Africa Humanitarian Action (AHA) is a non-governmental organization that provides relief services to countries in Africa . It was founded by Dr. David Zawde in 1994 in response to the Rwandan genocide .
190-620: In 1994, the Rwandan genocide occurred. Hundreds of thousands of people were killed in Rwanda , Africa. At this time, Dr. Dawit Zawde, a medical doctor in Ethiopia , noticed the lack of an African response and organized a medical team to respond out of Kigali . Formally launched in Addis Ababa , within months of its opening, AHA sent two teams of young health and relief professionals during
380-513: A League of Nations mandate called Ruanda-Urundi and started a period of more direct colonial rule. The Belgians simplified and centralised the power structure, introduced large-scale projects in education, health, public works, and agricultural supervision, including new crops and improved agricultural techniques to try to reduce the incidence of famine. Both the Germans and the Belgians, in
570-772: A civil war in 1990. Habyarimana was assassinated in April 1994. Social tensions erupted in the Rwandan genocide that spanned one hundred days. The RPF ended the genocide with a military victory in July 1994. Rwanda has been governed by the RPF as a de facto one-party state since 1994 with former commander Paul Kagame as President since 2000. The country has been governed by a series of centralized authoritarian governments since precolonial times. Although Rwanda has low levels of corruption compared with neighbouring countries, it ranks among
760-462: A proportional representation system. Rwanda's legal system is largely based on German and Belgian civil law systems and customary law . The judiciary is independent of the executive branch, although the president and the Senate are involved in the appointment of Supreme Court judges. Human Rights Watch has praised the Rwandan government for progress made in the delivery of justice including
950-474: A 1999 clash between the two countries' armies as they backed opposing rebel groups in the Second Congo War, but improved significantly in the early 2010s. In 2019, relations between the two countries deteriorated, with Rwanda closing its borders with Uganda. Before western colonization, the Rwandan government system had a quasi-system of political pluralism and power sharing. Despite there being
1140-582: A 2019 Forest Landscape Integrity Index mean score of 3.85/10, ranking it 139th globally out of 172 countries. Rwanda's economy suffered heavily during the 1994 genocide, with widespread loss of life, failure to maintain infrastructure, looting, and neglect of important cash crops. This caused a large drop in GDP and destroyed the country's ability to attract private and external investment. The economy has since strengthened, with per-capita nominal GDP estimated at $ 909.9 in 2022, compared with $ 127 in 1994. As of
1330-649: A basic framework for defining the sector, the United Nations' International Standard Industrial Classification categorizes health care as generally consisting of hospital activities, medical and dental practice activities, and "other human health activities." The last class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, patient advocates or other allied health professions . In addition, according to industry and market classifications, such as
1520-642: A catastrophic situation in the crisis area. AHA carried out community education programmes in partnership with UNHCR, UNICEF , WFP, the British Embassy , and Save the Children UK. The programmes included HIV/AIDS awareness, microcredit education, preschool activities, and assistance with displaced women. AHA worked in the Viana (refugee camp) with IDPs from the provinces of Malange , Moxico and Kwanza. Micro credit projects with aims at improving
1710-556: A ceasefire and then a peace agreement were finally negotiated between the warring factions. The assembly of UNITA soldiers and families presented emergency problems, as there was severe malnourishment between both adult and child population, however, due to the intervention of the Government, UN and NGOs, the situation was abated. In Ethiopia, AHA started the second phase of its integrated family planning, reproductive health, and HIV/AIDS prevention programme, expanding its coverage in
1900-569: A challenge for the design of ICT (information and communication technology) for home care. Because statistics show that over 80 million Americans have taken time off of their primary employment to care for a loved one, many countries have begun offering programs such as the Consumer Directed Personal Assistant Program to allow family members to take care of their loved ones without giving up their entire income. With obesity in children rapidly becoming
2090-612: A clear correlation between worse quality and higher spending. Expand the OECD charts below to see the breakdown: The management and administration of health care is vital to the delivery of health care services. In particular, the practice of health professionals and the operation of health care institutions is typically regulated by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance . Most countries have credentialing staff in regulatory boards or health departments who document
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#17327934765102280-483: A coalition with the domestic opposition and eventually to sign the 1993 Arusha Accords with the RPF. The cease-fire ended on 6 April 1994 when Habyarimana's plane was shot down near Kigali Airport, killing him. The shooting down of the plane served as the catalyst for the Rwandan genocide , which began within a few hours. Over the course of approximately 100 days, between 500,000 and 1,000,000 Tutsi and politically moderate Hutu were killed in well-planned attacks on
2470-585: A consultant to work on gender equality and SGBV in the Osire camp in Namibia, bringing about awareness and ultimately sexual behavior, while in Burundi AHA initiated a series of training and information/education session where audio-visual aids were used to send clear messages about the importance of prevention. Throughout 2008 training programmes were held with the aim of developing existing skills and impart
2660-503: A fast warming country, with an increase in average temperature of between 0.7 °C to 0.9 °C over fifty years. In prehistoric times, montane forest occupied one-third of the territory of present-day Rwanda. Naturally occurring vegetation is now mostly restricted to the three national parks , with terraced agriculture dominating the rest of the country. Nyungwe , the largest remaining tract of forest, contains 200 species of tree as well as orchids and begonias . Vegetation in
2850-420: A few large towns; dwellings are evenly spread throughout the country. The only sparsely populated area of the country is the savanna land in the former province of Umutara and Akagera National Park in the east. Kigali is the largest city, with a population of around one million. Its rapidly increasing population challenges its infrastructural development. According to the 2012 census, the second largest city
3040-609: A gain of 10 years since 1970. The US (78.7 years) ranges only on place 26 among the 34 OECD member countries, but has the highest costs by far. All OECD countries have achieved universal (or almost universal) health coverage, except the US and Mexico . (see also international comparisons .) In the United States , where around 18% of GDP is spent on health care, the Commonwealth Fund analysis of spend and quality shows
3230-441: A licensed independent practitioner such as a physiotherapist , or a non-physician primary care provider such as a physician assistant or nurse practitioner . Depending on the locality and health system organization, the patient may see another health care professional first, such as a pharmacist or nurse . Depending on the nature of the health condition, patients may be referred for secondary or tertiary care. Primary care
3420-419: A major concern, health services often set up programs in schools aimed at educating children about nutritional eating habits, making physical education a requirement and teaching young adolescents to have a positive self-image. Health care ratings are ratings or evaluations of health care used to evaluate the process of care and health care structures and/or outcomes of health care services. This information
3610-419: A military coup . Pro-Hutu discrimination continued, but there was greater economic prosperity and a reduced amount of violence against Tutsi. The Twa remained marginalised, and by 1990 were almost entirely forced out of the forests by the government; many became beggars. Rwanda's population had increased from 1.6 million people in 1934 to 7.1 million in 1989, leading to competition for land. In 1990,
3800-513: A monthly basis in places like Wolayita and Gamo Goffa zones, while schools and community based anti-AIDS clubs were supported at various capacities in the zones. With an objective of improving healthcare at household and community levels, AHA also focused on over 3 million beneficiaries with a need for improved healthcare for newborns and mothers in 28 districts of Gamo Goffa, Hadiya , Kembata Tembaro and Wolayita zones of Southern Ethiopia. Consecutively, in their relief and recovery efforts, AHA
3990-398: A multi-party system of government, with politics based on democracy and elections. However, the constitution places conditions on how political parties may operate. Article 54 states that "political organizations are prohibited from basing themselves on race, ethnic group, tribe, clan, region, sex, religion or any other division which may give rise to discrimination". The president of Rwanda
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#17327934765104180-485: A population of 10,515,973. The population is young: in the 2012 census, 43.3% of the population were aged 15 and under, and 53.4% were between 16 and 64. According to the CIA World Factbook , the annual birth rate is estimated at 40.2 births per 1,000 inhabitants in 2015, and the death rate at 14.9. The life expectancy is 67.67 years (69.27 years for females and 67.11 years for males), which
4370-707: A presentation at the International Symposium on Refugees in Africa, organized by the Japanese Government in Tokyo in June 2003. AHA had earned widespread recognition as an experienced and well-functioning organization, which permitted it to go into Darfur , Sudan, swiftly in response once mote to violence, displacement and desperate need. AHA, in 2004, brought together its partners from around
4560-400: A primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care , health education , and every time they require an initial consultation about a new health problem. The International Classification of Primary Care (ICPC)
