Committees & Time Problems, Dirndls, Play Pumps, 16 Years of Palliative Care at Baragwanath & Polio, the Last Hurdle.

Last Week
It was a Committee Meeting meeting with feedback to the club.  For some committees it's fine but for Community Service and Youth it isn't really long enough and no doubt they will go back to having meetings after a Rotary Meeting.
The whole point of attempting to keep things within the framework of the meeting is really for those who have to go back to work on a Friday afternoon.

Thursday Evening at Schwabinger Stuben

Even though this is before our normal Friday meeting you'll only get pictures next week...any dirndl pics I wonder.
It's really an 18th century maids dress but now is often a fashion statement and now made of less coarse material.
Incidentally lederhosen is also peasant working clothes but it has been replaced for work by a material invented by a Bavarian who set up shop in San Francisco, Levi Strauss.



Play Pumps
Brian Leech's enthusiasm for Play Pumps is infectious.  We've already put in one this year and now he has found the need for a second one.

Keatlholela is a primary school 45 km east of Kuruman, in the North West. It has 187 learners and 7 educators. Water used to be accessed from a borehole at the school but the pump hasn’t worked for 2 years so water is obtained from the community borehole ONE day a week so the school has to send a donkey cart to fetch the water. The school also relies on rain water which currently is non est. Result, children become dehydrated in the hot weather and the school has to close early and send them all home.   
The advantage of sponsoring this PlayPump is that it is relatively close to the first one that has been installed at Koning PS and the 2 can be visited together in one trip.
As for the Koning PlayPump, the cost of this PlayPump, tank, piping and installation is also R125 000. It would be a great help to the school if it could be installed before the year end so that it will all be in operation in the New Year when the hot weather really sets in.

What fascinates me is Brian's ability to find the communities that really need these pumps where the water is also potable.  It conjurs up an image of him seeking out the driest parts of the country, visiting  them and then saying "What about a pump?"  It fits in very nicely with RI's Areas of Focus.

16 Years of Palliative Care.

James Croswell, Marianne Soal and Mark Franklin represented the club at this event last Friday morning at Chris Hani Baragwanath.  Many thanks for doing so.  Here they are with Dr Mpho Ratshikana-Moloko....I like the convenient staircase!

This Week
It's a social meeting....Mark Franklin is sergeant,.........try and bring some better jokes than his!

ROTARY’S WORLD POLIO DAY EVENT LOOKS AHEAD TO ENDING THE DISEASE FOR GOOD

Dennis Ogbe, Paralympian and polio survivor, tells his personal story of the disease at Rotary’s World Polio Day event on 24 October 2016 at the headquarters of the U.S. Centers for Disease Control and Prevention in Atlanta, Georgia, USA.

Photo Credit: Rotary International/Alyce Henson

While the fight to eradicate polio suffered a blow this year when the virus re-emerged in Nigeria, Rotary leaders and top health experts focused Monday on the big picture: the global presence  of the paralyzing disease has never been smaller.

The headquarters of the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA, served as the site of Rotary’s fourth annual World Polio Day event. Some of the biggest names in the polio eradication campaign were there to reflect on the year’s progress and discuss what’s needed to end the disease for good.

More than 200 people attended the special live program, and thousands more worldwide watched online. Jeffrey Kluger, Time magazine’s editor at large, moderated the event.

In a question-and-answer session with Kluger, CDC Director Tom Frieden talked about the latest developments in the effort to eradicate polio.

“We have the fewest number of cases in the fewest number of places in the world right now,” said Frieden. “We continue to make ground against polio, but we’re still recording cases in Pakistan, Afghanistan, and Nigeria.”

The total number of cases worldwide so far this year is 27, compared with 51 for the same period last year.

Unfortunately, Nigeria slipped back onto the list of countries where polio is endemic this year, after cases appeared in the northern state of Borno, which was under the control of Boko Haram militants until recently. The World Health Organization estimates that the virus has been circulating in the region for five years. The country was on the verge of celebrating two years without any polio infections.

But this hasn’t stopped Rotary and its partners, who are working with the Nigerian government, Chad, Cameroun, and parts of the Central African Republic, from executing a sweeping emergency response. Shortly after the outbreak, a robust immunization campaign targeted about 1 million children with both oral and inactivated polio vaccines.

