Cyprien Shyirambere, MMED
Director of Oncology,
Partners in Health/Inshuti Mu Buzima
Administrative Director, Oncology Program
Butaro Cancer Center of Excellence
Creating infrastructure and training health care professionals to ensure that underserved women in Rwanda receive quality screening and treatment for breast cancer.
Breast cancer is a major public health concern in low- and middle-income countries such as Rwanda, where women have a much higher risk of dying from their disease. This is due, in part, to delayed and late-stage diagnoses. By focusing on training and infrastructure, Drs. Shyirambere and Shulman have developed effective strategies to integrate early detection services into the healthcare system in rural Rwanda and reduce time to treatment. To date, the team has trained hundreds of Rwandan healthcare workers in ways to educate patients about breast cancer, perform high-quality breast exams, utilize ultrasound to identify those who may have cancer, and refer patients for timely diagnosis and treatment. Their program has provided breast exam screening to thousands of patients and expanded into four districts in the country, leading to significant improvement in patient outcomes in an area where women have a much higher risk of dying of breast cancer. They are now working to expand these efforts to reach more women with the goal of reducing preventable breast cancer deaths in Rwanda and other low-income countries and shaping national cancer control policy.
One of their major innovations has been the development of a tablet-based electronic medical record that allows clinicians to share information across facilities and identify patients who have missed visits and re-engage them in care. This mobile platform also helps patients navigate the health care system and obtain timely care and maximize any follow-up care. In the last year, they have developed and implemented a Women’s Cancer Early Detection Program Learning Collaborative in two key districts and 19 health centers in Rwanda. This Collaborative focuses on clinical mentorship, local leadership, and building a culture of data-driven practice improvement. In addition, Drs. Shymirambere, Shulman, and their colleagues are seeking to offer U.S.-driven advancements in diagnostic curriculum to Rwandan radiologists. To accomplish this, they have engaged a Rwandan radiologist as a local leader and trainer to serve as a liaison. The team will leverage their success with virtual mentorship and employ the previously trained Rwandan medical staff to implement virtual and in-person ultrasound training and mentorship to other radiologists.
The team will continue to expand their clinical trials program to other districts in Rwanda and evaluate the program’s impact on the health system and patients. In ongoing efforts, they will optimize the use of the mobile platform and expand its availability to more medical centers. In the next year, they will assess the results of the Collaborative’s efforts and continue to utilize their innovative virtual curricula to expand the cadre of Rwandan clinicians with U.S. diagnostic skills
Cyprien Shyirambere, MD is a pediatrician and currently serves as the Director of Oncology at Partners In Health Rwanda. He received a BS degree in General Medicine and Surgery and a MMed degree in Pediatrics at the National University of Rwanda, Butaro, Rwanda. He has provided clinical care as well as administrative leadership at Butaro Cancer Center of Excellence (BCCOE) and in the Partner’s In Health national oncology program since 2013.
Dr. Shyirambere has been a key leader in the breast cancer early detection program, overseeing program implementation in Butaro and beyond. As a clinician focused on cancer care in Rwanda, he also has profound insights into cancer diagnosis and care in Rwanda. His research focus has been in examining the success and challenges facing a cancer program in rural, resource-limited areas. He has been working closely with Drs. Shulman and Pace and the Rwanda Biomedical Center since 2013 in a collaborative effort to increase breast cancer early detection in under-resourced areas of Rwanda.
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