Patients who are hungry, homeless, or extremely poor are not going to get healthy and stay healthy unless those root causes are addressed. Our Livelihood program works to treat the social and economic determinants of a patient's health. With more than ten years’ experience working in Rwanda, we have seen how poverty leads to illness. Pneumonia is more common among the homeless, medicine is less effective on malnourished children, and appointments are more often missed among ultra-poor populations.
We created our Livelihood program because we believe everyone has the right to health care, food security, housing, and education. We work with patients, families, and communities to ensure that everyone living in the areas we support have these basic rights.
The Government of Rwanda offers a community based health insurance program that effectively provides coverage to the majority of the population. Under this system, the population is divided into economic categories. The government covers the fees for people living in extreme poverty and offers subsidized rates impoverished families. However for some Rwandan families, even the discounted rate of about 4 U.S. dollars a year is not possible for them. We purchase health insurance for patients and families that are unable to afford it. We cover the costs of health insurance for about 25,000 patients a year.
Almost four out of every ten Rwandans report food insecurity and nearly half of all children under five have experienced malnutrition. At PIH supported health facilities, therapeutic food is prescribed along with medicine for patients who are underweight or malnourished. Patients receive monthly food packages throughout their treatment in order to achieve the best possible health outcomes. We also provide nutrition education to help patients learn how to create balanced diets with the food available to them. Each year we provide about 35,000 patients with food packages to supplement their treatment.
Malnourishment makes people more susceptible to getting sick and being sick makes people more susceptible to becoming or staying malnourished. We seek to end this cycle by supporting vulnerable households to become food-secure and self-sufficient. We work with individuals to determine what support is needed to help increase their income and stability. Depending on their needs, we provide vulnerable households with livestock, seeds, and farming equipment. To accompany these physic inputs, we also provide trainings on crop management, crop spacing, and composting. We also organize groups of vulnerable households and provide microloans and education sessions on collective money saving techniques.
Homelessness is a major determinant of health and also prevents individuals and families from breaking out poverty. We work with social workers and communities to determine extremely vulnerable persons and then construct housing for them. To date, we have constructed more than 150 homes in the districts we support.
We believe every child has the right to education. We cover the school fees for children of poor or vulnerable families. By investing in the education of children, we are investing in the development of the nation. Each year we support more than 650 students’ education and commit to supporting them for at least six years.