With a population of 12 million, of whom 83% live in rural areas where access to doctors is often scarce, the odds seemed stacked against Rwanda to deal with Covid-19. Yet its containment plans proved its salvation.
Officials in the tiny central African country watched the pandemic unfold in Europe, Asia and the US with growing concern.
On March 3 2020, nearly two weeks before it reported its first confirmed case of Covid-19, the government had formed a joint task force to draw up the country’s national response plan.
The objective was to stop “human-to-human transmission of the virus and caring for those affected”, the ministry of health said.
Weeks before its first confirmed case, the country was already offering free Covid-19 tests, WHO Rwanda reported.
On March 14, Rwanda reported its first confirmed case in a person who had arrived from India.
By March 16, there were seven confirmed cases. On March 20, international flights were suspended for 30 days.
On March 21, the government ordered a two-week lockdown. The country’s borders were closed, with only Rwandans and cargo being allowed through.
The country confirmed its first death from Covid-19 on May 31.
SA’s route into the pandemic was different.
Health minister Dr Zweli Mkhize confirmed SA’s first known case — a traveller arriving home from holiday in Italy — on March 5.
On March 15, President Cyril Ramaphosa declared a national state of disaster, followed two days later by the first confirmed locally transmitted infections.
SA’s first Covid-19 death was on March 27, the same day SA went into a gruelling two-month lockdown that would devastate the economy.
By the end of the month, SA had reported 1,353 confirmed cases and five deaths.
The experiences of both countries continued to diverge after that.
SA’s caseload continued to skyrocket — by the end of June, the number of confirmed cases had surged to more than 150,000, while more than 2,600 people had died.
By the end of June in Rwanda, the country’s caseload was just over 1,000 cases while one more person had died, doubling the death toll.
Up to April 20, SA had reported more than 1.5 million cases and nearly 53,000 deaths, while Rwanda had nearly 24,000 cases and 325 deaths.
Former Rwandan health minister Agnes Binagwaho said when they learnt China had a problem managing the spread of the pandemic, they stopped flights and started rigorous checking and tracing protocols.
That Rwanda already had structures in place to combat epidemics was a critical tool in containing the virus.
“There is cholera, Ebola ... there are things that are put in place at the time the alert is given,” she said.
Lessons learnt during the 2018 Ebola outbreak had helped sharpen government's response to epidemics.
“The government of Rwanda follows science,” she said.
From the start, people with Covid-19 who needed hospitalisation were sent to dedicated clinics. A Covid-19 toll free number was also set up for people seeking help.
Despite high ratios in the number of patients to healthcare workers and hospital beds — there are an average of 8,919 people per doctor, 1,261 people per nurse and 552 people per bed, according to health ministry data — Rwandans’ trust in their country’s health care sector is high.
The Wellcome Global Monitor — a study of 140,000 people in more than 140 countries — showed that 97% of Rwandans had faith in their healthcare system.
The trust helped the country fend off an Ebola outbreak in 2018 that killed thousands in the neighbouring DRC and laid the groundwork for Rwanda’s response to the pandemic.
As with the Ebola epidemic, Rwanda rolled out mass media campaigns to increase social awareness of the pandemic.
Official communications were broadcast on Twitter, with official accounts on the platform being used to debunk conspiracy theories.
While SA also adopted similar measures such as closing borders, instituting curfews, closing schools, restaurants, churches, gyms and live entertainment venues, Rwanda’s path out of the pandemic has been easier.
According to “Lessons Learned from Rwanda”, a paper published in January by the Annals of Global Health, the country’s success in containing the spread of Covid-19 is largely due to its early planning and “aggressive use” of innovative strategies such as drones to broadcast information and deploying robots at treatment centres.
The robots can take temperatures and readings of vitals and also instruct people how to wear their masks correctly, the WHO reports.
Another robot called “Urumuri” is based at Kigali’s airport to help with temperature screening of arriving passengers.
Drones, meanwhile, are used to broadcast health information and ensure people comply with safety measures.
The drones, mostly used in areas that are hard to reach or places that have high infection rates, are operated by the Rwandan police.