4750-987: A second at Kabarondo in Kibungo Prefecture in the southeast. They provided unprecedented 24-hour emergency health services and regular out and in-patient care. As the operation in Rwanda grew, AHA decided to extend their presence to other countries in Africa. By the end of 1995, AHA had moved to Uganda , Angola and began operations in Ethiopia. By the end of 1999, the framework that was implemented in Eastern and Central Africa by AHA had now been transferred to offices in Western Africa. it currently operate in 20 African countries AHA in 1995, published their objectives, in order to establish their focus with humanitarian efforts, which are listed below: After this
4940-633: A short period of time for a brief but serious illness, injury, or other health condition. This care is often found in a hospital emergency department . Secondary care also includes skilled attendance during childbirth , intensive care , and medical imaging services. The term "secondary care" is sometimes used synonymously with "hospital care". However, many secondary care providers, such as psychiatrists , clinical psychologists , occupational therapists , most dental specialties or physiotherapists , do not necessarily work in hospitals. Some primary care services are delivered within hospitals. Depending on
5130-989: A significant part of a country's economy , development, and industrialization . Health care is an important determinant in promoting the general physical and mental health and well-being of people around the world. An example of this was the worldwide eradication of smallpox in 1980, declared by the WHO, as the first disease in human history to be eliminated by deliberate healthcare interventions. The delivery of modern health care depends on groups of trained professionals and paraprofessionals coming together as interdisciplinary teams . This includes professionals in medicine , psychology , physiotherapy , nursing , dentistry , midwifery and allied health , along with many others such as public health practitioners , community health workers and assistive personnel , who systematically provide personal and population-based preventive, curative and rehabilitative care services. While
5320-439: A strict hierarchy, the pre-colonial system achieved an established, combined system of "centralized power and decentralized autonomous units." Under the monarch, the elected Chief governed a province that was divided into multiple districts. Two other officials appointed by head Chief governed the districts; one official was allocated power over the land while the other oversaw cattle. The king ( mwami ) exercised control through
5510-542: A sustainable means of living. Training was provided to refugees in Burundi on income generation concept and management as well as other practical teachings of six months in sewing and carpentry . Close to 140 income generating associations were gearing to launch their activities some of whom have already benefited from their initiatives to develop selected activities for which they received money. Meanwhile, AHA's Zambia Assistance for Urban Refugees programme worked to build
5700-565: A system of commercial courts created in 2011 to expedite commercial litigations. Between 2004 and 2012, a system of Gacaca courts was in operation. Gacaca , a Rwandan traditional court operated by villages and communities, was revived to expedite the trials of genocide suspects. The court succeeded in clearing the backlog of genocide cases, but was criticised by human rights groups as not meeting legal fair standard. Rwanda has low corruption levels relative to most other African countries; in 2014, Transparency International ranked Rwanda as
5890-585: A system of provinces, districts, hills, and neighbourhoods. As of 2003, the constitution divided Rwanda into provinces ( intara ), districts ( uturere ), cities, municipalities, towns, sectors ( imirenge ), cells ( utugari ), and villages ( imidugudu ); the larger divisions, and their borders, are established by Parliament. In January 2006, Rwanda was reorganized such that twelve provinces were merged to create five, and 106 districts were merged into thirty. The present borders drawn in 2006 aimed at decentralising power and removing associations with
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6080-547: A third of the country's farmland, potatoes , beans , sweet potatoes , cassava , wheat and maize . Coffee and tea are the major cash crops for export, with the high altitudes, steep slopes and volcanic soils providing favourable conditions. Reports have established that more than 400,000 Rwandans make their living from coffee plantation. Reliance on agricultural exports makes Rwanda vulnerable to shifts in their prices. Animals raised in Rwanda include cows, goats, sheep, pigs, chicken, and rabbits, with geographical variation in
6270-602: A time where Angola was slowly recovering from almost three decades of armed conflict that displaced more than four million people, AHA's programmes in Angola actively worked on providing healthcare. During 2006, AHA attended to more than 50,000 people at its health post/centers and delivered health education to more than 10,000 people, during which time AHA recorded a minimal mortality rate , well within WHO accepted standards, thus providing timely and effective protection and assistance to
6460-438: A two-project cost, estimated at over US$ 1.5 million in total. In the year 2000, AHA was actively working in six countries with emergency relief , refugee, and health programmes. The biggest problem AHA faced was the lack of funding for the institutional structures that would make all of its goals a reality. In order to maintain its activities, AHA needed US$ 350,000. An estimated three million people were displaced in Angola at
6650-486: Is Gisenyi , which lies adjacent to Lake Kivu and the Congolese city of Goma , and has a population of 126,000. Other major towns include Ruhengeri , Butare , and Muhanga , all with populations below 100,000. The urban population rose from 6% of the population in 1990, to 16.6% in 2006; by 2011, however, the proportion had dropped slightly, to 14.8%. Rwanda has been a unified state since pre-colonial times, and
6840-457: Is a provincial-level authority, which coordinates urban planning within the city. At 26,338 square kilometres (10,169 sq mi), Rwanda is the world's 149th-largest country, and the fourth smallest on the African mainland after Gambia , Eswatini , and Djibouti . It is comparable in size to Burundi , Haiti and Albania . The entire country is at a high altitude: the lowest point
7030-494: Is a standardized tool for understanding and analyzing information on interventions in primary care based on the reason for the patient's visit. Common chronic illnesses usually treated in primary care may include, for example, hypertension , diabetes , asthma , COPD , depression and anxiety , back pain , arthritis or thyroid dysfunction . Primary care also includes many basic maternal and child health care services, such as family planning services and vaccinations . In
7220-417: Is considered necessary, regardless of whether the funding is from private insurance schemes or national health insurance . Allied health professionals , such as physical therapists , respiratory therapists , occupational therapists , speech therapists , and dietitians , also generally work in secondary care, accessed through either patient self-referral or through physician referral. Tertiary care
7410-535: Is empowered by the constitution to oversee the activities of the president and the Cabinet. The lower chamber is the Chamber of Deputies , which has 80 members serving five-year terms. Twenty-four of these seats are reserved for women, elected through a joint assembly of local government officials; another three seats are reserved for youth and disabled members; the remaining 53 are elected by universal suffrage under
7600-527: Is home to an estimated one-third of the worldwide mountain gorilla population. Nyungwe Forest boasts thirteen primate species including common chimpanzees and Ruwenzori colobus arboreal monkeys; the Ruwenzori colobus move in groups of up to 400 individuals, the largest troop size of any primate in Africa. Rwanda's population of lions was destroyed in the aftermath of the genocide of 1994, as national parks were turned into camps for displaced people and
7790-428: Is low but rising rapidly; in 2015 there were 12.8 internet users per 100 people, up from 2.1 in 2007. In 2011, a 2,300-kilometre (1,400 mi) fibre-optic telecommunications network was completed, intended to provide broadband services and facilitate electronic commerce. This network is connected to SEACOM , a submarine fibre-optic cable connecting communication carriers in southern and eastern Africa. Within Rwanda
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7980-626: Is no discernible physical difference and the categories were not historically rigid. In precolonial Rwanda the Tutsi were the ruling class, from whom the kings and the majority of chiefs were derived, while the Hutu were agriculturalists. The current government discourages the Hutu/Tutsi/Twa distinction, and has removed such classification from identity cards. The 2002 census was the first since 1933 which did not categorise Rwandan population into
8170-433: Is nominally democratic, elections are manipulated in various ways, which include banning opposition parties, arresting or assassinating critics, and electoral fraud . The RPF is a Tutsi-dominated party but receives support from other communities as well. The constitution was adopted following a national referendum in 2003, replacing the transitional constitution which had been in place since 1994. The constitution mandates
8360-499: Is now Rwanda dates from, at the latest, the last glacial period , either in the Neolithic period around 8000 BC, or in the long humid period which followed, up to around 3000 BC. Archaeological excavations have revealed evidence of sparse settlement by hunter-gatherers in the late Stone Age , followed by a larger population of early Iron Age settlers, who produced dimpled pottery and iron tools. These early inhabitants were
8550-574: Is often used as the term for the health care services that play a role in the local community. It can be provided in different settings, such as Urgent care centers that provide same-day appointments or services on a walk-in basis. Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health , and patients with all types of acute and chronic physical, mental and social health issues, including multiple chronic diseases . Consequently,
8740-400: Is one of the cleanest cities in Africa. Government policy measures to improve sanitation are limited, focusing only on urban areas. The majority of the population, both urban and rural, use public shared pit latrines . Rwanda's electricity supply was, until the early 2000s, generated almost entirely from hydroelectric sources; power stations on Lakes Burera and Ruhondo provided 90% of
8930-449: Is one of the fastest-growing economic resources and became the country's leading foreign exchange earner in 2007. In spite of the genocide's legacy, the country is increasingly perceived internationally as a safe destination. The number of tourist arrivals in 2013 was 864,000 people, up from 504,000 in 2010. Revenue from tourism was US$ 303 million in 2014, up from just US$ 62 million in 2000. The largest contributor to this revenue
