From birthing chairs to mountain gorillas: What Rwanda taught me about medicine, privilege and connection
From birthing chairs to mountain gorillas: What Rwanda taught me about medicine, privilege and connection
By: April Oertle
Flying to Africa alone felt like a daring leap. Just hours after finishing my neurology shelf exam, I tossed a 36-liter backpack into my classmate Claire’s (Sagartz) car, waved goodbye at O’Hare (International Airport) and boarded a plane to Rwanda. I was exhausted but buzzing with anticipation.
The streets of Kigali greeted me with wildfire-scented smog, a blur of motorcycles and helmeted moto-taxi drivers zipping through traffic. The helmets, clearly shared by countless passengers, looked like thin plastic shells – mandatory, but far from reassuring. My apartment had a designated guard and a simple bed and after 18 hours of travel, that’s all I needed. I collapsed under the mosquito net.
Alone and jetlagged, I ventured out on foot the next morning in search of breakfast. I walked a kilometer through unfamiliar streets for a delicious breakfast with exotic fruits and mountain tea. Then, I met up with the rest of the University of Illinois Study Abroad crew. That’s where I met Meli, a midwife (nurse practitioner) student. We clicked immediately – both independent, curious and drawn to challenges.
Our clinical rotation was eye-opening. The hospital had two wings: one for high-paying patients, and one for those with limited resources. We chose the latter every day. It was stiflingly hot, overcrowded and buzzing with mosquitoes. We recorded vital signs in paper booklets and sat with patients in places where power dynamics were stark and undeniable. Women were denied care unless their husbands were present – even if they were acutely ill. Their husbands would also make healthcare decisions on their behalf, even if it was not what the patient wanted.
One day, our program traveled into the mountains beyond the tea plantations to a rural health post. It was remote, beautiful and devastatingly bare. The birthing center had two metal chairs, no oxygen and no equipment. Still, one to two babies were born there every day. We arrived just after a delivery – someone was still mopping up blood.
Later, I showed a photo of that room to my Somali OB/GYN attending in Kigali, expecting her to echo my horror. Instead, she looked at it and said gently, “This looks so nice. You’re American.”
Her words hit hard. I realized how much I took for granted – and how much I had to learn.
In the hospital, Meli and I saw advanced breast cancers with peau d’orange skin, a 26-year-old woman with heart failure from untreated strep throat, and postpartum women burning with fever in overcrowded wards. On morning rounds, we joined doctors from France, Somalia, Germany, Ethiopia and Rwanda. We became close with a Sudanese refugee physician named Sara, who had escaped with her sister. Each conversation added nuance to what we thought we knew.
Outside the hospital, we spent time at women’s shelters for mothers ostracized after giving birth out of wedlock. We even held a class on maternal health at a coffee shop, sipping banana smoothies as Meli gave a presentation on HIV, AIDS and antiretroviral therapies. We bumped into Harvard Medical School students conducting research and a transfusion medicine specialist from Canada teaching safe blood banking. Kigali felt like a crossroads of global health – and we were lucky to be there. So much science and communication about global health, all happening at coffee shops dotted across the city center.
One of our favorite places in Kigali quickly became Question Coffee, a café with a mission as rich as its brews. More than just a place to sip iced lattes and enjoy free Wi-Fi, it served as a hub for social impact – supporting more than 30,000 female Rwandan coffee farmers. The proceeds helped fund hands-on training in agronomy and entrepreneurship, equipping women with the tools to build sustainable livelihoods. They even offered full-day trips to visit the cooperatives, giving visitors a chance to meet the growers face-to-face and witness the roots of the movement firsthand.
On one of our final days, we visited a children’s center that had served as a human hiding spot during the genocide. I danced, laughed and held hands with children who showed me how to play and how to be joyful. It was impossible to grasp the depth of what had happened in that building – and what it meant to now be dancing inside it.
After Meli left, I journeyed north to Volcanoes National Park. Trekking past farmland, I climbed over a stone wall and into the misty jungle with two armed guards meant to deter buffalo. Deep in the forest, I saw the mountain gorillas Dian Fossey fought to protect. It was a surreal ending to a month that had changed me.
Coming back to the U.S. was both comforting and unsettling. I’ve never seen a bug in an American operating room. And yet, I often think about the kids at the children’s center, the rural births, the courage of women I met and what it means to provide care when resources are limited.
Rwanda reminded me why I’m in medicine – not just to diagnose and treat, but to listen, connect, and someday return to help empower communities to thrive on their own terms.
April is an M4 at UICOMR
aoertl2@uic.edu