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By Annonciata Byukusenge
Ngoma is a district (Akarere) in Eastern Province, Rwanda. Its capital is Kibungo. Ngoma district is divided into 14 sectors (Imirenge) with 404,048 Population; 874.3 km² Area 462.1/km² Population Density; 1.8% Annual Population Change 2012 – 2022, according to the 5th Rwanda Population and Housing Census (RPHC-5) from 16-30 August 2022.
Micheline Batamuriza wakes up at five in the morning every day. Her main activity is irrigating crops in a small 2-hectare farm at Rango, a remote rural village in Ngoma district in Eastern Rwanda.
The 45-year-old mother never envisioned that by age 40 she would be walking long distances to seek health services in her neighborhood.
“From my childhood, I traveled to the hospital at a distance of 18 km in the other sectors. It was a big challenge because when you feel ill and walking this journey, you feel ill double. In our sector Kazo, for 40 years we didn’t have a Health Center can provide services to pregnant women.” Said Batamuriza.
The image of pregnant women walking 18 km to access health services
“To be pregnant 20 years ago was a challenge even necessary to have a family. Many women died during and after giving birth at home, because no health center existed in the Kazo sector.” Said Batamuriza.
She added that the long journey to reach the health services required many things like transport, take away of food, and drink to walk with a pregnant woman when going to the health center to checking.
“Many women decided to give birth at home because going to Mutenderi or Kibungo Health Center is very expensive. During hospitalization, we thought about how a person would take care of us with a journey of 18 km and we needed nutritious food, the family at home also needed to eat, hospitalization fees, and other basic needs for a woman who gave birth. Those things pushed us to give birth at home.”
Vestine Mukandayisenga is a community health worker in the Kazo sector. She says “Before having a health center in our sector, women gave birth at home. Four out of 10 women I could be transferred to the health center gave birth at home because of various challenges. Now one woman in 10 could give birth at home because of her mindset not lack of access to health services. We still educate women until all women give birth at a health center.”
How this situation changed
The Regional Rusumo Falls Hydro Electric Project (RRFHEP) implemented by the Nile Equatorial Lakes Subsidiary Action Program (NELSAP) is to benefit the three neighboring countries of Rwanda, Tanzania, and Burundi at the border of Rusumo in the eastern part of Rwanda, the Western part of Tanzania and Northern part of Burundi.
In 2015, local leaders told us that Rusumo Hydropower Falls was going to be built on the border and that the benefits would come back to us, we did not understand this because we felt that the benefits were from the government and the citizens would get nothing but the jobs they told us we would gain. At this time, the benefits have started to reach us because the Rusumo project built us a Health Center and a Market. The construction activities began in 2017.” Said Mukandayisenga.
Camalade Shumbusho is a Manager of Kazo Health Center. He says that before having a health center provided by NELSAP, they had a Health Post.
“Before this health center, we provided basic services like Out Patients Department (OPD), intestinal services, and consultation, because we couldn’t receive many patients in one small building we had.”
After having a health center, they provide various services like maternity, hospitalization, planning family, non-communicable diseases, HIV services, and youth services. The activities of building this health center started in March 2023, and completed in January 2024.
Challenges
Manager Shumbusho says that the main challenge is the lack of employees, even if they have materials at the health center level. Now four employees are serving more than 30 thousand people.
“Before as health post, we received between 600 and 800 patients per month, but now as health center, we receive between 1300 and 1500 patients per month.”
The Kazo sector has 32 thousand people and all need health services at this health center. They have also people from the Gashanda sector and Mutenderi. Those people are served by four health facilitators only. The need that the Ministry of Health help them to get more employees.
Recently Forefront Magazine talked with Mr. Celestin Mutabazi in charge of Infrastructure and Natural Resources in Ngoma district, who said that the infrastructures like Health Centers, Markets, Youth Training Center, and water stations were built in partnership with their partner NELSAP which is implementing the Regional Rusumo Falls Hydro Electric Project (RRFHEP).
“Our district is the one in the Eastern Province that was faced with health facilities and water issues, but two years ago those problems were resolved. Our people have clean water near their homes, livestock improved, they have health services in their villages and the markets for their production.”
He added that the infrastructure planned already achieved a value worth five million and eighty-three thousand US dollars (5. 83000.000 USD).
The infrastructure supported by NELSAP is a 28 km Water Pipe, which supplies water to the two villages of Gahima and Gatonde in the Kibungo sector comprising 10,500 households; Kigina Health Center, Kazo Health Center, Karembo Health Center, and Kibungo youth training center.
The Rusumo hydropower project is a joint venture between three countries namely Rwanda, Tanzania, and Burundi. It will provide 80 MW of electricity to the people of these countries.
Rusumo Project established the $15M Local Area Development Plan to enhance regional social economic development in Busoni and Giteranyi Communes, Ngara District, and Kirehe and Ngoma Districts. Each district identified priority investments: access to water and roads, schools, and health centers.
These countries are also part of the 11 countries of the Nile Basin, namely Burundi, DR Congo, Egypt, Ethiopia, Eritrea, Kenya, Rwanda, South Sudan, Sudan, Tanzania and Uganda.
