“When I began my residency in general surgery, colorectal surgery was not a clearly defined subspecialty
in my mind. Many colorectal procedures were performed by general surgeons, and my early exposure was limited to basic anorectal and abdominal operations. It was not until the early years of my residency, when a visiting professor performed advanced colorectal surgeries at our facility, that I first appreciated the depth, precision, and impact of this field. Watching those operations marked a turning point in my surgical thinking.
I gradually came to understand that being a great surgeon is not defined solely by knowledge, but by
mastery of procedures, attention to detail, and adaptability. Surgery demands technical excellence, but it
also requires human connection. Patients and their families look to their surgeon not only for an
operation, but for reassurance, clarity, and trust during moments of vulnerability. This balance between
technical skill and compassionate care resonated deeply with me and drew me further toward colorectal
surgery.
There is a common misconception that colorectal surgeons “only deal with the anus and rectum.” In
reality, colorectal surgery encompasses a wide spectrum of disease processes, from complex anorectal conditions to major abdominal pathologies, including malignancies, inflammatory bowel disease, and pelvic floor disorders. It is a dynamic and evolving subspecialty, continually reshaped by new paradigms such as minimally invasive surgery, advanced laparoscopy, robotic platforms, and therapeutic endoscopy. This constant evolution challenged me intellectually and technically, reinforcing my desire to pursue focused training.
As I entered colorectal surgery fellowship training, I became acutely aware of the unique challenges
within the Rwandan context. Many patients present late, often with bowel obstruction, perforation, fistula,
or metastatic disease. These delays are driven by limited public awareness, stigma surrounding anorectal
symptoms, reliance on traditional remedies, and restricted access to diagnostic tools such as colonoscopy,
pathology, and advanced imaging. The consequences are profound with reduced chances of cure,
increased healthcare costs, and preventable mortality.
Beyond cancer, benign colorectal conditions cause significant suffering. Complex anal fistula, fissures,
hemorrhoids, volvulus, functional bowel disease, etc lead to chronic pain, infection, anemia, and diminished quality of life. Obstetric-related injuries, particularly sphincter injuries, carry devastating physical, psychological, and social consequences for women. Addressing these conditions is not only a surgical responsibility but a matter of dignity, equity, and social reintegration.
My journey into colorectal surgery has been shaped by these realities. It is a commitment to technical excellence, compassionate care, and building capacity to meet an urgent and growing need within Rwanda’s healthcare system.”