McLaren Nurses' Motivation to Improve Cardiac Care in Rwanda?

Their in-country cardiac emergency

By Ross Boissoneau | Sept. 22, 2018

Vianney Ruhumuliza wanted to give back to his home country. The mass murders of Tutsis during the Rwandan Civil War was one of the most harrowing acts of genocide in the 20th century: An estimated 500,000 to 1,000,000 Rwandans were killed in 1994, constituting some 70 percent of the Tutsi population. So in May 2012, he and his wife Cairn Ruhumuliza, both RNs at McLaren Northern Michigan, flew to the country to work with the population, not realizing they were putting her life at stake.
 
Within hours of their arrival, Cairn began having chest pains. They immediately went to the emergency department of one of the best hospitals in Rwanda. To their shock and horror, they found that the hospital was totally unprepared to help someone suffering from cardiac distress. As medical professionals, they decided the only course of action was to immediately return home. “We left [the U.S.] Friday. Saturday we went to the hospital. By Tuesday we were back home,” said Vianney. Cairn ended up having a stent inserted once they were back in the United States. Fortunately she was able to make a complete recovery. “My wife is fine now,” Ruhumuliza said.
 
The terrifying incident left an indelible imprint on them both. Ruhumuliza knew that his wife’s condition was not unique, meaning that those in Rwanda without the means to seek care elsewhere were doomed to suffer and eventually die from heart disease, which was treatable. “I wanted to see if we could interest (Rwandan medical professionals) in cardiology and get government support.”
 
To that end, he formed a 501(c) 3 non-profit organization, Helping Hands for Rwanda. In October, he will be leading a team of six medical professionals on his third trip to Rwanda. McLaren Northern Michigan cardiologists Gerald Gadowski, D.O., and Harry Colfer, M.D; their nurse-wives, Sharon Gadowski and Dawn Colfer, respectively; and echo technician Christine Johnson-Ferguson will accompany Ruhumuliza to a military hospital in Rwanda. Their goal is to not only treat Rwandans while there but also to educate physicians and Rwandans about the importance of treating cardiac conditions and their causes, such as hypertension.
 
“In America, we take for granted that our grocery stores have a free blood pressure machine, or that we have a hospital within driving distance of our homes,” stated Ruhumuliza. “This is not the case in Rwanda, so we want to make sure they have the tools to treat the patients when they seek help. And provide the education to Rwandans to know when they need medical care.”
 
Ruhumuliza originally left his home country in 1982. He wanted to pursue his education, and met Cairn when they were both students in the U.S. He had hoped to return to Rwanda to provide medical care when the country’s civil war broke out. “Who knows if I was still there if I would still be alive,” he said.
 
Dr. Dalton Miranda accompanied Ruhumuliza on his trip this past spring. “I was taken with the story and the numbers. There was no cardiology in the country,” said Miranda, a cardiologist who practices with Michigan Heart & Vascular Specialists and at McLaren Northern Michigan Hospital.
 
The numbers he’s referring to reflect the difference in care. At McLaren, a 200-bed hospital, they see 15 to 20 cardiology patents per day. At the 500-bed hospital in Kigali, Rwanda, where they went, doctors would see one or two cardiology patients per week. That meant there were huge numbers of people not getting the care they needed.
 
So in the spring of this year Miranda went to Rwanda with Ruhumuliza, a nurse from Detroit, a nurse assistant and an EKG technician. They saw over 120 patients. Miranda said a number of them suffer from high blood pressure and diabetes. “There’s not much smoking, but a lot of salt and sugar (in the diet).”
 
“We saw all types of patients, from congress members to judges to farmers. Many of the jobs in Rwanda are stressful, due to physical labor or long hours, and can cause hypertension, or high blood pressure,” said Ruhumuliza. They worked alongside Rwanda physician residents, diagnosing and treating patients and educating the patients and the doctors. “By simply training resident physicians on treating hypertension, cardiac episodes have decreased,” Ruhumuliza said.
 
Miranda said changing the mindset of doctors there and engaging more of them in cardiology will be a long process. “We are trying to start a movement so there’s no brain drain. They (doctors) go out to get trained and don’t come back.” Those who might wish to return are at a disadvantage. “One trained in South Africa and came back, but was unable to use their skills because of the lack of infrastructure,” said Miranda.
 
While the cardiology infrastructure may be lacking, the country is hardly bereft of technology. Ruhumuliza said the entire country is covered by high fiber network. “There are towers in the mountains – there’s no problem with reception. Even my 87-year-old mom has a cell phone.”
 
So today, would he consider returning to his home country full-time? “I think I make a difference more here than I would there,” Ruhumuliza said. “I communicate with my family there on a daily basis. I go there every six months or so. It’s a small country, about the size of Maryland. You can go from one of it to the other in a few hours.”
 
The effort is not restricted to those who are traveling to Rwanda. The organization is seeking additional funding, but has already received an EKG machine purchased and donated by Anton Sharapov, MD, general surgeon on medical staff at McLaren Northern Michigan. Dr. Sharapov is covering the cost of the Echo Tech to travel to Rwanda. Other members of the team are, like their predecessors, covering their individual costs themselves. To learn more about Helping Hands for Rwanda and the upcoming mission trip, visit mclaren.org/northernheart or hhfr.org.