Author: Veronica Houser

With support from UNICEF and Rwanda’s National Agricultural Export Development Board, tea plantations like this one have begun investing in daycare centres, so children have a safe and stimulating place to learn and play while their parents work to earn an income.

But amidst the excitement this morning, one child sits conspicuously still, a bit quieter than the rest as he sips his milk.

David is five years old, but when he arrived at the daycare centre two months ago, he was not able to walk.

“When his mother told me his age, I could not believe it,” says Betty Mukazitoni, a lead caregiver at the centre. “He always chose to sit away from the other children, always with his arms crossed.”

Almost as if defying Betty’s recollections, David stands up and totters over to the playground. He is unsteady, but clearly able to walk on his own. As a gentle rain begins to fall, a little girl runs to David, adjusting the hood of his sweater gently and snugly on his head.

Betty smiles. It is impossible not to.

“You would never believe it now, but he could not even hold his own food. But look at him now,” she says warmly.

David slides down the slide, backward, but on purpose. He walks calmly back towards the other children, sits among them and begins to peel a banana.

David’s mother Josiane harvests tea on the plantation to support herself and three children. Before the centre was built, Josiane was forced to leave David home alone when she worked, in a closed room with no cognitive stimulation or proper nutrition.

With David at home and concerned for his safety, Josiane was not able to work a full day, missing out on valuable wages.

“David was very malnourished because I could not always afford a variety of food,” she says. “I felt like I had so few options… I had to choose between spending time with my son or earning money to buy the things he needs.”

“At one point, the doctors told me he might not survive. But when this centre was built, I felt like my prayers had been answered. David is much healthier and happier now, and I can work the full day.”Josiane, David’s mother

Children between ages 3 and 6 also participate in play and learning sessions in the centre’s pre-school. Sitting at colorful tables and surrounded by blocks, puzzles, crayons and other toys, they spend the day learning through songs, games, and fun activities, led by Betty and other caregivers.

“Even though David is five, when he first arrived I placed him in the daycare with the children under three. He was so afraid. Actually, he had trouble sitting up by himself.”

But when David heard the clapping, singing and shouting in the pre-school, for the first time in his life, he stood up.

“I saw him peeking around the corner one day,” recalls Betty. “He had taught himself to walk. Then one day, he sat with the other children in the pre-school. He is still too shy to answer questions, but the other day I saw him clapping when we were singing.”

Maybe he understands because as Betty describes his progress, David claps along to a private game he is sharing with his friend. Break time is nearly over, and Betty begins to usher the children back into the classroom.

It is nearly impossible to discern that David arrived with a few more setbacks than others. He sits among his friends in the pre-school, quiet but attentive, and if you watch closely, you might even see a smile.

Source: UNICEF Rwanda

In the calm of her shared hospital room, Jemimah Nyirabimana sits relaxed as she holds her twin babies against her bare chest. Jemimah’s twins were born premature, weighing less than two kilogrammes at birth.

She gently pats one of her babies on the back, looking around the room where she rests with other mothers cuddling their babies.

A few weeks ago, when her twins were born too early, Jemimah was terrified that they would not survive.

“They were both so small…”

Premature babies are more likely to have chronic health issues, some of which may require hospital care. They are prone to infections, health issues like asthma, feeding problems, and even Sudden Infant Death Syndrome. As they grow, these children are more likely to be chronically malnourished, which can lead to stunted growth.

{{Kangaroo Care}}

Jemimah’s babies are sleeping peacefully. “The doctors taught us to hold our babies like this,” she says, gesturing gently at the tiny bundles wrapped tightly to her chest. “When they feel the mother’s skin and warmth, they sleep better.”

This “Kangaroo Care” technique also helps premature infants gain weight and grow. It promotes bonding between parents and their babies due to decreased stress and crying.

In fact, the Kangaroo Care room at Gahini Hospital is nearly silent. Although three other mothers occupy the room with Jemimah, none of their children are crying. The room is clean and comfortable, the atmosphere is serene. The mothers chat quietly, occasionally giggling at a private joke.

