When I told friends and family I was going to Burundi, many of them had to reach for a map. Nestled in the African Great Lakes region, bordered by Tanzania, the Democratic Republic of Congo (DRC) and Rwanda, it seemed that for many it is a forgotten country.
This was my first project visit with Primary Care International, and I was lucky to be going with two experienced team members – Peter and Sarah- the clinical directors. My first impressions on arrival in Bujumbura were of a beautiful, lush country, with a magnificent view of Lake Tanganyika and its resident hippos, and DRC in the distance.
We were in Burundi to provide training in non-communicable diseases (NCDs), such as hypertension and diabetes, to healthcare workers in the UNHCR health centres in both urban settings and in the camps. Burundi currently hosts around 80,000 Congolese refugees, with almost 35,000 of them based in urban settings in the former capital, Bujumbura. Our first week was spent listening, learning and trying to understand the situation that both the refugees and the healthcare workers find themselves in. I soon learned this is a key part of all PCI’s work. We visited two urban health centres, two urban hospitals, two camp health centres and further rural referral hospitals. With a shared language of French, we were able to talk to people based in Musasa camp, where some have lived for over 15 years. We met with the ministry of health, the WHO and UNHCR healthcare partners, GVC.
At the end of each day, we would sit and discuss what we had learned, share conversations we’d had individually with colleagues and patients, and consider what this meant for the training we were to give the following week. We would then make changes to the prepared materials to ensure it was relevant to what we had seen and heard during our visits. For example, it was clear that using a particular measure for diabetes, glycosylated haemoglobin, was not a priority in the current setting, and so we did not focus on this, instead discussing the importance of monitoring with blood sugar testing strips.
The healthcare teams were already looking for ways to improve the NCD care they were able to provide. Doctors and nurses from the camps’ health centres and referral hospitals attended the week-long training held in Bujumbura, enthusiastically engaging with all the activities asked of them, such as planning a meal for a family with a diabetic father on a very limited budget or using a homemade spacer device for a patient with asthma.
We will return in January to visit the three remaining refugee camps, and to see how our colleagues who attended the training are getting on, but the communication does not stop once the visit is over. Already we have an active Whatsapp group with the participants of the training, and just this morning we received photos of a homemade spacer in action!