Medical doctors from district and referral hospitals in Rwanda are receiving training on the early detection and treatment of cancer and neurological disorders as a mechanism to address the current small number of specialists in neurology and oncology in the East African region. 

The training is part of a four-year programme funded by the East African Development Bank (EADB) and implemented by the British Council in collaboration with the Royal College of Physicians and the Rwandan Ministry of Health through Centre Hospitalier Universitaire de Butare (CHUB).   

David Odongo, Acting Head of Business at the East African Development Bank-Rwanda Office, said that they have been funding the medical training programme since 2016.

"EADB provides resources to various partners including the British council and we facilitate the Royal College of Physicians across the region where there is generally a lack of specialists in the field of neurology as well as oncology. What the bank is trying to do is to increase capacity in early detection and treatment. Our target is 600 doctors over a four-year period. We wish this number could go higher but this is what the resources will allow. However we feel it will have a significant impact to start a process where we can train even more doctors,” he said.

According to Esperance Uwamaliya, Programmes Manager at the British Council, the current neurology clinical training course, being the third cohort, is benefitting 20 Rwandan medical doctors from different hospitals. 

The first day of the training focused on history taking and examination, headaches, brain tumours, nerve and muscle disease, movement disorders, brain infections, epilepsy, pediatric conditions, stroke and dementia among others.

With 30 doctors trained previously, the number has now increased to 50 trained medical doctors.

Uwamaliya said that the trained medical doctors will build strong knowledge and skills in the early detection and treatment of neurological disorders in their respective hospitals and also be able to appropriately refer cases to referral hospitals that need specialized professionals.

"The training has a positive impact as medical doctors are learning and acquiring new knowledge. They will be able to carry out preliminary checking, interpreting symptoms and understand the condition, before treating or referring the patient. They are still general professionals but in the end they can specialize in neurology.” Uwamaliya said.

She noted that once the general medical doctors do suitable referrals, it will become easier for specialists at referral hospitals to treat patients.

She said that neurological cases are on the rise and previously weren’t really spoken about.

"Many used to think they are suffering from witchcraft. Many patients seek treatment when the disease has reached further stage since there was no early detection. Now people are becoming more aware and getting knowledge about the disease. Trained doctors are needed in early detection and treatment,” she said.

The British Council, she said, was selected as a partner to run the programme as the UK education and medical environment is known to be advanced in neurological disorders and cancer treatment.

Dr. Francois Xavier Nshimiyimana, a consultant neurologist at the University Teaching Hospital of Kigali (CHUK), is one of the trainers of the programme who highlighted the expected impact of the training.

"Once we will have more general medical doctors who can help in early detection and treatment of neurological diseases, it will also reduce the high number of patients who are referred to specialists such as in CHUK,” he said, lauding the partners who designed the programme.

He said neurological conditions are on the rise, where previously there were no mechanisms to raise awareness on how to detect and treat them.

"People continuously become aware of such diseases. They can understand, for instance, that chronic headaches, paralysis, instant blindness, backache and other conditions are neurological diseases. Whether a country is poor or rich there are always related non-communicable diseases. That is why more awareness is needed,” he said.

He mentioned that at CHUK, they receive and have to treat many cases of stroke among many other neurological diseases.

"Some of these diseases are also effects of non-communicable diseases such as high blood pressure that is not treated well and diabetes and obesity that can cause paralysis. We also receive many cases of epilepsy. Another neurological disease is chronic headache. All these affect people’s pockets since they lose the ability to work,” he added.

Dr. Nshimiyimana said that most patients are treated while some may need to be transferred elsewhere. He also recommends positive healthy habits to prevent neurological disorders.

"Prevention of such diseases will require regular medical check-ups at least once a year to control our body. Even as people grow up, such diseases also emerge meaning that if there are any changes to the body, the patient must consult the doctor. People should also embrace a good diet and physical exercise,” he said.

There are currently three neurologists in Rwanda serving 12 million people, yet the World Health Organization recommends at least one specialist for 100,000 people. in Rwanda there isn’t even one specialist per one million people.

"With partners like the EADB, the British Council and the Royal College of Physicians, we will be able to increase access to treatment,” Dr. Nshimiyimana said.

Dr. Dyna Nyampinga , a post-graduate student in internal medicine, is one of the trainees who  expressed her expectations from the training.

  "I am expecting a lot from this training. Neurology is normally a difficult course in medicine school. This means that recurrent trainings are paramount for me. Therefore, this training shall improve my knowledge and quality treatment for patients. With skills to acquire from this training, it will become much easier for me to treat patients with neurological disorders,” she said.

She added that she also looks forward to building networks with other medical doctors and specialists in treating the diseases and share experiences and knowledge in the future.

The training started on Monday 30th September and will end on Friday 04th October.

editor@newtimesrwanda.com