Rwanda: To guarantee the right to health
With “Mutuelle de Santé”, Sextantio Onlus aims at paying for the primary health care of those who cannot afford it, hence who can even die of diseases, easily treatable at low cost. After the genocide in Rwanda in 1994, the Government has started spreading health services by opening health centres. However, for a long time, access to health care has been banned to a high percentage of the population.
For the first time, in 2005, the Rwandan Government introduced the Mutuelles de Santé project (health insurance).
Today, Mutuelle de Santé covers more than 81% of the population, while 9% of it relies on other kinds of insurance. We can estimate that as for the remaining 10% of the population, half of it can take care of their health privately, whereas 5% (roughly 550,000 people), cannot afford basic health insurance as they cannot pay for Mutuelle (about $ 4 per person).
To get health insurance means to get primary care; in particular, one can undergo a medical examination as well as have blood tests and take medication for the most common diseases, by paying 200 Rw Francs (roughly 30 cents of a Dollar).
To identify people unable to pay for their health insurance, the Rwandan Government (committed to some supporting projects) and Caritas (carrying out checks for us) use extremely empirical criteria: family units, owned land and animals, people as well as houses health and hygiene conditions, impossibility to meet primary needs and to pay for children’s education, etc.
During community public meetings, attended by all members of the village or of the reference community – in case of more urban conditions – the recipients who meet the above requirements are identified, evaluated and approved by show of hands.
Associazione Sextantio (Sextantio Association) with Honorary President Tara Gandhi started its activity by its own means in 2008; the pilot project has already covered 8,000 people. In 2009, we worked all over the country, covering 80,000 insurance policies; in 2010, 125,457 policies were supplied and in 2011, we covered 161,000 recipients (roughly 30% of those unable to pay for their insurance).
In the latest years, due to personal financial difficulties, we could supply a definitely lower number of insurance policies: in 2012, we distributed 12,662 policies and in the following years, the number of recipients has even decreased (between 4,000 and 8,000 per year).
Because of an available fund reduction, and due to the impossibility to cover the whole country, we focused on a specific and well known geographic area (where Roberto Santavenere – a collaborator of the Association – lives). We hoped we could quantify both greater access to health structures and some epidemiological data.
As for 2017, we aim at covering health insurance costs for the poor of Nkombo Island on Kivu lake, on the border with Congo (DRC). We estimate 6,846 people and a cost of roughly $26,500.
This year, we have also started a fundraising campaign by Crowdfunding.