Jörgen Rutegård has a long professional career behind him. He studied medicine in the 60's and 70's and fell in love with surgery. Surgery was a broad field, and Jörgen worked with everything from vascular surgery to hand surgery. During his time in Örebro, he led the section for colorectal surgery, and after eight years in Örebro, he ended up in Umeå on a lectureship 2007-2015. Although he has now retired, his commitment continues, and Jörgen is now involved in several projects to improve surgery and care in low-income countries.
"We have a three-year air purification project based at Chalmers University of Technology," says Jörgen.
It is easy to see the value in it
The project is funded by Formas and involves developing cheap air purifiers for use in operating theatres at clinics in countries such as the DR Congo.
"The rate of infection is much higher in operations in low-income countries, and it is often airborne. So if we can clean and improve the air, that rate should go down," says Jörgen.
Denis Mukwege, who holds an honorary doctorate from Umeå University and was awarded the Nobel Peace Prize in 2018, works at Panzi Hospital in DR Congo, where measurements are taken.
Air purifier on the ceiling of an operating theatre in Congo
There are many people involved in the project, from surgeons, technicians and clinicians to a professor of ventilation technology, so the project is truly synonymous with translational research. Right now, basic measurements are being made on site in two hospitals in the DRC, while the air purifiers that will be installed in the operating theatres are being designed and manufactured. In this way, they hope to see what effect an air purifier has on air quality. They are also conducting experiments in a laboratory environment here in Sweden.
"When this is finished, maybe we can continue with a clinical project and measure infection rates," says Jörgen.
"One of the surgeons at the clinic in DR Congo is interested in the project, and the hope is that a doctoral project may be possible in the future. "The air purification project has been welcomed locally and the people are positive about it.
"It's easy to see the value in it," explains Jörgen.
For the last eight or nine years, Jörgen has travelled to Congo once or twice a year to train younger surgeons.
"That's what you can do when you're retired," laughs Jörgen.
For a couple of weeks, he can provide guidance and assist in surgery, to pass on his knowledge and experience.
"I guide them in surgical technique, but also indications and contraindications," explains Jörgen.
Eezer means helper
Another major project that Jörgen was involved in starting and still runs today is the Eezer project. Eezer, which means "helper" in Hebrew, is a motorbike ambulance that will help get pregnant women to healthcare units for antenatal visits and when they are about to give birth. The maternal mortality rate in Africa is high, and getting these women to a clinic when it is time to give birth is crucial. The motorbike ambulance helps with that because cars are expensive and difficult to drive in that environment.
"It's about the simplest possible solution. Because there are many motorcycles there. It's not a question of healthcare, it's a question of transport," explains Jörgen.
The motorcycles are easily converted so that a small trolley can be attached to it, so the woman can sit in the trolley. The existing motorcycles are fitted with a hitch, but as a rule they have bought new ones because they are not very expensive.
"We've done that with fundraising money. I think we have built almost 70 wagons so far. It's being built at a fast pace now," says Jörgen.
The trolley attached back of the motorbike
The vehicles are built on site in workshops in Kenya and Burundi, creating jobs for local people. The hope is to eventually get the government, churches, companies and clinics to equip themselves with motorcycle ambulances. Today, the motorcycles are driven by local people, often with a connection to a clinic.
"It could be the caretaker, or one of the paramedics. They are used to driving these bikes. The most important thing is not to drive too fast," says Jörgen.
They have not seen any major problems with the handling, although the ambulance has been used for other purposes on a few occasions.
"It has gone very well. They guard these carefully. I have seen wagons left inside at night for safety reasons," says Jörgen.
In some countries Jörgen visits, women are told to give birth at a clinic. In addition, the UN has set a global goal for 2030 to reduce maternal mortality to less than 70 deaths per 100 000. Getting sensible transport is therefore essential.
"That's where we felt we could help. Because transport matters," says Jörgen.
If the mother in the family dies, the whole family is torn apart. Getting pregnant women to medical care is therefore of the utmost importance.
"Home births can work here, with expert help. But in these countries it can be disastrous for both mother and child," explains Jörgen.
The importance of infrastructure and networks
To notify when an ambulance is needed, there is a number to call for the coordinator of that particular carriage. But you need mobile phone coverage to make it work, otherwise they have to send a runner, which means far too long a wait for treatment.
- In Africa, the mobile phone network has taken off. "A few years ago, mobile phone masts appeared everywhere," says Jörgen, "enabling women in rural areas to reach the coordinator and get to the clinic quickly.
There are local people that the Eezer Initiative is in constant contact with. Having a network of contacts is extremely important to see that everything works well. Jörgen has been involved in various projects for many years, and over the years has made important contacts to continue the work of improving healthcare in these countries. A network he started to build up already in the 60s. During his studies, Jörgen and his future wife travelled to Central Africa as students for six weeks to visit clinics. After training as a surgeon in the mid-1980s, Jörgen spent a couple of months working in a hospital in Chad, and his commitment remains as strong as ever.
Some areas are still unsafe to travel. Countries can suffer from drought, flooding and famine. This, of course, can affect whether Westerners can be there.
"The Panzi Hospital is located in Bukavu in South Kivu, DR Congo. It's always a bit of a semi-risky place. I've been there many times, but have never been exposed to anything, says Jörgen.
Safety is something you have to be careful about, for example not travelling to the countryside where there may be rebel groups and where there is unrest. However, during his many trips, he has never been afraid.
"You stay in the city, and you don't go out by yourself in the evenings in the dark. You have to think about it," says Jörgen.
To build schools and clinics, much of the funding comes from second-hand shops and their surpluses.
"Even if it is linked to churches, the surplus must go to humanitarian projects," explains Jörgen.
The unrest in the world has not made funding more difficult, but Jörgen sees that money is still being donated and that donors continue to contribute.
"There is a lot of goodness and generosity," says Jörgen.
The driving force in Jörgen's work is to be able to pass on the knowledge and experience he has accumulated over the years and help others.
"You want to achieve something, but it is also linked to personal development. You want to do some kind of good," explains Jörgen.
The important role of education
Although Jörgen is involved in several other projects, it is the Africa projects that take up most of his time. 1-2 times a year they travel there and keep in touch with all the people.
"If you show that you are faithful, that you come back, it is extremely appreciated," says Jörgen.
Jörgen has seen progress in development in these countries since the 1960s, especially in education.
"Especially things like literacy, because it's very important. The children are going to school longer, and even the girls are going to school almost as long in the places I know," says Jörgen.
In the areas Jörgen visits, schools and kindergartens are also being built, and more children are attending school and receiving an adequate education. "The school language in Chad is French, and it's important to have basic knowledge of French already in pre-school.
"Pre-schools are needed just as much there as here. Children need to be taught to learn things," explains Jörgen.
The next trip is already being planned. In January, he will be travelling to Chad, and in February to Kenya to check on the motorcycle ambulances deployed there.
"We have planted ten vehicles in ten new clinics in Kenya. It became an event, with training and anchoring in villages and clinics. So now we will go out to these places after a couple of months to see how it goes," concludes Jörgen.