Team Heart, Rwanda

FINAL REPORT

During the summer I worked with Team Heart, a non-profit medical organization focused on providing sustainable medical care in Rwanda. During my one-month stay with Team Heart, I had an opportunity to visit hospitals in different districts of Rwanda (especially ones in rural areas), talk to the cardiac patients, and collect their personal and medical data. Before leaving for the internship, my goal was to understand the difficulties that people in rural areas face when trying to access medical care and how the health institutions in Rwanda approach this issue.

Team Heart specifically deals with pre-operated and post-operated cardiac patients suffering from rheumatic heart disease, a condition in which the heart valves have been permanently damaged. However, more attention is given to the post-operated patients. After receiving their heart surgery, patients are advised to stick to a diet plan every day and to see a doctor regularly to check their condition. 

My work at the beginning involved attending research roundtable meetings with specialized cardiologists to familiarize myself with the disease, how it works, its burden to the population of Rwanda and what to do to reduce the burden. I had the opportunity to meet with the minister of health in Rwanda and the director of the cardiology department. I was partnered with three other interns and one Team Heart employee to accomplish the projects assigned. We spent the first week contacting nurses in charge of cardiac patients in rural hospitals of Rwanda to inform them of our visitation plan to meet with the patients. In addition, before our hospital visitation I developed education posters and flyers to help the patients understand the causes of the disease and prevention methods, the importance to regularly consult a doctor for their follow-ups, and the importance of their daily medicines and diet provided by their doctors. 

During the last week of my internship, we visited five rural hospitals in different districts of Rwanda to talk to cardiac patients. They shared the challenges they face while trying to lead healthy lives, and most of them were centered on poverty. The medicine prescribed by their doctors, Warfarin, to reduce the formation of blood clots in the walls of the heart, is very expensive and the patients cannot afford the price as most of them are unemployed or are farmers in their neighborhoods. As a result of the price, some patients end up not taking the medicine, which puts their lives at risk. In addition, most patients in rural areas are used to eating sweet potatoes and yams because they are the staple crops. Hence, finding money to buy the nutritious food for their diet becomes a problem. The burden of the disease in some families have pushed parents to take their operated children out of school and dedicate their little earnings to their health. In some cases, the patients live far away from the health centers and rarely receive post follow-up care from their doctors because they have no means of transportation. 

One of the big challenges we encountered was the fact that most patients expected us to solve their problems right away, but as a communication and outreach intern, I was supposed to communicate their problems to my supervisor for Team Heart to find ways to approach the issues. At times it was hard to deliver this bad news to the patients, but with my team we would assure them that their problems would be communicated to the right people in charge and that solutions would be found. Communication was another challenge the patients face. Most patients who stop taking their medicines lose their lives because they do not have anyone with whom they can address their problems.