The 1994 genocide in Rwanda claimed the greatest number of lives in the shortest period of time in recorded human history. In less than 100 days, nearly one million people were slaughtered as a result of a long-standing and long-tolerated cultural divide. There is no single answer to how a culture recovers from such wounds, but among the effective responses are the arts. The arts have been instrumental in healing in many global crises including in post-Apartheid South Africa, 9/11, the Asian tsunami, and the Gulf Coast Hurricanes. Rwanda serves as a model for the devastation that can occur as a result of cultural divides, for the capacity for healing in a wounded society, and for the roles that the arts can play in such healing. This year, CAHRE launches a new multifaceted AIM for Africa initiative to bring the arts to genocide surivors and their families in Rwanda and to bring these important messages home to Florida communities.
The project, with its three primary components, utilizes partnerships with the Barefoot Artists, the UF School of Theatre and Dance, Shands Arts in Medicine, and the UF Digital Worlds Institute, as well as funding from the Florida Division of Cultural Affairs and the UF Center for World Arts.
AIM FOR AFRICA RWANDA 2008-09
The UF Center for the Arts in Healthcare’s AIM for Africa initiatives create cultural bridges between the arts and healthcare in the U.S. and African nations. We are committed to cross-cultural collaborations that provide clear benefits to communities in Africa, to our local communities, and to University of Florida students and faculty across disciplines. In 2008-09, following five years of innovative and successful work on the African continent, the Center for the Arts in Healthcare (CAHRE) launched a new initiative in Rwanda.
In 1994, Rwanda was injured to its cultural core. The Genocide of 1994 was one of the fastest and deadliest atrocities in our human history and left nearly one million Rwandan people dead in one hundred days. The slaughter between neighbors was preceded by years of conflict fueled by oral radio propaganda persuasive enough to stir neighbors and even family members to kill one another. Today, Rwanda continues a long process of healing. According to UNICEF, 56% of children in post ‘94 Rwanda have witnessed killings, 80% have lost an immediate family member due to the violence, and 60% of surviving children said they did not care whether they ever grew up. But they have grown up and are now part of a Rwandan society that is deeply committed to reconciliation, peace, and unity.
In planning the AIM for Africa: Rwanda project, CAHRE’s director and international program coordinator were committed to a collaborative process that could facilitate the highest level of sustainable impact possible. The work of the Barefoot Artists in Rwanda greatly inspired CAHRE’s leaders and provided a foundation of work and accomplishments upon which CAHRE’s work could make a significant impact in Rwanda.
Rugerero Genocide Survivor Village
 Introduction/Overview – For over a year prior to traveling to Rwanda, CAHRE’s Director, Jill Sonke, and International Program Coordinator, Cindy Nelly, worked with identified partners in the US and Rwanda to identify needs that could be effectively addressed by CAHRE’s AIM for Africa: Rwanda program. The primary partners in the project are the Red Cross of the Western Region of Rwanda and the Barefoot Artists (based in Philadelphia and working in Rwanda for five years). The Barefoot Artists, led by Lily Yeh, have worked in Rugerero for the past five years, developing arts, health and economic projects. Secondary partners include Jefferson Health, a group of health professionals from Jefferson University in Philadelphia that has been working with the Barefoot Artists in Rugerero to establish health initiatives including building latrines and a malnutrition program, and the Rwandan Village Concept Project, a student-led program based in Butare, Rwanda, and also working in Rugerero on the village health initiatives.
In Rwanda, functional relationships were also developed with officials from the Rubavu and Rugerero districts, and the Commissioner of Police for the Western region. The main project liaison is John Bosco Rukirande, Director of the Red Cross, Western Region. Additional support for the project was provided by the State of Florida Division of Cultural Affairs, the UF Center for Worlds Arts, Shands Arts in Medicine, UF Pre-Med AMSA, and Shands Hospital.
Upon arrival in Rwanda, CAHRE leaders Jill Sonke and Cindy Nelly used two days before the students’ arrival to meet with Red Cross and government officials to discuss current and long term needs and existing initiatives, and to obtain the necessary approvals to implement projects. A village meeting was planned in Rugerero for the day following the student’s arrival. The Rugerero Village meeting gathered over 140 residents to introduce the CAHRE tam and to discuss plans. Through consensus, it was decided that the theatre, art, and health projects, as well as the survivor interview projects would proceed as planned and begin immediately as described in the following narrative.
Addressing Health in the Village: Rugerero has no health clinic, but does have a “health team”, a small g roup of non-health-professional village residents organized by the Barefoot Artists and dedicated to addressing and monitoring the health needs of village residents. The AIM for Africa nurses and artists worked with the health team to identify health issues and then to address those issues through a number of projects, as described below.
