How women are revolutionizing Rwanda Agnes Binagwaho

I came back to my home of Rwanda

two years after the 1994 genocide
against the Tutsi.

The country was devastated.

The children I was caring for
in the hospitals

were dying from treatable conditions,

because we didn’t have equipment
or medicine to save them.

I was tempted to pack my bag and run away.

But I debated with myself.

And because I’m really dedicated
to social justice and equity,

and there were only
five pediatricians in total

for millions of children in Rwanda,

I decided to stay.

But among the people
who have motivated my decision to stay,

there were some fantastic women of Rwanda,

some women who had faced
the genocide and survived it.

They had to overcome
unbelievable pain and suffering.

Some of them were raising children
conceived through rape.

Others were dying slowly with HIV

and forgave the perpetrators,
who voluntarily infected them

using HIV and rape as a weapon.

So, they inspired me.

If they can do that,

I can stay and try to do my best.

Those ladies were really activists

of peace and reconciliation.

They show us a way
to rebuild a country

for our children and grandchildren
to have, one day,

a place they can call home, with pride.

And you can ask yourself

where this shift of mindset
has brought our country.

Today in Rwanda,

we have the highest percentage
of women in parliament.

(Applause)

Wait till I tell you the percentage –

sixty-one percent.

(Applause)

Today, we have the best campaign
for the vaccination of children

with, among our success, 93 percent
of our girls vaccinated against HPV –

(Applause)

to protect them against cervical cancer.

In this country, it’s 54.

(Laughter)

We have reduced
child mortality by 75 percent,

maternal mortality by 80 percent.

In early 2000s,

there were nine women
who were dying every day

around delivery and pregnancy.

Today, it’s around two.

It’s an unfinished agenda.

We still have a long way to go.

Two is still too much.

But, do I believe that those results

are because we had a big number of women

in power positions?

I do.

(Laughter)

There is – yes –

(Applause)

there is a study in the developing world

that shows that if you improve
the status of women,

you improve the status
of the community where they live.

Up to 47 percent of decrease
in child mortality.

And even in this country where we are now,

it’s true.

There is a study by a lady
called Patricia Homan,

who projected that if women and men

were at parity in state legislatures,

there would be a drop of 14.5 percent
in child mortality –

in America!

So we know that women,

when they use their skills
in leadership positions,

they enhance the entire population
they are in charge of.

And imagine what would happen

if women were at parity with men
all over the world.

What a huge benefit we could expect.

Hmm?

Oh, yeah.

(Applause)

Because in general,

we have a different style of leadership:

more inclusive,

more empathetic,

more caring for little children.

And this makes the difference.

Unfortunately, this ideal
doesn’t exist in the world,

and the difference between men and women
in leadership positions

is too big.

Gender inequity is the norm
in the majority of professions,

even in global health.

I have learned that if we focus
on women’s education,

we improve their life positively

as well as the well-being
of their community.

This is why now I dedicate
my life to education.

And this is totally aligned
with my sense of equity

and my pursuit of social justice,

because if you want to increase
access to health services,

you need first to increase
access to health education.

So with friends and partners,
we are building a beautiful university

in the rural north of Rwanda.

We educate our students

to provide quality,
equitable, holistic care

to everyone, leaving no one out,

focusing on the vulnerable,
especially women and children,

who are historically
the last to be served.

We transform them into leaders

and give them managerial skills
and advocacy skills

for them to be smooth changemakers

in the society where they will be,

so that they can build health systems

that allow them to care
about the vulnerable where they are.

And it’s really transformative.

Because currently,

medical education, for example,

is given in institutions based in cities,

focused on quality health services
and skills, clinical skills,

to be given in institutions.

We also focus on quality clinical skills

but with biosocial approach
to the condition of patient,

for care to be given in communities
where the people live,

with hospitalization only when necessary.

And also,

after four to seven years
of clinical education in cities,

young graduates don’t want
to go back to rural area.

So this is why we have built
the University of Global Health Equity,

an initiative of Partners
in Health, called UGHE,

in the rural north of Rwanda.

