State Chancellery of the Canton of Ticino
Municipality of Bioggio
Vidar Suisse Foundation
Rotary Club Lugano
Foundation for the Heart, Lucerne
Swiss Society of Hypertension (SSH)
Heartfelt thanks to the supporters of our "health" projects:
Great Nyamyumba: Health
The medical dispensary that depends on the Munini Area Hospital and the Ministry of Health is managed by nurses and assistants.
It serves 14,925 people from the surrounding area.
Munini Hospital Director Dr. Innocent Ndenbeyaho, a valuable supporter and supervisor, visits us weekly.
The constructions of the recent studies (dentistry, epilepsy, hypertension) have been made by Mabawa, who provides medicines and small sanitary materials when necessary: autoclave, electron microscope, ultrasound, EEGigraph, various tensiometers, etc..
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After the stay of a dentist, a member of Mabawa, the need to build a dental office emerged: in fact, statistics showed that 54% of the pathologies that occurred at the dispensary were of dental origin and that there was no suitable structure for treatment in the area.
Construction began in January 2012 and was completed in April 2012. The facility alternates between European dentists and a dentist from the University of Medicine of Butare who is present on site one or two days a week, depending on the need.
The construction of the new dental office is finished but with the lockdown that even in Rwanda was very rigid (and useful) we still could not install the new chair.
Angela Casadei, Neurophysiopathology technician at the Civic Hospital of Lugano, worked with Mabawa from 2014 to 2017.
Thanks to the skills acquired following a first MABAWA project, at the Mibilizi hospital, where she was put in contact with the Rwandese reality, she accepted to concentrate her forces in this field familiar to her.
Thus, in 2015, the new "Epilepsy" project, which began with an EEGigraph and related software, came to life at the Nyamyumba dispensary (serving 14,925 people).
Telesphore Vuguzigame, already responsible for neurological care in the reference hospital in our District (Munini) was made available to the project and trained by Angela during several stays: today she is very competent. She regularly attends training seminars to improve her training and from the beginning of 2018 she will start a path to obtain the Master in Neuro-physiology.
Since 2014 Professor Sebera, neurologist at Ndera Hospital in Kigali is our "tutor" and follows the project with great interest and passion. He comes monthly 2 days in Nyamyumba to monitor the work in general and in particular the most complex cases.
In Rwanda it is estimated that 4.9% of the population suffers from epilepsy, which makes the project particularly necessary.
In July 2017, Telesphore reported a case history of 187 patients who came to the clinic, 163 of them epileptic ... and the numbers are constantly increasing.
A room for the diagnosis and treatment of epilepsy (photo below), an extension of the dental cabinet structure, was built and has been in use since May 2017, greatly facilitating the work previously done in the dentist's antechamber!
The project is constantly being developed and many improvements are being studied. Telesphore has applied for and obtained a scholarship to obtain a master's degree in neurological technology and regularly attends training seminars.
The Girokwizera cooperative, made up of 47 destitute epileptic patients from our medical dispensary, asked and obtained help from Mabawa in order to pay for access to the "mutuelle de santé", which is essential for access to treatment.
In addition to financial aid to members and their families, 29 goats were distributed to the poorest to encourage them.
For those who wonder why there are so many cases of epilepsy, we propose the reading of this article on neurocysticercosis. Recent statistics suggest that over 40% of cases in Rwanda are related to this problem and Mabawa keeps the community on guard against free breeding of pigs, which can carry the tapeworm and its eggs.
Newborn and gynaecology
In use since 2011 and then enlarged, today it takes care of all women and mothers. Since February 2018 there is in use an ultrasound scanner that allows pregnant women to do the check-ups on the spot and not having to spend an hour (on the outward and return) on a motorcycle on the dirt track to go to Munini Hospital, where until today there was the only ultrasound machine in the area.
Centre for diagnosis
Hypertension is the main risk factor for cardiovascular disease. Due to the common lack of clinical symptoms, hypertension often remains undiagnosed and treated with delay.
The increase in the percentage of hypertension in Africa has been attributed to a combination of factors including population ageing, as well as factors resulting from rapid urbanization (built environment, diet, sedentary lifestyles, exposure to tobacco, soft drinks and alcohol).
The consequences are more devastating among Africans and include: heart failure even severe, chronic kidney and cerebrovascular diseases and sudden death.
