Emmanuel Gasakure
Photo courtesy of Agnes Soucat
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Cardiologist and former Dean of the then National University of Rwanda’s Faculty of Medicine. Born in Butare, Rwanda, on April 13, 1958, he died in Kigali, Rwanda, on Feb 25, 2015, aged 56 years.
Instead of returning to his native Rwanda at the end of that country’s 1994 genocide, Emmanuel Gasakure could have stayed in France. He was already an assistant professor at the University of Nancy, the institution where he had done his residency, while also working in the cardiology ward at the university’s hospital and running a private clinic. “When ′94 came, he had an extremely comfortable life in France having a brilliant career, with a brilliant career ahead of him in research”, said his partner, Agnes Soucat, a paediatrician and health economist with The World Bank. But Gasakure left it all to go back and help rebuild Rwanda.
Over the next 21 years, he would draft a nursing training curriculum, serve as Dean of the then National University of Rwanda’s medical school, help establish the university’s School of Public Health, serve as physician to Rwandan President Paul Kagame, and help design the country’s universal health insurance programme. “This man just did things”, said Nancy Mock, an Associate Professor at Tulane University’s School of Public Health and Tropical Medicine in New Orleans, LA, USA, who first met Gasakure as he searched for US universities to partner with Rwanda’s medical programmes. “And he did not seek, nor did he claim, credit for any of this. He was truly into it for the success of the country.”
It was a country he was forced to flee in 1973, when he was still in secondary school. Members of Rwanda’s Hutu community had launched a violent campaign against the minority Tutsi group which he belonged to. Word came that his Catholic boarding school was going to be attacked, so “he left in the middle of the night”, Soucat said. “He went back home to say goodbye to his family and then crossed into Burundi.” He would finish secondary school there before joining the University of Burundi to study medicine. After a mandatory 2-year stint managing a health facility in rural Burundi, he decided to specialise in cardiology. In 1987, he went to France to join the University of Nancy as a resident.
7 years later, the Rwandan genocide began and in less than 4 months at least 800 000 people were dead—including two of Gasakure’s brothers, his sister-in-law, and several of his nieces and nephews—and the country’s infrastructure was ravaged. When Gasakure finally returned home what he saw devastated him, Soucat said. He returned to France and locked himself in a room. His hair fell out. Then, “after 3 months, he decided to survive”, she said. “He decided to go back there.” And over the next two decades, the high-energy cardiologist—who relaxed by dancing, listening to music, cycling, or playing squash—would help develop the country’s medical infrastructure. “Even with the genocide and this personal tragedy he was living, he saw this tragic, but historical opportunity for him to contribute in building a new Rwanda and a better society”, said André-Jacques Neusy, Chief Executive Officer of the Training for Health Equity Network.
Gasakure first took on the rebuilding of the hospital in his home town, Butare. One of his initial tasks was to help pull the corpses of massacred Tutsis from the hospital’s wells. In the process of getting the hospital up and running, he was generating ideas for how to improve the country’s health system. The genocide had devastated Rwanda’s medical ranks. So he overhauled the training curriculum for nurses, allowing them to assume more responsibilities until new doctors could be educated. “He was such a visionary in Rwanda”, said Dan Deckelbaum, an Assistant Professor at the McGill University Health Centre in Montreal, Canada, who worked with Gasakure to improve the National University of Rwanda’s postgraduate surgical training. “He was always thinking of the next step. Once he implemented a programme and developed it, he was thinking, ‘What’s next?’”
Gasakure developed a reputation for cultivating projects he believed were important, even if they fell outside his responsibilities. When he was Dean of the medical school from 1996 to 2000, Mock said he pushed for the creation of a School of Public Health, although the new institution might compete with his own faculty for resources. He also helped conceive and create Rwanda’s community-based health insurance scheme, which has now achieved near-universal coverage. In the early days, when the project was just being introduced, he drove around the country explaining to people how it would work and why it would benefit them. Outside of the health field, Gasakure served as president of the Scouts of Rwanda and the Sports Club of Kigali, and as Chairman of the board for the country’s National Assistance Fund for the Needy Survivors of Genocide.