Our Story

Initially aspiring to be a surgeon, Dr. Christian NTIZIMIRA’s career trajectory shifted dramatically after a profound encounter with a young patient dying in pain without medication and with the patient’s mother, who knelt before him asking for help. “I was really shocked. Culturally, as a Rwandan, an older adult should not be kneeling before a younger person, especially not to ask me to do what I am supposed to do – and could not. Like many physicians, I feared to prescribe morphine at that time due to the myths surrounding it, the fears that if you prescribe it, the patient will die and you will go to prison," Dr Ntizimira explains. “And in any case its availability was severely limited.

I wondered, does it make sense to be a surgeon if such vulnerable people do not get any support?” This was in 2009 and the government was organising the first palliative care training, which Dr Ntizimira attended. He then completed a fellowship in palliative care at Harvard Medical School in 2011, as Rwanda was launching the first African national policy on palliative care to improve the quality of life of patients, particularly those at advanced stages of HIV/AIDS. This policy was later integrated into the national cancer control plan and the non communicable diseases (NCD) strategic plan, with a focus on the accessibility and availability of morphine.

When Dr Ntizimira began his advocacy, there was a widespread lack of awareness and understanding among healthcare professionals and the general population about the need for palliative care. “Palliative care was generally understood exclusively as end-of-life care, only for the dying. People called me ‘the gravedigger’, considering the people I was caring for as already condemned. I told them, ‘the gravedigger sees patients five minutes after they die, I see them before’. But, of course, there are two essential aspects of palliative care. Terminal patients in any case deserve our attention and a better quality of life as they die; and it is supportive care for people who we expect to survive but are going through treatment and in pain.”