At the Ruhengeri Hospital in Musanze, Rwanda, the tables in the surgical rooms aren’t just places where people receive crucial medical care – they’re also vital training tools.

Here, surgical trainees and hospital staff can gather to observe plastic surgery procedures and gain hands-on experience to improve their skills in treating cleft conditions.

With a six-bed intensive care unit (ICU), four operating theatres and a teaching room, Ruhengeri is a ‘spoke’ hospital that brings essential surgeries and care closer to communities.

Reduced travel time and costs to access cleft surgery

“Until now patients would have to travel to Kigali to have plastic surgery,” explains surgeon Dr Charles Furaha. “That is not only far, but also costly for patients.”

Now serving as a spoke to the central hub in Kigali, the new facility at Ruhengeri represents far more than a building. It’s making a lasting impact on access to care for people with a cleft – and on the training for the people who treat them.

This is just one of Operation Smile’s initiatives to strengthen local access to healthcare, not only in Rwanda , but in 37 countries worldwide. Better opportunities for education and training create a ripple of care that can positively impact an entire country.
 

A map of Rwanda highlighting the cities of Kigali and Musanze, with dashed lines connecting Kigali to other regions. Nearby lakes and towns are labeled, along with national borders.
The hub and spoke model will ultimately see six ‘spoke’ hospitals linked to the central hub in Kigali.

Making space to teach and learn

Dr Faustin Ntirenganya, a plastic surgeon and associate professor at the University of Rwanda, emphasises the value of having more locations for training and treatment. As he said at the hospital’s inauguration ceremony: “You can’t teach a person how to swim if you don’t have a swimming pool.”

He explains: “We are building a hub and spoke model, with a central a hub in Kigali. Then we are reaching out to the periphery. In the end, we will have 6 spokes dispatched all over the country, and each Rwandan will be at least 75 kilometres from plastic and constructive services.

“Not only will we be able to treat patients near their homes, but also, we will staff those hospitals with the newly graduating plastic surgeons trained here.”

Training and supporting more plastic surgeons in Rwanda

Drs Furaha and Ntirenganya were the first two plastic surgeons in Rwanda. Today, with support and partnership from Operation Smile, University of Rwanda, the College of Surgeons of East, Central and Southern Africa (COSECSA) and the Ministry of Health in Rwanda, there are now five certified plastic surgeons in Rwanda with six more in training.

Dr Fidel Simba is one of the trainees. “It feels really great to be working in this new facility. All the equipment is new. It’s a big, big contribution to the development of the country and in particular this city,” he says.

A man wearing glasses, a blue surgical cap, and a green surgical gown stands in a hospital room, looking at the camera with a slight smile. The background is blurred, showing medical equipment and another person.
Dr. Fidel Simba, trainee surgeon, says it’s a privilege to train with colleagues at the Ruhengeri Hospital. Until recently, there were only two certified plastic surgeons in Rwanda. Photo: Jorgen Hildebrandt.

A new conference for an important focus

The search for solutions to reduce the global shortage of surgical care providers was also the focus of the first Pan-African Surgical Conference in Kigali, in February 2025. Bringing together academic leaders, policymakers, global surgery experts and other stakeholders, it addressed critical challenges and opportunities in plastic and reconstructive surgery on the continent.

Dr Billy Magee, Operation Smile’s chief medical officer, worked with Dr Ntirenganya on the agenda for this historic gathering.

“We’ll be talking about the state of global surgery, the state of healthcare and how we can work together towards a more comprehensive system,” he said ahead of the February conference.

“By prioritising capacity building, infrastructure development and policy advocacy, our goal is to secure access to essential surgical services for all communities, supported by the plastic and reconstructive surgical community.”

The future of closer care

While each country is unique, by working with local leaders, partners, ministries of health and governments to understand the needs, we can make an impact that’s locally led and globally supported. Spoke hospitals like Ruhengeri will be central to bringing care closer to the people we support.

Agustino Hellar, regional director of East Africa for Operation Smile, explains: “Once this is built locally, it can be expanded within the country to provide care to everyone. It shows us that this will be sustainable for a long time.”


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