The culture of Rwanda is rooted in togetherness. Sharing in life. Sharing in progress. Sharing in health.
This summer I worked with the Rwanda-Zambia HIV Research Group (RZHRG) at Project San Francisco in Kigali, Rwanda. RZHRG is a globally renowned force in HIV/AIDS prevention, specifically through Couples Voluntary Counseling and Testing (CVCT). Couples get tested – together. Couples get counseled – together. Couples commit to pursuing better health – together. The results are greater empowerment and greater commitment among couples, both of which have contributed to Rwanda’s decreasing HIV incidence. Due to the success of CVCT, this method of prevention has been adopted by the Ministry of Health and continues to be a healthcare norm across Rwanda.
CVCT also allows researchers to observe HIV transmission events. About 80% of all Rwandan couples have been jointly counseled and tested, and more than 40,000 discordant couples (only one partner has HIV) have been identified since 1988. Although unfortunate, transmission does occur; however, these events can help us better understand contributing factors and the serological aftermath of infection. This is where I come in.
This summer I returned to my natural habitat. As a biochemistry major in undergrad, I spent nearly all my free time in the lab. For three months, my love for laboratory science mingled with epidemiology on the global stage. Let’s just say I will never be the same!
Using the tools of molecular epidemiology, I amplified and sequenced the DNA of seroconverted couples and determined linkage. When HIV infects someone, the DNA integrates into the host genome. Not only does the HIV-specific DNA confirm infection, but it also confirms the source of the infection. If the virus was acquired from the positive partner, the couple is linked; however, if the virus was acquired from an outside source, the couple is unlinked. I look forward to sharing the results of my analyses so that we will better understand factors associated with increased risk of transmission in CVCT enrolled couples.
All this is possible because of the Rwandan sense of togetherness. In Kinyarwanda, the word for this is turikumwe. Not only did I witness this in research but also in my daily life. When I stepped into the research lab, I was part of an active force. Turikumwe. Traveling to places like Lake Kivu, Nyungwe Park, and Volcanoes Park, I connected with people that saved me from jungle mudslides while simultaneously conversing about family life. Turikumwe. After visiting the Genocide Memorial, I debriefed with people who have experienced the worst pain imaginable but have become acquainted with the freedom of forgiveness. Turikumwe.
This summer experience has shown me that public health on the global stage works best when we work together—when we commit ourselves to understanding a culture, when we become partners not stakeholders, and when we open our eyes to learning from our partners.