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Communications in Rwanda

 “RWANDA?” I blinked a couple of times as I looked at the email. The Pfizer Global Health Fellows Program had recommended me to the Access Project, based in Kigali, Rwanda, and they wanted me to interview at their New York office at Columbia University’s Earth Institute, on the Upper West Side of Manhattan. I was in utter shock at the location of the assignment since I knew very little about Rwanda except the genocide that took place in 1994, which led to the death of close to one million people. So I was less than thrilled at the prospect of working there for close to six months. 

This all changed a week later when I met with one of the directors of the program. As we sat and discussed the work that I would be doing as a Communications and Media Fellow, I began to see that this fellowship was the right fit for me professionally. As a healthcare representative with Pfizer for the past eight years, I know firsthand the benefits of having a comprehensive communications system that not only coordinates the work that I do in the field, but also allows me to share best practices and success stories with internal colleagues, external clients and the general public. I was also inspired by the work of the Access Project, founded in 2003 to improve the health of the poor communities in Rwanda by applying a business management approach to its public health systems. While the Access Project employs specialists in various business and medical fields to fulfill its mission, it currently lack a full-time communications person who can manage its various internal and external communications channels. When I accepted the position with the Access Project, I became the project’s communications specialist, responsible for assisting Access colleagues with developing an internal communications system that will garner stories from the field to share with partners, donors and the general public.  After arriving in late February, I spent my first week getting to know my colleagues and the organizational structure and culture. The staff of 30 people is divided into five teams.  The first team consists of district health advisors (DHAs) who work with 80 health centers in six districts across Rwanda to ensure proper health center management. The second consists of specialists in IT, finance, data management and pharmacy management who work closely with the DHAs to provide training and mentoring to the health center staff. The third team, NTD Control, works with the Ministry of Health (MOH) to control Neglected Tropical Diseases (NTDs) throughout Rwanda, while the newly formed tuberculosis (TB) team works with community health workers to control TB in Kigali City. Finally, administration handles paperwork and coordinates meetings and events.  The Access Project has successfully transformed its staff from a start-up of all expatriates to a fully operational program run by Rwandese professionals.  This does present a challenge when developing communications, however, because of language and cultural differences. Many Rwandans speak English well, but it is typically a second or third language, so written English can be a challenge.  Some of my colleagues expressed to me that they are not as confident writing articles or reports in English as they are in French or Kinyarwanda. The most difficult part for most people is the written English language with its numerous grammatical rules, tenses and expressions.  Some of my colleagues expressed to me that they are not as confident writing articles or reports in English as they are in the other two languages. This doesn’t affect the work that they do in Rwanda, but it does affect their international impact, since the Access Project is an initiative of Columbia University and derives most of its funding from U.S. donors. All external communications such as business reports, articles, success stories and online communications are primarily intended for an American audience and must be written in English.  Over the past three months that I have been working with the Access Project, I have worked to build the trust of my colleagues in the office and in the field, conducted interviews, developed articles for the website, developed an online marketing strategy, expanded on the current communications strategy, and created numerous printed materials and web documents. In addition, I am working with the IT specialists to develop an internal site for colleagues to share their work calendars, documents, and success stories. However, this is just the tip of the iceberg. To make the communications strategy sustainable, I will have to focus on culture and language. So my mission for the next few weeks is to develop and lead an Access refresher course entitled ‘Communications Skills 101” which will include topics like writing skills for business reports, news reports and success stories.  I had the opportunity to visit the Gashora Health Center with Jean Marie Rukanikigitero, the DHA for the Bugesera district, during my first month with the Access Project. Gashora, located in the Bugesera district, a place that lost 80-90% of its population in the genocide, can now offer quality care to its community as a result of the support and training provided by Jean Marie, Access specialists and partnerships with the Ministry of Health and private donors.  The previous health center did not have running water, electricity or adequate rooms for patient services. Doctors did consultations in the dark or by candlelight and could not easily wash their hands after delivering babies or performing routine exams. The new center is now a model health facility that features modern consultation rooms, well-trained staff and best of all, running water and electricity in all rooms. As I walked through the center taking pictures, I was motivated by the mothers holding their newborns, the patients holding up their mutuelle (insurance) cards and the little boy in the blue tracksuit running through the hallways of the building.  Hopefully, this little boy will no longer be a statistic, subject to NTDs, HIV/AIDS or the other illnesses that have plagued the population for so long. He is the face of a new Rwanda that will no longer be known just for the genocide, but as an emerging country that is increasing healthcare access for all of its citizens. I am proud to be Pfizer Global Health Fellow, working with the Access Project to bring these stories of hope to new audiences.