After the hand over of its last project, MSF leaves Rwanda

The international humanitarian organisation Médecins Sans Frontières (MSF) is closing down its activities in Rwanda after 16 years of presence. Its last remaining programme, providing medical care for people with HIV/Aids in Kigali, has now been officially handed over to the health authorities, after a gradual transition of the activities over more than a year.

MSF started working in Rwanda in 1991. Its teams initially provided an emergency medical response to populations suffering from the hardships of war, and in recent years re-focused their activities on vulnerable groups during the reconstruction period.

The diverse response of MSF has included assistance to displaced persons; war surgery; programmes for unaccompanied children and street children; support to victims traumatised by the conflict; programmes for improving access to health care; responding to epidemics such as malaria, cholera, tuberculosis, Aids and projects linked to maternal and reproductive health.

MSF's HIV/Aids programme in Kinyinya and Kimironko health centres in Kigali was set up at a time when the country's resources were running short and the provision of therapy for people living with HIV/Aids was virtually non-existent. MSF contributed to defining a response to the epidemic in this type of poor resources setting. More than 6,200 patients now receive medical care in the two health centres, and 2,700 of them benefit from anti-retroviral treatment (ARV). Among the people on ARV’s, 10% are children, and MSF has developed an adapted approach for support and treatment for this group.

In addition to bringing medical assistance, MSF has also been a witness of Rwanda's difficult recent history. The duty to speak out is a pillar of MSF's identity and became fundamental in the light of the 1994 events.

"As a direct witness of the violence, MSF swiftly and forcefully denounced the tragedy unfolding in front of its eyes, qualifying the crimes as genocide, and denouncing the political inaction, particularly with what became a rallying wake-up call, 'You can't stop genocide with doctors!'", explains Sébastien Roy, MSF spokesperson and former head of mission in Rwanda. "Our volunteers also looked on, powerless, at the assassination of hundreds of their patients and medical colleagues. These events have scarred MSF deeply. But over and above the denunciation and memories, it was essential to continue relieving the suffering of the populations, and remain at their side."

There are still needs in the country, particularly in terms of access to health care (since 2006, the health system has been based on a compulsory insurance which raises issues in regards to the population's economic situation). But the country's general and health care capacities have been strengthened and Rwanda has moved into a development phase, receiving help from numerous organisations and donors who provide technical and financial support.

As a humanitarian organisation, MSF's departure from Rwanda is therefore logical, and allows it to re-focus its activities to situations of crisis and lack of medical assistance elsewhere.

MSF remains ready to come back to Rwanda should a new emergency require it.