Three Tufts students have made a remarkable impact on the health and education of children in rural Rwanda through their involvement in the Move Up Global fellowship program. Krystal Lwanga A23, Dan Nguyen A24, and Annie Li A24 spent a month in Musanze, Rwanda, working with Move Up Global partners to introduce the concepts of One Health, Health Passport, and Oral Health to elementary school students and teachers. 

What is One Health?

One Health is an approach that recognizes the interconnection of the health of humans, animals, and the environment. It aims to promote collaboration and communication among different sectors and disciplines to achieve optimal health outcomes for all. One Health is especially relevant for communities that live near wildlife habitats, such as the Volcanoes National Park in Rwanda, where the risk of zoonotic diseases (diseases that can be transmitted between animals and humans) is high. In addition to enhanced surveillance and vaccination, these diseases could be prevented by raising awareness and education. 

What is a Health Passport? 

Health Passport is a novel health education workbook designed like a passport to ensure a longitudinal health education and validation of individual knowledge acquisition. This booklet includes essential knowledge in oral health and other priority topics, such as water, sanitation, and hygiene (WASH), nutrition, and mental health. Move Up Global plans to issue a Health Passport to each child to be used throughout an academic year. The Health Passport will include interactive content, such as games, quizzes, and stickers, to engage the students and reinforce their health literacy.

How did the fellows implement One Health and Health Passport?

Krystal, Annie, and Dan collaborated with the local public schools and community health professionals and educators to introduce and adapt the Health Passport to the Rwandan context and curriculum. They also brainstormed alternative ways to promote the message of One Health, such as organizing a One Health Day school event and having the Cultural Dance Club serve as ambassadors of One Health. Cows are an integral part of Rwandan culture and are symbolically referenced in some Rwandan traditional dances; therefore, they believed the Cultural Dance Club would be great ambassadors to spread awareness about the importance and interconnectedness of animals, humans, and the environment. This event was a time to encourage peer-to-peer learning between the trained students and the rest of the students in their grades.

During their placement in Musanze, the Tufts students conducted a three-day training session for 40 students from the Health Club in Oral Health and WASH. There is little to no oral health learning in this community, but the fellows were able to introduce oral health fundamentals and start the students thinking about how oral health works in relation to health in general. They led innovative, interactive activities to engage the students in learning through play.  Some games they devised included hygiene tag, where a student played “the germ” and chased the other students around to simulate infection.  Another was a food sorting game to learn about nutrition. The fellows also demonstrated how to properly clean water so it is safe to drink, and then they were refreshed in a healthy way after playing tag.

Additionally, they conducted a one-day session for 10 teachers. At the end of the training session, they held a One Health Day school event to celebrate the completion of the training and to equip the trained students and teachers with the knowledge to train other students. Certificates with information sheets on the back were provided to all participants. 

Capitalizing on community-informed design and feedback loop 

The fellows have received positive feedback from the school administration, the students, and the teachers about the One Health and Health Passport initiatives. The school administration expressed their appreciation for the innovative and engaging methods of health education and the provision of health supplies. The students showed enthusiasm and curiosity for learning about health topics and demonstrated improved health literacy and skills. The teachers reported increased confidence and competence in teaching health subjects and integrating One Health concepts into their lessons.

The fellows hope that the One Health and Health Passport initiatives will have a lasting impact on the health and education of the children in rural Rwanda. This work laid an important foundation for continued relationships between the schools and health posts to improve health literacy and healthy behaviors in the community to fight malnutrition and neglected tropical diseases. They plan to continue their collaboration and expand their reach to more schools and communities.

Why did they join Move Up Global Fellowship?

The Move Up Global fellowship provides an immersion program for the next generation of global health leaders to have hands-on exposure and interaction with communities in low-resource settings. The program aims to foster cross-cultural understanding, mutual learning, and sustainable partnerships among participants and local organizations. Move Up Global currently operates in Rwanda and offers opportunities for students and professionals from various disciplines and backgrounds to engage in global health, research, education, and community development projects.

What are the plans of the Tufts students?

Krystal Lwanga A23, Dan Nguyen A24, and Annie Li A24 remain in touch with Move Up Global as senior fellows. Dan will attend Tufts University School of Medicine and also hopes to pursue an MPH in his dream career as an infectious disease physician and a global health researcher and advocate. Krystal will begin dental school this year and hopes to also pursue a master's degree in dental education, with a goal of continuing her interest in global oral health. Annie plans to go to dental school and work in underserved communities. They are grateful for the opportunity they had to travel to Rwanda and work with Move Up Global. They believe their experience has enriched their personal and professional development and inspired them to pursue their passion for global health. 
Krystal’s project on One Health was selected for the Lily Glidden Award, and the Oral Health project was selected for Projects for Peace. 

“It was an incredible experience that allowed me to make new connections and learn about the importance of community-led sustainable projects. The program enabled us to interact with the community. I enjoyed accompanying the CHW on his home visits and interacting with the students,” Krystal said. 

"This was truly the experience of a lifetime. I am forever grateful to have worked alongside such incredible leaders in the community, truly doing impactful work,” said Dan. 

“Move Up Global and IREME demonstrate what caring for a community truly entails. I am inspired to dedicate my career towards learning from different communities and positively contributing to the field by improving oral health care access,” said Annie. Both Annie and Dan are recipients of the Tufts-Laidlaw scholarship as well as the Anne E. Borghesani Memorial Prize.

Krystal, Dan, and Annie have successfully initiated One Health and Health Passport projects in the local schools and communities. Their work has made a positive difference in the lives of children in rural Rwanda and demonstrated the power and potential of these concepts to foster a culture of health literacy and awareness in Rwanda and beyond.