9120-458: Is one of the twenty deepest lakes in the world . Other sizeable lakes include Burera , Ruhondo , Muhazi , Rweru , and Ihema , the last being the largest of a string of lakes in the eastern plains of Akagera National Park . Mountains dominate central and western Rwanda and the country is sometimes called " Pays des mille collines " in French ("Land of a thousand hills"). They are part of
9310-505: Is seen from the analysis carried out each year by Bloomberg. Clearly this kind of analysis is flawed in that life expectancy is only one measure of a health system's performance, but equally, the notion that more funding is better is not supported. In 2011, the health care industry consumed an average of 9.3 percent of the GDP or US$ 3,322 ( PPP-adjusted ) per capita across the 34 members of OECD countries. The US (17.7%, or US$ PPP 8,508),
9500-622: Is sometimes used as an extension of tertiary care in reference to advanced levels of medicine which are highly specialized and not widely accessed. Experimental medicine and some types of uncommon diagnostic or surgical procedures are considered quaternary care. These services are usually only offered in a limited number of regional or national health care centers. Many types of health care interventions are delivered outside of health facilities. They include many interventions of public health interest, such as food safety surveillance, distribution of condoms and needle-exchange programs for
9690-545: Is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital . Examples of tertiary care services are cancer management, neurosurgery , cardiac surgery , plastic surgery , treatment for severe burns , advanced neonatology services, palliative, and other complex medical and surgical interventions. The term quaternary care
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#17327934765109880-671: Is the Rusizi River at 950 metres (3,117 ft) above sea level. Rwanda is located in Central/Eastern Africa, and is bordered by the Democratic Republic of the Congo to the west, Uganda to the north, Tanzania to the east, and Burundi to the south. It lies a few degrees south of the equator and is landlocked . The capital, Kigali, is located near the centre of Rwanda. The watershed between
10070-504: Is the head of state , and has broad powers including creating policy in conjunction with the Cabinet of Rwanda , commanding the armed forces , negotiating and ratifying treaties, signing presidential orders, and declaring war or a state of emergency. The president is elected every seven years , and appoints the prime minister and all other members of the Cabinet. The Parliament consists of two chambers . It makes legislation and
10260-417: Is the 26th lowest out of 224 countries and territories. The overall sex ratio of the country is 95.9 males per 100 females. At 445 inhabitants per square kilometre (1,150/sq mi), Rwanda's population density is amongst the highest in Africa. Historians such as Gérard Prunier believe that the 1994 genocide can be partly attributed to the population density. The population is predominantly rural, with
10450-430: Is the largest religion in the country; the principal and national language is Kinyarwanda , spoken by native Rwandans, with English, French and Swahili serving as additional official foreign languages. Rwanda's economy is based mostly on subsistence agriculture . Coffee and tea are the major cash crops that it exports. Tourism is a fast-growing sector and is now the country's leading foreign exchange earner. As of
10640-536: Is the road to the port of Mombasa via Kampala and Nairobi , which is known as the Northern Corridor . The principal form of public transport in the country is the minibus , accounting for more than half of all passenger carrying capacity. Some minibuses, particularly in Kigali, operate an unscheduled service, under a shared taxi system, while others run to a schedule, offering express routes between
10830-414: Is translated into report cards that are generated by quality organizations, nonprofit, consumer groups and media. This evaluation of quality is based on measures of: Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions as well as health policies . Providing health care services means "the timely use of personal health services to achieve
11020-617: Is used in the manufacture of electronic and communication devices such as mobile phones. Rwanda's service sector suffered during the late-2000s recession as bank lending, foreign aid projects and investment were reduced. The sector rebounded in 2010, becoming the country's largest sector by economic output and contributing 43.6% of the country's GDP. Key tertiary contributors include banking and finance, wholesale and retail trade, hotels and restaurants, transport, storage, communication, insurance, real estate, business services and public administration including education and health. Tourism
11210-557: The Democratic Republic of the Congo were tense following Rwanda's involvement in the First and Second Congo Wars ; the Congolese army alleged Rwandan attacks on their troops, while Rwanda blamed the Congolese government for failing to suppress Hutu rebels in North and South Kivu provinces. In 2010, the United Nations released a report accusing the Rwandan army of committing wide scale human rights violations and crimes against humanity in
11400-599: The East African Community in 2007, and has ratified a plan for monetary union amongst the seven member nations, which could eventually lead to a common East African shilling . Rwanda is a country of few natural resources, and the economy is based mostly on subsistence agriculture by local farmers using simple tools. An estimated 90% of the working population farms, and agriculture constituted an estimated 32.5% of GDP in 2014. Farming techniques are basic, with small plots of land and steep slopes. Since
11590-682: The Global Industry Classification Standard and the Industry Classification Benchmark , health care includes many categories of medical equipment, instruments and services including biotechnology , diagnostic laboratories and substances, drug manufacturing and delivery. For example, pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States. The United States dominates
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#173279347651011780-517: The Kingdom of Rwanda . By 1700, around eight kingdoms had existed in the present-day Rwanda. One of these, the Kingdom of Rwanda ruled by the Tutsi Nyiginya clan, became increasingly dominant from the mid-eighteenth century. The kingdom reached its greatest extent during the nineteenth century under the reign of King Kigeli Rwabugiri . Rwabugiri conquered several smaller states, expanded
11970-649: The Namibia Red Cross Society was responsible for the preventive health care in Namibia, as an implementing partner of the UNHCR. In May 2001, the management of curative health care services was transferred to AHA. Prior to assuming responsibilities, AHA analyzed the situation in the Osire camp and made a member of proposals for improvements, later accepted by the Namibia Government and UNHCR. AHA provided treatment to over 23,000 refugees in
12160-556: The Netherlands (11.9%, 5,099), France (11.6%, 4,118), Germany (11.3%, 4,495), Canada (11.2%, 5669), and Switzerland (11%, 5,634) were the top spenders, however life expectancy in total population at birth was highest in Switzerland (82.8 years), Japan and Italy (82.7), Spain and Iceland (82.4), France (82.2) and Australia (82.0), while OECD's average exceeds 80 years for the first time ever in 2011: 80.1 years,
12350-721: The Republic of Rwanda , is a landlocked country in the Great Rift Valley of East Africa , where the African Great Lakes region and Southeast Africa converge. Located a few degrees south of the Equator , Rwanda is bordered by Uganda , Tanzania , Burundi , and the Democratic Republic of the Congo . It is highly elevated, giving it the sobriquet "land of a thousand hills" ( French : pays des mille collines ), with its geography dominated by mountains in
12540-704: The Rwandan Patriotic Front (RPF), a rebel group composed of Tutsi refugees, invaded northern Rwanda from their base in Uganda, initiating the Rwandan Civil War . The group condemned the Hutu-dominated government for failing to democratize and confront the problems facing these refugees. Neither side was able to gain a decisive advantage in the war, but by 1992 it had weakened Habyarimana's authority; mass demonstrations forced him into
12730-627: The Rwenzori turaco and handsome spurfowl . Eastern Rwanda, by contrast, features savanna birds such as the black-headed gonolek and those associated with swamps and lakes, including storks and cranes . Recent entomological work in the country has revealed a rich diversity of praying mantises , including a new species Dystacta tigrifrutex , dubbed the "bush tiger mantis". Rwanda contains three terrestrial ecoregions: Albertine Rift montane forests , Victoria Basin forest-savanna mosaic , and Ruwenzori-Virunga montane moorlands . The country had
12920-578: The UN High Commissioner for Refugees (UNHCR) invited AHA to play a bigger role in the health sector. AHA was then given management responsibility for the health district of Rwinkwavu in Kibungo Prefecture in the east and Mugonero health district. In 1997, AHA expanded the process of community-based development in Rwanda, which helped AHA improve the health of about 60,000 people. AHA also made it an important project to improve
13110-643: The Volcanoes National Park is mostly bamboo and moorland, with small areas of forest. By contrast, Akagera has a savanna ecosystem in which acacia dominates the flora. There are several rare or endangered plant species in Akagera, including Markhamia lutea and Eulophia guineensis . The greatest diversity of large mammals is found in the three national parks, which are designated conservation areas. Akagera contains typical savanna animals such as giraffes and elephants, while Volcanoes
13300-481: The biopharmaceutical field, accounting for three-quarters of the world's biotechnology revenues. The quantity and quality of many health care interventions are improved through the results of science, such as advanced through the medical model of health which focuses on the eradication of illness through diagnosis and effective treatment. Many important advances have been made through health research, biomedical research and pharmaceutical research , which form
13490-536: The social model of health and disability , which emphasizes the societal changes that can be made to make populations healthier. Results from health services research often form the basis of evidence-based policy in health care systems. Health services research is also aided by initiatives in the field of artificial intelligence for the development of systems of health assessment that are clinically useful, timely, sensitive to change, culturally sensitive , low-burden, low-cost, built into standard procedures, and involve
