Lack of specialists, funding sees rise in heart disease in Rwanda

Saturday March 18 2017

A health worker takes the blood pressure of a participant at a campaign raising awareness on non-communicable diseases. PHOTO | CYRIL NDEGEYA

Rwanda faces a growing threat from an increase in cardiovascular diseases, which are emerging as one of the leading causes of mortality.

Health experts at a recent meeting on non-communicable diseases said they were concerned about preventable and treatable conditions like rheumatic heart disease, which were resulting in more deaths.

“There is a need for specialised cardiac services because rheumatic heart diseases are on the rise,” said Ntaganda Evariste, the head of the cardiology programme in the Ministry of Health.

Delayed diagnosis has been cited as a big problem but even those who are diagnosed early enough end up dying while waiting for surgery because of limited capacity.

Several health initiatives championed by charities such as Open Heart International, Team Heart and Rwanda Heart Foundation sponsor surgery for some cases but their efforts are small-scale.

In the past 10 years, Team Heart has performed 150 open-heart surgeries, but increased capacity is needed in terms of infrastructure, resources and skills. The broader approach taken by the government to tackle non-communicable diseases as a bracket intervention seems to have diverted attention from individual diseases like cardiovascular diseases, experts say.


“The country’s healthcare system has made great strides against non-communicable diseases, but the ongoing burden of cardiovascular diseases shows lack of funding, expertise and research data,” says the Rwanda Biomedical centre.

The government and its partners are coming up with ways of raising awareness, expanding research and scaling up screening, diagnosis, specialised treatment and prevention interventions.

The government also faces an acute shortage of specialised cardiologists, which has left the country dependent on foreign surgeons who fly in to help out, but they are few compared with the case burden.

Cardiovascular diseases are growing at a 15 per cent rate in the country, the highest in the region.

“The problem I see is lack of manpower, primarily because of insufficient incentives for doctors by governments to retain talent. More than 5,000 cardiologists from Africa are currently practicing in the US alone,” said Cryslogue Gakuba, a retired cardiologist.

He said there is a need to grow and retain local expertise. Currently, Rwanda has only five cardiologists.

Globally, non-communicable diseases now kill 38 million people annually, with almost 75 per cent of these deaths occurring in low- and middle-income countries. It is estimated that by 2030, non-communicable diseases will cause more deaths in Africa than communicable, maternal, and nutritional illnesses combined. Some 17.5 million people on the continent die from cardiovascular diseases every year.