Photo Essay: Expanding a Hospital, Serving More Patients in Rwanda

On the grounds of Butaro District Hospital, a four-story building is rising rapidly. The construction is phase one of Partners In Health’s multi-year expansion project, launched in December 2021. And it seeks to widen access to cancer care and other specialized services in a region where there was once no hospital and where the current facility lacks enough beds for all patients in need of care.

“We are progressing well,” said Fabrice Nusenga, infrastructure manager at Inshuti Mu Buzima, as Partners In Health is known locally. “We want to hand over the building [to the Ministry of Health] as soon as possible so that it can start serving its purpose.”

The construction is part of a two-phase project to expand the capacity of Butaro District Hospital to serve more patients and become a university teaching hospital for students from the nearby University of Global Health Equity.

Just a decade ago, the rural district of Burera was one of only two districts in Rwanda without a hospital. In 2011, Inshuti Mu Buzima, in partnership with the Ministry of Health and MASS Design Group, built Butaro District Hospital to bring health care closer to those who most need it—ultimately providing quality care to a community of 350,000 people.

Now, the hospital has become a regional hub for cancer care, provided at the Butaro Cancer Center of Excellence. Approximately 1,200 new patients arrive at the cancer center each year from across the region and from as far as countries like Sierra Leone to receive comprehensive treatment. That growing demand has stretched the cancer center’s resources, making the expansion project crucial. When construction ends in 2023, the bed capacity is set to increase from 150 to 256, serving even more patients.

The progress made since construction began is notable. Most of the structural work is now complete, including foundations, floor and ceiling slabs, exterior walls, columns, and beams. Roofing, installation of electric wiring and water pipes, and wall finishing activities are well underway.

The 62-foot-long building will accommodate new departments and double the capacity of existing wards and services, including a modern emergency department, a new imaging unit with a CT scanner, and new pediatric and adult wards.

The new spaces are designed in a way that prioritizes the comfort and safety of patients. The floor plan is meant to ease the flow of patients and staff. Big windows and higher ceilings will allow natural light into the building. To create a more welcoming environment for young patients, the new pediatric ward will include a large outdoor playground. The expanded hospital will also have a cafeteria for students and health workers, while patients receive free meals at the nearby support center.

The project is boosting the local economy in Burera, where most people make a living from subsistence farming.

“We have an average of 150 daily workers working on the project,” said Nusenga. “Some of the materials we use are locally sourced to create more opportunities for the local community.”

Those materials include sand, water, and timber from local forests. 

A short walk from the construction site, the economic impact of the project is on display in the boisterous town of Rusumo. A gas station refuels construction trucks; banks have long queues of people waiting to cash their paychecks; hostels have seen a spike in demand since construction began.

Most importantly, though, the project will enable the hospital to provide quality care for the growing number of patients who walk through its doors.

Seraphine Uwimana, 46, was one of those patients. The mother, who lives in Kigali, was diagnosed with stage three breast cancer in 2019. Because this stage is considered advanced, she had to travel regularly between Butaro and Kigali for a CT scan as part of her treatment. The journey is three hours long and includes an hour of travel on a rocky dirt road. Once the new CT scanner is installed in the expanded facility, such a trek will no longer be necessary for future patients.

“The journey was long and unpleasant for a sick person,” said Uwimana. “But I now look back and realize it was necessary. People who saw me when I was very sick are always amazed to see how well I am doing.”

Through Inshuti Mu Buzima’s support, Uwimana completed her chemotherapy treatment and had a mastectomy, with all care free of charge. Now, she only returns to the hospital for follow-up appointments every six months. This has meant that she can spend more time with her two children, ages 9 and 5.  

Today, as Uwimana watches the expansion of the hospital take shape, she is grateful that patients will be able to access its lifesaving services in one place.

“The hospital has given me the treatment and care that was before not possible for someone who is poor,” she said. “It’s wonderful that in the future patients will access more services here in Butaro."

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