Mummy Nyiragatete rests in her bed next to her one day old baby. She is one of the at least two women who give birth inside Gihembe; health centre for Congolese refugees in Gihembe camp.

Gihembe camp located in Gicubi, Northern Province is a ten minute drive journey from Byumba town. Here 18,427 people leave in the camp according to UNHCR officials. The camp was established in the mid nineties to serve Congolese fleeing from the civil war that took place in Eastern Congo.

The camp is run by UNHCR in partnership with other organisations like, Jesuit Refugee council, American refugee council and other partners like MINALOC, and FAWE.

UNHCR and its partners obviously have a huge challenge to maintain order in the camp and provide for the refugees who have no other source of income. According to the UNHCR field officer for Gihembe camp, Jerusalem Eyob, there is a high birth rate in the camp.

She attributes this to several factors. But some are quite surprising. "A number of these people will just have kids in order to get more aid from us and our other partners”. This is because the more children one has the more support one gets from the aid providers.

Whether this was on Nyiragatete’s mind when she was conceiving her now one day old son, is only known to her.
But what is clear is that she is very happy with her new addition to the population of Gihembe camp.

But the challenges of providing such health services like enjoyed by Nyiragatete, have already taken a toll on the health care providers in the camp. With only one doctor for a population of close to twenty thousand people, one can only imagine the pressure such a medic is constantly under.

Apart from the women who are waiting to give birth or have just given birth in the maternity ward, more than fifty people are lined up for medical consultations just a stone throw away.

In order to be able to serve all these patients, it is mostly the serious cases that are referred to the doctor. Not every one according to Leona Nzabakomeja, a nurse working in the pharmacy at Gihembe health centre, is referred to the doctor because some just come with very minor complaints, which given the big numbers may not warrant a doctors’ visit.

"Because the drugs are free, we get many more people coming in than would be the case if they were buying them,” says Nzabakomeja.

She adds that due to this and other professional reasons, patients are only given drugs after consulting the doctor.

According to Eyob, UNHCR does international purchases for drugs that are not available in Rwanda. However, she adds that they prefer to procure them in Rwanda, because some time the drugs are held in customs at MAJERWA for long periods of time.

Nzabakomeja says that most of the patients they receive have respiratory complications. "Because of this, most of the drugs in stock are antibiotics” she explains.

Despite the numerous challenges faced in the provision of health services, the staff at the centre is highly committed and dedicated to their calling. There are three consultation rooms with three nurses. When the case is beyond them, they refer the patient to the doctor.

Giving hope through nutrition
Gihembe also boosts of a nutrition centre that helps to avert the consequences of malnutrition. The centre also targets HIV positive kids.

"For kids, who have issues of poor feeding, they come here and we feed them and while some go home in the evening, others stay over,” says Paster Kaboyi, the coordinator of the nutrition centre.

The centre according to Kaboyi receives around twenty people every month. At the time of this reporter’s visit, there were 14 people receiving special nutrition at the centre.

According to Kaboyi, the centre started with the camp. This is because it was realised at an early stage that this challenge would be met given the life conditions of disadvantaged people like refugees.

Some kids come with sever malnutrition according to Kaboyi. "This month, there were two cases of severe malnutrition but we solved the problem.” He adds that "most kids who are born with AIDS, get this problem of malnutrition”.

One year old Kwizera is one case that came with severe malnutrition. But after a month, he has greatly improved according to Kaboyi and is ready to be discharged and sent home.

The centre also helps breastfeeding mothers and the pregnant.

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