13680-821: The Albertine Rift Mountains that flank the Albertine branch of the East African Rift , which runs from north to south along Rwanda's western border. The highest peaks are found in the Virunga volcano chain in the northwest; this includes Mount Karisimbi , Rwanda's highest point, at 4,507 metres (14,787 ft). This western section of the country lies within the Albertine Rift montane forests ecoregion. It has an elevation of 1,500 to 2,500 metres (4,921 to 8,202 ft). The centre of
13870-481: The Angolan returnees and local communities. In addition to efforts on health, one of the many programmes implemented by AHA in the same year was on building the strengths and capacities with individuals, communities, and local organization. In 2006, around 1,000 people were trained as Community Based Reproductive Health Agents and 100 people living with HIV/AIDS were educated in income generating programs in developing
14060-527: The Democratic Republic of the Congo during the First and Second Congo Wars , charges denied by the Rwandan government. Relations soured further in 2012, as Kinshasa accused Rwanda of supporting the M23 rebellion , an insurgency in the eastern Congo. As of 2015 , peace has been restored and relations are improving. Rwanda's relationship with Uganda was also tense for much of the 2000s following
14250-530: The Environment, and Development Society of Ethiopia, and other national and international NGOs already established in both areas. The project in Liberia started as a trial project with the government as the project focused on both Liberia and Sierra Leone. By the end of 1999, AHA planned to extend its services to West Africa after the then-OAU approved funds amounting to US$ 100,000 as a first installment of
14440-511: The Italian government, and our local partners at the ministry of health, and in the field. In 2003, AHA continued its advocacy and response services (health and community, water and sanitation, HIV/AIDS and primary education ) to 43,500 refugees, IDPs and returnees in Angola, 125,000 in Burundi, 635,000 in Ethiopia, 17,500 in Namibia, 16,000 in Rwanda, 430,000 in Uganda and 65,000 in Zambia. AHA
14630-709: The Ministry of Health in Liberia by launching numerous promotional activities that has helped sensitize communities and engaged them in various forms of similar activities. AHA's efforts in the relief and recovery of refugees in the DRC are concentrated in two provinces: the Katanga and Equateur Provinces. 2009 was a year of much progress in capacity development in these two provinces. In Katanga, AHA's repatriation based projects provided medical attention and assistance to returnees from Zambia and Tanzania . AHA has also facilitated
14820-466: The Nyangweso refugee camp. AHA operates through a community-based referral system and early identification of cases by community health workers, trained traditional birth attendants, and outreach primary health staff and health related education. In 2002, AHA hosted its Second Assembly of International Trustees. New trustees were introduced and Dr. Salim Ahmed Salim , a prominent African personality,
15010-748: The Osire refugee camp, as Angolan refugees accounted for over 95% of the base population. Since 1995, AHA, on behalf of the Government of Uganda and the UNHCR, has implemented health services to both the refugee community and the national population in the Adjumani district of Uganda. AHA participated in the development of the health services as operations has gradually grown to a network of 23 permanent health units, which are equipped with VHF radios . In 2001, AHA has assisted more than 57,700 refugees and 40,000 nationals, with 1,753 births were registered and 291 deaths. In Zambia, AHA assumed responsibility for
15200-562: The RPF-led army was a key belligerent in the First and Second Congo Wars . Within Rwanda, a period of reconciliation and justice began, with the establishment of the International Criminal Tribunal for Rwanda (ICTR) and the reintroduction of Gacaca , a traditional village court system. Since 2000 Rwanda's economy, tourist numbers, and Human Development Index have grown rapidly; between 2006 and 2011
15390-491: The Rwandan crisis.These professionals hailed from seven African countries— Benin , Cameroon , Ethiopia , Guinea , Malawi , Rwanda, and Senegal , becoming the first African-only Non-government organization (NGO) operating in Rwanda. The AHA teams targeted returnee populations and the internally displaced as they were deployed at two health centers, one in the northwest region at Tare in the Kigali Prefecture and
15580-412: The Rwandan king and perpetuated a pro-Tutsi policy. The Hutu population revolted in 1959. They massacred numerous Tutsi and ultimately established an independent, Hutu-dominated republic in 1962 led by President Grégoire Kayibanda . A 1973 military coup overthrew Kayibanda and brought Juvénal Habyarimana to power, who retained the pro-Hutu policy. The Tutsi-led Rwandan Patriotic Front (RPF) launched
15770-456: The UNHCR, in 2005, 60,288 Burundian refugees were still living in DR Congo and 2,000 in Rwanda. The total number of beneficiaries in 2005 IDPS and refugees respectively was 118,000 and 486,000. The war with Ethiopia and Eritrea resulted in hundreds of thousands of displaced people. Ethnic clashes had left nearly 100,000 Ethiopians internally displaced. The total number of refugees and IDPs
15960-684: The Ugandan capital, Kampala , due to the deteriorating conditions on the ground. AHA also began to manage two health posts previously under the management of Medecins Sans Frontiers – Swiss at Kolididi and Mirieyi. Insurgents also attacked and abducted about 20 refugees and local people including AHA's medical assistant during 1997. By 1999, due to a calming of the chaos, health services were extended to 71,000 refugees and 36,000 nationals living in Adjumani District through 22 health units under AHA management. Angola, entered by AHA in 1995,
16150-507: The United States, European Union , Japan, and others. The transport system consists primarily of the road network, with paved roads between Kigali and most other major cities and towns in the country. Rwanda is linked by road to other countries in the East African Community, namely Uganda, Tanzania, Burundi and Kenya , as well as to the eastern Congolese cities of Goma and Bukavu ; the country's most important trade route
16340-416: The United States, the 2013 National Health Interview Survey found that skin disorders (42.7%), osteoarthritis and joint disorders (33.6%), back problems (23.9%), disorders of lipid metabolism (22.4%), and upper respiratory tract disease (22.1%, excluding asthma) were the most common reasons for accessing a physician. In the United States, primary care physicians have begun to deliver primary care outside of
16530-589: The abolition of the death penalty, but also alleges interference in the judicial system by members of the government, such as the politically motivated appointment of judges, misuse of prosecutorial power, and pressure on judges to make particular decisions. The constitution provides for two types of courts: ordinary and specialised. Ordinary courts are the Supreme Court , the High Court , and regional courts, while specialised courts are military courts and
16720-542: The ancestors of the Twa , aboriginal pygmy hunter-gatherers who remain in Rwanda today. Then by 3,000BC, Central Sudanic and Kuliak farmers and herders began settling into Rwanda, followed by South Cushitic speaking herders in 2,000BC. The forest-dwelling Twa lost much of their habitat and moved to the mountain slopes. Between 800 BC and 1500 AD, a number of Bantu groups migrated into Rwanda, clearing forest land for agriculture. Historians have several theories regarding
16910-662: The basis for evidence-based medicine and evidence-based practice in health care delivery. Health care research frequently engages directly with patients, and as such issues for whom to engage and how to engage with them become important to consider when seeking to actively include them in studies. While single best practice does not exist, the results of a systematic review on patient engagement suggest that research methods for patient selection need to account for both patient availability and willingness to engage. Health services research can lead to greater efficiency and equitable delivery of health care interventions, as advanced through
17100-501: The best possible health outcomes". Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the ability to take paid time off work to use such services), sociocultural expectations, and personal limitations (lack of ability to communicate with health care providers, poor health literacy , low income). Limitations to health care services affect negatively
17290-502: The best possible health outcomes". Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the ability to take paid time off work to use such services), sociocultural expectations, and personal limitations (lack of ability to communicate with health care providers, poor health literacy , low income). Limitations to health care services affects negatively
17480-561: The building of community centers. AHA became the implementing agency for the water, sanitation, health, and community mobilization components of a UNHCR project. In partnership with OXFAM , it undertook the installation of six water points. In 2000, AHA continued a two-year programme funded by Pathfinder International to develop family planning, reproductive health services, and STI / HIV / AIDS prevention in two Ethiopian districts. AHA took interest in Shashemene because it has one of
17670-520: The busiest routes being those to Nairobi and Entebbe ; there is one domestic route, between Kigali and Kamembe Airport near Cyangugu . In 2017, construction began on the Bugesera International Airport , to the south of Kigali, which will become the country's largest when it opens, complementing the existing Kigali airport. The national carrier is RwandAir , and the country is served by seven foreign airlines. As of 2015
17860-413: The cables run along major roads, linking towns around the country. Mobile provider MTN also runs a wireless internet service accessible in most areas of Kigali via pre-paid subscription. In October 2019, Mara Corporation launched the first African-made smartphone in Rwanda. The Rwandan government prioritised funding of water supply development during the 2000s, significantly increasing its share of
18050-507: The camp catered to 18,000 refugees by the end of the year. In 2001, AHA continued its partnership with the UNHCR and related support programmes for refugees in Angola, Liberia, Namibia , Ethiopia, Rwanda, Uganda, and Zambia. The humanitarian situation in Angola did not improve in 2001. While the government recaptured many areas, this did not bring security or free movement of people and goods. Humanitarian organizations, including AHA, had to continue providing emergency support in order to avert
