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..
Select a section to read the details
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.
"Mabawa Cuore" Project
Diagnosis and treatment for hypertension and
...A SINGULAR STORY BECOMES AN EXTRAORDINARY ADVENTURE
On her return from Nyamyumba, Katrine Keller goes to her doctor, Dr Franco Muggli, for the usual check-up to ask how things are going in Africa. The answer interests the doctor, a specialist in hypertension, greatly: almost all deaths among the inhabitants of Nyamyumba occur in their sleep.
Intrigued, Dr Muggli sets off for Nyamyumba... and falls in love with the project: that of Mabawa in general and those concerning health in particular.
Thus was born an association with Mabawa and the beginning of an extraordinary adventure.
HYPERTENSION IN AFRICA
Hypertension is the main risk factor for cardiovascular diseases.
Due to the lack of clinical symptoms, hypertension remains undiagnosed and treated with delay.
The increase in the rate of hypertension in Africa has been attributed to a combination of factors including an aged population, as well as factors arising from rapid urbanisation (built environment, diet, sedentary lifestyles, exposure to tobacco, soft drinks and alcohol).
The consequences are most devastating among Africans and include even severe heart failure, chronic kidney and cerebrovascular diseases and sudden death.
THE FIRST STAGE
The need for a health intervention to diagnose and treat cardiovascular risk factors became apparent in 2017, after Dr Franco Muggli's stay.
It is decided to carry out a screening on a sample of about 800 people at the Nyamyumba dispensary and Munini hospital.
The result confirms the hypothesis that even in a rural and poor region, high blood pressure is present in a large percentage of users.
In 2018, a proposal for a 'Health Capital Project' will be formulated and presented to the authorities. This will include a targeted intervention in the two dispensaries and is intended to be a model for preventive medical counselling:
- functional and easily accessible clinical consultation, so that the population can be informed of risk factors
- possibility of transferring the model to other hospitals and health centres in the country
The project receives the "endorsement" of the World Hypertension League (WHL)
and the Swiss Society of Hypertension (SSH): recognition of the programme which
gives visibility for funding and increases the interest of the Rwandan authorities.
Primo incontro con il ministro, Febbraio 2018
In Nyamyumba and Munini in summer 2019, Dr Muggli worked with two Ticino nurses Barblina de Tann and Patrizia Venzin at first and with Professor Paolo Sutter shortly afterwards.
In October 2019, great satisfaction for Mabawa: the project obtains the approval of the Ethics Committee of the Rwandan Ministry of Public Health. Dr. F. Muggli, creator and implementer of the "Mabawa Heart" project, attends many meetings with the authorities, who are also convinced of the validity of the project and promise their support.
The Munini District Hospital, on which the Nyamyumba Medical Dispensary depends, becomes the project's reference centre.
In Nyamyumba, Dr Muggli organises and trains a network of 25 'health volunteers' who will collect data through 'door-to-door' screening in the villages in the Nyamyumba dispensary area (approx. 15,000 people).
Alice Umulisa, an experienced public health worker, becomes our on-site collaborator. Thanks to her valuable work with the health workers in the area of the Nyamyumba Medical Dispensary, blood pressure values of more than seven thousand inhabitants will be recorded from February to July 2020.
These will be used to proceed to the second phase, which will be carried out under the auspices of the World Hypertension League and the Swiss Hypertension Society, in close cooperation with the Faculty of Biomedical Sciences of the University of Lugano, the Faculties of Medicine of the University of Zurich and Milan.
In February 2020, the project was accepted and presented by Dr Muggli at the 19th European Congress of Internal Medicine (ECIM)
Pdf of the slides
by Dr. Muggli
"Mabawa Heart" Team
Dott. Franco Muggli
Founder and manager
Prof. G.F. Parati
President of the World Hypertension League
Prof. Mario Bianchetti
Dean of the Faculty of Biomedical Sciences - USI
Prof. Paolo Suter
Prof. University of Zurich
Nurse Alice Umulisa
Manager and co-worker
In Kigali Mabawa heart met with important health personalities in Rwanda, including:
Dr Charlotte Bavuma from Kigali University Hospital
the Executive Secretary for Human Resources for Health Patrick Ndimubanzi
the Directors and new Director of Munini Hospital
the Minister of Health Daniel Ngamije
the Presidential Adviser on Health Dr Santus Musafiri
the Director of the University Hospital in Kigali
They all welcomed us very warmly, with great interest in what Mabawa is doing in the sector, and our feedback is very positive.
At the beginning of 2022, after a 'forced' pause due to the Covid-19 pandemic (which concerned the practical part and not the planning part), the Cuore project was able to resume its activities at full speed.
During the summer of 2022, there were many visits: with the return of Barblina de Tann and Patrizia Venzin, Dr Franco Muggli and Professor Gianfranco Parati were in Rwanda for the start of the second phase of the project, together with the newly appointed Dr Isabella Hunjan and PhD student Clara Stroppa.
Dr Muggli and Prof. Parati also attended the 'RCP HTA Symposium' for hypertension and cardiovascular risks held in Kigali in July.
Now it is a question of deepening the clinical picture and taking on the most at-risk patients identified during the first phase of the project.