Emergence
Stories from the frontlines – family physicians around the world responding to COVID-19
- episode 7 - Rwanda
A narrative collaboration between the Besrour Centre of the CFPC and CFP
Interview with Dr. Vincent Cubaka on May 1, 2020
Rwanda
“I see the Future Bright for Family Medicine”
Dr. Cubaka is a family physician who works with Partners in Health (PIH) in Rwanda, accompanying the Rwandan government in strengthening the health system. He is one of only nine Family Medicine graduates trained in-country, as the residency training program suffered financial instability and was put on hold. Vincent’s PhD research centred on patient-centred communication; he embodies and has a deep understanding of the values and principles of Family Medicine. Knowing there are many strains on their health system, he was curious as to how even in a busy clinical day it would be possible to exhibit that human touch.
His work at PIH, as Director of Research and Training, focuses on generating evidence and training health care providers to support the most vulnerable communities in Rwanda. When the outbreak was imminent, the well-organized Rwandan government was proactive in providing guidance for health facilities and providers, but mostly the population in preparing for the arrival of the virus. Rwanda has not had a single death, as of the interview time.
“The government has been providing food… almost everywhere in the country.”
Dr. Cubaka attributes the success to the reactivity in preparing the country as well as the discipline of the local population’s compliance with the requested measures. In a low-income country, the community will be stressed with food insecurity. In fact, the government worked to provide people with food support. (As did Vincent himself)
When thinking of the pandemic from a systems-level perspective, Vincent acknowledges that the situation is more complex. The infections came mostly to the capital city by travel, and so contact tracing was possible until this evolved to the long-haul truck drivers coming through borders.
“One factor that may have contributed is the distribution of the population that is young… this influenced the spread in a positive way... and the severity of infection.”
The measures in Rwanda have proved to be effective thus far and the country looks to ease restrictions, starting the week after we recorded, with businesses opening. He attributes clear communication as helping people understand how to manage their families or facilities. Health care providers’ ties to community have also been important in disseminating truthful information. He dreams of a time when there are many more Family Medicine doctors - where they are all community-oriented and supporting primary health care teams - in many more districts.
Research. Trust. Patient-centred communication.
Thank you, Vincent, for this brief view into the Rwandan response and your particular keen understanding of a patient-centred approach to both clinical work and to pandemic preparedness. As a co-lead in the Narrative Working group of the Besrour Centre, your wisdom proves what a great advocate and thought-leader you are in our field.
Listen to the podcast here: https://cfppodcast.libsyn.com/covid-19-global-pandemic-and-family-medicine-ep7-rwanda
Dr. Vincent K. Cubaka is a family physician. For the past fourteen years he practiced as a rural clinician, then served as a lecturer and researcher and head of the Department of Primary Health Care at the University of Rwanda (UR). He recently joined Partners in Health Rwanda (PIH-IMB) to hold the position of Director of Research and Training. He trained as a specialist in Family and Community Medicine at UR. He also holds a doctorate in medicine from the University of Aarhus in Denmark. His doctoral work explored patient-provider communication in primary health care in Rwanda.
Dr. Christine Gibson (www.christinegibson.net) is a family physician in Calgary, Canada with a background in justice work, medical education, and global health. A skilled facilitator and speaker, she is engaged in building individual and community resilience. Her writing creates the woven narrative between her interests – wellbeing, trauma recovery, and the power of story.
The Storybooth article published by the Narrative team can be found at BMJ here.