From Transportation to Transplants: How PIH Demonstrates Social Medicine in Action

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Steven Mutabazi, 30, woke up early every morning to start work at 6 a.m., even after his face and feet began to swell.

Mutabazi rode his bicycle around Rwanda's eastern Rwamagana district to deliver merchandise to vendors. On particularly busy days, he would carry more than 250 kilograms (550 pounds) of merchandise by himself.

It was exhausting and physically demanding work.

Then, Mutabazi started to grow weak. His face and feet were swollen. He didn't feel well, but knew his mother and sister relied on his income. The money from his job was the only reason they could afford basic home goods and pay for his sister's school fees.

Eventually, in 2019, Mutabazi went to the hospital. He was diagnosed with high blood pressure and referred to another hospital in Kigali, 60 kilometers from his home, for further treatment.

Mutabazi had been told the cost in Kigali would be high, and he delayed his treatment. Six months after his initial hospital visit, he visited a clinic near his hometown at the urging of a friend.

Mutabazi was diagnosed with chronic kidney disease, and he immediately visited another health facility where he could use his insurance to start a regimen of medication.

For a while, it seemed that Mutabazi's health issues had been solved.

He was taking his pills, had received the opportunity to go back to school to study automobile mechanics, and felt hopeful.

Then, one night during the holidays, Mutabazi was cooking with a friend and started feeling dizzy before vomiting. He went to the local hospital that night.

When he checked in, he had no idea that he would stay for an entire month.

His medicine was no longer working.

"One day the doctor came and told me that my kidneys were completely damaged and that I would have to look for another kidney," Mutabazi said.

Navigating Treatment

Steven Mutabazi (right) with his mother, Eveline Nyiramuhana, at their home. Asher Habinshuti / PIH

Mutabazi was experiencing end-stage kidney failure.

He needed to start dialysis immediately-and find another kidney for a transplant.

To make matters worse, he knew his insurance would only cover his first 15 dialysis sessions, and that it required a copayment of 15,000 RWF. That's equivalent to more than two weeks of work for Mutabazi.

"At first I refused to do dialysis, not because I didn't want it, but because I couldn't see how the money would be paid," he said.

Family ultimately stepped in to help pay for his copayments, but it was not a long-term solution. If Mutabazi could not find a donor, he would have to continue dialysis indefinitely. And even if he did find a donor, he wasn't sure how he would pay for the transplant, which would have to be done in a hospital in Kigali, 60 kilometers from his home.

"One night after returning from the hospital, I went to bed and started wondering how the treatment would continue," he said. "I felt like life was not working out for me. I felt confused and asked myself what would happen next. I couldn't find a solution and thought it would be better to end my life quickly rather than go through agony without treatment."

Overwhelmed and afraid of becoming a burden, Mutabazi considered removing his catheter. He had been told that if removed, it might cause death.

"I don't know what stopped me, but something inside me made me hesitate," Mutabazi said. "It was a miracle."

Mutabazi made the courageous decision to remain hopeful, even in the face of despair.

Around this time, Mutabazi's cousin, Theophile Mbarubukeye, made a life-saving decision for him: he agreed to donate one of his kidneys.

"When they said a donor was needed, I felt I had to help," Mbarubukeye said. "Letting someone die while I live would not be right."

Then, at his next dialysis session, his doctor told him he might be able to receive financial support from Inshuti Mu Buzima (IMB), as Partners In Health (PIH) is called in Rwanda.

Mutabazi and his uncle traveled 40 kilometers to Rwinkwavu, where IMB is based, the very next day.

Getting Health Care to Those Who Need it Most

When Mutabazi and his uncle arrived in Rwinkwavu, they learned IMB would cover the remaining cost of Mutabazi's dialysis sessions and his health care ahead of the transplant-from medication to transportation to Kigali for the surgery.

The combination of community-based health insurance and support from IMB allowed Mutabazi to afford the kidney transplant process. The Ministry of Health fully covered the transplant, which Mutabazi received in 2025, through the Rwanda Social Security Board. IMB then stepped in to cover three months of post-surgery treatment and recovery, an often-forgotten aspect of medical care.

PIH and its partners believe that part of medical treatment should also involve analyzing the social forces that affect our health and lead to health inequities, like access to food, housing, and transportation.

From July 2024 to June 2025, IMB helped nearly 18,000 patients in Rwanda with transportation-an essential but often overlooked piece of reaching medical care. In the same time period, IMB fed over12,000 Rwandans, helping people receive the nutrients they need for their bodies to function and heal. From covering copayments to providing housing, IMB is committed to addressing the range of needs that contribute to a person's health.

Steven Mutabazi (from left), his cousin Theophile Mbarubukeye, his mother Eveline Nyiramuhana, and PIH Right To Health Care Program Assistant Feza Mukeshimana, at Mutabazi's home in Rwamagana District, Rwanda. Asher Habinshuti / PIH

IMB even operates a recovery home near the hospital in Kigali for patients and their families to recuperate following medical procedures.

This was essential for Mutazabazi and Mbarubukeye, who had to heal before traveling home in order to prevent infection at the surgical site.

"The care was very good, the special diet, everything I needed to recover," Mutabazi said. "I did not have to worry about food, transport, or medication, only about healing. When you don't worry about survival, you regain hope."

PIH's commitment goes beyond the individual patient. While Mutabazi was receiving care, his mother was miles away, worried and praying. She was not left in the dark.

"It was PIH who would call me," she said. "They told me how my son was improving. That gave me strength."

Her fear slowly turned into hope.

"I believed God was using the doctors to heal him," she said.

Choosing Hope Every Day

Now, it has been a year since the transplant and nearly seven years since Mutazbazi first started experiencing symptoms. Throughout his recovery, PIH has continued to provide Mutazbazi's monthly medications and follow-up care. While doctors have advised Mutabazi not to do any heavy work, he has begun to return to some household chores. Eventually, he hopes to start a small business and begin generating an income again.

Through comprehensive support, PIH helped Mutabazi move from survival to hope and toward a future he once thought was lost.

Mutabazi's story shows that healing is not only about medicine; it is about standing with patients when life becomes too heavy to carry alone.