This is the second blog post of our FemInEM Forward series, featuring blog submissions from the The FIX19 International Attendee Scholarship. The post below is written by Dr. Chantal Uwamahoro (@DrUwamahoro), the first female emergency medicine physician in Rwanda. She received the FI19 International Travel Award and attended #FIX19. Dr. Uwamahoro was supported by EM:RAP GO. Thank you to EM:RAP GO, Abbott Fund, and RCEM/EMJ for their support and partnership in supporting gender equity around the world.

I am Chantal Uwamahoro, a native Rwandan and an emergency physician. I graduated from Rwanda’s first emergency medicine (EM) residency graduating class in 2018 and I am the country’s first female emergency physician (EP).

As background, Rwanda ranks in the top 5 countries worldwide for gender equality. Gender equality is demonstrated through the roles of Rwandan women in the government, the respect for women’s education and the role of women in Rwandan healthcare. The government is structured with at least 30% of parliament seats to be filled by women, and has the highest number of women in parliament globally. Programs for girls and equality in education are in place to ensure all Rwandan girls go to school. The promotion of health for the country of Rwanda has been led by a female Rwandan health minister.

I became interested in EM in 2013 when I enrolled an EM post-graduate diploma program at The University of Rwanda. For two years, I alternated 3 months in the national referral hospital as an EM trainee with 3 months as a general practitioner developing an emergency department (ED) in my district hospital. I started with 3 beds and had to fight to maintain the ED with regularly assigned nurses and physician staff. I completed the program in 2015 and subsequently entered Rwanda’s first EM residency program with the Human Resources for Health Program (affiliated with Brown and Columbia Universities). I became a mother while in my last year of residency and am learning how to balance motherhood with a career in EM. In 2018, after graduation from EM residency, I was appointed by the Rwandan Minister of Health to work clinically at Kigali’s University Teaching Hospital in the ED.  I also have an academic role with the EM residency and am a clinical lecturer for the University of Rwanda.

My research interests include implementation of triage systems in Rwanda. I have submitted my research “Evaluation of a Modified South African Triage Score as a Predictor of Patient Disposition at a Tertiary Hospital in Rwanda” to the African Journal of Emergency Medicine. I presented my research at the African Conference on Emergency Medicine and the International Conference on Emergency Medicine where I was awarded the “International Scholar Award” for best research.

As a female EP, I remember vividly a story that helped me grow. One afternoon, while still in residency, I was in the ED and a patient presented after having been involved in a motorcycle accident. I quickly attended to his decreased level of consciousness, intubating and completing the primary and secondary surveys. X-rays were obtained and I groaned as I looked at the pelvis film. While pointing out his hip dislocation, I looked over at my female attending and lamented, “I think we are going to need to get some strong boys to intervene.” However, that afternoon, we were able to set a new precedent. Using my newly developed skills in systems-based practice and accessing FOAMed I was able to use a smartphone to search the internet. I reviewed a video instruction hip reduction, learning a new method that relies much more on physics than on strength. Moments later, dressed in a skirt, I donned a floor length personal protection apron, lifted my leg onto the stretcher and with one try, reduced my first hip. I smiled, full of confidence that would last much longer than that day. I proved to myself that, while it is always nice to have assistance when one is feeling overwhelmed, I would be able to lead my resuscitation room without relying on any one else to complete any procedure. I had overcome the limitations that I had perceived as restricting to my practice and scope as a physician; since that time, I began to change my approach on each and every shift. I thank my woman physician mentor that helped me grow from timidness to confidence.