The first time I met Josiane at Kigali’s largest public hospital, she burst into tears. A young, skinny orphan with a heart complaint, she had been in and out of hospital for over four years. During that time, she had received no visitors.
Looking at her thin frame, I asked if she had eaten that day. The question was not mere small talk. Meals are not included in the medical care at Rwandan public hospitals and so family members either bring or purchase food at the cafeteria.
Josiane said she didn’t have anyone or the means to buy food but that sometimes church or student groups would bring meals.
Then she added: “When they bring the food I barely eat as I have a lot of diet restrictions.”
As I spoke to Josiane, my friend Ariane struck up a conversation with an older woman in the same ward. This woman had a request because she knew she would die soon. Her last wish was a plate of beans stirred in oil with a few onions. She was so specific that Ariane promised to bring it. When we came back a few days later, the woman had passed away.
That day we started bringing nutritious soup to Josiane. We went on feeding her for eight months during which time she gained 10kg (22lbs). As our awareness of the need grew, we started bringing food to other patients in the hospital.
Today, the organization we founded – Solid’Africa – provides one meal per day to 400 patients. We recently reached a milestone of more than one million meals. But our challenge is still real and very big. The reality is that food is medicine and that patients must have appropriate diets to restore their strength and therefore their health.
Nutrition experts agree on the importance of diet in the prevention and treatment of disease. They also agree that not only is nutrition is an important part of everyday life but a good nutritious and balanced meal can go a long way in contributing to patient experience, satisfaction, sense of wellbeing and recovery from illness. Evidence further suggests that a diverse diet with fruits, vegetables, nuts, and select animal products can help reduce risks of stunting, micronutrient deficiencies and nutrition based non-communicable diseases, which are illnesses in themselves, and can exacerbate other illnesses.
Rwanda-specific data is limited but the reality on the ground speaks for itself.
Patients respond better to medicines when they are well fed. Even psychological health improves when patients don’t have to worry about whether they will eat. We are lucky in Rwanda to have a government that places priority on public health care and we are one of only a few countries with universal health coverage, but this food gap still exists.
Our mission is to make sure that patients – regardless of their economic background – have access to healthy nutritious meals during their hospital stay so that they can recover in the best conditions and get back to their communities.
Along the way many people have joined the movement of feeding insecure patients, and our organization was fortunate to partner with Imbuto Foundation in building an industrial kitchen which will be operational by the end of 2019. Our centralized kitchen will allow us to provide three meals per day to 1,000 patients in the six Kigali public hospitals. We envision that in the next five years, this movement will contribute to ending food insecurity in public hospitals throughout Rwanda.
The issue of patient food insecurity is not only a Rwandan problem. The challenge exists in many countries in Africa, South America and Asia – especially in rural communities. Hospitals relying on families to feed patients is not a sustainable way of approaching the issue. It is not just about access to food – it is about access to appropriate food with the correct nutrition that aids in the healing process for patients.
We recognize that feeding alone is not the only solution: Policy is critical. Our goal is to raise awareness of the need to include food in the medical system as part of health policy.
The issue of food for patients should not simply be one of charity. We need politicians to recognize the critical importance of ensuring patients are well-fed by ensuring there is appropriate policy in place to grant widespread access to food in the hospital system.
In short, we need policy that recognizes that the right food is also medicine.
Our health system will be stronger and healing processes faster when the medical industry worldwide acknowledges that food heals.
Isabelle Kamariza is a social change maker who founded Solid’Africa to help vulnerable patients in public hospitals. The organization provides food, hygienic products and other services with the goal to accelerate patient’s recovery process, preserve patient’s dignity and promote equity. She is a 2019 Aspen New Voices Fellow.