Onlus
The Project
Sextantio Foundation: The Socio-Sanitary Project in Rwanda
Sextantio Foundation has the mission of improving socio-sanitary conditions in developing countries. To this end, in Rwanda, Sextantio Foundation, through the “Mutuelle de Santé“, aims to provide basic health insurance for those who cannot afford it and who might otherwise die from easily treatable, low-cost pathologies.
The Healthcare Context in Rwanda
After the 1994 genocide in Rwanda, the government initiated a widespread distribution of health services by opening health centers; however, for a long time, access to health remained out of reach for a high percentage of the population. In 2005, the Rwandan government introduced the Mutuelles de Santé (health insurance) project. Today, over 81% of the population has the Mutuelle de Santé and 9% possess other forms of insurance.
It is estimated that for the remaining 10%, half can afford private care, while the other 5% (approximately 550,000 people) cannot afford basic healthcare as they are unable to pay the cost of the Mutuelle, which is approximately $4 per person. Having health insurance means receiving basic assistance; specifically, with 200 Rwandan Francs (about 30 cents of a Dollar), it is possible to receive a medical visit, blood tests, and medicine for the most common diseases.
Identification of Beneficiaries
To identify the indigent individuals unable to pay for health insurance, the Rwandan state and Caritas (which performs checks on our behalf) use empirical criteria: family composition, land and animal ownership, hygienic conditions of the home, and the inability to meet primary needs or pay for their children’s education. The identification of beneficiaries with these characteristics is evaluated and sanctioned, by a show of hands, during public assemblies of “base communities” in the presence of all village or community members.
Sextantio’s Commitment
The activities of the Association, of which Tara Gandhi is the Honorary President, began with its own resources in 2008, with a pilot project covering 8,000 people. The growth has been steady:
– In 2009, we intervened across the country, covering 80,000 insurances.
– In 2010, 125,457 insurances were provided.
– In 2011, we reached 161,000 beneficiaries (representing about 30% of the indigent population unable to pay for insurance).
– From 2008 to 2024, our intervention has financed 337,649 annual health insurance quotes through the Mutuelle de la Santé. Approximately 30% of these covered children under the age of 5. While the activities were funded via crowdfunding for several years, today they are entirely funded by the profits of the Sextantio and DOM companies, which donate a portion of their profits to the Onlus. The future goal is for the Rwanda resort, which is now ready (despite a rejected bribery attempt to obtain the habitability permit), to become the primary and continuous source of funding for health insurance through its revenues. This will be realized as a local Community Benefit Company.
Results and Impact
The Health Insurance program (MHI) has had a strongly positive impact on access to care and healthcare services:
– Infant Mortality: Mortality for children under 5 decreased from 15.2% to 5% in ten years (2005-2015) thanks to health insurance. Providing insurance to 100 children for 10 years can save approximately 10 lives.
– Malaria: In a district served by Caritas, among a thousand cases diagnosed and treated promptly, no deaths were recorded among children under 5 this year.
– AIDS: Mortality dropped from 49,000 in 2001 to 5,600 in 2012.
– Maternal Mortality: Drastically reduced thanks to births in health facilities, with the rate of assisted births rising from 28% (2005) to 91% (2015).
However, the health insurance system shows a weakness in the diagnosis and treatment of neoplasms (tumors), as high costs for imaging and specialized therapies are not sustainable under current coverage.
Future Prospects
In summary, while the credit for the improved health conditions goes primarily to the State of Rwanda, which has developed a system accessible to 92% of the population, our project has demonstrated an excellent and efficient cost-benefit ratio.
In the future, a qualified research center is planned to monitor the project through ex-post research or targeted clinical studies. This project serves as an experiment in African health services, with the goal of making it replicable in other countries of the Global South.
How to Help
You can support Sextantio Onlus through:
– Bank Transfer: Payable to C/C SEXTANTIO ASSOCIAZIONE DI PROMOZIONE SOCIALE – IBAN: IT33E0542477431000001000409.
– 5×1000 (Tax Donation): Use the Sextantio tax code: 91180090689.
– Donations are tax-deductible. For more information: onlus@sextantio.it.
no-profit Project “Capanne - Huts”, Nkombo island, Kivu Lake, Rwanda.
We intend to re-purpose the identity concept behind the projects in the village of Santo Stefano di Sessanio and the Sassi in Matera with the same philosophy in another place of “marginality”, slightly further away, Nkombo Island, in Rwanda. A border island in Rwandan territory, inhabited mostly by Congolese populations dedicated to fishing, agriculture and sheep farming, whose economy is purely for livelihood. www.sextantiorwanda.com
The island’s inhabitants speak a specific dialect of this area, Mashi. Verbal memory maintains that pregnant but unmarried, or married but somewhat liberal Rwandese girls were thrown into the lake near the Fisherman’s Island. Some would be saved by these, but sentenced to an existence between domesticated collaborators and veritable slaves. The current population of the island was formed from the unions between the Congolese fishermen and these Rwandan girls.
The project for building huts starts on and is based on the material present in the Ethnographic Museum of the French-speaking capital of Rwanda, Butare. This is a museum that belonged to the King of Belgium and is now owned by the Rwandan state. These huts are not dissimilar to many others found in the mountains of the equatorial rainforest.
The area where the huts are built is located at the northern end of the island, the one furthest from the mainland, with the lowest population density and inhabited by a Muslim minority which, despite poverty, is characterized by some particularly graceful women’s clothes. As in the whole island, even in our huts the population will live on self-subsistence through agricultural production on our land and breeding activities that characterize the family’s economy. A very deep rooted tradition that goes beyond basic needs is the production of “banana beer”, a local fermented product that’s present in many areas of the western equatorial rainforest.
The only small trade will be the purchase of fish from local fishermen or the opportunity to take fish soups with them which are prepared for daily meals. Compared to the typical African resort, the local anthropological element becomes the element around which the whole experience revolves. The attempt, even in this third experience and even more dramatically than the previous two, is to prevent tourism from disrupting the subtle socio-cultural balance of the area. In an island that saw western operators linked to NGOs come only a few times a year, the socio-economic dimension of the project will articulate in dispensing health insurance policies which prevent, at very low cost treatable diseases, but which still have a high mortality rate.
Funded entirely by the members of the Sextantio Onlus Association, the management profits from this activity will go to the Association to support the project that’s been in place for more than a decade, providing health insurance to the most indigent people in the state of Rwanda, starting from the poor of the island.
The hut project will finance Health Insurance, but since paying for Insurance is considered to be the worst welfare economy in Rwanda, at the same time the objective pursued should be supporting local cooperatives for all purchases for the inhabitants of the huts. Goods such as, for example, the mats that serve as a mattress and the traditional furniture still produced by artisan carpenters’ shops can be requested from the numerous Cooperatives, asking that all their members purchase Health Insurance.
This operation would be very well seen by the existing paradigm, both in Rwanda and more generally in International Cooperation, for many reasons, because it would mean generating revenue through the insurance purchased.
I am perhaps a bit old-school and with “Illuminist” heritage, because I think that at least for some groups of people who are objectively in economic difficulty, health insurance should be an inalienable right from birth.
When the hotel becomes operational, the cooperatives will be able to give us the food products that we will not be able to produce directly on our land.
All these operations will be aimed at the most important objective of maintaining intact the socio-cultural balance originated, so as to preserve the dignity of the local populations, not transforming them into masses of beggars, as it happens in many African resorts. This will be the most difficult and fundamental challenge of a project that starts with the best intentions but that is highly experimental and with uncontrollable variables.
