Residents of Bugarura in Rutsiro District are demanding for more medical facilities as the Island that has a population of 2,059 people struggles when people fall sick because there is only one health post and one  permanent nurse who runs the health post from Monday to Friday. 

Bugarura Island, which is part of Boneza Sector, is one of the largest and most densely populated islands on Lake Kivu. It takes about 1-hour and forty minutes by boat from Rubavu town to get to the island which borders Rwanda’ Iwawa and DRC’s Ijwi Islands.

According to the residents, Bugarura health post—an extended subsidiary of Kinunu Health Centre opens from 8am to 4pm, saying that the health service offered is insufficient for the Island made of two villages, Rutagara and Bugarura.

Pierre Hakizimana, 34, a resident of Bugarura told the Sunday Times, that they have made their query for improved healthcare known to various local leaders with minimum response made.

"One of the biggest challenges we have on this island is insufficient medical care. We only have one nurse. He does not satisfy the medical demands of the area,” said Hakizimana, adding that medical care offered at the island’s only health post include antibiotics, and malaria treatment.

"This is not the first time we are making these demands. Sometimes, the Ministry of Health sends some facilities and services to the island, only to hear that they have been held upat Kinunu Dispensary,” Hakizimana added.

Kinunu Health Centre is located off Bugarura Island; it takes about one hour to get to the health centre from the island, according to the Hakizimana.

"When we have a patient who needs emergency medical care, we have to transport that patient by boat to Kinunu,” he said.

"We need at least three more permanent nurses, and improved medical services to offer emergency care services”.

Transporting patients another nightmare

Anastase Tuyisabe, another resident of Bugarura Island told Sunday Times that for a patient to be transported off the island for emergency health care, one has to fuel the boat by him or herself.

"The ministry of health gave us a boat, which works as our ambulance, but in order to access it you need to buy fuel. In case of an emergency, you will need to buy 20 litres of fuel to be able to transport you across to Kinunu health centre and back,” he said.

A liter of fuel costs Rwf1,200 at Bugarura Island meaning that to fuel a boat to Kinunu Health Centre, one needs at least Rwf24,000.

Residents say the amount of money is a lot for a population mainly constituted of fishermen and coffee farmers.

Unlike in other parts of the country where community-based health insurance commonly known as "Mutuelle de Santé covers ambulance costs in case of medical emergencies the case is different according to Bugarura residents.

"Mutuelle de Santé should also cover boat expenses too, since it covers ambulance costs in other parts of the country. The government should intervene for sure,” Hakizimana said.

The island is prone to malaria, while available figures show that HIV prevalence rate is equally worrying, among other medical cases.

At least 30 residents of Bugarura Island are HIV positive and are under antiretroviral therapy (ART), meaning that more than 1 percent of the population of the island is infected and affected by HIV, according to the research made by Mboneza sector officials.

Health Minister, Agnes Binagwaho, in a telephone interview with the Sunday Times, acknowledged that the island is faced with health care challenges, but promised response as soon as the ministry can.

"It is true, the health post on this island needs more nurses but we have worked hard to even get the only one we have now,” said Binagwaho, adding that in normal terms a health post is meant to serve a cell.

"A health post is enough for the island, now, because we need more than 10,000 citizens to have a health centre and then you can have many nurses. This is because we don’t have enough nurses that we need,” she said.

Binagwaho added that, the ministry was moving towards having enough nurses with the availability of nine nursing schools producing about 400 nurses annually.

"These nurses will serve the purpose we have in the near future. This is a work in progress, the health services on the islands are improving though there is a long way to go and we are working tirelessly to improve, budget after budget, education after education,” Binagwaho added.

Tharcisse Niyonzima, an official in Rutsiro, said addressing the issue of transport will require collaborative discussions with Rwanda Social security Board (RSSB) to make sure that they agree to include boat expenses on insurance costs for the island’s residents.

"Issues relating to Mutuelle de Santé concerns RSSB, but this is something we can discuss with them and reach a mutually common conclusion so that residents of the Island access good medical care,” said Niyonzima.

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