“Because the new cases were only detected due to ongoing surveillance efforts,” said Frieden.  “We shouldn’t be surprised to see more cases, because better surveillance means better detection of all polio cases.”

Polio eradication efforts continue to make progress in Afghanistan and Pakistan. In Afghanistan, cases dropped from 13 in 2015 to eight so far this year. In Pakistan, they decreased from 38 to 15.

Frieden cited innovative tactics for reaching children in Pakistan who were often missed in the past. These include placing permanent vaccination sites at entry points to the country, provinces, and large cities. Rotary has funded the purchase of cell phones for vaccination teams, so they can send data to health centers immediately.

“The virus is cornered, we just have to make sure never to let it out again,” Frieden added.

CELEBRITIES JOIN ROTARY’S GATHERING

Dennis Ogbe, a polio survivor and Paralympian athlete, told his personal story of survival. Ogbe contracted polio at age three at a clinic near his home in rural Nigeria while being treated for malaria.

Ogbe competed in the Paralympics in Sydney in 2000 and London in 2012. But he says the toughest challenge he’s faced is helping to rid the world of polio.

Shira Lazar, host of the show “What’s Trending,” gave a social media update during the live streamed event in which she announced that more than 3,000 World Polio Day events were happening around the world. In Pakistan, a huge End Polio Now message was illuminated at the Kot Diji Fort in the Khairpur district.

Video addresses came from Maryn McKenna, author and journalist, and new polio ambassador Jenna Bush Hager, chair of UNICEF’s Next Generation, a journalist, and an author. Hager’s father-in-law is a polio survivor.

Rotary, with support from the U.S. Fund for UNICEF, also debuted a virtual reality presentation that transported attendees to the streets of India and Kenya, where they interacted with polio survivors and heard their stories.

“This is very good technology to put people in places where polio has affected so many,” says Reza Hossaini, director of polio eradication for UNICEF. “It’s important we see the places and people we are helping with our polio eradication programs.”

Earlier in the day, Frieden and Rotary International President John F. Germ announced major contributions to polio eradication. The Canadian government committed $10 million, and Michael Bloomberg, businessman, philanthropist, and former mayor of New York City, donated $25 million.

Rotary has contributed more than $1.6 billion to polio eradication since taking on the virus in 1979.

“We started this more than 30 years ago,” said Germ. “We’ve stuck with it all this time. And soon, we’re going to finish it.”

Paul Botes, Rotary Family Health Day, Roger Else gets stuck in, Committees and Haiti.

Last Week

As I surmised, Graham Pugin wasn't in a fit state to come and talk to us having been shot in the mouth with a rubber bullet but we had almost a gala lunch with Joan Sainsbury bringing Petra Oelofse and Paul Botes and his wife.

Mark Franklin, as chairman of the Arts Festival Committee, presented him with a certificate for the most paintings sold at the Rotary Arts Festival.

Friday was also one of the Rotary Family Health Days which meant that some of our members weren't present as they were 'tending the sick'.  Melodene and Ken Stonestreet gave us a run down on what they had been doing in conjunction with Morningside Club in Diepsloot the day before which was well organised and a tremendous turn out of people.  Melodene felt that two people's lives were saved because they had been checked at the clinic and were immediately packed off to hospital.  That in itself made it worthwhile.
In contrast Mark Franklin had a disappointing time in Ivory Park with Kyalami Club.  He didn't feel it was advertised properly as they had very few people turn up compared to last year.

In our club one of the requirements for membership is for a prospective member to help on a Rotary Project.



Roger Else wasted no time in doing his community service.  He kindly dedicated his Saturday
morning to helping Lebohang Sithole and Jan Tshikhuthula, co-founders of the newly established EditionVary Print Studio, at the Parkhurst Recreational Centre.  

Two things needed doing:

•  The delivery of a much needed metal cupboard for keeping valuable printing paper and other supplies under lock and key.  
• And the fixing of the entrance door to the studio for the added security of the Printing Press so generously donated to Edition Vary by the Club as part of its support to the arts community by developing a business development, training and educational project. 

