When many of us hear the name Rwanda, what one word comes to mind?
Team LR decided to do an e-poll on this to see what the result would reflect. Of the fifty persons who we sent open-ended-questionnaires to, forty-two responded. Twenty-nine of them answered ‘genocide’ or ‘war’. Six persons responded with ‘Paul Kagame’, four told us ‘tourism’ two came up with the word ‘recovery’ and one said ‘women in politics’.
Some of us at Team LR felt the responses of more than one word should be voided but when we took a vote, the majority voted for those responses to be collated because it gives a true picture of the way people perceive things.
It is true that in 1994, this landlocked East African nation experienced what the world wishes never to see again. A revolution that exploded in genocide – an occurrence that can be traced way back to external influences setting the stage for a revolt even the plotters may never have imagined the extent of. However, what the media does not sing with the same energy that was devoted to all the negative news which came out of Rwanda is that like a phoenix, this nation has risen out of its ashes, determined to be together, bigger, and better. In her recovery, this country with Kigali as the capital has blazed the trail in preserving our world – perhaps the aftermath lesson they have imbibed from their sad experience. As far back as 2008, Rwanda banned the use of plastic bags and is one of the cleanest eco-oriented countries in the world. Ranked the second easiest country to do business by the World Bank, it is little wonder that many of us are still stuck in 1994. Around the world, people are still associating Rwanda with negatives, many of them may not know, a few may refuse to believe the trajectory of this new emergent nation of positives. By the way, when we critically look at our world, which nation is without her negatives?
There are many positives about this nation that is also known as the land of a thousand hills. From her unique natural scenery, being home to the mountain gorillas and golden monkey to having 64 percent parliamentary seats for women way back in 2013, Rwandans have shown that they are set to make the needed changes worthy of emulation.
It is in the light of presenting you with certain narratives that many people may not know, that we bring you this guest feature who epitomizes how Rwanda is determined to promote closing her gender gap. Some postulate that the dearth of men following the genocide is why the women are taking over – not a hundred percent true at all. If we x-ray the global development in the country, we find policies being restructured for growth in all facets. They may not get it all right, however, what they get right deserves as much publicity as what they got wrong….or what do you think?
Did you know, that Dr. Claire Karekezi is the first and only female Neurosurgeon in Rwanda? You read right1! The small Central-Eastern African country, with a population of nearly 12 million has only 5 Neurosurgeons among them is Dr. Karekezi. She did most of her training outside Rwanda. However, in the spirit of national recovery, this brave woman has gone back to help build her fatherland and help take control of her country’s positive narrative!
My name is Claire Karekezi (CK); I was born and raised in Rwanda. I attended both my elementary and high school in Kigali, Capital of Rwanda. I later joined the National University of Rwanda in 2002 on a full government scholarship, where I completed my General Medical studies and graduated as a Medical Doctor (M.D.) in March 2009 with a distinction mention.
I later completed my residency program in Neurosurgery in May 2016 at Mohamed V University of Rabat, Morocco, an accredited center by the World Federation of Neurosurgical Societies (WFNS) as one of the recognized centers for Neurosurgery Training worldwide. I also had the opportunity to do a 3-month fellowship as an International Visiting Surgeon (IVSF), funded by the American Association of Neurological Surgeons from May- Aug 2016 at the Brigham and Women Hospital, Harvard University. I later joined my clinical fellowship in Neuro-Oncology and Skull Base Surgery at Toronto Western Hospital, University of Toronto from July 2017-June 2018. I am a fully trained Neurosurgeon with a sub-specialty in Neuro-Oncology and skull base surgery.
Why did you choose Neurosurgery?
During my 5th year of medical school, I had the opportunity to do an exchange program as a visiting medical student in Sweden; to be in a department of Neurosurgery at the Linköping Teaching Hospital for four weeks and was directly mentored by Professor Jan Hillman, Chairman of the Department of Neurosurgery.
I had planned to be in the Department of Radiology, but during that summer period, most departments did not receive interns. Professor Jan Hillman, head of the Department of Neurosurgery at the Linköping Teaching Hospital kindly accepted me. When I arrived, he was on holidays. I roamed around in the Intensive Care Unit.
When he got back, Prof. Hillman asked me “Are you the girl from Rwanda?” I said “yes”. “Have you been in the operating room (OR)?” “Not yet”, I replied. “Come with me.” he said.
For the first time, I discovered the beauty of the brain attending numerous surgeries performed by Prof. Hillman in person. This experience became an enormous inspiration that shaped my interest in Neurosurgery. It was the first time in my life to see or to touch a human brain when Prof. Hillman let me scrub in with him.
Later in February 2009, after completing my medical school, I had another enormous opportunity to be in an Elective program at John Radcliffe Hospital, Oxford University, United Kingdom and spent another six weeks observing in the Department of Neurosurgery under the tutelage of Professor Cadoux-Houdson. It was at that point in my education that it became clear to me: I knew I wanted to become a Neurosurgeon!!! How and where to train, I didn’t know. That time back in 2009, Rwanda had only one Neurosurgeon for a population of 11 million and not even a single Neurosurgical training program available in the country.
What I didn’t know that time was how hard and competitive it was/is to get into a neurosurgery training program/“residency”. In my program at JRH, there were about 5 consultants in the department. Each consultant, including the one I was assigned to, had between 7 to 8 trainees in his care. These 7 to 8 people went in order of seniority from Fellows, Chief, Senior and Junior Registrars and Medical students.