(Applause)

Our students

are meant to go and change the world.

They will come from all over –
it’s a global university –

and will get the medical
education for free

at one condition:

they have to serve the vulnerable
across the world

during six to nine years.

They will keep the salary
for themselves and their families

but turn the education we give
in quality clinical services,

especially for the vulnerable.

And doing so,

they sign an agreement at the start
that they will do that,

a binding agreement.

We don’t want money.

We have to go and mobilize the money.

But they will turn this
in quality service delivery for all.

For this, of course,

we need a strong gender equity agenda.

And in all our classes, master’s course,

minimum of 50 percent of women.

(Applause)

And I’m proud to say

that for the medical school
that started five months ago,

we have enrolled 70 percent girls.

(Applause)

This is a statement against
the current inequity

for women to access
medical education in our continent.

I believe in women’s education.

This is why I applaud African ladies
who go all over the world

to increase their education,
their skills and their knowledge.

But I hope they will bring
that back to Africa

to build the continent

and make the continent a strong continent,

because I’m sure

a stronger Africa
will make the world stronger.

(Applause)

Twenty-three years ago,

I went back to Rwanda,

to a broken Rwanda,

that now is still a poor country

but shining with a bright future.

And I am full of joy to have come back,

even if some days were very difficult,

and even if some days I was depressed,
because I didn’t find a solution

and people were dying,

or things were not moving enough.

But I’m so proud to have contributed
to improve my community.

And this makes me full of joy.

So, African women from the diaspora,

if you hear me,

never forget your homeland.

And when you are ready, come back home.

I did so.

It has fulfilled my life.

So, come back home.

Thank you.

(Applause)

在 1994 年针对图西人的种族灭绝事件发生两年后,我回到了卢旺达的家

这个国家被摧毁了。

我在医院照顾的孩子

们死于可治疗的疾病,

因为我们没有设备
或药物来拯救他们。

我很想收拾行囊逃跑。

但我与自己辩论。

因为我真的
致力于社会正义和公平,

而卢旺达数百万儿童总共只有
五名儿科医生

所以我决定留下来。

但在
促使我决定留下的人中,

有一些卢旺达出色的女性,

一些曾
面对种族灭绝并幸存下来的女性。

他们必须克服
难以置信的痛苦和苦难。

他们中的一些人正在抚养
因强奸而怀孕的孩子。

其他人正在慢慢死于艾滋病毒

并原谅肇事者,
他们自愿

使用艾滋病毒和强奸作为武器感染他们。

所以,他们启发了我。

如果他们能做到这一点,

我可以留下并尽力做到最好。

那些女士们真的

是和平与和解的积极分子。

他们向我们展示了
一种重建国家的方法,

让我们的
子孙后代有一天

能够自豪地拥有一个可以称之为家的地方。

你可以问问

自己这种思维方式的转变
把我们的国家带到了哪里。

今天在卢旺达,

我们
议会中的女性比例最高。

(掌声)

等我告诉你百分比——

百分之六十一。

(掌声)

今天,我们开展了最好
的儿童疫苗

接种活动,其中,我们的 93%
的女孩接种了 HPV 疫苗——

(掌声)

以保护她们免受宫颈癌的侵害。

在这个国家,有 54 人。

(笑声)

我们将
儿童死亡率降低了 75%,

孕产妇死亡率降低了 80%。

在 2000 年代初期,每天

有九名妇女

在分娩和怀孕期间死亡。

今天,两点左右。

这是一个未完成的议程。

我们还有很长的路要走。

二还是太多了。

但是,我是否相信这些结果

是因为我们有大量女性

担任权力职位?

