By any measure, the tiny east African nation of Burundi – one of the world’s five poorest – is a daunting assignment for a global health organization. Like neighboring Rwanda, the landlocked country of 10 million has witnessed its share of genocide and a 12-year civil war that left more than 300,000 casualties.
Yet for a small but growing network of Puget Sound area physicians and global health experts, Burundi also stands as a hopeful sign of change. Joined by Harvard’s Dr. Paul Farmer, founder of Partners in Health, Seattle physicians Sachita Shah, Kris Sherwood and Joseph Alsberge donate their time and medical expertise to the residents of Kigutu through the nonprofit organization, Village Health Works. Connections between Seattle and Kigutu date back to Village Health Work's very beginning. While the majority of Village Health Works employees are Burundian, the organization also employs a powerful network of advisors in global health, technology, women's health, development and agriculture — 12 out of 25 are based in Seattle.
More than 20 years ago, Village Health Work’s founder, Deogratias [“Deo”] Niyizonkiza, fled from a horrific massacre in the rural hospital in Mutaho in northern Burundi where he was a third-year medical student. Niyizonkiza’s harrowing odyssey, recounted in Tracy Kidder’s bestselling book, "Strength in What Remains," planted the seeds for what is today one of the remarkable success stories in community development and global health.
Following his daring escape from Burundi in 1994, Niyizonkiza landed in New York City, graduated from Columbia University and attended the Harvard School of Public Health. There he met Farmer and began working at the PIH in neighboring Rwanda. After further studies at Dartmouth Medical School, Niyizonkiza returned to Burundi to realize his dream of establishing a rural clinic in his native village of Kigutu in southwestern Burundi in 2007.
“Village Health Works was an idea in my mind for a long time,” he said during a visit to Seattle last week. “When I came to the United States, I left Burundi, but it never left my mind. One of those memories was mothers dying in childbirth.” Another was a rural community suffering from malnutrition, few roads, crumbling infrastructure and a lack of access to basic agricultural necessities or healthcare.
By all accounts, Burundi’s health statistics are numbing. The war-ravaged nation has fewer than 300 physicians. Waterborne diseases and lack of sanitation account for one in five deaths and more than 54 percent of children under five suffer from severe malnutrition. The average life expectancy is 50 years. Burundi also has one of the highest rates of child mortality in the world — 180 out of every 1,000 children under the age of five don't make it. Most of those deaths are due to infection, primarily diarrheal disease, pneumonia and malaria.
Equally paramount is the legacy of armed conflict between Hutu and Tutsi tribes from 1993 to 2005 and a generation still reeling from the trauma of bloodshed and decades of lingering mistrust.
In the middle of all this is Village Health Works. Since opening its doors in 2007, the clinic has treated more than 70,000 patients. In 2012 alone, Village Health Works saw huge advances: it treated 22% more patients than the year before, saw a 228% percent increase in the rate of voluntary HIV testing and a 221% rise in prenatal consultations.
Dr. Sachita Shah, who practices at the University of Washington’s Harborview Emergency Center, coordinates ultrasound training for doctors at Village Health Works. Shah got involved with the project after meeting the clinic’s first Burundian physician at a Partners in Health ultrasound training she conducted in Rwanda. She attributes the success of Village Health Works to its holistic approach to community development and health.
“It’s impossible to improve the health structure of a people without somehow addressing the challenges of poverty, food security, shelter and education as well,” she said. Community involvement with the clinic is the linchpin of that philosophy. “I’ve worked with several nongovernmental organizations over the years, and one of the most striking and unique things about VHW is how invested the Kigutu community is in making it successful.”
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