February 2, 2007

Durant fellow makes a difference
in Rwanda

Lucinda Langenkamp, RN, NP, isn't your average primary care nurse. As a 2006 Thomas S. Durant, MD, fellow, Langenkamp spent eight months providing health care to the rural poor in the Rwinkwavu and Kirehe provinces of southeastern Rwanda. Working as a pediatric nurse with Boston-based nonprofit Partners in Health (PIH) and the Rwandan Ministry of Health, she provided aid to young Rwandans suffering from malnutrition, HIV, malaria and other ailments. On Jan. 19, MGHers gathered in the Haber Conference Room to hear about her experience.

Through pictures and video, Langenkamp chronicled her work on behalf of some of Rwanda's neediest children, many of whom live in areas without doctors or adequate medical facilities. Langenkamp spoke of the day-to-day struggles she faced — both medical, healing children with malaria already weakened by malnutrition, and personal, being confronted with rampant poverty and the lingering effects of civil war and the 1994 genocide.

Langenkamp recounted ethical issues as well. One such episode took place when the Rwandan hospital's leaders debated whether or not to provide chemotherapy to Tuyishime, a young girl suffering from rhabdomyosarcoma, a tumor that is generally treatable in children. The tumor on her cheek had grown to almost the size of her head and was dangerously infected. The issue was whether adequate care could be provided without staff trained in chemotherapy, intensive care setup or the use of proper diagnostic tools, all of which are standard in American hospital oncology units. In the end, the team did provide the chemotherapy — a first at the district level in Rwanda — and, over her nine weeks of treatment, Tuyishime's tumor shrank to the point where it became operable.

During her months in Africa, Langenkamp periodically recorded her experiences in a blog. This online journal, which often reads as a record of hardship and grief, is
punctuated with glimmers of hope and determination. For example, after an encounter with a man who dreamt of saving $60 so that he could buy the rented mud hut where he lived with his five children, Langenkamp wrote, "We can improve the situation here, and yes, most definitely, despite the hardships that exist everyday, there is hope for the poor. But we have to make it that way."

Langenkamp plans to return to Rwanda Feb. 3 on the Durant Fellowship to continue her work with PIH. Together, they are working to create a sustainable, community-based model of public health that empowers Rwandan health workers as well as the local population to improve the quality of care and life in the area.

The Durant Fellowship in Refugee Medicine, established in 2001, honors the legacy
of long-respected MGH physician and humanitarian Thomas S. Durant, MD,
whose compassion and action on behalf of the world's underserved exemplify how one person can make a difference. The fellowship provides funding for education to assist in the prevention and treatment of disease among refugees throughout the world.

Langenkamp's blog can be viewed online at rwandahealthjournal.blogspot.com.

Langenkamp with a young patient