Rwanda recorded the first Covid–19 case in March 2020, and since then, medics have been at the forefront of fighting the pandemic.

Nurses have taken the lead in critical responses and, as such, are constantly exposed to the risk of infection.

They have not only been exposed to possible infection but are also subjected to working long hours, walking long distances in places that have from time to time been put under lockdown, psychological distress, fatigue, occupational burnout, stigma, and so much more.

"Under normal circumstances, one nurse should take care of one patient, but when numbers surge, one nurse has to take care of over five Covid–19 patients. This requires a lot of sacrifice on their part, but we are optimistic we shall overcome the pandemic,” says Clarisse Uwizerwa, the Director of Nursing at Nyarugenge District Hospital.

Nurses at the main Covid-19 treatment centre have also been working as caretakers of patients since family members are not allowed in the centre.

In some health establishments, especially private health facilities, nurses and midwives have had to risk their lives by working without proper or adequate personal protective equipment, according to Rwanda Nurses and Midwives Union (RNMU).

The union urged employers or managers of health facilities to honour the right to compensation, rehabilitation and curative services if infected with Covid-19, following exposure in the workplace.

It says this would be considered occupational exposure and the resulting illness would be considered an occupational disease.

It also recommends providing access to mental health and counselling resources. The union has 8,942 registered nurses and 2,200 midwives.

According to André Gitembagara, the president of Rwanda Nurses and Midwives Union (RNMU), account for 52 per cent of workers who provide medical care worldwide.

"In Rwanda, nurses and midwives make up over 62 per cent of health professionals, which means that this is a valuable profession,” he says.

As of August this year, more than 280 nurses in Rwanda had suffered from Covid-19, while two succumbed to the virus, which highlights their vulnerability.

However, Gitembagara says that all nurses and midwives have been vaccinated against Covid-19, adding that during the peak of the pandemic, nurses worked extra hours—over 60 hours a month.

Nurses’ international congress

Gitembagara says that Rwanda has applied to host a nurses and midwives international congress to be held in 2025.

"The assembly will attract over 6,000 nurses that include those in education, students, researchers, those who work in health technology, World Health Organization and other UN health agencies, among many others. The congress discusses nurses’ development, struggles and challenges and their contribution to the health sector,” he says.

After applying to host the congress, Rwanda was selected among the top three countries.

On September 16, Howard Catton, the Chief Executive of the International Council of Nurses (ICN), was in Rwanda to assess the county’s readiness and the status of nurses in Rwanda.

The council is composed of over 130 countries with 27 million nurses.

"We are still in competition to host the congress and we have hope,” Gitembagara says.

The 2017 congress took place in Barcelona, the 2019 congress took place in Singapore while the one of 2021 will be held in Abu Dhabi albeit virtually. In 2023, the congress will take place in Canada.

"The Chief Executive of the International Council of Nurses (ICN) is in Rwanda to assess our readiness. We have also talked about the resilience and efforts of nurses in the fight against the Covid-19 pandemic, especially in Kigali. We also discussed the capacity to host the congress,” Gitembagara says.

"We need to increase capacities of nurses and midwives and their conditions. They need to be promoted in terms of wages. We continue to urge them to be committed to their work to provide high-quality care,” he adds.

The International Council of Nurses (ICN) says the slow roll-out of vaccines across Africa and other parts of the developing world is continuing to put exhausted nurses and other health workers at risk.

"Nurses and other health workers are at the sharp end and are both directly and personally suffering the consequences of the unacceptably slow roll-out of vaccines in Africa where only 2 per cent of the population are vaccinated,” he said.

Catton said it was a positive development that the G20 health ministers meeting in Rome has agreed to create a pact to ensure fairer vaccine distribution, but added that words without action were not enough.

ICN Chief Executive says governments should invest rapidly in advanced nursing roles to maximise effectiveness of healthcare systems in a post-pandemic world.

"We know that Covid has taken an enormous toll on the nursing workforce globally, and ICN has run a commentary on its impact on nurses and nursing around the world,” he said.

"Nurses are ensuring not just that care is delivered but that there is increased access to care, and that it is safe, equitable and sustainable, and also that the values that care are based on are ones which put people at the centre.

"And as a consequence, I think that we are seeing a change in the way that people and the world’s leaders see and evaluate nurses and the nursing contribution,” Catton added.