When Liliane Uwukuli graduated in nursing eight years ago, she worked in different hospitals attending to the sick. Seeing her patients heal gave her a sense of gratitude and fulfilment. But for some reason, she wanted more—she wanted to create a bigger impact. During her shifts, she had a chance to interact with teen mothers. They shared their troubles with her and this touched her — she wanted to be there for them, heal their physical ailments — and also transform their livelihoods for the better. “Most of them were going through a lot of challenges, I dreamed of a better life for them. I wanted to empower them not only for their wellbeing, but for their children’s future as well,” Uwukuli shares. In mid-2012, she established a small dispensary in Nyamata, Bugesera District, to cater for the health of young mothers. Her vision also had a wider perspective to offer those living in the area access to quality healthcare and facilities. Uwukuli wants girls to know that there is still a life and opportunities even after giving birth at such a tender age That’s how Ivuriro Kira (now called Benefactor David Clinic) was established. This particular programme for the girls, The Benefactor David Impact, is one where teen mothers are helped to rebuild their lives. Uwukuli says through this platform, she wants girls to know that there is still life and opportunities even after giving birth at such a tender age. “This was a calling for me. When I came face to face with the hardships these young girls go through, I knew I had to do something for them. Most of them were stigmatised by families and communities, this affects their livelihood and that of the children they bear yet these children are our country’s future,” she says. To better help the beneficiaries, the centre provides vocational training and social entrepreneurship skills to help them build resilience and earn a living. They also organise adolescent reproductive health rights and livelihoods, education sessions to help them take care of their children, and also equip them with the knowledge that will prevent them from falling into the same pit twice. “They use that knowledge to empower themselves and their peers who are at risk and improve prevention at the community level,” she says. At the impact centre, beneficiaries are also provided with entrepreneurial skills, they are given a workspace and seed funding. The centre also has a shop where products from the work of the beneficiaries are sold. “With our impact centre, we want to build health, not as the absence of disease, but as general wellbeing. With the Benefactor David Impact, we want to help create a million stories of family transformation through women,” Uwukuli says. Forming an open discussion Uwukuli observes that most teen pregnancies are caused by poverty and a lack of knowledge about sexual reproductive health. “Some of these girls don’t even realise they are pregnant until the pregnancy matures. Let’s create an open discussion, parents need to sit down with their children and talk about this. Local leaders, on the other hand, need to be sensitised on this matter, we need to overcome this cultural obstacle that’s stopping us from dealing with this issue head on,” she adds. She is also of the view that communities should not make matters worse by, for instance, stigmatising victims. Creating a patient-centred healthcare system At the clinic, other services offered include general medicine, paediatrics, gynaecology, dentistry, hospitalisation, medical laboratory, immunisation, minor surgery and family planning. As a social enterprise, Uwukuli believes that re-investing their profit is one way of catalysing social change in her community. In regards to the country’s health system in general, she notes that one of the biggest challenges around it is creating a patient-centred healthcare system. “Healthcare providers should adapt an approach of being readily available for their patients. A patient is in some way a customer, which means that as with any other business, patients need to be treated as royalty. Another important issue that the sector needs is affordability of services and equity (especially targeting rural areas).” With the resources she has, Uwukuli hopes to scale up her services, personnel, infrastructure and impact. “Our vision is to establish a centre of healthcare excellence in Bugesera which would also promote medical tourism from Rwanda and the region.”