我做。

(笑声)

有——是的——

(掌声

) 发展中国家的一项研究

表明,如果你
提高女性的地位,

你就会提高
她们所居住社区的地位。 儿童死亡率

降低高达 47%

即使在我们现在所在的这个国家,

这也是事实。

一位名叫帕特里夏·霍曼的女士进行了一项研究

她预测,如果

州立法机构中的男女平等,

那么在美国,儿童死亡率将下降 14.5%

所以我们知道,

当女性在领导岗位上发挥自己的技能
时,

她们会提升
她们所负责的整个人口。

想象一下,

如果全世界的女性都与男性平等,会发生什么

我们可以期待一个多么巨大的好处。

唔?

哦耶。

(掌声)

因为总的来说,

我们有不同的领导风格:

更包容、

更善解人意、

更关心小孩子。

这会有所不同。

可惜,这个理想
在世界上是不存在的,

领导岗位上男女差距

太大了。

性别不平等
是大多数职业的常态,

即使在全球卫生领域也是如此。

我了解到,如果我们专注
于女性教育,

我们就会积极改善她们的生活

以及
她们社区的福祉。

这就是为什么我现在将
我的一生奉献给教育。

这完全
符合我的公平感

和我对社会正义的追求,

因为如果你想增加
获得卫生服务的机会,

你首先需要增加
获得健康教育的机会。

因此,与朋友和合作伙伴一起,
我们正在卢旺达北部农村建设一所美丽的大学

我们教育我们的学生

为每个人提供优质、
公平、全面的

护理,不遗漏任何人,

重点关注弱势群体,
尤其

是历史
上最后得到服务的妇女和儿童。

我们将他们转变为领导者,

并为他们提供管理技能
和宣传技能,

让他们成为

他们所在社会的顺利变革者,

这样他们就可以建立卫生系统

,让他们能够
关心他们所在的弱势群体。

它确实具有变革性。

因为目前

,例如医学教育

是在城市的机构中进行的,重点是在机构中

提供优质的卫生服务
和技能、临床技能

我们还专注于高质量的临床技能,


对患者的状况采用生物社会方法,以便

在人们居住的社区提供护理,

仅在必要时住院。

而且,

在城市接受了四到七年的临床教育后,

年轻的毕业生并不想
回到农村。

所以这就是我们在卢旺达北部农村
建立全球健康公平大学的原因,这是健康

合作伙伴的一项倡议
,称为 UGHE

(掌声)

我们的学生

注定要去改变世界。

他们将来自世界各地——
这是一所全球性大学——

并将

在一个条件下免费接受医学教育:

他们必须在六到九年内为世界各地的弱势群体服务

他们
将为自己和家人保留薪水,

但将我们提供的教育转向
优质临床服务,

尤其是针对弱势群体。

这样做,

他们一开始就签署了一项协议
,他们将这样做,这是

一项具有约束力的协议。

我们不要钱。

我们必须去筹集资金。

但他们会将这一点转化
为为所有人提供的优质服务。

为此,当然,

我们需要一个强有力的性别平等议程。

在我们所有的课程中,硕士课程中

至少有 50% 是女性。

(掌声)

我很自豪地说

,对于
五个月前开始的医学院,

我们招收了 70% 的女生。

(掌声)

这是
对目前

我们大陆女性接受医学教育的不平等的声明。

我相信女性的教育。

这就是为什么我赞扬非洲女士
们走遍世界

以增加她们的教育、
技能和知识。

但我希望他们能把
它带回非洲

,建设非洲大陆

,让非洲大陆成为一个强大的大陆,

因为我相信

一个更强大的非洲
会让世界更强大。

(掌声)

二十三年前,

我回到了卢旺达,

回到了破碎的卢旺达

,现在仍然是一个贫穷的国家,

却有着光明的未来。

我很高兴能回来,

即使有些日子非常困难

,即使有些日子我很沮丧,
因为我没有找到解决办法

,人们正在死去,

或者事情进展得不够顺利。

但我很自豪能
为改善我的社区做出贡献。

而这让我充满喜悦。

所以,来自海外的非洲妇女,

如果你听到我的话,

永远不要忘记你的祖国。

当你准备好了,就回家吧。

我这样做了。

它充实了我的生活。

所以,回家吧。

谢谢你。

(掌声)