Based on our 8 days of meetings with medical personnel around the country, it is clear that they have much of the knowledge they need but have critical deficiencies in training, equipment, and supplies, in addition to the challenge of dealing with a slow-moving and semi-impoverished government bureaucracy.

Our delegation left behind our presentations, reference books, interactive CDs, and EM protocols – as well as money, several dozen soccer balls, 40 stethoscopes, two otoscopes, two dozen sheets and blankets, and the clothes off the backs of some delegates who perceived the Rwandans’ needs to be greater than their own. But it will take much more to make a sustainable impact.

The main Kigali teaching hospital handles 30,000 visits in two rooms and regularly runs out of disposables and critical medications. The ICU has six monitors for 70 beds. X-ray and CT are available but often out of service due to breakdowns, and there is no MRI. Of perhaps greater import is a culture of mostly learned resignation. The physicians for the most part know what should be done, but after years of confronting overwhelming demand and insufficient resources, they have become resigned to these conditions and lack confidence in the possibility of change.

On the positive side, 92% of the population has health insurance. Even the poorest Rwandans purchase the $7 per year government insurance plan – both to demonstrate their civic commitment and because farmers (90% of the population) are denied access to improved seed stock if they don’t buy the health insurance.

Civic commitment is encouraged in other ways, as well. The last Saturday morning of every month is Community Service Morning, and every family is expected to send one person to work on neighborhood improvement or clean-up projects from 7:30 a.m. to 10:30 a.m., followed by a neighborhood-wide meeting to discuss neighborhood problems. Those who fail to participate must pay a fine.

So while there are many things we can teach Rwanda, Rwanda has some things it could teach us as well.

“Our People to People delegation to Rwanda was fantastic in terms of the cultural, medical, and social experiences we encountered,” Dr. Seaberg said. “We learned a great deal about the Rwandan people, and we hope to continue our mission of helping establish emergency medicine in Rwanda.”

If you haven’t done so in a day or two, take a minute and count your blessings. A few days spent in East Africa brings into stark relief how incredibly fortunate we are despite our problems, which are in fact relatively minor when viewed from the Rwandan perspective. Our delegation’s hope is that they will say of us Yaámpaaye inká! – “He (or they) gave me a cow,” meaning that we will remain friends forever.