Primo incontro con il ministro, Febbraio 2018
The need for a health intervention to diagnose and treat cardiovascular risk factors is highlighted in 2017: a screening on a sample of about 800 people at Nyamyumba dispensary and Munini hospital confirms the hypothesis that even in a rural and very poor region, high blood pressure is present in more than 30% of users.
In 2018, a proposal for a "Health Capital Project" was formulated and presented to the authorities, which includes a targeted intervention in the two dispensaries and is intended to be a model of preventive medical counseling:
- it is essential that the clinical consultation is functional and easy to access, so that the
population can be informed of risk factors
- the model can later be transferred to other hospitals and health centers in the country
We are recognized and have the "endorsement" of the World Hypertension League (WHL) and the Swiss Society of Hypertension (SSH): a recognition of the program that gives visibility to the project for funding and increases the interest of the Rwandan authorities.
In Nyamyumba and Munini in summer 2019 a lot of work was done with the two Ticinese nurses Barblina de Tann and Patrizia Venzin at first and with Professor Paolo Sutter later.
In October 2019, great satisfaction for Mabawa: the project received approval from the
Ethics Committee of the Rwandan Ministry of Public Health.
Dr. F. Muggli, creator and implementer of our hypertension project, immediately ran to Rwanda: many contacts with the authorities, all convinced of the validity of the project and we can count on their support. Dr. Bienvenu Muvunyi, director of the Munini hospital, destined to become the reference center for the hypertension project, is our most valid pillar.
In Nyamyumba, our doctor Muggli has set up a network of "health volunteers" who have been trained and
who have been trained. We will have available, through a "door to door" screening of the communities that refer to the dispensary of Nyamyumba (about 15'000 people) an important collection of fundamental data.
In January 2020 the construction of the new hypertension clinic is progressing, exploiting the size of the useless space of the former dental office, which is being moved to a smaller but sufficient room.
Approved by the Rwandan National Ethics Committee and the Ministry of Public Health, the hypertension project has entered the implementation phase: 25 "auxiliaires de santé" are in the villages affiliated to the Nyamyumba dispensary (about 1,500 people)..
Subsequently, depending on the results, subjects suffering from hypertension will be taken over by the local nursing staff, under the supervision of the project managers.
The aim of the project is to train local medical staff to effectively take care of hypertensive patients, avoiding the development of serious complications.
Training and first screening in the villages:
We have 7,500 screening data, which are currently being processed: a unique initiative in which the Rwandan Ministry of Health is also interested. Health in Rwanda.
Our project on hypertension sent as an oral communication to the 19th European Congress of Internal Medicine (ECIM)
which will be held virtually from March 18 to 20, 2021 has been accepted and will be presented by Dr. Franco Muggli.
Alice Umulisa, an experienced public health professional has become our collaborator on site. Thanks to the valuable work she has done together with the health animators in the area of the Medical Dispensary of Nyamyumba, from February to July 2020, it was possible to measure the blood pressure values of more than to more than seven thousand inhabitants.
The data will now be used to proceed to the second phase that takes place under the auspices of the Hypertension League and the Swiss Society of Hypertension, in close collaboration with the Faculty of Biomedical Sciences of the University of Basel.
the Faculty of Biomedical Sciences of the University of Italian Switzerland, the Faculties of Medicine of the University of Zurich, and the Swiss Society of Hypertension.
of the University of Zurich and of Milan.
Door-to-door screening is still ongoing in each
agglomeration under the supervision of a trained public health worker, Alice Umulisa.
graduate in public health, Alice Umulisa.
Based on the results of an initial sample of 1,000 subjects screened, it was found that about
16% of the population is affected by high blood pressure and needs appropriate treatment.
Just today (June 4) we are in possession of other 3'500 screenings and waiting for others that will be recorded in turn: this makes the work a first of its kind statistics in which the Ministry of Health is also interested, despite at this time is engaged in the Covid-19 emergency that is managing with excellent results.
The 19th European Congress of Internal Medicine (ECIM) was held in virtual form and our project was presented.
Those who are interested can find below all the data regarding this research.
We can be reached by email at firstname.lastname@example.org or by phone at the number
+41 79 240 15 07 for further information.
Pdf of slides
Screening Summary and Analysis