How Late Paul Farmer Started A Famous Hospital, University in Remote Village of Rwanda

Butaro hospital

Friends, personnel who worked with/under Paul Farmer and patients who were fortunate to see him, government officials and all those who met him at least once in their life on Saturday April 2, joined the family of the deceased in requiem mass.

Tributes to this American physician, philanthropist and friend of Rwanda who died on February 21 continue to remind what a great person Paul was.

From, Saint Michel Cathedral in the heart of the capital Kigali, they were in hundreds, all sharing the great heart that had accommodation for every soul on his way.

One of the people who met Dr. Paul Farmer when he was starting to write history in Rwanda’s healthcare system is Dr. Tharcisse Mpunga the current Minister of State in Rwanda’s Ministry of Health.

Dr. Tharcisse Mpunga

In 2009, the medical doctor met Paul Farmer at the Butaro hospital which was under construction in Burera district, Northern Rwanda.

He started watching the great work full of zeal and hope, despite a few believing in him. Then came the launch of the hospital, January 24, 2011, a day that attracted Mpunga’s attention.

“During the tour of this hospital, President Paul Kagame who was guest of honour challenged us and asked a very simple question: How are you going to maintain this hospital at this level of standard while serving this surrounding community with limited resources?” Dr. Mpunga who opened the floor of speeches said at Saint Michel.

Dr. Paul who believed in people turned to Dr. Mpunga and asked him another simple question in his turn, in regard to President’s challenge.

“Are you ready? Then I said Yes Sir! But in reality, I didn’t have a very clear understanding how I would do that,” said Mpunga.

After the following two weeks, Mpunga and his team from Butaro hospital gathered around Dr. Paul and started developing the vision of the hospital, always mindful of the challenging question of President Kagame.

They came up with a vision first to serve as a centre of excellence-by attracting several talents and skills, bringing in professionals, collaborating with other medical institutions from Rwanda and beyond.

They set a vision of selling their services to the community around and beyond and to make the hospital a teaching hub starting with the local community by using the design of the hospital.

They then decided that the hospital would economically empower the neighboring community by means of employment.

“A part from clinicians, other staff of the hospital were picked from the area,” said Dr. Mpunga.

“We also wanted the hospital to be a teaching site.”

I want a school here

Mpunga also recalls another important date in the life of Paul Farmer.

“One day Paul came and joined us in a beautiful place of the hospital where we used to have coffee from and said: You know! I need a school here. Everyone in the room was surprised because what we were trying to do was totally different from having a school,” Mpunga said.

University of Global Health Equity

“We wondered: what kind of school? A nursery school, secondary school…we needed to understand how a school could come in that business of ours.”

In a similar challenge, he also wanted to propose a cancer centre, but people were never ready for anything at the beginning.

“I remember it was a Sunday near Galaxy Hotel. Doctor Agnes Binagwaho, Paul Farmer, some clinicians from King Faisal Hospital and CHUK were brainstorming on how it would look like. Most people said a cancer centre in this remote area?”

Mpunga recalls that Dr. Paul defied them and said: “ I need services there because there are people who are suffering and those in remote area deserve better service than those who are in the city because they have alternatives.”

They started preparing the ground, working with experts and in July 2012, they started the cancer centre.

“But to tell the truth, none of us, hospital staff had any expertise in cancer area, but with the help of Paul Farmer and people with great expertise, we got it,” said Dr. Mpunga.

“Today, we have an international cancer centre which addresses cancer cases in general, starting with screening, detection, treatment, and radiotherapy services.”

A lot happened ever since, including decentralization of services from the hospital to the health centers, etc.

After the cancer centre, the dream to have a school became a reality with the inauguration of University of Global Health Equity(UGHE) in 2015.

Today, said Mpunga, if you read publications around Butaro hospital, it is very encouraging and inspiring.

One week before the passing of Paul Farmer, he called Mpunga informing him about the work that was going on at Butaro hospital.

“We were planning to meet in the following week, unfortunately it did not happen. I would like everyone here to believe that Paul’s legacy will live on forever through the organization he has founded – Partners in Health,” said Mpunga.

First Lady Jeannette Kagame (Middle) at the requiem mass

His legacy will also continue through the University of Global Health Equity, the equity health system he advocated for and helped to strengthen and a generation of young change makers he inspired who believe health as a human right.

He will be remembered through the life of patients and other vulnerable people he served and also the young generation who benefited school fees from the foundation he put in place.

“Death is something inevitable. When a man has done what he considers to be his duty to his people and his country, he can rest in peace,” Mpunga quotes late President Nelson Mandela.

“I am very convinced that Paul Farmer has done his duty now it is our mission to continue in the same direction and carry on his legacy,” Mpunga said.

Dr. Agnes Binagwaho, Vice Chancellor UGHE

Speaking about Paul, Dr. Agnes Binagwaho who is current vice chancellor of University of Global Health Equity, said: “Paul has left a mark in all our lives. Whether you meet him once, whether you assist to one of his lecture, or work with him for many hours or live with him for twenty years of friendship like I was grateful to be, Paul enlighted every room he entered in, he connected with every body in a second, no matter who they are, treated everyone the poorest, heads of state with the same attention, love and respect.”

It is a testimony he probably may share with Jean Claude Rutayisire, one of Dr. Paul’s former patients living with HIV.

Paul Farmer told Jean Claude Rutayisire that they would work together for 35 years

He said that meeting Muganga Mwiza was one of the best things that happened to him in his life. He recounted how he met Dr. Paul in 2005 with a team from Partners In Health seeking to support people living with HIV and tuberculosis to receive medical assistance.

“Dr. Paul Farmer asked me if I knew anyone living with HIV who would need medical assistance. Without hesitation I told him I was one of them and could only get 7 people who were open to get this assistance,” Rutayisire explained indicating that people living with HIV in his village were skeptical about antiretroviral drugs at first and were not free to disclose their HIV status.

Dr. Joel Mubiligi, Executive Director of Partners In Health

Binagwaho further said of Paul: “He loved Rwanda that much to an extend he carried his Rwandan passport in the front pocket of his shirt and when you asked him, he would say: Because I have Rwanda at my heart.”

Joel Mubiligi, the Executive Director of Partners in Health, the organization also founded by Paul Famer said: “He(Paul) looked at the weakest among us with all the dignity they deserve and there was no excuse of a different treatment between the rich and the poor.”




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