Rwanda

Rwanda December 1st, 2020

Rwanda: Final Training for Medical Cooperation Activities at Nyamata District Hospital

From December 1st we started our third and final workshop. The topics we focused on this time were CTG interpretation, neonatal management, family planning and other topics related to perinatal medical care. It has been 3 months since we started these workshops, so the instructors could recognize each student and have a greater understanding about their different personalities and skill level. This led to smoother and more efficient lectures.

In Rwanda, where maternal mortality and infant mortality rates are high, accurate interpretation of CTG is a very important improvement point, so students' attention was focused heavily on CTG interpretation. During the case studies, the image of the students enthusiastically discussing and answering questions left a strong impression on our minds.

The instructors, who had initially given lectures entirely in Japanese, gradually switched to using some English, which was a very popular move and helped improve communication between the two sides. In the CTG follow-up session, the impressions and problems of using Melody's iCTG in a short period of time were identified at Nyamata district hospital. It was a meaningful session where we could exchange opinions on how to tighten the belt, the timing of monitoring, the interval until the next observation, the positioning of the device and other matters.

English is not the mother tongue in Rwanda so sometimes there were issues with communication but to tackle this problem we asked Dr. Calliope to give a detailed explanation in Kinyarwanda to help the lectures proceed smoothly.

The purpose of this training was not only to provide localized medical support but also to consider prospects in East Africa and to build human relationships for any future medium to long-term partnerships. The relationship between instructors and participants has grown considerably stronger and warmer since the sessions started in September and we are all optimistically looking forward to seeing what the future brings in terms of a collaboration between Kishokai and Nyamata district hospital.

The fashion sense of Nyamata's medical team was also a big hit, and it would be great if such fashionable hats, beehives and mohawks could be introduced into our overseas division.

Finally, we'd like to express our utmost gratitude to Dr. Taomura, Ms. Umezaki, Ms. Hatanaka, Ms. Yamamoto and all the other people, who although busy with their own work, over the last 3 months were able to find the time to create materials and devise ideas for continually improving and making the training more effective. We sincerely hope that our recent achievements will be used as a springboard to help improve maternal and child health in Rwanda.

A scene from a lecture (Maternal dentistry and smoking during pregnancy)

Confirming the attachment position of the iCTG device

Rwanda November 6th, 2020

Rwanda: 2nd Training for Medical Cooperation Activities at Nyamata District Hospital

Following on from the first online training held at the end of September, medical cooperation activities were held in October as well. The participants included 2 doctors, 4 midwives and 3 pediatric nurses from Nyamata. Dr. Taomura was responsible for providing lectures for the doctors, while Ms. Umezaki (Director, Nursing Division), Ms. Hatanaka (Chief Midwife) and Ms. Yamamoto were responsible for the midwifery and nursing side. Necessary technical guidance was provided with the aim of improving the quality of ANC visits and providing appropriate diagnosis and treatment based on evidence for abnormal pregnancy and delivery.

In the first workshop, there were some difficulties due to unstable internet conditions and communication problems arising from the use of English technical terms, which led to frequent silences. Therefore for the second training, we focused on strengthening the internet environment so that the speaker's voice could be heard without interruption and we realized that ensuring the lecture content could be clearly understood in English would result in more effective permeation of the sessions. To this end, in order to improve the situation, we decided to share the teaching materials with English notes attached. In addition, in order to build relationships with the students, we devised ways to encourage them to actively participate in the training, for example, by calling on participants specifically to answer questions regarding CTG interpretation and response.

During this project, while exchanging opinions on the differences between Rwanda and Japan and looking at how to provide better services in Rwanda, we are providing training that meets local needs.

As part of this project, we are also implementing feasibility studies on telemedicine using portable CTGs (iCTG). By sending CTG data from health centers, where there are no doctors present, to Nyamata District Hospital, and having the doctors there interpret the CTG will help achieve our goal of building a medical system in which abnormalities can be detected early and appropriate measures can be taken. Guidance on the use of iCTG was provided by Melody International Co., Ltd. on November 9, and medical staff at Nyamata District Hospital are currently using iCTG to actually monitor pregnant women. In the next workshop we plan to hold sessions on interpreting and responding to CTG waveforms, and confirming the current implementation status of iCTG.