18240-558: The capacities of assisted communities in Southern Ethiopia, with the training of 1,000 Community Based Reproductive Health Agents, along with many other staff. In Liberia, increasing health concerns resulted in AHA's establishment of five new clinics, in addition to their pre-existing two health centers and 17 clinics, thus increasing access to essential healthcare services for returnees, ex-combatants and local residents in 2006. In
18430-518: The capacities of refugees integrated with host communities through several projects such as support for refugee children by facilitating basic primary education and overseeing 30 education scholarship programmes in an attempt to secure a brighter future. AHA executed its Early Epidemics Detection scheme in 2008 and successfully controlled the outbreak of meningitis , Ebola and cholera in the Adjumani District of Uganda as well as reducing
18620-551: The child and maternal mortality rates. 2008 marked a successful year in terms of access, proximity, consultation, drug availability and referral and paramedic services to refugees and communities in Uganda. In 2009, AHA supplied potable water to the growing number of refugees in Aysaita and Berhale camp of Ethiopia through a tripartite agreement with UNHCR and the Government of Ethiopia 's Administration for Refugee Affairs (ARRA) established in 2008. Both camps are now supplied with
18810-766: The completed houses to beneficiaries in Musasa , Rushashi, and Tare communes. At the end of the decade, UNHCR and AHA worked on a project in the northwest of the country; however this was halted due to financial constraints. In the northwest, AHA felt morally obligated to continue providing health care services to needy returnees and the local population as the rest of the international NGO community retreated due to security concerns and deteriorating conditions. In 1995, AHA entered Uganda providing services to refugee settlers in Mongula, East Moyo District , which borders Sudan . These early AHA refugees all hailed from Sudan, following
19000-555: The conflict between the government forces and, the SLA, JEM and Janjaweed military action, exposure, starvation and disease. An estimated of six million of Sudanese citizens had been forced to leave their home as a direct or indirect result of fighting between government troops and allied militias and various insurgent groups. The total number of refugees and IDPs was 693,267 and 5,300,000 respectively. The various programmes AHA participated in were food distribution and medical services. In
19190-746: The construction of latrines and showers, as well as furniture replenishments such as closets and chair in Katanga. In the Equateur Province, AHA collaborated with other INGOs to be the implementing partner of the UNHCR in efforts to improve the health status of returnees. Some of the programmes that were implemented included: In 2010, AHA provided Ethiopian refugee communities at risk of infection with HIV/AIDS services. More than 3,000 young refugees participated in an adolescent and youth education initiative on sexually transmitted diseases in Southern Ethiopia. Peer educators and counselors were guided on
19380-470: The context of global population aging , with increasing numbers of older adults at greater risk of chronic non-communicable diseases , rapidly increasing demand for primary care services is expected in both developed and developing countries. The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary health care strategy. Secondary care includes acute care : necessary treatment for
19570-610: The corporate sector with innovative and progressive methods, already providing education, health, and social services to many of Africa's citizens. Angola continued to recover in 2005 from its most recent turmoil. There were still was an estimated 91,000 people who remained displaced in Angola in 2005. 11,322 returnees and 186,710 patients benefited from AHA programs including but not limited to Capacity Building, Training of TBAs and community health workers, mine awareness, medical services and water and sanitation. As of November 2005, 200,000 Burundi refugees had been repatriated. According to
19760-481: The country had no railways, but there is a project underway, in conjunction with Burundi and Tanzania, to extend the Tanzanian Central Line into Rwanda; the three countries have invited expressions of interest from private firms to form a public private partnership for the scheme. There is no public water transport between the port cities on Lake Kivu, although a limited private service exists and
19950-400: The country is 72.6%, up from 41.6% in 2011. MTN Rwanda is the leading provider, with 3,957,986 subscribers, followed by Tigo with 2,887,328, and Bharti Airtel with 1,336,679. Rwandatel has also previously operated a mobile phone network, but the industry regulator revoked its licence in April 2011, following the company's failure to meet agreed investment commitments. Internet penetration
20140-425: The country is predominantly rolling hills, while the eastern border region consists of savanna , plains and swamps. Rwanda has a temperate tropical highland climate, with lower temperatures than are typical for equatorial countries because of its high elevation. Kigali, in the centre of the country, has a typical daily temperature range between 15 and 28 °C (59 and 82 °F), with little variation through
20330-521: The country's electricity. A combination of below average rainfall and human activity, including the draining of the Rugezi wetlands for cultivation and grazing, caused the two lakes' water levels to fall from 1990 onwards; by 2004 levels were reduced by 50%, leading to a sharp drop in output from the power stations. This, coupled with increased demand as the economy grew, precipitated a shortfall in 2004 and widespread loadshedding . As an emergency measure,
20520-448: The country's main highways passing through it, indirectly contributing to the commercial sex trade in that region. The second selected was Gofa Zuria , 525 km from Addis Ababa, because of minimal infrastructure, low socio-economic development and poor health status. AHA provided health, nutrition, sanitation, and water services to Congolese and Burundian refugees in Rwanda throughout the year supplying staff and technical support to
20710-420: The country's power generation by 40%. Only 18% of the population had access to electricity in 2012, though this had risen from 10.8% in 2009. The government's Economic Development and Poverty Reduction Strategy for 2013–18 aims to increase access to electricity to 70% of households by 2017. The government has increased investment in the transport infrastructure of Rwanda since the 1994 genocide, with aid from
20900-422: The country, little use is made of rainwater harvesting , and residents are forced to use water very sparingly, relative to usage in other African countries. Access to sanitation remains low; the United Nations estimates that in 2006, 34% of urban and 20% of rural dwellers had access to improved sanitation , with this statistic increasing to 92% for the total population (95% urban and 91% urban) in 2022. Kigali
21090-635: The country, including illegal and arbitrary detention, threats or other forms of intimidation, disappearances, politically motivated trials, and the massacre of peacefully protesting civilians. Rwanda is a member of the United Nations , African Union , Francophonie , East African Community , and the Commonwealth of Nations . For many years during the Habyarimana regime, the country maintained close ties with France, as well as Belgium,
21280-599: The crisis started to take a hold of the post-genocide Rwandan population, AHA evolved and started to provide care for psychological issues as well. AHA found that women and children were the major victims of the emotional and psychological changes and along with the UN Fund for Women / Africa Women in Crisis Programme, they began care and counseling services. In 1996, the Rwandan Ministry of Health and
21470-438: The definitions of the various types of health care vary depending on the different cultural , political, organizational, and disciplinary perspectives, there appears to be some consensus that primary care constitutes the first element of a continuing health care process and may also include the provision of secondary and tertiary levels of care. Health care can be defined as either public or private . Primary care refers to
21660-428: The delivery of public services as mandated by the districts. Districts and sectors have directly elected councils, and are run by an executive committee selected by that council. The cells and villages are the smallest political units, providing a link between the people and the sectors. All adult resident citizens are members of their local cell council, from which an executive committee is elected. The city of Kigali
21850-551: The district level. The Rwanda Decentralisation Strategic Framework developed by the Ministry of Local Government assigns to provinces the responsibility for "coordinating governance issues in the Province, as well as monitoring and evaluation". Each province is headed by a governor, appointed by the president and approved by the Senate. The districts are responsible for coordinating public service delivery and economic development. They are divided into sectors, which are responsible for
22040-520: The east of the country. Rwanda was ranked 104th in the Global Innovation Index in 2024. The largest radio and television stations are state-run, and the majority of newspapers are owned by the government. Most Rwandans have access to radio; during the 1994 genocide, the radio station Radio Télévision Libre des Mille Collines broadcast across the country, and helped to fuel the killings through anti-Tutsi propaganda. As of 2015 ,
22230-538: The eastern border with Tanzania. The Nyabarongo-Kagera eventually drains into Lake Victoria , and its source in Nyungwe Forest is a contender for the as-yet undetermined overall source of the Nile . Rwanda has many lakes, the largest being Lake Kivu . This lake occupies the floor of the Albertine Rift along most of the length of Rwanda's western border, and with a maximum depth of 480 metres (1,575 ft), it
22420-410: The end of 1996, from a high of nearly 5%. Health care in Angola was defined by producing preventive/curative health care, general education/information, and sanitation, while hospitals were being equipped with laboratory and surgical equipment. Drug distribution proved harder than it was thought to be. However, by the end of 1997, Cazombo had their own distribution points of clean potable water , giving
22610-571: The escalation of fighting between the Sudanese government forces and its southern opponents. AHA provided immunization services, reproductive health care, preventive activities, environmental hygiene, and general health education . At the end of the year, AHA also started training a selected group of refugees in the health and sanitation sectors. In 1996, however, AHA evacuated its international and senior staff from Adjumani in East Moyo to