Health Insurance and Access to Healthcare: CAHRE leaders, in working with the Red Cross of Rwanda in advance of the project, had identified a significant need among village residents forhealth insurance. In response, CAHRE developed a two-part plan to connect village residents with healthcare. IN conjunction with UF’s Pre-Med AMSA student organization, CAHRE collected donations sufficient to provide health insurance (at a cost of $2 per person per year) for every resident of Rugerero village. Upon arrival in Rwanda, the Red Cross identified the nearest clinic and AIM for Africa artists began working with clinic staff to gain approval for arts projects that would connect village residents with the clinic and improve the clinic’s overall environment. AIM for Africa artists brought village residents to Murara Health Clinic to create murals in patient care areas and on external walls. The result was a significant beautification of the clinic and a direct personal connection between the clinic and village residents.
 Health Education Sessions: AIM for Africa nurses organized and taught four health education sessions for the health team. The team identified four key health issues to be addressed through teaching and arts projects: 1) hygiene; 2) nutrition; 3) HIV/AIDS; and 4) pregnancy (including antepartum, intrapartum, and postpartum issues). The nurses partnered with AIM for Africa artists to create visual teaching materials, providing 100 photocopies of each to the health team for future use, and to create theatre pieces for teaching each of the identified health concepts. The health team helped create and will continue to perform the theatre pieces. They also conceptualized and created a micro-financing proposal to launch a revenue-based project that would bring the plays to schools, villages, and community gatherings throughout the region.
 Massage/Range of Motion Workshop: The Rugerero health team identified muscle and joint pains, particularly among older women, as a significant health issue. In response, AIM for Africa nurses (with assistance from the entire UF team) taught a workshop on massage and range of motion for village women, which was extremely well received and effective. Throughout the days following the workshop, women could be observed practicing and sharing the skills they learned.
Health History Project: The UF nursing team addressed long-term health concerns with the health team and village residents and as a result, initiated a health-history project. Health histories of the village elders and numerous other residents were documented, and the project will be continued by the Rugerero health team.
Latrine Project: In support of the Jefferson Health Latrine Project, AIM for Africa nurses and artists worked together to design and install small murals in each latrine to provide residents with a reminder of the importance of hand-washing after using the latrine.
Other Small Projects: In response to identified needs and in an effort to continue and strengthen the work begun by the Barefoot Artists and Jefferson Health, the UF AIM for Africa team purchased rubber boots and clothing for village children, purchased chicken feed for the chickens, and provided ongoing first-aid and basis healthcare assistance for village residents. Additionally, each member of the AIM for Africa team donated at least one pair of shoes to the village soccer team and residents.
Art Projects in Rurgerero
House Mural Painting: In support and continuity with the Barefoot Artist’s house-painting project (27 of 50 houses had been painted thus far), the AIM for Africa team donated paint and supplies and worked with village residents to paint four more houses. Enough supplies were donated to allow residents to paint six additional houses under the leadership of the village art teacher.
Documentation of Genocide Survival Stories: Per the request of the Red Cross and the Barefoot Artists, the UF AIM for Africa  team engaged UK arts in healthcare professional and filmmaker, Gavin Clayton, to facilitate and film interviews with village residents. Twelve interviews, highlighting stories of genocide survival by residents aged 26-85 years, were completed. A video camera, tri-pod, and hard drive were donated to the Red Cross of Rwanda and an interviewer trained so that the project can continue in our absence. The resulting films will become a permanent part of the area’ s Genocide Museum.
The Theatre Project – The Theatre team spent their first day in Rwanda touring project sites and becoming familiar with the people and lifestyles in Rugerero. At the village meeting on the second day, a workshop/rehearsal schedule was established for the theatre project. The project began on day three with a three-hour workshop with over 100 village residents in attendance. A primary corps of participants was established and a vision for the performance was collectively established. Over each of the next ten days, the group which was comprised of approximately 20 primary participants and 30 secondary participants, met and developed several health education scenes and a major piece reflecting the story of a young couple. The AIM for Africa theatre team shared playback and improvisational theatre techniques that facilitated the sharin g of cultures, including genocide experiences, and guided the development of the performance pieces. The project culminated in a three-hour performance in the village with over two hundred people in attendance. The performance featured the health-education scenes focused on HIV, hygiene, domestic abuse, and women’s empowerment, as well as dance performances, performances by the UF theatre team, and presentations by regional government officials. Upon return to the US, the team began development of a full-evening theatre work reflecting their experience and learning in Rwanda that will be produced at the University of Florida in June and July or 2009.
Arts Workshops for Village Children – On most of the AIM for Africa team’s days in Rwanda, the art team led workshops in the village for children. The workshops were intended to teach arts skills and simply to provide fun, engaging and uplifting experiences. Workshops included mask-making, friendship bracelets, drawing, painting, crafts, and other art projects.