A scene from the 2nd workshop

iCTG guidance and usage

Rwanda September 1st, 2020

Confirmation of subsidies from the Ministry of Economy, Trade and Industry regarding 「Project for Establishing Japan-style medical services in Rwanda」

From September 3rd 2020 we received a subsidy for「Project for Establishing Japan-Style Medical Service」a Pilot Project for Establishment of a Bridgehead for Japanese-style Perinatal Care and ICT Telemedicine in Rwanda
As an outline of the project, we will utilize the necessary delivery monitoring equipment and incubators to start a collaborative project with Nyamata District Hospital to provide Japanese style maternal services from pregnancy to newborn management. We are planning to strengthen the skill level of local medical staff while also providing the technical guidance necessary to implement Japanese style perinatal care at regional based hospitals.
In addition, we will conduct remote delivery management using ICT and at the same time we will also carry out various surveys related to business schemes, business feasibility and so on.
Activities commenced in September, two months behind schedule due to the Corona virus, and will conclude in Feb 2021.

A look at the first training session

Rwanda December 12th, 2018

Joint Surgical Operation with Rwandan Hospital

On December 10, 2018, Kishokai sent a team of doctors and nursing staff to La Croix du Sud Hospital in Kigali, Rwanda for the joint conduct of a cesarean section delivery. This joint surgical delivery is the first such endeavor by a Japanese medical company in Rwanda.
The Rwandan Ministry of Health has expressed its strong desire to cooperate with Kishokai, including human resource development projects, in order to quickly improve maternal health and the level of care.
For this collaboration, Kishokai doctors, a midwife, and a nurse, obtained local medical licenses, so that they could conduct the antenal exam and cesarean section on-site in Rwanda. This was an important first step towards the development in Rwanda of Japanese style perinatal services leading to safer and more secure deliveries.
Maternal health in a priority area in Rwanda, and going forward Kishokai would like find a local medical partner for continuous collaboration in medical activities, encouraging medical cooperation as well as provide direct technical guidance to local medical teams.
Finally, Kishokai and the long-standing German stuffed animal company Margarete Steiff GmbH, established in 1880, have created the first partnership between Steiff and a OB/GYN medical group. At each Kishokai clinic, all newborns are given a "My First Steiff" teddy bear as a celebratory gift. The baby delivered on this occasion in Rwanda was also given a Steiff Teddy Bear, which we hope will be the first of many to come.

Rwanda March 1st, 2018

Visit to Rwanda

From February 4th to the 9th, a team from Kishokai, including CEO Dr. Mamoru Yamashita, visited the Rwandan capital of Kigali, in East Africa. Rwanda is a small country, only 1.5 times the size of Japan's Shikoku island, with a population of 11.61 million people. It is situated in hilly land 1,000 to 4,500 meters above sea level, and so the temperature is a comfortable 15 to 26 degrees Celsius. Following the genocide of 1994, Rwanda has worked hard to develop as a country and promote industry under the strong leadership of President Kagame, and in recent years has been noted for its economic development among the African countries with strong potential for growth. It is continuing to proactively develop policies for bringing in foreign investment, and many overseas companies and venture companies are actively entering the Rwandan market. On this visit, Kishokai's team was impressed with how clean the capital was, and the beautiful streets of houses that followed the hills.
It was learned on this trip that the population in their 40s is low due to the forementioned genocide, and so the human resources that would normally be expected to be teaching the next generation are not enough, while there is a high need for obsetrics and pediatric care due to population growth, requiring strengthening of soft resources (human resources) more than hard resources. Based on this trip, Kishokai would like to further study Rwanda's health care status and issues, and explore in what way Kishokai can contribute to perinatal care there.

Dr. Wiliam Rutagengwa, Director, Muhima National Hospital