Christian Mazimpaka: Learning about the “lion” of leadership in Rwanda

Christian Mazimpaka explains how his studies in Global Health Delivery taught him the importance of leadership skills in challenging health provision environments

When I was in my last year of my medical school at the University of Rwanda, I did my internship at a tertiary university teaching hospital. While working in the hospital, I often cared for patients transferred from district hospitals. I was constantly complaining that the district hospitals could have provided better quality of care, could have done more for the patients, or that the transfer was unnecessary. After I graduated, I was assigned to work at one of the biggest district hospitals in the Southern province of Rwanda. Like many young graduates, I was an ambitious idealist—I told myself I would provide the best quality of care at the district, I would not refer patients unnecessarily. Twelve months into the job, I was receiving complaints from the tertiary hospitals—the same complaints I was once making. I’d failed to make any of the changes that I had vowed to make. I felt I lacked the skills to manage changes, or to understand the challenges of the health system that I was working in. That’s when I decided to pursue a masters’ degree.

In July 2015, I was enrolled in the first cohort of the Master of Sciences in Global Health Delivery (MGHD) programme at the University of Global Health Equity (UGHE) on a full scholarship. This two year long programme enrolls about 25-30 students per year and it’s aimed at practitioners from diverse backgrounds including clinicians, veterinarians, policy makers, government staff, NGOs and private sector staff focused on global health delivery. My first class was in 2015 and it was taught by Paul Farmer, the founder of Partners In Health. He talked about the Ebola outbreak in West Africa and the challenges in handling the outbreak due to the lack of staff, stuff, space and systems (the 4Ss). As he discussed every single “S”, I was nodding my head remembering how I have witnessed the same at my hospital and how that had affected healthcare delivery. But that was just the beginning.

As part of the programme we discussed the most challenging healthcare delivery cases around the world. We had an opportunity to study how other health practitioners took the lead in advancing their countries’ health system challenges. For example, we studied how Pedro Suarez built a strong national tuberculosis programme in Peru during the country’s economic struggles. We studied how Elizabeth Chizema led the National Malaria Control Center (NMCC) in Zambia to meet the national malaria targets by developing a national plan to improve partners’ coordination. We learnt how Agnes Binagwaho led the ministry of health in rebuilding Rwanda’s health system after it was destroyed in the 1994 Genocide against Tutsis. Faculties who teach these cases are actually implementors of the interventions and this made me feel like I was learning the practice. Field visits to the community with lecturers provided me an opportunity to see, analyze, and understand everything I heard in the classroom. Students had various expertise in their fields and their insights were realistic and practical. It was easy to learn multidisciplinary collaboration and team-work from diverse professional backgrounds in group assignments and discussions.  

Furthermore, the programme teaches leadership skills that are uniquely oriented to global healthcare delivery and that are often overlooked in medical education. Skills such as data driven decision making, problem solving, communication, advocacy, and writing skills have all been valuable to my work. As one Ghanaian proverb says “An army of sheep led by a lion will always defeat an army of lions led by a sheep”—this proverb applies not only in sports, business and politics, but also in healthcare delivery, especially in resource-limited settings. I’m glad that the MGHD programme is providing healthcare practitioners with lessons in “lion leadership”; leadership that analyses healthcare delivery challenges through the lens of equity and leadership that can drive change in the healthcare setting with limited resources. As I look back, the skills, the value and the principle of equity will guide my practice in the years to come and that’s thanks to the MGHD programme.


Christian Mazimpaka is District Clinical Director at Partners In Health/Inshuti Mu Buzima(PIH/IMB)

Competing Interests: None declared