A Haven for War Casualties in Rwanda

Up in the hilltop hospital, a doctor walks from bed to bed surveying patients suffering from machete and bullet wounds. Almost all of the 117 beds are full.

For Dr. Jules Niteyimana, the tiny hospital and its traumatized patients--halfway between the capital, Kigali, and the stronghold of Hutu rebels in the northwest--reflect the reality of Rwanda.

“We have both rebel and army casualties. It’s confusing here. Everyone is scared,” he whispers, making sure there are no eavesdroppers. “First the rebels threaten to kill you unless you give money. Then the army kills you when they find out you paid the rebels.”

One patient, Bonna Musabyimana, 12, was shot in the left leg in April when government soldiers approached her house in nearby Cyeru. The doctors had to amputate above the knee after the wound became gangrenous. Her 14-year-old brother was shot in the face but survived.

“The soldiers came and shot me,” Bonna says in a low voice. “They took away cattle from our village.”

Pushing the girl’s wheelchair is a 13-year-old boy who can’t remember his name and can’t say if it was soldiers or rebels who fired the bullet that ripped through his right knee two months earlier.

Hidden by thick banana trees, the whitewashed, hangar-shaped hospital is reached by a winding dirt road leading from Gakenyi, the small town at the bottom of the hill.

Inside clean, quiet wards, patients lie on metal beds with sterile sheets that are meticulously changed every day. Those who can get around with crutches lounge in the shade of the backyard garden.

Outside the iron-gate entrance, dozens of barefoot farmers line up every day to get medicine.

The hospital, which is financed by the Roman Catholic Church, has an X-ray machine and a well-equipped operating room. It charges less than private hospitals in the cities and is affordable to most people. Humanitarian groups provide medicines and medical equipment.

Founded in 1974, the hospital and its staff have survived political upheavals, ethnic tensions between Hutus and minority Tutsis, a 1990 civil war and a Hutu-organized genocide four years later that ended with Tutsis in control of the government.

But this may be the year the hospital closes down, Niteyimana says.

In February, he dodged behind his desk to escape bullets sprayed into the wards. For two hours, the Tutsi-led army fired in and around the compound. The soldiers later said they opened fire because they suspected the rebels were nearby, Niteyimana says.

A month later, the rebels attacked Gakenyi, burning the town hall and killing 31 people but leaving the hospital intact. Charred buildings and cars still blacken the green hills and lush banana plantations.

In April, the hospital’s only surgeon, a Spaniard, packed and left without warning. The Catholic nurses who lived on a hill across from the hospital soon left, too, leaving Niteyimana, who is a Gakenyi native, three other doctors and a handful of medical assistants and nurses.

“We’re surrounded here. The rebels are everywhere. You cannot see them, but they can see you,” Niteyimana says. “They have been telling people in the mountains not to come down because the hospital will be attacked soon.”

Often the mere presence of soldiers is reason for the rebels to attack.

Road ambushes, attacks on prisons to free detained Hutus, and more brazen raids on military convoys have become common in Rwanda since November 1996, when more than a million Hutu refugees returned from 2 1/2 years in exile.

Defeated Hutu soldiers and militiamen, many of them responsible for the 1994 slaughter of more than 500,000 Tutsis, hid among the returning refugees and are now bent on destabilizing the country.

Many human-rights groups and diplomats say both the rebels and the army are responsible for the deaths of thousands of Rwandans. The government says it prosecutes soldiers accused of killing civilians and denies the army is systematically killing Hutus in revenge for rebel attacks.