PIH's Emmanuel Kamanzi on Working in Global Health

Emmanuel Kamanzi has worked for Partners In Health for almost a decade in many places and roles. He's spent the last three years in PIH's Boston office and is now returning home to Rwanda to take on his biggest project yet—overseeing the building and development of the University of Global Health Equity. We asked him to reflect on his career and offer advice to aspiring global health professionals.

Standing on a hill in Burera, a rural district in northern Rwanda, I see other green and terraced hills all around. I can see the beautiful Butaro Hospital across a valley, and to the east is Mount Muhabura, which is home to the gorillas that attract so many tourists every year.

I’m at the construction site of the University of Global Health Equity, which is owned and operated by Partners In Health. Launched in 2015, the institution was founded to train the next generation of global health leaders. I just returned from the United States, where I have been for the last three years, to work as the university’s director of campus development.

Several people have come to me for advice on working in global health. They ask whether I am a doctor or a nurse. My answer is always very direct: No. I am trained in business studies, management, and leadership, and I use these skills to make life better for those who need it most. People think that to be successful in global health, you need to have a clinical background. While that can be very helpful, my experience tells me that anyone with spirit and a passion to make a positive impact on the lives of those in need can be involved in global health.

My parents were decent subsistence farmers who lived as refugees for 30 years. They raised me and my other nine siblings. They didn’t go far in their studies, but they were keenly aware of the importance of education and did their best to send all of us to school.

When I passed my high school exams with distinction and got awarded a government student loan to join the University of Rwanda, I wanted to do business studies. I wanted to help my family and those in need, and I thought making a lot of money was a wise way to go about it.

Partners In Health

When I graduated, the university hired me as a tutorial assistant—my first formal job after school. Six months later, I accepted a job with PIH as the human resources manager for a new hospital in rural Rwanda.

I remember all those years ago, my friends thought there was something wrong with me when they saw me packing my things and leaving the biggest and most prestigious university in the country to go work for PIH in Kirehe District, which was the most rural place in Rwanda at the time. It meant giving up clean running water, electricity, and good roads. And I’d be far from Janet, who is now my wife and was studying international economics at the same university.

But I was very sure of my decision. I hadn’t known about global health formally, but I carried its principles within me unknowingly. I truly believed in fighting extreme poverty and in health equity even before I learned about PIH. That was the start of my career in global health

It took time to get used to my new life. My house in Kirehe had no running water, electricity, and Internet. I had cold bucket showers every morning and felt quite frustrated sometimes. But this would fade when I arrived at the hospital and saw patients getting care not far from my office. I helped recruit dozens of doctors, nurses, social workers, and office staff to open Kirehe Hospital, which was the first in the district. I also put human resources policies in place that aligned with Rwanda's Ministry of Health, our close partner.

I also served on the hospital advisory committee, which helped patients benefit from PIH social support such as health care coverage, food packages, housing support, and school fees for children. Irrespective of my lifestyle, I felt very satisfied with the work I was doing.

Ten months later I was promoted to project director, managing all of PIH’s work in Southern Kayonza, another district. I helped build a team that worked closely with the government of Rwanda on many projects. One involved revitalizing 21 health centers in Southern Kayonza and Kirehe.

Twelve months later, I was promoted to a similar role in Burera District, where I remained for about two and a half years. A major highlight of the work I managed was the construction, outfitting, and opening of the 150-bed Butaro Hospital that serves nearly 350,000 people. About 3,500 jobs were created with this project. Like Kirehe, where I started with PIH, Butaro Hospital was the first of its kind in the district.

During this time, my business studies had been useful in my work, but I realized I needed advanced and specialized project management skills to manage bigger and more complex projects. In 2013, I enrolled in an online part-time MBA with Business School Netherlands. Students, who were from all over the world, completed projects with access to a 24/7 tutor and gathered twice for conferences. The skills I gained were invaluable for global health. You can read more about my MBA experience here.

