Dr. Lauri Romanzi in Nairobi.

Dr. Lauri Romanzi, a pelvic reconstructive surgeon, travels the world repairing, as best she can, the female pelvic organs that nature—or culture—has damaged. See our recent posts, “If Men Had to Go Through Labor” and “The Vulnerable Female Body,” for a glimpse into Dr. Romanzi’s life in Africa and Asia, working on the devastating fistulas, prolapsed bladders, damaged uteruses, and mutilated genitals of poor women, many of whom must walk for days, through dangerous territory, to receive treatment.

Dr. Romanzi, a member of Women’s Voices’ Medical Advisory Board, has agreed to keep a diary, “Postcards from Africa,” to give us a peek into what her life is like in Kenya, Somaliland, the Democratic Republic of Congo, and Rwanda. Here she is in Rwanda, assessing how the country has rebounded since the 1994 genocide in which an estimated 800,000 to 100,000 men, women, and children perished. —ED


“The story is our escort; without it, we are blind.” –the late Nigerian novelist Chinua Achebe


For the past six weeks I’ve been immersed in FPMRS (Female Pelvic Medicine & Reconstructive Surgery), capacity-building, and clinical-skills development at Centre Hospitalier Universitaire de Kigail as part of Rwanda’s Human Resources for Health Program.  I’ve been busy.

This is not the Kigali of the genocide. I repeat, NOT the Kigali of the genocide. Rwandans, demonstrating unfathomable resilience, have restored the country to its organized, dynamic, industrious ways of being many years ago. Yes, that’s right—many, many years ago. Don’t believe me? It’s all there in the Genocide Memorials located throughout Rwanda.

Email exchange from a colleague and dear friend:

Where are you, NYC?


Kigali, working in the Human Resources for Health program til early next year.


What are you DOING in Darfur?!?!?

Wow.  It’s as if I tell her I’m in, let’s say, North Dakota and she thinks I’m dodging the Shining Path in Peru.

Africa contains the world

Credit: Mercy Ships

The entirety of the continental USA fits inside West Africa. That’s how big Africa is. Think massive continent, within which exist 57 countries (if you include Somaliland, which you ought), thousands of ancient cultures, and dozens of economies, many of them doing phenomenally well at the moment.

Darfur is a region the size of France located inside the country of Sudan. That’s how massive Africa is. This small, recently war-torn region inside of Sudan IS AS BIG AS THE ENTIRE COUNTRY OF FRANCE.  Darfur-inside-Sudan is way up in the northeast region of Africa, with coastline on the Red Sea, just below Egypt, right across the pond from Saudi Arabia. Sudan is massive, dry, sandy, hot, and recuperating from recent devastation.

Rwanda, by contrast, is a tiny green gem of a land-locked country in central Africa, 1,500 miles south of Sudan, slightly smaller than the state of Maryland, bordered by the Democratic Republic of the Congo, Burundi, Tanzania, and Uganda. Rwandans continue to heal from the 1994 genocide without being defined by it.


Rwanda. Helicopter ViewRwanda is called “the land of 1,000 hills,” most of them cultivated and each verdant beyond one’s ability to conceive of variations on the color green. It’s the rainy season right now. It’s as cold as Edinburgh in July, by which I mean quite chilly. Please send me some gloves, a down parka, and a few Totes umbrellas. I under-packed.

While Kigali is a bustling metropolis where I live like a New Yorker, walking to everything I need in my life, 80 percent of Rwanda’s population lives in rural areas. Maternal mortality is at 476/100,000 live births (2010), a major reduction from 750/100,000 in 2005 and 117th out of 176 countries on the 2013 Mother’s Index Rankings. Sudan is 143rd. By comparison, the stagnant U.S.A. finally crawled out from under last place (ranking #31) among industrialized wealthy nations. Thanks to Japan’s tsunami, they are right behind us as of 2013, at #32.

Fecundity in Rwanda hovers just below 5 children born per woman, with life expectancy 60.4 years for women (57.34 years for men) and a total national population of 12,012,589 as of July 2013, making it the most densely populated country in Africa. Maternal age at first birth is 22 years, with a 98 percent rate of antenatal care by skilled clinician and steady growth in rates of delivery assisted by skilled provider (69 percent in 2010) and delivery at a Health Facility (69 percent in 2010).

Rwanda Corruption SignThe U.S. could learn a healthcare lesson from Rwanda –with almost nothing left of its doctor population and medical infrastructure in 1994, the Rwanda Ministry of Health now oversees a well organized healthcare system that includes 4 public referral hospitals, 38 district hospitals, 5 provincial hospitals, and 453 local health centers. All Rwandans have access to affordable health insurance through the Mutuelle Insurance Plan that covers the majority of Rwandan citizenry, though many live at or below the poverty line.

I call Rwanda the “Switzerland of Africa”–it’s meticulously clean, it’s tiny, they follow the rules to the letter, they practice robust citizenship, and it is one of the least corrupt nations in Africa. Unlike the farcical post-colonial commerce development that plagues most of Francophone Africa, Rwanda takes care of its business, from technology and telecom to its gorgeous gorillas, which you can visit in five-star facilities available throughout Rwanda’s thriving tourist industry.  Bring your bicycles.

Come visit. Seriously. Come visit.


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  • Patricia Yarberry Allen, M.D. December 22, 2013 at 8:20 pm

    Dear Lauri,

    I am so glad I did not send that email about Darfur! You are right that so many Americans don’t understand the progress that some countries have made after years of horror. At a recent TEDWomen conference I learned that the genocide had made it possible for women who had been terribly suppressed in that culture before the genocide to take on important cultural roles in the new Rwanda. A fantastic woman had created a school to teach women to be the new drummers, formerly a tightly held male role. The stories of survival and reinvention were extraordinary. keep writing to us. The only way that some of us will know about the lives of African women may be from your postcards.

    Pat Allen

  • ellen sue spicer-jacobson December 22, 2013 at 11:43 am

    Thanx for this info on Rwanda. The female members of my family are sponsoring one woman in Rwanda through Women for Women,so this info is very helpful. And Dr. Romanzi is making a real difference in the lives of the women there. I plan to send a copy of this to Women for Women.Thanx again!