Beyond Borders: Lessons in Surgery and Humanity from Kigali

By Kacylia Roy Proulx

Last July, I packed my scrubs, alongside my curiosity, open-mindedness, and sense of adventure, ready to embark on a four-week surgical elective in Kigali, Rwanda. Heading to a hospital 11,000 kilometres away from home, I was ready to be humbled, to learn, and to witness firsthand what global surgery truly meant. I expected to step out of my comfort zone, but I hadn’t anticipated the profound personal growth, the lasting connections I’d make, the vibrant pull of Kigali’s energy, and, most importantly, how this experience would reshape my understanding of caring for others. Both Kigali and the University Teaching Hospital of Kigali (CHUK) became far more than a clinical setting; they were the foundation of a chapter rich in resilience, compassion, and a testament to the unbreakable human spirit. Global surgery was simply the backdrop for a deeply human experience –– one that has forever altered my perception of the profession I’m training for.

Each day in Kigali began before dawn, with the hospital alive with an energy that pulsed through its corridors as doctors, nurses, and residents gathered for morning rounds. There was a rhythm to these rounds that felt familiar, yet everything was different. Patients spoke in a language I was barely beginning to understand, the lack of AC made the air thick and humid in the 38°C heat, and every patient’s record was documented exclusively by hand. CHUK was more than a hospital — it was a lifeline, serving patients from distant villages who had made long journeys with injuries and illnesses requiring urgent care. Trauma from road accidents was incredibly common, and the cases were often more complex than typical scenarios, with patients coming in later than they might have in Canada, sometimes due to distance, other times due to cost, or due to barriers in access to care. It was eye-opening and, at times, overwhelming. However, I also saw a fierce determination and resilience in each patient’s face that reminded me that health and healing are far more than just the clinical actions we perform.

Days were intense, from 6:00 to 18:00, especially for a third-year medical student freshly beginning a clerkship in a completely new environment. I scrubbed in on every case, gloved and masked, ready to assist however I could. Each procedure taught me something new, from technical skills adapted to a resource-limited setting to witnessing the resilience and ingenuity of the Rwandan surgical team, who met every curveball with a new solution. In one case, I assisted with an orthopedic surgery for a young man injured in a severe motorcycle accident. His leg was broken in multiple places, and though he’d likely have had surgery immediately in Canada, limited resources here meant waiting, improvising, and strategizing. Watching the surgeons in Kigali was like watching artists, flexibly adapting techniques to maximize what was available. It became clear that resourcefulness, creativity, and collaboration were as essential as clinical skills. This experience dispelled any assumptions I’d held about what “good surgery” required –– it wasn’t about having fancy technology and resources, but about skilled hands, teamwork, and humanity in the most challenging circumstances.

My time at CHUK also taught me that global surgery is about bridging divides, not just medically, but in understanding. Rwanda’s healthcare landscape is shaped by a unique blend of past challenges and present resilience, with communities working together to create solutions and offer support. One day, I assisted in caring for a young boy with osteomyelitis, a severe bone infection. His family had traveled long distances to get him the care he needed. The clinical decisions were complex. Back home, he might have gone straight to surgery and received an antibiotic regimen stat, but here, the limited availability of antibiotics, along with financial constraints, meant that every decision was carefully weighed. Engaging with the team and his family to find a balance between optimal treatment and realistic feasibility was a humbling reminder of the importance of compassion in medicine. Practicing medicine in this setting taught me that global surgery is not about imposing solutions; it’s about listening, understanding the context, and adapting care to meet patients where they are.

Outside the hospital, Kigali embraced me with open arms. I was fortunate enough to live with a local family of eight who welcomed me without hesitation, immediately making me feel at home. Weekends and evenings became a joyful blend of discovery — wandering through the city’s vibrant markets, savoring local dishes, and hiking Rwanda’s famed thousand hills. This small land-locked country revealed its beauty in layers: the misty waterfalls of Nyungwe Forest, the tranquil shores of Lake Kivu, and the dense, magical forests of Volcano National Park, one of only three countries on Earth where the endangered mountain gorillas still roam. But even more captivating than the majestic landscapes were the people I met along the way. Kigali introduced me to a community that radiated warmth and connection. I found myself sharing meals and stories with people from all walks of life, from wide-eyed kids who laughed with pure joy as they taught me new Kinyarwanda words to elders who spoke with a quiet strength, reflecting on Rwanda’s journey and the dreams they hold for the future. Many evenings were spent around tables with cold beers and generous servings of pilau rice, exchanging stories in a mix of French and English. We talked about everything –– from the challenges of the past to the hopes for what’s to come, with moments of laughter, deep reflection, and an unspoken understanding of our shared humanity.

And at the hospital, this sense of community and connection extended into patient care; everyone was committed to improving not just individual health, but the well-being of the entire community. This philosophy influenced my role as a visiting medical student; I wasn’t just there to observe –– I was there to become part of this family of caregivers, even if temporarily. I am profoundly grateful to the mentors who guided me, sharing both surgical skills and the deeper values of empathy, resilience, and dedication. Their mentorship illuminated the broader purpose of knowledge-sharing in global surgery: it’s not merely about transferring skills, but about learning from each other to understand how our systems can work together to bridge gaps in access. This experience made me realize how essential it is for healthcare providers worldwide to understand cross-cultural differences, valuing both science and humanity in medicine. By building partnerships based on mutual respect, we can create sustainable growth in surgical care, knowing that we’re each enriched by the perspectives and wisdom we exchange.

Leaving Kigali was bittersweet. I boarded my flight home with tears streaming down my face and a heavy heart, scrolling through my camera roll, already feeling nostalgic for the incredible moments I had lived and the beautiful souls I’d encountered. Yet, I was leaving with a piece of Kigali: a profound respect for the strength of community, a clearer sense of purpose in my journey toward global health, and a newfound understanding of what it means to serve with compassion and humility. Above all, I had grown profoundly as a human being in just those four weeks. I had come expecting to practice surgery, but I left with a broader understanding of our profound responsibility as healthcare providers. Every procedure and decision in Kigali reminded me that we are all interconnected, and that health is not a privilege but a universal right worth fighting for. As I came to this realization, my tears stopped; I knew without a doubt that someday I would return to Kigali — these people had become my second family.