Global health is about caring for people irrespective of where they live. I was honored to be a part of PIH’s work in those three districts. You get to live in the communities you are helping. You see the life-threatening needs of people and help them. You get to see people with smiling faces be discharged from the hospital—totally different from the looks they had when they came to seek care. You get to hear stories of families who earned an income from being employed on projects you manage and were later able to start new businesses, send their children to school, and pay their health insurance premiums. You also get to see children who had dropped out of school become the best performers in class with your support.

And last but not least, you see the power of partnership. This is a major component in global health. PIH’s work is about working with other organizations. I worked very closely with public officials and health leaders in all three districts. I also was honored to serve as president of the Joint Action Development Forum, a platform where private partners and civil society agents come together to map out district development priorities and make sure we were not duplicating efforts.

Coming to the U.S.

In mid-2013, I took on a new role with PIH in Boston, representing our Rwanda work as program officer. My motivation to take this role was to build my career in global health, work closely with PIH leaders, and get more exposure to PIH’s work in other countries. My wife moved with me. When colleagues in Rwanda heard, some congratulated me and thought that I would never return to Rwanda. This is common among young people living not only in Rwanda, but also in other developing countries. People leave their jobs and find ways to live in the United States. Some call it heaven or “Igihugu cy’isezerano,” as they commonly refer to it in Kinyarwanda, the local language.

Of course, the United States is one of the wealthiest nations in the world, but it’s not heaven. You can’t pick up money on its streets and become rich, as many young Africans think.

The last three and a half years in this role have been uplifting in many ways. One major experience was seeing how people make sacrifices and generously provide financial and in-kind resources to support our work in Rwanda and globally. I had never seen this spirit of concern and generosity before. PIH’s work is deep in the hearts of its supporters around the world. I always say thank you to these people, and I tell them about people our work is touching in rural Rwanda. I invite them to visit Rwanda to see how their support is making a huge impact and how Rwanda is developing and becoming a beacon of hope for other African countries.

Adjustment to the work and lifestyle in the U.S. was not easy. There was a lot to learn, and you need to adapt quickly. There were so many options and you end up getting confused between which to pick. Time counts a lot there. You miss one meeting and your entire day gets spoiled. The food was so different. The weather was not your normal forecast. The list goes on.

While navigating all of this, I found relief in many people I met, many of whom I’d worked with before in Rwanda. Some of them had shared a house with me and had also experienced the bucket showers in Kirehe and Burera. I also found a few Rwandans living in Boston. They all helped me integrate quickly and have become my adopted extended family.

Back home

Three years in, I became used to the U.S. lifestyle. My wife found a job she liked. I enjoyed the vegetarian food—the likes of Sweet Green and Panera bread menus. I made many friends. While not in Rwanda, I felt I was still serving the poor.

But another big change came my way. The day before the U.S. presidential election, PIH told staff of my decision to accept a job with the University of Global Health Equity, which we call UGHE. Amidst congratulatory messages, friends asked why I’d leave the United States. Again, I was driven by my career goals and my will to join hands with others to build my country. I am also moved by UGHE. It embodies the values of equity and service to the poor. So much of the world, Rwanda included, lacks health professionals. In Rwanda, there is only one doctor for every 15,000 people. UGHE will help to close this gap in Rwanda and in other countries.

The university will rise on the ground I am standing on, facing the hill where I helped build Butaro Hospital. I see construction workers and bulldozers digging along a dirt road winding to the hills. The government of Rwanda is helping to pave a 64-kilometer road connecting Butaro with Kigali, and the nearby border with Uganda. White aluminum poles cross the valley to the university, bringing electricity to the area for the first time. The government of Rwanda is extending electricity to the UGHE site. The progress Rwanda has made post-genocide is remarkable. However, there is still so much to do. Despite being in global health for nearly a decade, it is as if my work has just begun. I look forward to what the future holds.

My main advice to those who are still figuring out their careers is to start where your passions and interests lie. When your daily actions and decisions are motivated by those, you will pick a career you will enjoy. For those of you interested in global health, get your feet down on the ground and start by understanding the suffering that people living in poverty have, and build from there. You’ll learn how you can make an impact in the world.