This Week.
It's our Committee Meeting week.  I printed out a number of large labels to put on the tables relating to the committee.  Most of them vanished.  If you feel you need one, committee chairmen, just bring one along.  If you feel it is unnecessary, don't bother.

Rotary Careers Morning.
We have set the date for Saturday 25th February, 2017.  Last year we had 325 Grade 12's and this year we are anticipating a lot more and we have already added a number of extra vocations such as Printing and Physiotherapy.  Because we are anticipating greater numbers there will be food stalls and a number of 10 minute talks that learners can attend when they wish to.  Logistically it requires more careful planning because of numbers and we have already started.

Don't forget to book with me for Schwabinger Stuben next week, Thursday, 27th!

ROTARY AND SHELTERBOX ON THE GROUND IN HAITI

Staff from ShelterBox and the United Nation’s World Food Programme help unload a delivery of ShelterBox supplies at Les Cayes harbor in Haiti, where tents are likely to be used to help health professionals screen and treat cholera victims.

Photo Credit: Alexis Masciarelli

Even as parts of Haiti were still recovering from a catastrophic 2010 earthquake, Hurricane Matthew tore through the impoverished island country 4 October, leaving hundreds dead and many more homeless.

The Category 4 storm affected an estimated 330,000 people in Haiti, including 6,400 who were moved to temporary shelters. Extensive damage to main bridges and other transportation networks have left some areas cut off and vulnerable. Torrential rains have resulted in flooding and landslides. And contaminated water supplies threaten to lead to a surge in cholera cases and other waterborne illnesses.

A ShelterBox response team of volunteers from Canada, England, New Zealand, and the United States traveled to Port-au-Prince, Haiti's capital, last week to assess the damage and decide how best to help people. ShelterBox, an independent charity, is Rotary's project partner for disaster relief.

Working with Rotary members, government authorities, and other relief agencies, ShelterBox is focusing on the cholera outbreak in the southern region of the island and emergency shelter. A shipment of ShelterBox supplies arrived in Les Cayes, in the south of Haiti, on Wednesday, which likely will be used to help health professionals screen and treat cholera victims.

"We hope to provide ShelterKits along with other crucial supplies like solar lights, mosquito nets, water purification units, and water carriers. All of which will help in the fight against cholera," says Chris Warham, chief executive of ShelterBox.

With wind speeds reaching 155 miles per hour, Hurricane Matthew is considered the worst storm to make landfall in Haiti in more than 50 years.

STORM'S PATH HITS UNITED STATES AND CANADA

The destructive path of the hurricane cut through communities in Florida, Georgia, and South and North Carolina, USA, and as far northeast as Nova Scotia, Canada, causing flooding, severe damage, injury, and death. Rotary members are working together to provide emergency supplies and help families find shelter.

"Rivers are still rising and expected to crest on Sunday," says Rusine Mitchell Sinclair, governor of District 7710 in North Carolina. "We'll work with our neighboring districts to provide relief once the flooding has peaked and we can get in to assess what's needed."

Human Trafficking, Youth Leadership Course, Fr Graham Pugin and Students Today, Schwabinger Stuben, Foundation Seminar and Polio raises its ugly head again in Nigeria.

Last Week

Philip Frankel gave us a rapid overview of Human Trafficking, not only in South Africa but also worldwide.  I think we were all startled by the huge numbers of people and the money involved.  40 000 sex workers in Johannesburg alone but not all have been trafficked.
Strangely his book isn't available in out local bookshops so you'll have to buy it from Amazon.

The Rotary Club of Rosebank Johannesburg Senior Youth Leadership Course

Gerry Bernardo slaved away at the braai.

The Weekend also saw the Rotary Youth Leadership Course run by Jean Bernardo and her team for 65 Grade 11's from a huge number of different schools, some public, some private, some township, some suburban.  The Course has been run by our Rotary Club for many years before RYLA was even thought about.

I spent quite a lot of time chatting to the various participants....I managed to at least say hello to everyone.  They all had a wonderful time, learnt a lot and met many new people of their own age.

Other Rotarians helped.