22800-552: The fifth-cleanest out of 47 countries in Sub-Saharan Africa and 55th-cleanest out of 175 in the world. The constitution provides for an ombudsman , whose duties include prevention and fighting of corruption. Public officials (including the president) are required by the constitution to declare their wealth to the ombudsman and to the public; those who do not comply are suspended from office. Despite this, Human Rights Watch notes extensive political repression throughout
22990-407: The formation of an alliance with the king, beginning the colonial era. The Germans did not significantly alter the social structure of the country, but exerted influence by supporting the king and the existing hierarchy, and delegating power to local chiefs. Belgian forces invaded Rwanda and Burundi in 1916, during World War I , and later, in 1922, they started to rule both Rwanda and Burundi as
23180-492: The former colonial power. Under the RPF government, however, Rwanda has sought closer ties with neighbouring countries in the East African Community and with the English-speaking world. Diplomatic relations with France were suspended in 2006 following the indictment of Rwandan officials by a French judge, and despite their restoration in 2010, as of 2015 relations between the countries remain strained. Relations with
23370-518: The four districts received CBRH cervices in place. Services to beneficiary communities gradually improved in quality and quantity, as a significant change in attitudes was registered. As a result, the demand for more contraceptives and protective knowhow increased. Initially, the Namibian Ministry of health and Social Services provided curative health services at the Osire refugee camp and
23560-482: The government are widely available in Kigali. Restrictions were increased in the run-up to the Rwandan presidential election of 2010, with two independent newspapers, Umuseso and Umuvugizi , being suspended for six months by the High Media Council . The country's oldest telecommunications group, Rwandatel , went into liquidation in 2011, having been 80% owned by Libyan company LAP Green . The company
23750-529: The government has initiated a programme to develop a full service. The Ministry of Infrastructure is also investigating the feasibility of linking Rwanda to Lake Victoria via shipping on the Akagera River . As of 2015 , the National Institute of Statistics of Rwanda estimated Rwanda's population to be 11,262,564, while the projection for 2022 was 13,246,394. The 2012 census recorded
23940-463: The government installed diesel generators north of Kigali; by 2006 these were providing 56% of the country's electricity, but were very costly. The government enacted a number of measures to alleviate this problem, including rehabilitating the Rugezi wetlands, which supply water to Burera and Ruhondo and investing in a scheme to extract methane gas from Lake Kivu, expected in its first phase to increase
24130-467: The implementing partner of the UNHCR, has provided emergency health , nutrition and sanitation services to refugees in the Mayukwayukwa settlement area in Zambia since January 2000. The program began in response to the serious conditions created by the influx of refugees from Angola, Burundi, the Democratic Republic of the Congo , and Rwanda, with the great majority of the refugees being Angolans,
24320-464: The income generation projects initiated, AHA strengthened its activities in animal health treatment activities in Kilmando, Wadaáh and Dar Salam areas of Darfur. Camels , cattle , donkeys , and chickens are basic assets for the wellbeing of Darfurians who economically rely on their animals to transport firewood, haul water, and to provide income and food. Over the years since 2007, AHA has saved
24510-405: The industry. The industrial sector is small, contributing 14.8% of GDP in 2014. Products manufactured include cement, agricultural products, small-scale beverages, soap, furniture, shoes, plastic goods, textiles and cigarettes. Rwanda's mining industry is an important contributor, generating US$ 93 million in 2008. Minerals mined include cassiterite , wolframite , gold, and coltan , which
24700-494: The kingdom west and north, and initiated administrative reforms; these included ubuhake , in which Tutsi patrons ceded cattle, and therefore privileged status, to Hutu or Tutsi clients in exchange for economic and personal service, and uburetwa , a corvée system in which Hutu were forced to work for Tutsi chiefs. Rwabugiri's changes caused a rift to grow between the Hutu and Tutsi populations. The Twa were better off than in pre-Kingdom days, with some becoming dancers in
24890-635: The livelihood of displaced families, particularly those headed by women, by providing access to credit for small-scale trading were undertaken. Over 140 people have received loans in 2001. The Family planning /Reproductive Health and HIV/AIDS/STDs prevention project in Ethiopia was in 30 rural and semi-urban locations of Gofa and Shashamene woredas with 260,000 target beneficiaries in 164 peasant associations. In 2001, more community based reproductive health (CBRH) project sites were initiated in Boloso Sore and Sodo Zuria districts, and over 164 kebeles of
25080-601: The lives of thousands of livestock in Sudan thus ensuring food security for many conflict-affected populations and easing tensions between communities. Cognizant of the devastating personal and socio-economic impacts of Sexual and Gender Based Violence (SGBV), AHA made SGBV a top priority in 2007, with offices in Rwanda, Namibia and Burundi notably spearheading these efforts. AHA created a working group on GBV in Rwanda, which provided training to numerous relevant partners, including refugee and community members. 2007 saw UNHCR assign
25270-619: The lowest in international measurements of government transparency, civil liberties and quality of life. The population is young and predominantly rural; Rwanda has one of the youngest populations in the world. Rwandans are drawn from just one cultural and linguistic group, the Banyarwanda . However, within this group there are three subgroups: the Hutu , Tutsi and Twa . The Twa are a forest-dwelling pygmy people and are often considered descendants of Rwanda's earliest inhabitants. Christianity
25460-690: The major Congo and Nile drainage basins runs from north to south through Rwanda, with around 80% of the country's area draining into the Nile and 20% into the Congo via the Rusizi River and Lake Tanganyika . The country's longest river is the Nyabarongo , which rises in the south-west, flows north, east, and southeast before merging with the Ruvubu to form the Kagera ; the Kagera then flows due north along
25650-459: The major cities. There are a smaller number of large buses, which operate a scheduled service around the country. The principal private hire vehicle is the motorcycle taxi ; in 2013 there were 9,609 registered motorcycle taxis in Rwanda, compared with just 579 taxicabs . Coach services are available to various destinations in neighbouring countries. The country has an international airport at Kigali that serves several international destinations,
25840-526: The managed care (insurance-billing) system through direct primary care which is a subset of the more familiar concierge medicine . Physicians in this model bill patients directly for services, either on a pre-paid monthly, quarterly, or annual basis, or bill for each service in the office. Examples of direct primary care practices include Foundation Health in Colorado and Qliance in Washington. In
26030-439: The mid-1980s, farm sizes and food production have been decreasing, due in part to the resettlement of displaced people. Despite Rwanda's fertile ecosystem, food production often does not keep pace with population growth, and food imports are required. However, in recent years with the growth of agriculture, the situation has improved. Subsistence crops grown in the country include matoke (green bananas), which occupy more than
26220-482: The most recent survey in 2019/20, 48.8% of the population continues to be affected by multidimensional poverty and an additional 22.7% vulnerable to it. Major export markets include China, Germany, and the United States. The economy is managed by the central National Bank of Rwanda and the currency is the Rwandan franc ; in December 2023, the exchange rate was 1250 francs to one United States dollar. Rwanda joined
26410-545: The most recent survey in 2019/20, 48.8% of the population is affected by multidimensional poverty and an additional 22.7% vulnerable to it. The country is a member of the African Union , the United Nations , the Commonwealth of Nations (one of few member states that does not have any historical links with the British Empire ), COMESA , OIF and the East African Community . Modern human settlement of what
26600-604: The national budget. This funding, along with donor support, caused a rapid increase in access to safe water; in 2015, 74% of the population had access to safe water, up from about 55% in 2005; the government has committed to increasing this to 100% by 2017. The country's water infrastructure consists of urban and rural systems that deliver water to the public, mainly through standpipes in rural areas and private connections in urban areas. In areas not served by these systems, hand pumps and managed springs are used. Despite rainfall exceeding 750 millimetres (30 in) annually in most of
26790-505: The nature of the Bantu migrations; one theory is that the first settlers were Hutu , while the Tutsi migrated later to form a distinct racial group, possibly of Nilo-hamitic origin. An alternative theory is that the migration was slow and steady, with incoming groups integrating into rather than conquering the existing society. Under this theory, the Hutu and Tutsi distinction arose later and
26980-497: The northern part) as a UN trust territory after the Second World War , with a mandate to oversee eventual independence . Tensions escalated between the Tutsi, who favoured early independence, and the Hutu emancipation movement, culminating in the 1959 Rwandan Revolution : Hutu activists began killing Tutsi and destroying their houses, forcing more than 100,000 people to seek refuge in neighbouring countries. In 1961,
27170-435: The numbers of each. Production systems are mostly traditional, although there are a few intensive dairy farms around Kigali. Shortages of land and water, insufficient and poor-quality feed, and regular disease epidemics with insufficient veterinary services are major constraints that restrict output. Fishing takes place on the country's lakes, but stocks are very depleted, and live fish are being imported in an attempt to revive
27360-532: The old system and the genocide. The previous structure of twelve provinces associated with the largest cities was replaced with five provinces based primarily on geography. These are Northern Province , Southern Province , Eastern Province , Western Province , and the Municipality of Kigali in the centre. The five provinces act as intermediaries between the national government and their constituent districts to ensure that national policies are implemented at