They were all men who had most likely been the best from their Medical Classes with the highest recommendations. These trainees would spend 7-8 years training to become general Neurosurgeons and subspecialize later taking 12 additional months of fellowship in a certain area of interest like spine, brain tumor, and pediatric surgery.
The training in Neurosurgery lasted a minimum of 10 years after completing medical school.
After one month in this program, I was almost certain that I will never become a Neurosurgeon.
- The criteria for selection abroad
- The lack of training programs in sub-Saharan Africa,
- and the time to train
All these made it sound like an impossible dream.
What hurdles were there in your way of getting into Neurosurgery?
Despite insurmountable difficulties to train and practice as a neurosurgeon in most regions of Africa, I was determined deep within me, that I would become a Neurosurgeon and did not give up on my dream. Through perseverance, determination and patience while working as a General Practitioner (G.P) in Kigali I kept looking for training programs abroad, that could accept me. It looked almost impossible to me, but I kept at it. I remember most people telling me it is hard for a woman wanting that kind of training.
During my time at Oxford, I had heard about the World Federation of Neurosurgical society (WFNS). When I googled for the WFNS for the first time, I saw that they had “Training Centers and Fellowships” and The University Mohamed V of Rabat, Morocco happened to be the very first accredited center by the WFNS to train other African Neurosurgeons, led by Prof. Abdeslam El Khamlichi who later became my second mentor.
This revived my hopes for the chance to become a Neurosurgeon. I started emailing El Khamlichi non-stop and copying-in everyone on the WFNS committee. At first, I didn’t get a response. The first response I eventually got back from him was that the center was full and not taking new applications. Nonetheless, that didn’t stop me; I emailed consistently for 36 months! Finally, in April 2011, I was admitted. I was given the opportunity to specialize as a Neurosurgeon.
I had to move to Morocco. I joined the center for a full five-year residency in Neurosurgery. I kept the same fighting spirit forgetting everything else that came after. I kept working hard and applied wherever I even thought I would never be able to get in.
Living in Morocco expanded my reach. It was there that more incredible opportunities came to me. I became more exposed to practical skills, and won several awards, enlarged my Neurosurgical circle. Most importantly, I gained more Mentors – incredible women who had ventured on this path before me and inspired me. I later transitioned from being a Chief resident in Morocco to incredible opportunities of being a fellow in the US and then Canada.
How was your experience after you had completed your residency?
I got several other opportunities to carry on my training in the US, and made it into a clinical fellowship in the Neuro-oncology and skull base fellowship at Toronto Western Hospital /University of Toronto (UofT)), Thanks to the Generosity of Dr. Mark Bernstein who funded me, this was a great opportunity for me as this sub-specialty is scarce in my country. I took the clinical fellowship for a year.
Most challenges have been moving to compete in new places I hadn’t been before, starting a completely new life with new people; people I have never met before. Many staff who of course read my resume but had never worked with me: it was always a huge challenge each time I had to get adjusted and earn their trust every step of the way. It wasn’t always easy! Though I had met great mentors along the way, it was still hard to be from a developing country, from Africa, and also be black and a woman. I didn’t allow any of these obstacles to stop me.
In July 2018, 11 years since that moment in the Operating theater in Sweden, 15 years since I started Medical School; I was, Finally a Neurosurgeon subspecialized in the removal of brain tumors. I became the first and only female Neurosurgeon in Rwanda. The country now has 5 Neurosurgeons for her population of 12 million people. Together, five of us along with other Neurosurgeons, doctors and all healthcare providers on our continent, will keep working hard, re-writing our healthcare narrative.
Were there any advantages in you moving from place to place?
Through my different experiences, I got exposed to medical education and healthcare systems in different countries. It also allowed me to integrate into new cultures and, of course, meet different people: I traveled a lot around the globe; I made lifetime friends and learnt under great mentors. It has been an enormously enriching experience, meeting such great people that made a huge difference in my life. It was really fun as well.
What do you have to say to other CKs who wish to do more than even you have done?
I would tell them that they should hold on to their big “dreams” no one can take their dreams away from them. They must keep working hard and things will eventually fall in place, “the first step is the idea” and “there is no unattainable dream”.
What do you consider your best achievement?
I had many occasions to fail and to give up. However, I chose the difficult path and did not give up. Carrying on an almost impossible dream to reality was my biggest achievement. Ten years later here I am, A Neurosurgeon!! I definitely made it.
The future plans you hold?
My next step is to contribute to the training of the next generation of Neurosurgeons in my home country Rwanda. One person, male or female cannot do it alone. So, we must increase the numbers and contribute to the neurosurgical care of our people. I also hope to inspire young girls to know they can succeed – empowering them to pursue whatever dreams they have.
Claire Karekezi, MD
Rwanda Military Hospital
We thank you for reading this thus far…it is not possible to abridge the force of nature that is Claire or her country. Emailing consistently for 36 months!!! Did you read that? What does that tell you about the tenacity and grit of CK and her fellow Rwandans?
Now, think of one word that comes to mind when you think of Rwanda, and put it in our comment section.
Many thanks to our editors who worked hard with CK, to put this on your e-motivational menue.
*All pictures and media used with the express permission of Dr. Claire Karekezi