A number mentioned how difficult they discovered leadership actually is and all had really fruitful discussions amongst themselves, sometimes until the small hours.  I was told that this was the best thing of all.  The Course facilitated that and provided the space for it.

We as a Club owe a great debt of gratitude to Jean & Jerry Bernardo, Ann & John Hope-Bailie and Neville Howes for putting it all together and running it.....not just for this year but over a number of years.

There aren't any photographs of the Anns because they were busy preparing salads, buttering rolls and things like that.  I am sure we will have more photographs next week from Jean and Ann.

This Week
Our speaker should be Fr Graham Pugin SJ, a Jesuit.
He is an English scholar, national chaplain to Christian Life Communities and chaplain to the Universities of the Witwatersrand and Johannesburg as well as being parish priest at Holy Trinity, Braamfontein. 

He joined the Jesuits after being one of the early conscientious objectors in 1979.
He studied in London and studied and taught English Philology at Oxford.   
He was going to talk to us about his involvement with students and the problems they face at the moment, at least I think he was.....but it might not be possible looking at this video which was taken in the churchyard at Holy Trinity on Monday.  The Church is on the Wits campus in Bertha Street.

Dinner @ Schwabinger Stuben Thursday 27th October.
I have sent out a notice about this and we have had some response already...don't forget to let me know!  If there are a lot of us I will negotiate a set price.

Foundation Seminar 19th November
I know it's a long way away.  I have already had one person who wants to go.  The Club always pays for members to attend courses as it's important that we keep up to date with changes  in Rotary and know what is happening at Rotary International.  Foundation is particularly important in its Centenary Year, especially as we hope to apply for another grant.

Our Treasurer, Kevin Wolhuter's mother died last week and the funeral is on Tuesday 11th October at 11 a.m at the Christian Community Church corner Dover and Pine streets FERNDALE.  Our condolences, prayers and best wishes to him and his family.

NIGERIA’S TOP HEALTH OFFICIAL VISITS ROTARY TO DISCUSS COUNTRY’S RESPONSE TO POLIO OUTBREAK

Nigeria’s health minister, Isaac Adewole, said on Friday that his government is determined to rid the country of polio again. New cases recently landed Nigeria back on the list of countries where the disease is endemic.

Adewole met with Rotary leaders at Rotary International World Headquarters in Evanston, Illinois, USA, to discuss Nigeria’s recent efforts to stem the outbreak.

All three of the country’s cases were detected in the northern state of Borno, which was under the control of Boko Haram militants until recently. The World Health Organization (WHO) estimates that the virus has been circulating in the region for five years.

“The new cases devastated us. Even one case is unacceptable. It’s very unfortunate we are in this position, but we are recalibrating our efforts to end this disease,” Adewole said. “We consider this situation a national emergency.”

Shortly after the outbreak, the minister sent an emergency response team to Borno for an immediate and robust vaccination campaign targeting about 1 million children. More than 850,000 were immunized in the first five days of the campaign, according to Adewole. To reinforce the effort, the country is using both oral and inactivated polio vaccines.

Moreover, Nigeria established a task force to tackle other issues in Borno, including lack of clean water, sanitation, health, nutrition, and psychosocial disorder stemming from Boko Haram’s occupation. “Rebuilding Borno is a national priority,” he added.

Nigeria, with the help of Rotary and its polio partners, has already begun additional large-scale immunizations aimed at reaching 60 million children by December. Rotary released $8.5 million to support the response in high-risk areas and parts of the Lake Chad Basin.

Nearby countries including Cameroun, Central African Republic, Chad, and Niger are also coordinating vaccinations to protect their polio-free status.

Together, the five countries are conducting what Adewole called a “ringed fence” immunization. Inoculations take place along the countries’ borders.

“We can’t do this alone. Working with the other countries is crucial to the overall polio eradication in Africa,” he added.

In 2015, after Nigeria passed more than a year without any cases detected, WHO announced that it was polio-free and removed it from the list of countries where polio is endemic. Adewole admitted that the country stopped focusing on polio after the achievement. “We started the celebration too early. But these cases have awakened us, and we are now redoubling our efforts so this doesn’t happen again,” he said.

