HISTORY OF THE CENTER

PRESENTATION OF « CENTRE DE CHIRURGIE ORTHOPÉDIQUE PÉDIATRIQUE

ET DE RÉHABILITATION SAINTE MARIE DE RILIMA »

1. Supreme Organ

The Supreme Organ of « Centre de Chirurgie Orthopédique Pédiatrique et de Réhabilitation Sainte Marie de Rilima” is the Board of Directors. The current members of the Board of Directors include:

1. His Lordship Antoine KAMBANDA : Archbishop of Kigali, Chairman;

2. Father Donatien TWIZEYUMUREMYI : Deputy – Chairman ;

3. Doctor Albert NZAYISENGA : Secretary;

4. Father Patrice TWAGIRAYEZU : Member;

5. Doctor Bosco KANANI : Member

2. Owner

The “ Centre de Chirurgie Orthopédique Pédiatrique et de Réhabilitation Sainte Marie de Rilima » is a health organization owned by the Catholic Church, Kigali Archdiocese acquired from Italian benefactors of “Association pour l’Aide et Assistance aux Handicapés et Orphelins du Rwanda”. It is located in Rilima Parish at around 50 km from Kigali Archbishopric.

3. Historical background

• The idea of founding the Centre arose in 80’s. It came from local church leaders. This dream came true thanks to the collaboration with Italian benefactors of “Association pour l’Aide et Assistance aux Handicapés et Orphelins du Rwanda”. The first phase was unveiled in 1988 but construction activities were completed in 1993 and the Centre’s operations started in the same year.

• The management of the Centre was then entrusted to « Association pour l’Aide et Assistance aux Handicapés et Orphelins du Rwanda »; at that time the centre served as an orphanage and took care of children with disability.

• Due to the Genocide against the Tutsi in 1994, the Centre was used during several months to host emergency health activities in Bugesera region.

• Damaged and looted during that emergency period, the Centre was rehabilitated and reequipped by a group of Italian volunteers known as « AUGERE ONLUS ». In 1999 the Centre started its medical activities. The first surgeries were carried out in 2000 jointly with a Non Governmental Organisation known as Médecins sans Vacances.

• In 2001, health activities of the Centre tremendously increased thanks to Rwandan consultants’ collaboration.

• In 2003, Kigali Archbishop the owner of the premises inherited the entire structure of the centre from the hands of Italians benefactors « Association pour l’Aide et Assistance aux Handicapés et Orphelins du Rwanda”. This transfer did not put an end to the collaboration with these benefactors.

• In 2004, the Centre had its first contacts with « Fondation Carlo Don Gnocchi”. This led to a long lasting and profitable collaboration until now.

• In 2005, The Ministry of Health recognized the Centre as a specialised Centre in Paediatric Orthopaedic Surgery and Rehabilitation through agreement between Kigali Archdiocese and Rwandan Government.

• From 2004 up to 2007, the management of the centre was carried out according to an agreement between Kigali Archdiocese and Fondation AUGERE.

• From 2008 up to 2012, the management was carried out according to an agreement between Kigali Archdiocese, Fondation AUGERE and Fondation Carlo Don Gnocchi.

• In 2012, the Centre was recognized by the Ministry of Health as a Centre of Excellence that could be deemed to be a reference centre in paediatrics orthopaedic surgery and rehabilitation.

• Since 2013, the management of the centre was entrusted to a team of Rwandans to replace Italians.

• From 2013 up to 2018, the Board of Directors was managed by Kigali Archdiocese and la Fondation Don Carlo Gnocchi. In November 2018, Fondation Carlo Don Gnocchi decided to resign from the Board of Directors and preferred to remain a partner rather than management member.

4. Infrastructures

The buildings of the centre were conceived, constructed and maintained by Italian benefactors of Fondation AUGERE during their stay at Rilima. They comprise the following categories: administration buildings, surgery rooms, hospitalization rooms, accommodation rooms, kitchens, sanitary blocks, store blocks in metal containers, overhead and underground water tanks, and so on.

