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Rwanda’s Nurses Communicate to Protect Themselves and Their Clients

Before, during, and after COVID-19, open dialogue is key to workplace safety and security.

Philippe Kayibanda is a registered nurse with 13 years of experience working to improve Rwanda’s health system. For him, it’s the power of communication that helps nurses meet their own needs while responding to COVID-19 and caring for patients.

“I want nurses around the world to improve communication on their teams,” he says. “In order to be successful, we have to communicate our challenges, our experiences, and our lessons.”

When Kayibanda became head nurse at Mareba health center in 2005, Rwanda was actively engaged in reconciliation efforts from the 1994 genocide.

“I made it my responsibility to build trust and promote unity and reconciliation inside of my team and in the surrounding community, because I knew that we cannot succeed with a divided team,” he says. “It was not easy to manage people born with different family histories who were dealing with post-traumatic stress disorder brought on by the genocide.

“Dialogue was very closed, with poor collaboration inside the team, between health teams, and with the community. To improve this, I created an environment in which all staff could express their feelings at work at any time and respected everyone’s ideas in all activities we planned. We used a participative style during our staff meetings and presentations. We organized social events and information exchanges, and closely monitored team dynamics for anything that could damage our relationships.

“Thanks to these efforts, we got results: staff started to feel like one team—and they trusted each other. This helped improve the quality of health services and led to our health center becoming exemplary in our district as we collaborated with partners and the Ministry of Health staff.”

Kayibanda’s team saw more women giving birth at the health center and more children coming in for immunization, which meant the community began to trust the health teams.

Not only does open communication foster stronger ties among teams of health workers, he says, but it helps nurses deliver messages to government and health policymakers about what they need to do their jobs safely.

“In a former role as district chair of the Rwanda Nurses and Midwifery Union, I knew that if nurses didn’t communicate their problems, I couldn’t intervene,” Kayibanda says. “So, I motivated our nurses to be more open and to communicate well—to express themselves freely and feel confident seeking assistance. This helped me to defend nurses at the district level.”

Open dialogue and clear communication are always essential for good teamwork—but the need is even more urgent as we cope with a global pandemic.

“Effective communication will help Rwandan nurses build confidence and avoid fear and anxiety in the workplace when dealing with COVID-19,” Kayibanda says. “Nurses who express their feelings about the challenges and propose solutions will help reduce errors and clear up wrong information and rumors among team members. There’s also an opportunity for them to learn from each other and advocate for themselves.”

For Kayibanda, the only way to successfully combat the COVID-19 pandemic is to work together. And nurses are a key part of the solution.

“Nurses play a big role in the COVID-19 response from the front lines all the way to the national level,” he says. They’re in leadership, conducting epidemiological surveillance, case management, infection prevention, and community health engagement.

So how can we help keep them safe and healthy?

“Call upon health leaders and planners to supply adequate personal protective equipment (PPE) for protection,” Kayibanda says. “Facilities managers must improve the organization of facilities. Employers must provide the highest level of protection and training—hospitals have a responsibility to provide staff the protection they need to be able to safely do their jobs.”

Nurses themselves must adhere to strict guidelines for infection prevention and control as they face risks on the job every day.

“I'm still connected to the nurses on the front lines,” says Kayibanda. “They work from day to night. We have to ensure they’re protected and motivated.”

Philippe Kayibanda is a community health facilitator for IntraHealth’s work on Ingobyi, a five-year, USAID-funded effort to reduce preventable infant and maternal deaths, reduce the incidence of malaria, and bring high-quality, integrated health services to more Rwandan mothers, children, and adolescents.