Rwandan Minister of Health Visits Brigham and Women's Hospital

Dr. Agnes Binagwaho, minister of Health in Rwanda, shares the successes of the Human Resources for Health program with BWHers.

The impact of the Human Resources for Health (HRH) program on Rwanda is not simply improving health in the African country; it's changing everything.

"This program is a way that we can reverse the injustice of poverty," said Dr. Agnes Binagwaho, minister of Health in Rwanda, of HRH's long-term impact.

The seven-year HRH program is a partnership between the Rwandan government and universities and hospitals in the U.S. that strives to achieve one goal: to help Rwanda develop a high-quality and sustainable health care system. The program enables Rwanda to educate and train its health care workforce, care for the country's patients and, as an indirect result, generate new jobs for the country that will stimulate economic growth.

BWHers filled the Bornstein Amphitheater last week to hear Binagwaho and BWH President Betsy Nabel, MD, discuss Rwanda's health care needs and HRH's first year of progress. Binagwaho likened her country's challenge in developing its own health care workforce to the classic "chicken and egg" conundrum.

"How can we produce these professions we need when we don't have the people to train them?" she asked. "So we thought about creating partnerships with universities and hospitals like the Brigham. Let's borrow ‘chickens' from the U.S. to produce ‘eggs' for Rwanda. This is a way to bring more justice by improving access to care."

HRH launched last fall, with 97 faculty members-nine of whom are BWH physicians-participating from 23 universities in the U.S., including Harvard Medical School. The faculty members are focused on educating and training the next generation of doctors, nurses, midwives and other health care professionals in Rwanda.

When the program concludes in 2019, Rwanda's workforce should be sustainable without foreign aid. In its first year, HRH is focusing on educating professionals in five specialties: gynecology, internal medicine, surgery, pediatrics and anesthesiology. After two years, the program will begin to focus on building subspecialties, such as pediatric surgery.

The needs in Rwanda are staggering. The country currently has six physicians per 100,000 people. By comparison, Boston alone boasts 1,053 physicians per 100,000 people. There isn't a single cardiac surgeon, pathologist or cancer specialist in the country. HRH works to strengthen these and other specialty fields experiencing critical shortages.

Led by co-investigators Robert Riviello, MD, MPH, an associate surgeon in the Division of Trauma, Burn and Surgical Critical Care, and hospitalist Corrado Cancedda, MD, HRH also builds upon the existing partnerships that many BWHers have formed in Rwanda, including those through the Division of Global Health Equity, Partners In Health, the Center for Surgery and Public Health and the BWH-led Team Heart. While the HRH model builds on these programs and efforts, it also raises existing collaborations to an academic level to ensure Rwanda's health care workforce can achieve long-term success.

"This is a wonderful partnership," Nabel said. "I believe that reciprocity is the prize at the end of the day. We benefit from learning from one another and growing through this experience."

BWH President Betsy Nabel (right) joins Rwanda’s Minister of Health Agnes Binagwaho for a presentation about the Human Resources for Health partnership.