Adewole added that it will take sustained effort to be removed from the list again, including domestic and international financing, the commitment of thousands of health workers, and strategies that reach missed children. The government has allocated $300 million for the emergency response.

“Polio eradication is about national pride and honour,” he says. “We will not let our citizens or the world down.”

Human Trafficking and Boko Haram Refugees

Last Week
It was a Fellowship Meeting and there were a lot of jokes.  I think that the President should abstain from telling jokes completely.  Mark Franklin gave his apologies and we missed his endless supply.

This Week
It's good to have one of our prospective members talk to us before he has been inducted!  Philip Frankel is the former head of the department of Political Studies at the University of the Witwatersrand in Johannesburg and is now a policy and development consultant specializing in organisational transformation. He has worked extensively with local, regional and central government in South Africa, including the presidential office under Mandela and his successor.  His latest book is "Long Walk to Nowhere - Human Trafficking in Post Mandela South Africa".....and that's what he is going to talk to us about.

Human trafficking is a global crime affecting countless victims around the world. Yet its actual scope remains a mystery. The methodologies used to arrive at estimates about its nature and extent have been widely criticised as  lacking in scientific rigour.

In South Africa, claims by anti-trafficking campaigners and NGOs include that 30,000 children are trafficked into the country annually as part of the sex trade. The same figure has been used by the Department of Home Affairs to justify recently introduced visa regulations aimed at combating child trafficking.

But this number has been discredited as “exaggerated and unsubstantiated”.

Human trafficking has become a focus of attention in the country following the introduction of the onerous and controversial visa requirements. In addition, a new act aimed at preventing trafficking is expected to be operational in the next few weeks. It defines trafficking to include the recruitment, transportation, sale or harbour of people by means of force, deceit, the abuse of vulnerability and the abuse of power for exploitation.

A statistical dilemma

But the absence of reliable statistics means that there is no clarity on just how big the problem is.

Inflated guesstimates continue to be used by those trying to stop the crime. But they create a credibility dilemma, detract from a constructive conversation and frustrate efforts to understand the multi-layered realities of the problem.

Notwithstanding the lack of reliable numbers, the problem is prevalent in South Africa. The number of cases being reported suggests it is on the increase. The situation may in fact be far more chronic and severe than we know.

It is well documented that South Africa is a source, transit and destination country for human trafficking.

Philip's ongoing research draws on the experiences of role-players in counter-human trafficking. These include all the responding agencies including civil society, survivors and ex-perpetrators.

Preliminary themes highlight multiple accounts of undocumented cases, direct and indirect complicity by political elites and bureaucratic officials, the paucity of border controls, corruption and a culture of impunity.

This toxic concoction makes human trafficking an attractive business with high returns and low risk. For example, trafficking in persons for sexual exploitation is the most documented type of trafficking, locally and internationally. Yet none of the international syndicates dominating the sex trade have ever been successfully prosecuted in South Africa.

New Englanders, Nigeria clubs aid Boko Haram refugees

By Marty Peak Helman, District 7780 Foundation Chair

Children in a refugee camp in eastern Nigeria.

The American University of Nigeria (AUN) was co-founded by Rotarian Felix Obadan in 2000, and 12 years later, when Felix was governor of Rotary’s District 9125, which covers a large portion of Nigeria, he chartered the Rotary Club of Yola-AUN on campus. Their strong influence on campus makes it not surprising that many University professors and senior staff are Rotary members, and that the University prides itself on its work toward peace, entrepreneurship, and economic development as well as its strong academics.

The University’s mission is to graduate students prepared to take on the challenges in Nigeria and throughout West Africa – challenges of climate change, development, and peace building. And peace is not an abstract concept at the university. After all, it is located in Yola, the capital of Adamawa State, in the region where Boko Haram is most powerful. In fact, those few dozen Chibok schoolgirls who escaped from being kidnapped by Boko Haram are now safely living at the University, where they are receiving social services and education.

Boko Haram has brought me to the American University of Nigeria as well. I am here as part of a team from Rotary’s District 7780 in New England to meet with the two Rotary clubs in Yola, and to visit Rotary projects including a camp for internally displaced families in flight from Boko Haram. It is our intention to see what we can do in terms of a global grant to help them.

