Holes in decentralization
"Patients coming even from the north of Rwanda travel by foot for days to my center because their own district centers are not yet entitled to distribute ARVs."

"Coughing and sweating from high fever, they visit my clinic in the hope of getting treated, in order to live longer and continue to work", says Dr. Uta, the German doctor and Catholic nun who runs Gikongo Health Center. "They come once, twice and then give up. The journey is too exhausting and they cannot afford to stay away from their homes for long. I know if I start them on ARV treatment they will not be able to continue it. It's a difficult position to be in."