Not all child families in Rwanda are the result of the 1994 genocide. Major health concerns such as malaria, typhoid, tuberculosis malnutrition and HIV/AIDS contribute to a life expectancy of less than 40 years. Limited medical facilities and the lack of money to obtain quality treatment are also factors.
When a member of a child family falls ill, life turns into an even more complicated struggle. Daily problems, barely manageable under the best of circumstances, become severely compounded. Umuhoza knows this all too well.
Late in 1998, sixteen year-old Umuhoza could not raise her left arm above her shoulder. In constant excruciating pain, she was unable to attend school, cultivate or sleep. A visit to Butare University Hospital led to an operation. While recovering, the funds given to her from friends and neighbors for medical expenses, ran out. Even though a second operation had been scheduled, Umuhoza, having no more money, was forced to leave the hospital.
The operation alleviated much of the pain. Within a month, her health began to improve. Trouble with her stomach soon thereafter, however, prompted Umuhoza to return to the hospital. In doing so she was told that her arm had become infected. Her doctor recommended that X-rays be taken and that she be immediately admitted and scheduled to see a specialist. Again, having only enough money for transportation, another extended stay at the hospital was out of the question. She has not been back since.
"I was and still am scared," she admits, nervously rubbing her left arm. "My mother and father died because there was no money to see a doctor or buy medicine. It is only a matter of time for me." In addition to the pain, Umuhoza lives in a constant state of uncertainty.
Confined to her Gikongoro prefecture small, four-room home, which she shares with her two younger sisters, Umuhoza is not capable of securing a job. The infection in her arm has since spread to her shoulder and has enflamed the whole of her back. Working to earn an income or returning to school is not physically possible. She can do little more than care for the two year-old daughter of her 17 year-old sister and try to rest.
"My sisters know all about my pain," Umuhoza quietly states. "It does us no good to discuss my problems. There is nothing we can do to make them disappear." The thought of all that is required to assist Umuhoza depresses the three girls. They've no means, resources or any place to turn for the money needed to secure prescription pain medicine, transport to the hospital, a doctor's appointment, X-rays, blood tests or a second operation.
In addition to wearing her down physical, Umuhoza's condition has effected her fragile mental health. "I do my best to keep a positive outlook on tomorrow," she shares. "How much longer I will last, existing all alone as I do, unnerves me hourly."
Caption: Umuhoza [right] in front of her home with World Vision social worker Gaudiose