27550-484: The onset of the millennium. At UNHCR's request, AHA took on projects for IDPs in three provinces, Maquela do Zombo in Uige and M’Vanza Congo in the Democratic Republic of the Congo – from July to December. AHA worked in three camps for the displaced, Malanje , Moxico and Mussenge, and a camp for Katangese refugees. AHA provided the refugees and IDPs with water and sanitation, income generation, housing construction and
27740-539: The orders of the interim government. Many Twa were also killed, despite not being directly targeted. The Tutsi RPF restarted their offensive, and took control of the country methodically, gaining control of the whole country by mid-July. The international response to the genocide was limited, with major powers reluctant to strengthen the already overstretched UN peacekeeping force . When the RPF took over, approximately two million Hutu fled to neighbouring countries , in particular Zaïre , fearing reprisals; additionally,
27930-400: The organization and policies of the national health system, patients may be required to see a primary care provider for a referral before they can access secondary care. In countries that operate under a mixed market health care system, some physicians limit their practice to secondary care by requiring patients to see a primary care provider first. This restriction may be imposed under
28120-544: The patient. There are generally five primary methods of funding health care systems : In most countries, there is a mix of all five models, but this varies across countries and over time within countries. Aside from financing mechanisms, an important question should always be how much to spend on health care. For the purposes of comparison, this is often expressed as the percentage of GDP spent on health care. In OECD countries for every extra $ 1000 spent on health care, life expectancy falls by 0.4 years. A similar correlation
28310-542: The physical condition of health facilities and restore essential services for refugees/returnees, internally displaced persons (IDPs), and host communities living in the three districts. AHA has fostered local participation in the actual restoration work of the health units. AHA served about 115,000 patients and started different programs that included maternal and child health treatment, family planning, vaccinations and treatment of acute and chronic illnesses. AHA also started building houses for 360 families and handed over
28500-404: The population in 2009, the Tutsi 15% and Twa 1%. The Twa are a pygmy people who descend from Rwanda's earliest inhabitants, but scholars do not agree on the origins of and differences between the Hutu and Tutsi. Anthropologist Jean Hiernaux contends that the Tutsi are a separate race, with a tendency towards "long and narrow heads, faces and noses"; others, such as Villia Jefremovas, believe there
28690-473: The population is drawn from just one cultural and linguistic group, the Banyarwanda ; this contrasts with most modern African states, whose borders were drawn by colonial powers and did not correspond to ethnic boundaries or pre-colonial kingdoms. Within the Banyarwanda people, there are three separate groups, the Hutu, Tutsi and Twa. The CIA World Factbook gives estimates that the Hutu made up 84% of
28880-433: The poverty rate reduced from 57% to 45%, while life expectancy rose from 46.6 years in 2000 to 65.4 years in 2021. In 2009, Rwanda joined the Commonwealth of Nations , although the country was never part of the British Empire . Rwanda is a de facto one-party state ruled by the Rwandan Patriotic Front (RPF) and its leader Paul Kagame continuously since the end of the civil war in 1994. Although Rwanda
29070-553: The prevention of transmissible diseases. They also include the services of professionals in residential and community settings in support of self-care , home care , long-term care , assisted living , treatment for substance use disorders among other types of health and social care services. Community rehabilitation services can assist with mobility and independence after the loss of limbs or loss of function. This can include prostheses , orthotics , or wheelchairs . Many countries are dealing with aging populations, so one of
29260-577: The priorities of the health care system is to help seniors live full, independent lives in the comfort of their own homes. There is an entire section of health care geared to providing seniors with help in day-to-day activities at home such as transportation to and from doctor's appointments along with many other activities that are essential for their health and well-being. Although they provide home care for older adults in cooperation, family members and care workers may harbor diverging attitudes and values towards their joint efforts. This state of affairs presents
29450-532: The remaining animals were poisoned by cattle herders. In June 2015, two South African parks donated seven lions to Akagera National Park , reestablishing a lion population in Rwanda. The lions were held initially in a fenced-off area of the park, and then collared and released into the wild a month later. Eighteen endangered black rhinos were brought to Rwanda in 2017 from South Africa. After positive results, five more black rhinos were delivered to Akagera National Park from zoos all over Europe in 2019. Similarly,
29640-647: The residents easy access to water for the first time in decades. Cazombo represented great progress until the security situation greatly deteriorated to a point where it was no longer possible for AHA to soldier on. In addition, a budget decrease limited the operations and regular World Food Programme (WFP) flights to provincial towns had to be suspended in 1998. All of these problems forced AHA to be relocated to nearby Zambia . In 1997, AHA planned to enter more countries to provide health care and other services. Burundi , Ethiopia, and Liberia had programs start in 1997, and Sierra Leone had operations but Liberia hosted
29830-486: The resources and capacity of African NGOs but also raise their international standing. In 2004, AHA continued its health and social programmes for refugees and returnees in Angola, Burundi, Congo (DR), the Republic of Guinea , Liberia, Namibia, and Ethiopia. In September, AHA launched an emergency intervention in Darfur and started planning for support to South Sudan in 2005. AHA also made a concerted effort to reach out to
30020-539: The royal court, but their numbers continued to decline. The Berlin Conference of 1884 assigned the territory to the German Empire , who declared it to be part of German East Africa . In 1894, explorer Gustav Adolf von Götzen was the first European to cross the entire territory of Rwanda; he crossed from the south-east to Lake Kivu and met the king. In 1897, Germany established a presence in Rwanda with
30210-649: The same year, AHA focused on medical consultations, most commonly for the treatment of malaria, sexually transmitted infections, diarrhea , and respiratory tract infections . As a result, the number of people choosing to access services boomed, as well as a steadier rate in professionally overseen births. In light of hostilities in the Darfur region of Sudan, AHA implemented an innovative protection programme in 2006. The Enhancement of Civilian Protection from Physical Atrocities project put into operation measures to safeguard vulnerable populations, especially IDPs, from imminent harm and avert recurring harm. AHA's work included;
30400-481: The southern part of the country from two to seven woredas. AHA's activities in Zambia focused on providing health nutrition, sanitation activities in Nangweshi and Mayukwayukwa refugee camps. The project, which is responsible for over 22,000 refugees in each camp and about 5000 local residents in the surrounding area, was supported by a wide variety of local and international organizations – UNHCR, ECHO, UNICEF, WFP,
30590-649: The staff. AHA was the first medical oriented NGO to provide medical assistance in Burundi as they designed a project for reinforcing health care services in Burundi, aiming to cover the health needs of the population of the province and more than 40,000 displaced/dispersed and regrouped people in 17 camps. In Ethiopia, AHA focused on family planning and welfare services in Shashemene in the Oromia Regional State . The projects undertaken in Ethiopia were worked on jointly with indigenous NGOs such as LEM,
30780-519: The standard 20 liters of water per day and newly constructed sanitation facilities. In addition, AHA was responsible for the erection and management of shelters at the Boko Mayo and Melkadida refugee camps in the Somali region of Eastern Ethiopia. In the same year, to combat the high level of communicable diseases such as malaria, STI, respiratory tract infections and diarrhea, AHA worked closely with
30970-581: The state-run Radio Rwanda was the largest station and the main source of news throughout the country. Television access is limited, with most homes not having their own set. The government rolled out digital television in 2014, and a year later there were seven national stations operating, up from just one in the pre-2014 analogue era. The press is tightly restricted, and newspapers routinely self-censor to avoid government reprisals. Nonetheless, publications in Kinyarwanda, English, and French critical of
31160-453: The suddenly pro-Hutu Belgians held a referendum in which the country voted to abolish the monarchy. Rwanda was separated from Burundi and gained independence on 1 July 1962, which is commemorated as Independence Day, a national holiday. Cycles of violence followed, with exiled Tutsi attacking from neighbouring countries and the Hutu retaliating with large-scale slaughter and repression of the Tutsi. In 1973, Juvénal Habyarimana took power in
31350-503: The surgical unit of Kibuye Hospital. The program maintained a health centre for 13,232 Congolese refugees in Kiziba camp. In 2000 alone, the health care center in Kiziba refugee camp gave 24,152 consultations and hospitalized 630 people. In Uganda, AHA provides integrated health services to refugees and nationals living in Adjumani district through 24 health units and when the year began AHA targeted 71,392 refugees and 34,000 Ugandans. By
31540-410: The terms of the payment agreements in private or group health insurance plans. In other cases, medical specialists may see patients without a referral, and patients may decide whether self-referral is preferred. In other countries patient self-referral to a medical specialist for secondary care is rare as prior referral from another physician (either a primary care physician or another specialist)
31730-702: The territory in the Stone and Iron Ages , followed later by Bantu peoples . The population coalesced first into clans , and then into kingdoms. In the 15th century, one kingdom, under King Gihanga, managed to incorporate several of its close neighbor territories establishing the Kingdom of Rwanda . The Kingdom of Rwanda dominated from the mid-eighteenth century, with the Tutsi kings conquering others militarily, centralising power, and enacting unifying policies. In 1897, Germany colonized Rwanda as part of German East Africa , followed by Belgium , which took control in 1916 during World War I . Both European nations ruled through