{{Mentorship from abroad}}

Gahini Hospital was not always a haven for mothers with risky pregnancies. Doctors and nurses in Rwanda often lack the training and equipment they need if something goes wrong during pregnancy or childbirth.

“When I had my first child here in 2011, the hospital was small,” she says. “I was nervous about being a first-time mother, but the doctors were not confident when caring for us.”

Jemimah gave birth again in 2015, but this child did not survive.

For every 1,000 babies born in Rwanda, 50 of them will not live to see their fifth birthday. Over 40 percent of these deaths occur within the first month of life – the neonatal period.

UNICEF’s clinical mentorship programme is helping reduce these deaths by providing Rwandan doctors and nurses with more knowledge and equipment to save lives.

In partnership with the Royal College of Paediatrics and Child Health and Rwanda Paediatric Association, UNICEF brings pediatric specialists from the United Kingdom to spend six months mentoring Rwandan health care providers.

These mentors work alongside Rwandan nurses every day, advising on individual cases and teaching weekly modules on caring for premature infants.

With funding from Takeda Pharmaceutical Company Limited and support from the Japan Committee for UNICEF, Gahini Hospital also has new medical equipment. The doctors and nurses are trained to use this equipment and apply new knowledge in a crisis.

“Look around!” Jemimah says. “Now the hospital has enough beds for mothers. Before there were only two; we had to share, so we could not even spend time with our babies.”

While Jemimah speaks, a nurse attends to her babies, adjusting their tiny knitted hats more securely on their heads.

Jemimah’s eyes shine when she talks about her babies. “Our babies are growing well now; thanks to the new advice the doctors give us.”

{{Source: UNICEF Rwanda}}

Doctors and nurses in Rwanda are not strangers to situations like these. Doctors and nurses often lack the training and equipment to identify problems and to save the baby’s life if something goes wrong.

But in Nyanza Hospital’s bright new maternity ward, equipped with new essential medical equipment with support from UNICEF, there have been marked improvements in the number of mothers and children who survive premature deliveries.

“We used to have a very small space with questionable cleanliness,” says Jeanne d’Arc. “But now we have a lot of space and modern equipment, and well-trained nurses. These nurses are now able to shine in a crisis because they have the confidence and the proper equipment to save lives.”

Through UNICEF’s partnership with the Royal College of Paediatrics and Child Health, Nyanza Hospital is working with mentors from the United Kingdom who are training nurses and doctors in Rwanda. These mentors have also helped Nyanza Hospital improve their administration processes, developing well-maintained patient records and checklists for better follow-up care with new mothers.

Esther Mukanyandwi lies in the maternity ward with her new baby, practicing Kangaroo Mother Care by keeping her baby wrapped closely to her body. “My child was born two months early and weighed only 1.3 kilograms,” she says. “I was sure she would die because there were many times when she stopped breathing, but the nurses were always able to resuscitate her.”

Dr. Pascal Ngiruwonsanga, the Director-General of the hospital, has seen neonatal services drastically improve over the last two years.

“We can offer better health services now, and we have been able to rehabilitate old facilities,” he said. “With the right medical equipment and competent staff, we can focus on resuscitation of newborns, infection prevention, and education for new parents.”

“We hope to see the number of child deaths reach zero in the few years ahead.”

{{Source: UNICEF Rwanda}}

This is the {Tugane Ishuri } volunteer initiative.

{Tugane Ishuri } – or “let’s go to school” in the local language Kinyarwanda – builds on Rwanda’s strong culture of solidarity and community cooperation to engage young activists to accomplish social change. Volunteers with Tugane Ishuri work with children in their own communities who have dropped out of school and encourage them to re-enroll and complete their studies.

At just 21 years old, {Denise Murekatete } became a UNICEF volunteer with Tugane Ishuri to advocate for the importance of education among families in her community. Denise sees herself as a public spokeswoman, helping families face their challenges.

