During the 1970s and 80s, the majority Hutu government of Rwanda deported millions of the minority Tutsi people to inhospitable regions, hoping they would die from local diseases, wild animals or starvation. Many Tutsi were sent to Ntarama, a swampy area 45 minutes’ drive south of the capital Kigali, believing the Tsetse fly would kill them. No hospitals or schools or roads were built, and yet the Tutsi survived. Ntarama became one of the areas of greatest resistance once the genocide began in April 1994. However, they were without arms, and many thousands were massacred, often as they sheltered in churches.
Ntarama is still undeveloped, even by Rwandan standards. When Network for Africa asked local widows and orphans in Ntarama what they needed most, they were enthusiastic about having a clinic and maternity ward. As one young man remarked, “What is the point of providing us with a school first if half the children die in infancy and the rest are unproductive because of malaria?”
It is not uncommon for women to give birth at the side of the road, during the long walk to the nearest clinic. Women in Rwanda have a one in sixteen life chance of dying in pregnancy or childbirth, compared to a one in 42,000 chance in Ireland, for instance. Death in childbirth is a disaster for the whole family because the woman’s surviving children have much poorer chances of thriving without her. Yet, if a young woman gets a good start at motherhood, her baby will benefit, and so will her other children.
The Ntarama Clinic, which opened in September 2009, has a laboratory, a pharmacy, facilities for minor surgery such as stitching up wounds, and rooms for consultations with medical professionals. Other services offered are counselling, family planning, public health education, vaccinations and HIV/AIDS mitigation. The clinic sees 3,000 cases a month.
A doctor visits once a week. Serious cases are sent to the local hospital but there is no ambulance or public transport, so patients must be carried several miles. There are four nurses, one of whom works all night because demand is so great. UK medical students visit and work at the clinic for two weeks at a time. There is also a family planning service at the clinic and an outreach programme to take family planning to the villages, mainly to target men who won’t come to the clinic.
The maternity clinic has three beds in the labour ward, two delivery suites and three beds for women who have given birth. There are also 18 beds for general medicine, a kitchen for families to cook food for the patients, and a social worker to teach nutrition.
Soon after the project broke ground a local widow who did not know we were connected to the project told us how excited she was about “her new clinic”. She said she was happy because it was much less likely her daughters would die in childbirth.