The small African country of Rwanda has been remarkably successful in combating the coronavirus pandemic, with high levels of testing and low numbers of infections.
Experts have been raising alarm bells over the spread of the coronavirus in Africa, with cases moving past half a million on the continent earlier this month. In Rwanda, however, the situation is somewhat different, with authorities aggressively tackling the virus.
The country of over 12 million has recorded just 1,539 infections and five deaths since it first began recording cases in March, according to Johns Hopkins data. These numbers are impressive given how severe the impact of the coronavirus has been elsewhere.
Using a strategy known as “pool testing,” wherein large sets of blood samples are tested at once before being further examined, authorities in Rwanda have rolled out widespread testing across the country.
Pool testing takes multiple blood samples together in one batch and tests them together. If there is a positive result then each individual sample in the batch is tested. The technique allows for faster testing, and has recently been approved by the US Food and Drug Administration for use in speeding up testing.
Tests are even being conducted on the street, with the process taking about five minutes, according to a report by US-based news agency NPR.
“So whenever someone is driving a vehicle, bicycle, motorcycle or even walking, everyone is asked if you wish to get tested,” Sabin Nsanzimana, director general of the Rwanda Biomedical Center, the group charged by the country’s health ministry to fight the coronavirus, told NPR earlier this month.
“All these samples are sent that day to the lab … We have a big lab here in Kigali. We have also six other labs in the other provinces,” Nsanzimana explained.
Those that test positive for the virus are quarantined at a dedicated clinic, while high risk individuals are also quarantined, either at home or at a clinic until they can be tested.
Community healthcare and experience
Rwanda’s success in tackling the coronavirus is based on a couple of factors.
Firstly, authorities have focused on building a decentralized health care system, focused down on the community level, Rwanda’s former health minister and a senior lecturer at Harvard Medical School, Agnes Binagwaho said earlier this month, US news site Fortune reported.
“Rwanda has prioritized a decentralized health care system,” she said. This has led to community health workers being distributed throughout the country, and garners support across the spectrum.
Secondly, Rwandan authorities have been leveraging their experience with other infectious diseases. Nsanzimana told NPR that the main machines that are being used to test for COVID-19 were already in place to tackle HIV infections.
“The main machines we are using for COVID testing are the HIV machines that were [already] there,” he said.
This has allowed Rwanda to use the same organizational structure that it has used in the past.
“We are using the same structure, same people, same infrastructure and laboratory diagnostics, but applying it to COVID testing,” Nsanzimana explained.
Rise of the robots
Despite Rwanda’s classification as a low-income country by the World Bank, authorities have been pushing in recent years to develop its technology and business sector. The country is ranked 38th in the world for ease of doing business by the World Bank, the second best performance of an African nation behind Mauritius.
It has since applied its developing business and technology sector to fighting the coronavirus pandemic.
In May, treatment centers in the country began rolling out robot nurses to carry out temperature checks and patient monitoring amid COVID-19 social distancing.
“The three robots that we have are part of the treating team,” David Turatsinze, a doctor at the facility told Reuters at the time.
In addition, the country is also using drones to deliver blood samples across the country and enforce social distancing rules.
In an interview with monthly magazine The Africa Report earlier this month, Rwandan President Paul Kagame noted that approaching the coronavirus with technology has played a role in the country’s ability to fight the pandemic.
“Our digital infrastructure helps us grow the economy. We are building on lessons learned from this difficult situation, thanks to previous investments,” he said.
“We have seen digital solutions applied to the problems we have in this new coronavirus situation: People are being innovative, they are providing solutions to either tracing, or digital mapping of our country to know where the virus is hitting the people hard, or where is the movement of the transmissions and then infections,” Kagame explained.
The country also responded rapidly to the global rise of the coronavirus, implementing lockdown procedures early compared to other African nations. The lockdown has variously been described as one of the most stringent on the continent. Late last month, authorities reinstated lockdown in the nation’s capital, Kigali, as a infections began to increase.
“Rwanda did a few things that are quite smart,” Sama Sgaier, the head of the Surgo Foundation that has been analyzing coronavirus data trends across the continent, told NPR.
“One is they responded really early. They put some of the most stringent lockdowns in place compared to every other African country. In fact, we've been monitoring physical distancing data across the continent and Rwanda fares, I think, second; they've physical distanced the second most across Africa,” he said, basing the ranking on mobile phone tracking data.
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