“If someone had suggested to me 12 months ago that I would be living in Rwanda and working for a new type of university to eradicate global health inequity, I would have recommended they take to their bed and consult their physician. But, here I am. Such is life”. 

Professor Timothy Carey, Director of the Institute of Global Health, reflects on his first six months living and teaching in Rwanda. Prior to moving to Rwanda, Professor Carey was the Professor of Clinical Psychology in Health Equity at Charles Darwin University and the Director of Flinders University’s Centre for Remote Health in Alice Springs in Australia. He now finds himself as the Andrew Weiss Chair of Research in Global Health at the University of Global Health Equity in Rwanda. Professor Carey reflects on his first six months in Rwanda in this article titled “The Land of a Thousand Hills” –

Last year, the university I was working at in Australia, like many Australian universities, decided that some reshuffling was in order. The consequence of that for me was that I was presented with an opportunity to reconsider my career journey. In undertaking this reconsideration, my family and I decided that, initially, we wouldn’t limit our options. I began to search widely. 

One position in particular caught my attention. It was the inaugural Director of the Institute of Global Health Equity Research and the Andrew Weiss Chair of Research in Global Health at the University of Global Health Equity (UGHE) in Rwanda. I did some background reading about UGHE and its sister organization, Partners in Health, as well as the leaders of both these institutions. I prepared an application but, realistically, never considered I would hear anything more. At that stage, I knew almost nothing about Rwanda except for the 1994 Genocide Against the Tutsi. The rest, as they say, is history. 

After an extensive recruitment process involving three interviews, I found out on 20 December 2019 that I was being offered the position which would be based in Kigali (Rwanda’s capital). I was beyond excited. The HR team I’d been dealing with were fabulously helpful with all that we had to arrange. They even recommended some books we could read to provide some context to the land in which we were about to become residents. 

With a flurry of activity, we arrived in Rwanda on 20 February 2020. I commenced working at UGHE on 2 March 2020 and the country went into lockdown in response to COVID-19 a couple of weeks later. Even in the context of lockdown restrictions, however, we have been entranced by what we’ve experienced of the country and its people. It really is the most remarkable country. It’s an extraordinary place to live. We consider it an enormous privilege to be here and incredibly humbling to have the opportunity to contribute in this way. 

A few things stand out. There’s no doubt that we’ve had to make some adjustments. Our son, for example, was initially dismayed to find that ebay trading would not be happening! We also can’t yet speak very much Kinyarwanda (the local language), and while almost everyone speaks at least some English, a rudimentary knowledge of Kinyarwanda would be helpful at the markets and with local transport among other things. It seems commonplace here, though, for many people to know three or four languages. Being able to use Kinyarwanda, English, French, and Swahili is not unusual. 

There’s an incredible sense of productivity and busy-ness here that is almost tangible. Wherever we go people seem actively engaged in some useful activity. The lack of material wealth is also very evident. One statistic we’ve learned is that about 75% of the Rwandan population still live in houses with dirt floors. And it’s a big population. In a land mass about one-third the size of Tasmania, there are 12.2 million people. Despite the lack of affluence, people are quick to smile and laugh. We’ve found Rwandans to be extremely helpful, friendly, and generous. 

One of our first experiences was Umuganda. Umuganda occurs for several hours on the last Saturday of every month (at least when COVID-19 is not interfering). Even the President participates. During this time, the community come together to work on projects, fix things, tidy up the neighbourhood, and laugh and joke and enjoy each other’s company. On our first (and only) Umuganda we travelled with some UGHE colleagues to the main campus in the poor, rural district of Burera. Burera is about three hours north of Kigali. Our Umuganda experience was helping the local community of Butaro make mudbrick houses for vulnerable people such as single mothers and the elderly. It was a remarkable experience helping to dig the mud, make the bricks, and then lay them as walls. There were lots and lots of people. Many were engaged in fetching water or digging or laying bricks and lots of others were pointing and directing and joking around. We’ve had many discussions about Umuganda since that day. There’s a lot that other countries could learn from this simple monthly activity. 

There are other lessons too. From starting with less than nothing 26 years ago after the 1994 Genocide Against the Tutis, Rwanda has made extraordinary progress. It is ranked in the top 10 countries in the world for gender equity, it is rated as one of the least corrupt countries in the world, and it has made incredible gains in areas such as maternal and child health. Quite remarkable things happen routinely here. In April, for example, because lockdown restrictions were in place, the entire Government including the President and senior Ministers, as well as hundreds of senior Government employees, gave up their monthly salary so that the funds could help support people whose incomes were affected by the restrictions. 

Kigali has a very strong security presence. Police with serious looking guns, for example, are at most intersections as well as other places. We walk through security scanners to get into supermarkets and we usually have to hand over our backpacks before entering the store. It’s amazing, though, how quickly this becomes unobtrusive. There’s also a strong sense of safety here. In a conversation with a young, single female colleague during Umuganda, she explained to us that she feels safer walking on the streets in Kigali at night than she did in London. In fact, she said Rwanda was a fantastic place to be if you were female. She felt she had unparalelled opportunities here. 

We’ve become very interested in the local news and have quickly developed an appreciation of the importance of context and perspective. Even in our short time here we’ve gained the sense that other, apparently developed countries, can be quick to make judgements about decisions and initiatives in countries like Rwanda. What happens here, though, generally seems to work. And work well. The results speak for themselves. There is not one style of Government that is universally appropriate. From all that we’ve read, experienced, and learned, Paul Kagame is an incredible leader. He must surely rank as one of the greatest, most inspiring and effective leaders of modern times. 

I’ve mentioned the word “opportunities” already. It’s hard to discuss Rwanda without using that word repeatedly. Genuine initiative and innovation seem to be actively invited, encouraged, and nurtured. Both professionally and personally I’ve been astounded by the opportunities here. UGHE provides lots of exciting and challenging opportunities and is full to the brim with outstanding people. It is unlike any university I’ve ever worked at. I work closely with the Vice Chancellor and Deputy Vice Chancellor for Academic and Research Affairs. They are both incredible and inspirational people. It is an honour and a privilege to be able to work with them and learn from them. They are both enormously respected globally, and are strong, highly principled leaders, with clear visions, whose words and deeds are closely aligned. 

Our first six months has been an adventure we’ll never forget and we’re looking forward to the months and years to come. To be able to serve UGHE in its quest to eradicate global health inequities is simultaneously scarily daunting and invigoratingly uplifting. To live and work day to day in Rwanda, the Land of a Thousand Hills, is an opportunity to be embraced and cherished. Rwanda offers a glimpse of all that is possible if we’re brave enough to reconsider what we think we know, and bold enough to reimagine the way we approach and organize our individual, family, community, and national affairs.