Putting together a global grant will not be easy. The needs of the people living at the camp are immediate, and it is hard to think in terms of long-term sustainability. Food, for example, is a continuing problem. The men are agricultural workers and are eager to get back to working the soil, but even if they could rent land near to the camp, it’s hard for them to think ahead to next year’s crop. One non-governmental organization gave the men seed for planting, we are told, but because their children are hungry, the seed was promptly cooked and eaten.

The families at the camps – who are there because they have fled their villages for their lives – are living testimony of the need for us, their neighbors, to strive for peace.

Meanwhile, while they wait for political change, the women weave craft items to sell out of the plastic bags that litter the sides of the road, and the children – many of whom have been out of school for several years while their families have been on the run – attend a government school near the camp.

Still, I find myself very optimistic about being able to craft a global grant to help these families. After all, the Yola clubs know the camps intimately, and have both the contacts and the resources to understand what will work best. Our Districts – 9125 in Nigeria and 7780 in New England – have worked together for over a decade, with National Immunization Days, a Group Study Exchange, and both matching and global grants to our credit.

This is what Rotary is all about – developing relationships that span the globe and make possible long-term humanitarian change. And the families at the camps – who are there because they have fled their villages for their lives – are living testimony of the need for us, their neighbors, to strive for peace.

Steven Friedman, the JYO Concert, Fellowship and Indian Surgeons in Rwanda

 Last Week

Professor Steven Friedman spoke to us about the real outcome of the local elections and how, in the métropoles,  the majority party cannot make decisions without canvasing support where as this has never happened before as the majority party has always had an overall majority and coud really do it what liked. 

How the DA learnt very quickly that it could do nothing without EFF agreement.....we live in interesting times.

.  

Johannesburg Youth Orchestra Concert, Sunday 25th September

This was supposed to be a PR event for Rotary but other than a few banners I couldn't quite see what it sought to achieve.  It was also badly supported by Rotary.  Rosebank Rotary was great.  I don't know the exact number who attended but it was certainly more than 20...maybe as high as 30.

I reckon that if you like going to concerts you go to concerts whether there is a Rotary involvement or otherwise.

The JYO was conducted by Eddie Clayton and Stephen Maycock was the soloist in Carl Maria von Weber's Clarinet Concerto No 2.

The choice of music was obviously chosen to include all the musicians, including a harpist and to show the versatility of the orchestra.  It was good to hear modern classical music.  We started with Bernstein's Overture to Candide and finished with Holst's Planet Suite.  It was a great pleasure to hear the suite in its entirety.  One of our local radio stations seems only capable of playing Jupiter though I think I caught Venus once!  I hate odd movements...all part of trivialising the arts.

Congratulations to Steven Margo for organising the event.  I hope he gets better support next time.

A Thank You from Chris Hani Baragwanath Hospital 

                                                                                                                                                             

Dear Sir/ Madam,

Our palliative care team at Chris Hani Baragwanath Academic Hospital provides a vital service to the patients and their families who are dealing with life limiting, renal failure and life threatening illnesses, many of whom may not survive. This often places an enormous burden on families who have very few resources. Our multidisciplinary team of nurses, doctors and social workers as well as drivers, support patients and families in the hospital as well as in the community through home visits.

We offer support to patients and families who are in distress. This is beyond our normal duties expected of our team. From experience, we have found this to be a very valuable offering and much appreciated by those who are in need.

We need any assistance of any donations to offer our valuable patients, as same do not have food they take medication on an empty stomach. We would be very grateful if you would be able to donate any of these items.

We are so grateful for the blankets, sheets and morning slippers you donated for our patients as palliative care team (Renal Project). They were really grateful. We wish more for our patients and families.

May God multiply what you took from in many folds. Thanks a lot, May God Bless you all.

For further information, please contact me on 011 933 0260 or Dr Mpho Ratshikana-Moloko on 011 933 0051.

Warm regards

Mr. Tlou Mothata

Social Auxiliary Worker:

Wits Centre for Palliative Care

Chris Hani Baragwanath Academic Hospital                

This Week

It's a Fellowship Meeting when we talk to each other...perhaps!  It also does give the Board the opportunity to raise anything that the club should be aware of from the Board Meeting.  You will notice that Lyn Collocott is again Sergeant.  She was catapulted into the position last week and delegated the joke to Mark Franklin who must have a filing cabinet full jokes.   This week she has the time to be creative.       

