The Next Frontier in Rwanda

Alphonsine with her newborn baby who is just eight hours old and has no name as yet, at Ntaurka health Clinic, Burera District, Rwanda. Photo: Sebastian Rich/Save the Children

This article was originally published in the Huffington Post. Written by Mark Shriver. 

I suspect that many Americans are just like me when it comes to our knowledge of Rwanda: what we know about the genocide that started 20 years ago today that resulted in more than one million people killed in 90 days and what we know about the country itself, we learned from the movie Hotel Rwanda.

When I stepped off the plane at Kigali International Airport two weeks ago, I didn’t know what to expect: were the roads paved? Were there monuments everywhere to the more than one million killed? Were there schools and hospitals?

As we drove from the airport to our hotel, we saw a skyline punctuated by gleaming office buildings and as many cranes as you would see here in Washington, DC. I was hard-pressed to find a scrap of litter on the sidewalks, and traffic moved at a pace that would make any Beltway commuter jealous.

But it’s not just Rwanda’s investment in urban planning that’s paying off. President Kagame’s administration has made a concerted effort to improve the health of women and children since he took office in 2000. By prioritizing health, the country is on track to achieve the critically important Millennium Development Goal (MDG) 4 — reducing the under-five mortality rate by two-thirds since 1990 — ahead of schedule. Malaria, which was the number one killer of kids in 2004, doesn’t even make the top 10 today.

That said, children under the age of five are still dying, but they are dying younger. In fact, nearly half of all deaths of children under age five happen in the first 28 days of life, otherwise known as the newborn stage. The three leading causes of newborn death are premature birth, asphyxiation, and infection. Rwanda is one of the few countries in the developing world that has reduced the newborn mortality rate by 30 percent over the last decade, though the rate remains high at 37 per 1,000 live births. Luckily, Rwanda has Dr. Agnes Binagwaho — a neonatologist by training — at the helm of the Ministry of Health. During one of my meetings with her in Kigali, she referred to newborn mortality as the "next frontier."

When I met with President Kagame, I asked about the agenda for the upcoming U.S.-Africa Leaders Summit here in DC. I assumed that economic development and electrification were on the agenda but before I could say more, he interrupted and said, "What good is that if our babies and mothers are dying? They must be the priority."

There is much talk about economic development in Africa and clearly it is important. Indeed, Rwanda does have a number of significant barriers to its future, not the least of which are too many places where there are still dirt roads, lack of electricity, and unclean water — though they seem to pale in comparison to reconciling a population that was torn apart by a brutal genocide.

But we can also look to Rwanda and be proud of their achievements on the health front. Rwanda has a real opportunity to show the world what is possible when government, civil society, and the private sector come together around a common goal. Wouldn’t it be incredible to have a country that today is most associated with an atrocity that left one million of its citizens dead, instead be seen as a leader in the fight to save the 2.9 million newborns who still die each year around the world? Let’s hope that the U.S.-Africa Leaders Summit seizes that opportunity.

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