The tiny, central African nation of Rwanda is set to become the only sub-Saharan country to meet the health-related Millennium Development Goals (MDGs) despite its infamous past.
Just 20 years ago, Rwanda was embroiled in a particularly horrific civil war and genocide which saw 500,000 to one million dead and two million displaced.
But in the years since peace was reinstated, Rwanda focused on rebuilding itself from the ground up. Using its post-conflict aid wisely and responsibly, the country has seen tremendous results.
Since 1994, the average income has more than doubled, helping to bring the percentage of those living in poverty down from 77% to 49%. The maternal mortality rate dropped from 1,071 to 487 per 100,000 births. In 2010, 69% of expectant mothers delivered their babies with the help of skilled health workers compared to 31% in 2000. Better maternal care has also helped reduce under-five child mortality by 70%. Tuberculosis deaths dropped by 77%, the most significant decrease anywhere on the continent. HIV/AIDS deaths decreased 78% during the last decade and virtually every person in the country who is HIV positive, some 108,000 Rwandans, are receiving anti-retroviral treatment.
Though the country faces “one of the greatest shortages of human resources for health in the world,”with just 625 doctors in a nation of 11 million, they have managed to build up an army of 45,000 trained community health workers who can provide basic treatment and preventative services, follow-up care, collect data on public health issues like disease outbreak, and connect patients to the broader healthcare system.
As a result of improvements like these, life expectancy jumped from a staggering low of 28 years to 56 years today.
Instead of simply funding programs, Rwanda typically utilized its foreign aid to build long-term national institutions which allowed them to set up a universal health insurance program, create a business-friendly atmosphere that isn’t overburdened by bureaucracy, and set the standard as having one of the lowest corruption rates in all of Africa.
In keeping with their ambitious spirit, government officials have called for Rwanda to operate aid-free by 2020. While health professionals debate if that could actually be done so soon, Health Minister Agnes Binagwaho cites perseverance in the face of adversity as one reason for all the success stories in Rwanda. “The lesson we have learned is that you cannot solve every problem at once,” the minister said, “So you do the best with what you have and you don’t leave anyone out.”
– Jordan N. Hunt