The center occupies an area of around 9 hectares with a tree plantation that covers more than its half. The infrastructures of the Centre are electrified from three sources of energy: ordinary electric current, solar energy and generators.

The carrying capacity in hospitalization is 80 beds (70 for children and 10 for adults and children). A building of 18 private rooms is being rehabilitated by Fondation AUGERE and it will serve as hospitalization area.

5. Activities

The center is a health establishment recognized by the Ministry of Health as a specialised in paediatric orthopaedic surgery and rehabilitation. Its medical services were also opened to adults since October 2017 in order to financially back up the services to children from poor families. The centre provides specialised cares including:

• Corrections of congenital and acquired malformations;
• Arthroplasty ;

• Advanced cares of physiotherapy ;

• Making and repairing prostheses and orthoses

The center has the particularity of caring of patients without external “gardes malades” (external nurses).

The centre also hosts academic training for surgeons who are specializing in Orthopaedic Surgery. In addition it hosts training sessions for other health organizations in the country with regards to taking care of children with orthopaedic problems.

8. Clientele

Our customers come from all the regions of Rwanda. The majority of our patients are referred by district and reference hospitals. A great number of patients are financially helped by national and international NGOs.

Currently, health insurers in partnership with the centre include: RSSB (RAMA), MMI, MEDIPLAN, UAP, RADIANT. In order to serve more people, the negotiations with other insurers are going on including RSSB in its branch of « Mutuelle de Santé ».

9. Administrative Management

The administrative management of the centre is carried out through its organs: the Board of Directors, Direction Committee, management Committee as well as ad hoc coordination units and committees as per the activities of the centre.

The staff of the centre comprises 79 employees deployed in the following activity sectors:

• Medical sector 19 : 2 specialized orthopaedic surgeons, 8 nurses, 5 physiotherapists, 1 lab technician, 1 orthoprosthesis technician, 1 assistant orthoprosthesis technician, 1 anaesthetic technician.

• Administrative sector 10: 1 Director General (Specialized Surgeon), 1 Administrative and Finance Director, 2 Social Assistants, 1 Accountant, 1 in charge of billing, 1 Administrative Assistant, 1 in charge of Education, 2 Maintenance technicians.

• Support staff sector 51 : Members of a private company that carries out hygiene, security and support tasks for patients.

In part-time the centre hires 1 Orthoposthesis technician, 2 anaesthetic technicians and other specialized experts as per the case of intervention.

10. Partnership

The centre is in partnership with the following organizations according to respective conventions:

• MoH (MINISANTE): Support in terms of salaries; development of organization chart ; Accreditation program.

• Fondation Don Carlo Gnocchi : Financial and technical support

• Fondation RILIMA AUGERE : Technical support, Equipments, Infrastructure maintenance

• Sœurs OBLATES : Assistance to staff ;

• CENTURA : Medical equipment and training

• CURE INTERNATIONAL: Support to club foot program

• The Independent Public Health Care Institution – The Complex of General Hospital in CHORZOW/Poland : Training on local and regional anaesthesia techniques; equipment

• Health insurers : RSSB (RAMA), MMI, MEDIPLAN, UAP, RADIANT

11. Financial aspect

The budget of the centre is mainly based on internal earnings from medical activities but some grants from local and international partners back up the financial sector of the Centre. The budgetary system follows the annual calendar from July 1 up to June 30.

12. Projects

• Rehabilitation and equipment of private hospitalization rooms.

• Repairing of the storey to have more space for administration offices

• Using cooking gases for environment protection

• Equipment of the second surgery room

• Building the fence for security reinforcement

13. Obstacles

• Access to clean water is a common challenge for the region

• The lack of organization chart within the ministry of Health delays its support to the staff

Done at Rilima, May 2019

The Direction of the Center.