Muraho from the people of Rwanda. The ACEP President-Elect, Dr. David Seaberg, led an ACEP People to People Citizen Ambassador delegation on a medical exchange to Rwanda from August 12 through 20.

The delegation consisted of 10 emergency physicians and spouses that included an emergency nurse, a pediatrician, and a social worker. The delegation toured numerous medical facilities around the country and delivered presentations on emergency medicine and trauma care at the main teaching hospital in Kigali (the capital) and the district hospital in Gisenyi. Rwanda is in the process of rebuilding its medical system after the 1994 genocide and is seeking advice in the areas of emergency medicine, trauma system development, and EMS.

It is impossible to consider any aspect of health care in Rwanda without some understanding of the 1994 genocide, how its impact lingers on in the population, and the effects of the measures being taken to reconcile the population.

For decades leading up to 1994, the minority Tutsi population (and moderate Hutus) were progressively demonized as scapegoats for the country’s poverty by the military dictatorship of Hutu General Juvènal Habyarimana. As with the Holocaust, this marginalized group of citizens chose to put their faith in the government to protect them rather than arming themselves, and again as with the Holocaust, it was the government itself that was orchestrating the genocide behind the scenes.

Beginning within minutes of General Habyarimana’s plane being shot down over the Kigali airport on April 6, 1994 (in all likelihood by radical elements in his own party), and continuing for the next 100 days, 1 million people were tortured, raped, and shot, clubbed, or hacked to death with machetes.

Rwanda’s current president, Paul Kagame, a Tutsi, and his expatriate Tutsi “rebel” army ended the genocide by defeating Habyarimana’s military forces and Hutu Interhamwe militias 100 days after it began. Having just won a second 7-year term, he is in the process of creating a balanced government with representation from Tutsi, Hutu, and Batwa, and the country is hard at work putting the genocide behind it by seeking a full understanding of why it happened.