31920-931: The three groups. Health care Health care , or healthcare , is the improvement of health via the prevention , diagnosis , treatment , amelioration or cure of disease , illness , injury , and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields . Medicine , dentistry , pharmacy , midwifery , nursing , optometry , audiology , psychology , occupational therapy , physical therapy , athletic training , and other health professions all constitute health care. The term includes work done in providing primary care , secondary care , tertiary care , and public health . Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions and health policies . Providing health care services means "the timely use of personal health services to achieve
32110-497: The training and implementation of Protection Officers, facilitated dialogue, trust and confidence building exercises, increased co-ordination with external protection forces and ways to address resource scarcity. By 2007, protective measures were put in place against gender violence in the Darfur region, in addition to the initiation of income generation projects to support Darfurians living in camps based in El-Fasher. Among many of
32300-423: The turn of the 90s, growth had fallen short of expectations. In 1994, 35 million people remained at risk from famine ; and 20 million others were displaced by conflict and natural disasters while millions more were succumbing to treatable diseases. In Rwanda , AHA expanded from just providing health services to on-the-job training for Rwandan health personnel. As the emotional and psychological repercussions of
32490-626: The use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). Health care extends beyond the delivery of services to patients, encompassing many related sectors, and is set within a bigger picture of financing and governance structures. A health system , also sometimes referred to as health care system or healthcare system , is the organization of people, institutions, and resources that deliver health care services to populations in need. The healthcare industry incorporates several sectors that are dedicated to providing health care services and products. As
32680-661: The use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). Health systems are the organizations established to meet the health needs of targeted populations. According to the World Health Organization (WHO), a well-functioning healthcare system requires a financing mechanism, a well-trained and adequately paid workforce , reliable information on which to base decisions and policies , and well-maintained health facilities to deliver quality medicines and technologies. An efficient healthcare system can contribute to
32870-442: The villages inhabited by the resettled IDPs call for renewed attention. An organized repatriation process had begun, even though; there is still intimidation of those seeking to return by leaders trying to keep their resistance intact. The total number of refugees and IDPs was 145,704 and 4,158 respectively. 2,610,000 people had been affected by the violence in Darfur and some estimates put the death toll as high as 300,000 caused by
33060-468: The wake of New Imperialism , promoted Tutsi supremacy, considering the Hutu and Tutsi different races . In 1935, Belgium introduced an identity card system, which labelled each individual as either Tutsi, Hutu, Twa or Naturalised. While it had been previously possible for particularly wealthy Hutu to become honorary Tutsi, the identity cards prevented any further movement between the classes. Belgium continued to rule Ruanda-Urundi (of which Rwanda formed
33250-417: The west and savanna to the southeast, with numerous lakes throughout the country. The climate is temperate to subtropical, with two rainy seasons and two dry seasons each year. It is the most densely populated mainland African country; among countries larger than 10,000 km , it is the fifth-most densely populated country in the world. Its capital and largest city is Kigali . Hunter-gatherers settled
33440-592: The west and northwest of the country receiving more precipitation annually than the east and southeast. Global warming has caused a change in the pattern of the rainy seasons. According to a report by the Strategic Foresight Group, change in climate has reduced the number of rainy days experienced during a year, but has also caused an increase in frequency of torrential rains. Both changes have caused difficulty for farmers, decreasing their productivity. Strategic Foresight also characterise Rwanda as
33630-476: The white rhino population is growing in Rwanda. In 2021, Rwanda received 30 white rhinos from South Africa with the goal of Akagera being a safe breeding ground for the near-threatened species. There are 670 bird species in Rwanda , with variation between the east and the west. Nyungwe Forest, in the west, has 280 recorded species, of which 26 are endemic to the Albertine Rift; endemic species include
33820-401: The work of health professionals who act as a first point of consultation for all patients within the health care system . The primary care model supports first-contact, accessible, continuous, comprehensive and coordinated person-focused care. Such a professional would usually be a primary care physician , such as a general practitioner or family physician . Another professional would be
34010-766: The world with an African-set agenda. The event attracted representatives of hundreds of leading aid agencies and frontline NGOs. In collaboration with the AU, AHA organized the International Symposium on "Building the Capacity and Resources of African Non Governmental Organizations" in Addis Ababa. Building on the accomplishments of the Symposium, AHA helped form the African Centre for Humanitarian Action (ACHA). ACHA and other initiatives were viewed to not only increase
34200-833: The year's end, births, deaths, and new refugee arrivals had brought refugee numbers to 73,590. Ante-natal care (ANC), pre- and post-natal care, family planning, adolescent sexuality and monitoring of GBV activities were conducted throughout this period via both static and outreach service delivery points. Out of 1,942 deliveries, 87% were assisted by health units or by traditional birth attendants (TBA). With inputs from OAU, AHA provided short-term assistance to Sierra Leonean refugees relocated in Sinje, funneling aid through Southwestern Liberia with UNHCR's help. AHA provided for 2,000 families and agricultural tools, seedlings and fertilizers for 460 farming groups. AHA sought funding for two health projects in support of Sierra Leonean refugees in Maryland and in Upper Lofta counties. AHA, acting as
34390-492: The year. There are some temperature variations across the country; the mountainous west and north are generally cooler than the lower-lying east. There are two rainy seasons in the year; the first runs from February to June and the second from September to December. These are separated by two dry seasons : the major one from June to September, during which there is often no rain at all, and a shorter and less severe one from December to February. Rainfall varies geographically, with
34580-427: Was mountain gorilla tracking, in the Volcanoes National Park; Rwanda is one of only three countries in which mountain gorillas can be visited safely; the gorillas attract thousands of visitors per year, who are prepared to pay high prices for permits. Other attractions include Nyungwe Forest, home to chimpanzees, Ruwenzori colobus and other primates, the resorts of Lake Kivu, and Akagera, a small savanna reserve in
34770-407: Was 65,293 and 250,000 respectively. An estimated 38,500 refugees had gone through the UNHCR-led voluntary repatriation program started in 2004. As of 2005, 210,000 Liberian IDPs had been assisted to return home. The total number of refugees and IDPs was 23,000 and 464,000 respectively. More than four years after the issue of internal displacement was taken off the agenda in Rwanda, conditions in
34960-424: Was a class distinction rather than a racial one. The earliest form of social organisation in the area was the clan ( ubwoko ). The clans were not limited to genealogical lineages or geographical area, and most included Hutu, Tutsi, and Twa. From the 15th century, the clans began to merge into kingdoms. One kingdom, under King Gihanga, managed to incorporate several of its close neighbor territories establishing
35150-477: Was acquired in 2013 by Liquid Telecom , a company providing telecommunications and fibre optic networks across eastern and southern Africa. As of 2015 , Liquid Telecom provides landline service to 30,968 subscribers, with mobile operator MTN Rwanda serving an additional 15,497 fixed line subscribers. Landlines are mostly used by government institutions, banks, NGOs and embassies, with private subscription levels low. As of 2015 , mobile phone penetration in
35340-414: Was also able to increase its corporate staff resources and enhance the perception of the organization. AHA responded to the 2003 Boumerdès earthquake by providing material assistance to the victims and by establishing a Liaison Office for North Africa . AHA also opened a Liaison office in East Africa in Nairobi , Kenya , which undertook assessment missions to Southern Sudan and Somalia . AHA made
35530-418: Was elected as AHA's Chairman. Sheik Mohammed Hussein Al Amoudi , a well known entrepreneur was named Co-chair. Among the Assembly's resolutions, the decision endorsing the formation of AHA country associations stands out as particularly timely. The assembly decided to diversify AHA's activities more aggressively, to engage in HIV/AIDS, TB , and malaria . Angola underwent massive change during 2002. First
35720-417: Was mandated with the management of Makeni and Chilenje Transit Centers of Zambia in 2010. AHA's responsibilities included: 473 beneficiaries used these services, 254 of whom where children from the DRC, Burundi, Somalia and Rwanda. The centers also facilitated the resettlement of refugees to other areas including western countries. Rwanda in Africa (light blue) Rwanda , officially
35910-404: Was part of a massive international effort that resembled the intervention in Rwanda and by the end of the year, Cazombo Municipal Hospital and three other rural hospitals as well as a health post in Kafaria were receiving support from AHA. Cazombo Hospital covered about 2/3s of the entire country and by 1996; there was a notable fall in the morbidity pattern. The mortality rate stood at 2.3% at
36100-441: Was published, AHA focus turned to Uganda and Angola . In Uganda, AHA built from scratch the infrastructures required to provide health and related services in parts of the country where such facilities were not available. In Angola, AHA became part of a massive international effort to rebuild a nation largely reduced to ashes and rubble. The young organization was disappointed by the forecasts relating to growth in Africa and by
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