Africa

How COVID-19 startled Rwanda that seemed to have it under control

Rwanda's efforts to tackle the first wave of infections was recognised internationally 

 
By Christophe Hitayezu
Published: Thursday 01 April 2021
How COVID-19 startled Rwanda where authorities thought they have it under control

Since the first case of the novel coronavirus disease (COVID-19) was identified on March 14, 2020, Rwanda — a sub-Saharan landlocked country with an estimated 12 million people on an area of 26,338 square metres — has put in place various control measures. It organised a bi-monthly cabinet review to mitigate the spread of coronavirus while also conducting efficient tracing, testing and isolating of patients. 

Rwanda increased its testing capacity, with over 4,000 tests daily and up to 1,012,451 tests by March 1, 2021. The effort has led the country to being ranked first in Africa and sixth globally in managing the pandemic and making the information accessible to the public, by the Australian think-tank Lowy Institute.

Until the end of November last year, Rwandans were hopeful of returning to normal; businesses had mostly resumed with a curfew from 7pm to 10pm. This affected public behaviour as it projected a sense that the pandemic is over. Soon, officials started warning of a new surge.

“Now, another total lockdown is looming and we are responsible,” minister Johnston Busingye had written on Twitter. The country’s health minister also said December 17, 2020 if a lockdown was the best solution, the authorities will consider it.

A few weeks later, on January 19, 2021, Rwanda imposed a 15-day lockdown in its capital Kigali. This was later extended by another week. Heightened measures such as prohibited movement between districts and curfew after 7pm followed for the rest of the country.

It is during this surge that the country recorded the highest daily cases and deaths.

As concerns regarding COVID-19 variants shored up, health minister Daniel Ngamije said that the country had not yet carried out specific screening for this but efforts were underway to establish the necessary technology.

Containing first wave

The second surge came in when the country had been treating COVID-19 patients from home for about five months. This helped free up dedicated treatment centres for strictly severe cases and deal with the over 5,000 active cases in January without infrastructure shortage.

“To track patients in this condition, we put a bracelet on their hand so that they do not go out and infect other people at the market or other places,” said Dr Sabin Nsanzimana, director-general, Rwanda Biomedical Center had said.

Rwanda also employed robots at treatment centres to reduce risks for healthcare workers of getting infected. The five human-size robots deployed in July 2020 are programmed to perform temperature screening, take readings of vitals, deliver video messages and ensure people wear masks properly.

In February 2021, the country deployed three more robots to reinforce its efforts against the virus – the cutting-edge Ultra Violet light robots which help in cleaning and disinfecting treatment centres, hospitals and places of mass gathering.

Lower deaths

As of March 1, 2021, Rwanda’s death rate from COVID-19 was 1.4 per cent with a recovery rate of 91.2 per cent, according to health ministry figures. The country lost 264 lives from a total of 18,986 confirmed cases.

The death per capita in Rwanda is among the lowest in the world because the country has a relatively low number of deaths, compared to other countries with similar public health conditions (low- and middle-income countries) and even those with well-set health systems (high income countries).

Dr Menelas Nkeshimana, team lead for COVID-19 case management at Rwanda Biomedical Centre, said:

The low death is a result of efforts, including timely decisions in regard to lockdowns, regulation of international travel, improved testing capacity, contacts tracing, use of technology to boost efficiency in response, among others.

Death per capita, however, is not a good indicator to compare the disease severity across countries, he added.

A community-centered effort

At the level of villages (Umudugudu), the community health workers (CHW), the leader of village education structure (Mutwarasibo) and the Umudugudu leader have been working together to tackle the COVID-19 threat.

In Rwanda, CHWs have been trained to detect the alarming signs that would trigger a referral to the COVID-19 treatment centres. If a patient’s overall condition is stable throughout, then the CHWs link the patient for the final testing at the local health centre.

“There are eyes of the health ministry at the level that is closest to the beneficiaries of health services,” Dr Nkeshimana told Down to Earth.

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