Women’s Coop – Following on the Barefoot Artist’s establishment of the Women’s Sewing Co-Op, AIM for Africa artists taught women to make dolls and to crochet. The team also presented a business development workshop and, as a result of interest in revenue generation related to the new skills, invited a micro-finance proposal for the doll-making business.
Murara Health Center
Murara Health Clinic, located approximately 4 kilometers from Rugerero Village, provides healthcare services for an average of 50-60 patients per day from surrounding villages. In- and out-patient services include general care, pediatrics, maternity, HIV/AIDS, and family planning. CAHRE’s AIM for Africa team provided an array or healthcare and arts services as described below.
Mural Project: While the Barefoot Artists have done extraordinary work in transforming Rugerero Village through art, no work had yet been undertaken to implement the arts at Murara, the nearest health clinic. As described above, in an effort to connect Rugerero residents to the clinic and in an effort to bring the arts to the clinic itself, the AIM for Africa team undertook a major mural project at Murara. Clinic staff worked with the artist s to identify and prioritize locations for murals throughout the health center. The team then began a process of developing a set of images that would be most relevant and meaningful to the service population. Over the first afternoon, artists and patients created a series of images; and then, nearly 60 patients and staff selected the images that would be developed as murals. Over the next three days, the artists, along with Murara patients and residents from Rugerero, painted seven murals in the selected interior and exterior locations, transforming the clinic into an environment that reflects the people it serves.
Arts at the Bedside: AIM for Africa Artists also provided bedside arts for in- and out-patients of all ages at the clinic. Fifty art kits were given to pediatric patients, and hand-made dolls (from the Dollies without Borders program) were distributed in the maternity and pediatrics wards.
Medical Supply Donations: Through advance liaison with the Red Cross, a list of needed medical supplies was developed and approximately 500 pounds of supplies donated to the clinic upon arrival. The majority of these supplies were provided by Shands Hospital.
Medical Care and Teaching at Murara: The AIM for Africa nursing team worked over five days at the Murara Health Clinic, providing services and teaching nursing skills in the assessment and triage area, the pharmacy, maternity ward, and the HIV and family planning clinics. The most prevalent health issues addressed were diarrheal illnesses, respiratory illness (including TB), malaria, and foot injuries.
Excursion to Poste de Sante: The Poste do Sante is a small rural outpost located 15 kilometers from Murara along a footpath and serviced by a single Murara nurse. The CAHRE team worked at the Poste de Sante over two days, providing medical supply donations and mosquito bednets for local residents. The nurses conducted health assessments, dispensed medicines and, in coordination with Edmond Baganezi MD (from the Rwandan Village Concept Project), set up a microscope for assessment of malaria slides and for rapid HIV testing. The nurses also taught expanded nursing skills to staff and basic hygiene to patients.
Byahi Health Center
The Byahi Health Center, located approximately 6 kilometers from Rugerero, serves a population of 24,000 people, and cares for 40-60 patients per day. The clinic provides the same array of services as does Muara, with the addition of immunization and postpartum education programs. 
Medical Supply Donations: Through advance liaison with the Red Cross, a list of needed medical supplies was developed and approximately 500 pounds of supplies donated to the clinic upon arrival. The majority of these supplies were provided by Shands Hospital.
Medical Care and Teaching at Byahi: The AIM for Africa nurses provided an array of medical services and teaching including work in the prenatal clinic, HIV screening, pharmacy assistance, postpartum education, immunizations, family planning, and general care.
Immunization Clinics: The nurses traveled to Byahi’s immunization clinic outpost (located in a small, partially dem olished church) and provided over 150 immunizations to infants.
HIV Testing and Education at Rubavu Primary School: The nurses and theatre team traveled to Rubavu Primary School (1,500 students) with the Byahi Public Health worker to undertake HIV testing and education. In a four-hour period, blood was drawn from 120 children, and education provided to approximately 1,000 students. The theatre team performed HIV and hygiene skits that were developed in collaboration with the nurses.
Health Ed ucation Murals: During the planning process, the staff at Byahi emphasized the need for health education for patients at the clinic. In response, AIM for Africa artists created a set of murals at the clinic designed to communicate health information pertaining to nutrition (food pyramid) and breastfeedi ng.
Arts at the Bedside: As at Murara, AIM for Africa Artists provided bedside arts for in- and out-patients of all ages at the clinic. Fifty art kits were given to pediatric patients, and hand-made dolls (from the Dollies without Borders program) were distributed to children and new mothers. Many patients at the clinic painted for the first time in their lives and went home with their first supplies for making art.
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