   

SURGEONS FROM INDIA BRING RELIEF TO UNDERSERVED PATIENTS IN RWANDA

Photo Credit: Mussa Uwitonze

From the October 2016 issue of The Rotarian

Hundreds of people gather in an open-air courtyard at University Central Hospital in Kigali, Rwanda. Men in suits, women in flowered dresses, even prisoners in pink and orange gowns are waiting to find out if they will receive medical care. Some have no visible signs of injury. Others arrived on crutches, with arms in slings, or with catheters protruding from their clothing. Several have swollen, broken limbs: injuries that should have been mended long ago but were neglected because of the country’s long surgical-ward backlog, or simply poverty.

Emmanuel Mugatyawe, 36, sits on the ground as a friend fills out his yellow admissions form. He has been waiting two months for an operation to repair a broken leg – now infected – that he sustained when a car plowed into his motorbike.

“These are not routine cases; there are very few fresh injuries,” says Shashank Karvekar, an orthopedic surgeon and member of the Rotary Club of Solapur, India, after he and his Rwandan colleague Joel Bikoroti examine several dozen patients, scheduling many for surgery. Over the next eight days, a team of 18 specialized doctors (12 of whom are Rotarians) will perform surgeries on 268 Rwandan patients, including procedures in orthopedics and urology. The trip, initiated by District 3080 (India) and hosted by District 9150 (Central Africa), is funded by The Rotary Foundation with support from the Rwandan government. It’s the fourth medical mission to Rwanda that the two districts have organized since 2012. This time, among the volunteers is K.R. Ravindran, the first sitting RI president to take part in the mission.

A few buildings down on the University Central Hospital’s campus (referred to as CHUK), Rajendra Saboo, 1991-92 Rotary International president, is busy coordinating the last-minute logistics of the mission. The 82-year-old from Chandigarh, India, has done this many times. After finishing a post-presidential term on the Board of Trustees, Saboo and his wife, Usha, began to look for ways to participate in the type of hands-on service they had long encouraged of their fellow Rotarians.

They wanted to help India, a country that often receives outside assistance, make a stronger global contribution. It didn’t take long for Saboo to focus on medicine. He found that many local doctors had trained or worked in limited-resource settings similar to what they would find in Africa. “Our doctors are medically very strong,” Saboo explains. “And because India also does not have infrastructure of the highest level, they’ve learned how to innovate.”

Saboo’s first mission, to Uganda, took place in 1998 and focused on cataract surgeries and corrective operations to help disabled polio survivors. Organized with Rajiv Pradhan, a pathologist and past governor of District 3130, it consisted of doctors from Saboo’s district (3080) and Pradhan’s.

Today, Saboo recalls the mission as a life-altering experience – one so successful that the two soon arranged a trip to Ethiopia. That visit marked the start of an 18-year partnership that has brought more than three dozen surgical missions to 12 African countries, as well as Cambodia and six of India’s least developed states. Over time, the missions have increased in frequency to four per year, while adding specialties such as plastic surgery, urology, and gynecology. Saboo has been on almost every trip. “Raja Saboo is absolutely full of energy,” says Pradhan. “He’s constantly thinking of new ways to support medical missions. Even at this age, he’s working 12 hours a day.”

Rwanda, a compact central African country with mountainous topography that often draws comparisons to Switzerland, is perhaps best-known for its darkest moment: the slaughter of up to a million citizens, mostly members of the Tutsi minority, in the 1994 genocide. Twenty-two years later, it’s one of the fastest-growing economies in Africa. Kigali, its capital, is among the tidiest cities on the continent. Since 1994, life expectancy has more than doubled in Rwanda while maternal and child mortality rates have fallen.