“Volunteering builds a positive reputation for an individual in society, and it can help the country to achieve its goals since the work we do is for the public benefit,” says Denise. “I plan to speak out for every child to be sent to school. I hope to see the number of school dropouts in my community reduce to zero.”

{Jacques Muvandimwe} is 25 and lives in Rwanda’s Ngororero District. He chose to become a volunteer with Tugane Ishuri to help families who were suffering.

“There are families where the children have dropped out of school, and as a volunteer, I can approach these families and maybe make a difference in their lives,” he says. “If I can do this, the work will have been a great privilege to me.”

23-year-old {Vestine Uwimanirinze } became a volunteer to help a large number of street children living in her neighbourhood. As a volunteer, she believes it is her responsibility to teach these children and their parents about the importance of education.

“It really helps the community, even if I do not see direct benefit myself,” says Vestine.

At 24 years old, {Theophile Masengesho } believes that volunteering is important because it gives him an opportunity to transfer his knowledge and skills to another person. In this case, the children he encouraged to re-enrol in school.

As a volunteer in his community, Theophile plans to work hand-in-hand with local leaders on how to approach the dropout issue.

24-year-old {Therese Musengimana } believes that all parents need to understand how crucial it is for their children to complete school. She knows that school opens opportunities for a child’s future and keeps them away from harmful activities such as drug abuse.

“I have met children who have lost hope, thinking they cannot achieve anything because their families are poor,” says Therese. “But when I approach them, listen to their stories and use information from my volunteer training to speak with them, we see that deep down, they all have goals and dreams, and we can help them accomplish those goals by going back to school.”

Meet the volunteers of {Tugane Ishuri!}

While the children made friends, took naps, and played with their toys, UNICEF met with Rwanda’s National Early Childhood Development Programme (NECDP) and the National Agricultural Export Development Board (NAEB) to inaugurate this new centre on the plantation. A mother and tea plucker from the community cut the ribbon, officially opening the centre while she held her baby in her other arm.

{{Private Sector Partnership
}}

UNICEF’s partnership with NAEB first began in 2017, following the success of UNICEF’s first private sector partnership with SORWATHE Tea Company. When SORWATHE demonstrated willing investment in child-friendly workplaces for its employees, NAEB and UNICEF saw an opportunity to expand this partnership across the entire tea industry. The partnership now covers all 16 tea companies and 20 tea cooperatives in the country.

Inspired by UNICEF’s Early Moments Matter campaign which promotes family-friendly company policies, tea companies in Rwanda are beginning to transform their work spaces, making them places where children can develop physically and mentally, giving parents the peace of mind to work more productively.

“We are committed to ensuring child-friendly workspaces by providing maternity leave for our workers, flexible work hours to allow for breastfeeding, and investing in on-site ECD centres,” said Thushara Pinidiya, General Manager of the Rutsiro Tea Factory. “These services and policies will impact not only factory and cooperative workers, but also the surrounding communities we work with.”

{{ECD in Rwanda’s Muslim Community
}}

Rwanda Mountain Tea is not the only one making waves in ECD. Rwanda’s Muslim community has also opened its doors to ECD, inaugurating its first centre this week in the western town of Rubavu.

Singing at the centre with children’s song artist Peace Jolis, little ones in black and yellow uniforms clapped and danced, singing songs about washing their hands and learning to count.

The new ECD centre, hosted within a community mosque, will be open to all young children between 3 and 6 years, regardless of gender or religious affiliation. Two caregivers – one Muslim and one non-Muslim – will spend mornings encouraging the children to learn through play and discovery, following the competency-based pre-primary curriculum approved by Rwanda Education Board. Children will also receive nutrient-rich porridge each morning to help fight malnutrition.

At the inauguration ceremony, the Archbishop of Kigali said, “We pledge, as religious leaders, to advocate and promote ECD programmes in every village, to ensure all children access ECD and grow to their full potential.”

{{Source: UNICEF Rwanda}}