
Kibagabaga Hospital has launched an integrated education program for medical students during their Internship period focused on assessing and managing of pain and symptoms control.
Over the last decade, Rwanda has made significant strides towards improving public health and achievement of the United Nations Millennium Development Goals.
Rwanda has seen significant improvement in maternal and child health and in combating infectious diseases. Integrating palliative care into medical education can expand the scope of health delivery for Rwandans.
In its Vision 2020, Rwanda aims to achieve its Objectives through seven strategies and/or pillars, which include reducing birth rate, increasing access to education and enhancing healthcare to general population.
The government of Rwanda recognizes that achieving the Millennium development goals cannot be based only on emphasizing infectious diseases; they must also address treatment of non-communicable chronic diseases.
Thus the government advocates that palliative care should be adequate, that equity be ensured in all aspects of healthcare service delivery including dispensation of palliative care in cases of incurable diseases.
Kibagabaga Hospital is a public hospital located in Gasabo district, Kigali city. Sixty percent of the total population of Kigali resides in Gasabo district.
Kibagabaga Hospital has two hundred and thirty beds and four main departments: Pediatric, Obstetrics/Gynecology, Internal Medicine and Surgery. The Hospital also supervises sixteen health centers and one prison.
Kibagabaga serves fifty-five thousand in-patients & outpatients, annually. The goal is to provide the highest quality of care, which will lead to improve the quality of life for Rwandans.
Kibagabaga Hospital hosts a team of qualified physicians composed of five specialists: Internal Medicine, Ear/Nose/Throat, Ophthalmology, Obstetrics/Gynecology, Pediatrics and fiften General Physicians.
Ten medical students are assigned for their internship training at Kibagabaga. The hospital works closely with the community based health insurance program, which supports 90% of patient costs.
Palliative care has been integrated into care at Kibagabaga since 2010.
Guiding principles of the program are:
Improving quality of life of patients by relieving pain and controlling symptoms by integrating a holistic approach at all level and departments.
Reducing costs by giving supplies and medications to the patients and their families; advice families to avoid unnecessary travel which is not beneficial to the patient, and focus on care, rather than cure.
Recognising that freedom from pain is a human right and incorporate that value and the respect for individual dignity into teaching of health professionals.
Kibagabaga Hospital launched a new education program led by Dr. Christian NTIZIMIRA & Dr. Olive Mukeshimana for medical students from July 5th, 2013 till the end of their internships.
According to the curriculum from the Faculty of Medicine of Rwanda, every medical student must spend one year at the district level and work in at least 2 main departments. Kibagabaga is among the medical student sites. Palliative care is one of the focus areas integrated into medical student education at Kibagabaga.
The aim of this program is to introduce medical students to the concepts and principals of palliative care; to enable them to integrate these principles into care that improves services to patients with terminal and chronic diseases.
Students will participate in the program one day a week for six months under the guidance of two supervising physicians.
Teaching sessions will include relevant topics and case studies based on four areas of focus:
o Application of the concept and principals of palliative care;
o Assessing and managing pain and other physical symptoms appropriately;
o Communication with patients and their families with sensitivity and respect;
o Appreciating and working within a multidisciplinary, interprofessional team.
The program’s goal is that at the end of the internship, the medical students, upon graduation, will be deployed by the Ministry of Health to different health facilities throughout the country, will be competent in management of terminal and chronic diseases, including safe administration of analgesics such as morphine.
Every group of medical students who will participate in the internship program at Kibagabaga Hospital will benefit by working with the palliative care team that focuses on assessing and managing pain and controlling symptoms.
At the end of their internship, a certificate of completion for Palliative care will be awarded to each student.
Kibagabaga Hospital is also a site for student nurses, midwives and anesthetist training. The majority of these students spend more than 3 months at Kibagabaga.
In the future, we hope to extend the program to create a curriculum of palliative care for all health care student disciplines, so that every person studying to be a doctor, nurse, mid-wife, and anesthetist will be trained in palliative care during their education.
Let’s me wind up by quoting what Ghandhi inspired: “We have to be the change we would like to see in the world”.