Rwanda still faces public health challenges, however. Access to surgery is among them. According to The Lancet, an estimated 5 billion people, including nine out of 10 residents of lower- and middle-income countries, do not have access to “safe, affordable surgical and anesthesia care when needed.” In these countries, the British medical journal notes, 143 million additional surgical procedures are needed every year. Although most Rwandans are covered by national health insurance, which gives them access to low-cost care, many people living in rural areas cannot afford to get to a public health facility. Moreover, surgery is only available in five of the country’s public hospitals, and many patients must wait to be referred from local health centers or district-level facilities.

Aside from a minority of patients who can afford private care, complex cases wind up at one of two public hospitals in Kigali: CHUK and Rwanda Military Hospital, which also hosted doctors from the mission. A persistent shortage of surgeons means there’s typically a long waiting list. According to Faustin Ntirenganya, who heads the department of surgery at CHUK, the hospital employs just 10 surgeons and three anesthesiologists – a staffing shortage that, at times, means a backlog of up to 1,000 cases. Despite a growing number of surgical residents at Rwanda’s national university, the lure of better-paying jobs abroad makes holding on to specialists difficult, Ntirenganya says. “Our biggest challenge is numbers,” he says. “Our limited team cannot handle the needs of the whole population.”

The Rotary mission helps meet the high demand. In four trips to Rwanda, Saboo’s teams have conducted nearly 900 surgeries. For some patients, the mission represents a final chance. Michel Bizimungu, who had been out of work since rupturing a patellar tendon playing soccer last October, was told his case could be handled only at Rwanda’s top private hospital, at a price far beyond his means as a cleaner. Then his case was referred to Asit Chidgupkar, an orthopedic surgeon and member of the Rotary Club of Solapur. Although Chidgupkar had never encountered this specific injury, and CHUK lacked some needed equipment, including biodegradable screws and suture anchors, Chidgupkar devised a plan. The next day, in a four-hour procedure involving three separate incisions, he repaired Bizimungu’s knee. Chidgupkar called the procedure an “absolute improvisation.” (He later presented the case at an orthopedic conference in India, and he keeps in touch with Bizimungu, who updates him periodically on his recovery.) “It’s one of my most memorable cases,” he says.

The mission also provides training. Mission doctors teach cutting-edge surgical techniques to local physicians, medical students, and residents. During surgery, the visiting doctors demonstrate techniques and learn from host country doctors. Bosco Mugabo, a fourth-year resident in surgery at the University of Rwanda who assisted Chidgupkar with Bizimungu’s operation, says the opportunity was invaluable. “There are some tricks and hints that you don’t learn from school,” he says. “You learn them from a specific surgeon.”

With this in mind, Saboo worked with local health authorities to slightly modify the Rwanda mission. At a dinner in Kigali, he announced plans to invite 10 Rwandan doctors to India for three-month stints of training there – part of an effort to boost local capacity in a more sustainable manner. The next mission to Rwanda will also be smaller and focus more on teaching two in-demand specialties: reconstructive urology and anesthesiology. In addition, 20 Rwandan children will undergo open-heart surgery in Saboo’s home city of Chandigarh. With travel funds from the Rwandan Ministry of Health, 30 Rwandan children have already received such operations there. According to Emmanuel Rusingiza, one of only two pediatric cardiologists in Rwanda, the country’s high rate of rheumatic heart disease, which generally results from untreated cases of strep throat, means the country has a waiting list of more than 150 children. “A big number of them are passing away,” he says. “It’s a very hard situation.”

As the mission in Kigali winds down, Saboo is already looking forward to the next one. With more Indian districts interested in sending doctors, and African districts interested in hosting them, he expects the number of trips to increase, even if his own attendance becomes less frequent.

Many mission participants, both first-timers and veterans, say they plan to return, though it sometimes entails a significant personal and professional sacrifice. Karvekar, whose own son underwent heart surgery in India just days before he traveled to Kigali, is one of them. “I’d wanted to go on one of these trips for a while,” he says, noting that the mission was his longest absence from his family’s private clinic, where he’s the only orthopedic surgeon on staff. “There were a lot of challenging cases, but fortunately we were able to do them well and, I think, give the patients a good result.”

“It is totally a labor of love,” adds Saboo, speaking for himself as well as the team of doctors. “When they come here, there’s no compensation. They come purely because they want to extend their services to humanity beyond their own borders.”