, Onchoceriasis and Lymphatic Filiarisis.

FAREWELL TO AMANDA Access Project bids farewell to Amanda Miller, an intern from the University of Michigan. The team gave her the Rwandan name Umutoni, because she was a friend of everybody. She is known for her contagious laugh and very hardworking nature. We all miss her.

GETTING STRONGER As health, sanitation and education improve in Rwanda, its citizens are increasingly interested in programs and businesses that build prosperity. Foreign investment remains low, and lower still is the number of business people who have shown a willingness to set up in Rwanda and build Rwandan capacity. In every sector of the economy -- tourism, agribusiness, financial services, and technology -- there is an overwhelming desire to attract investment and talent to build competitive industries here. Rwandans wish to make their country a middle-income nation by 2020.

www.theaccessproject.com | Kiyovu, Rue du lac Mpanga, No 2106. PO BOX: 7393 Kigali-Rwanda

SUCCESS STORIES Community Health Insurance Protects Orphans By Aaron Mulaki and Jean M. Rukanigitero Vestine Kampororo is all smiles as she flashes yellow community insurance cards for her two adopted orphans. Her worries are over: she no longer is in debt at the health center and health care for the two orphans is guaranteed for the year. In her 50s, Vestine comes from Mbonwa village in Bugesera district, the former epicenter of the 1994 genocide and just 57 kilometers south east of the capital, Kigali. She adopted the elder orphan (now 19 years of age) after the genocide; his parents died in the genocide and are unknown to Vestine. She adopted the younger orphan (now 6) just three years ago, when the child’s mother died. Clad in a black scarf and multicolored Kitenge (a Rwandan dress), Vestine leans back in confidence and excitement in the health manager’s office: “I was in so much debt and distress because I could not afford to pay the medical expenses for these children…that is history now.” Vestine lets out a sigh of relief. Rwanda developed a community health insurance system known as mutuelle de santé in 2002. It costs approximately $2 US per person per year to obtain basic health care coverage offered at the health center level. Members covered under this scheme are only required to pay less than half a dollar for all services at the health center during each visit. This provides a huge relief for the majority of the community living in dire poverty. The package also includes C-section and minor surgeries provided at the district hospital. Once health center staff determine that they cannot treat a condition, a decision is made to transfer the patient to the district hospital where appropriate treatment is provided under mutuelle coverage. The hospital bill is then covered by the district mutuelle “risk

pooling system” which is a system covered mainly by the government. Philip Kayibanda, the manager of Mareba Health Center in Bugesera district, met Vestine two years ago. She had been to his office several times to negotiate credit while seeking care for her sick children. Through Philip’s intervention, the health center paid the insurance premiums for the two orphans. Despite this relief effort, a critical component was still missing. For one to be fully registered under the scheme, a passport size photograph is required. The photo must be fixed on the insurance card to verify the insurance holder’s identity. The cost of obtaining a photograph is equivalent to one year’s insurance premium or more. Vestine is responsible for feeding five children of her own. As a subsistence farmer, meeting all these needs and health insurance for her orphans was extremely difficult. In 2007, the Access Project, a joint effort of the Glaser Progress Foundation and Columbia University, found a solution to Vestine’s problem. Using a standard web camera and printer, the project provided photos to more than 15,000 people across three districts. No longer were individuals like Vestine’s orphans denied health insurance simply because they could not afford a photograph. In addition to providing much needed photographs, Access also organizes the health insurance scheme by developing management skills to effectively serve a population of more than

“I was in so much debt and distress because I could not afford to pay the medical expenses for these children…that is history now.” 35,000 people per health center. According to Mr. Kayibanda, insurance enrollment has increased four-fold over the last two years: “The money is much safer and well accounted for, too,” he said. The Access Project helps an estimated two million people in six districts receive health care by developing management skills and providing tools to improve organization, accountability, and efficiency in Rwanda’s growing health care system. “Thanks to the Access Project’s interventions,” Vestine said, her youngest adopted child remains healthy and will enroll in school this coming year. The older child enjoys good health and helps on the farm. Vestine believes that the once bleak future of the orphans is now bright, thanks to their new health coverage and the Access Project.

www.theaccessproject.com | Kiyovu, Rue du lac Mpanga, No 2106. PO BOX: 7393 Kigali-Rwanda

MEET OUR TEAM Josh Ruxin Director

Dr. Blaise Karibushi Country Director

Michel Musilikare Finance & Administration Director

Dr. Denise Mupfasoni NTD Program Coordinator

Dr. David Kamugundu Specialist Team & Research Coordinator

Sonia Ntukanyagwe Assistant to Country Director

Bertin Gakombe District Health Advisor (Musanze, Nyabihu)

Dr. Jean M. Rukanikigitero District Health Advisor (Bugesera)

Francois Kiboko Mutuelle & HR Specialist

Dr. Paul de Rire Habineza District Health Advisor (Gakenke)

Dr. Zimy Wansaula Pharmacy Specialist

Gaspard Kabanda Data Analyst

Dr. Eugene Ruberanziza Research & Treatment Coordinator

Teddy Kaberuka Data Management Specialist

Bosco Ngabonziza Financial Management Specialist

Michee Kabera Research Specialist

Didier Uwizeye IT Specialist

Aaron Mulaki Planning & Reporting Specialist

Malick Kayumba IEC & Community Mobilization Officer

Marie Yvonne Ingabire Accountant

Aimee Ingabire Administrative Assistant

Therese Uwimana Senior Accountant

Dorine Kayirebwa IEC & Community Mobilization Officer

Naomi Leonard Phizer Global Health Fellow

Fostering teamwork is creating a work culture that values collaboration. In a teamwork environment, people understand and believe that thinking, planning, decisions and actions are better when done cooperatively. People recognize, and even assimilate, the belief that “none of us is as good as all of us.” –from the book HIGH FIVE www.theaccessproject.com | Kiyovu, Rue du lac Mpanga, No 2106. PO BOX: 7393 Kigali-Rwanda