When Joseph Ngamije began working in public health, he was impatient. As a child, he saw suffering and mass murder during the genocide in Rwanda, and he dreamed of growing up to help people and alleviate suffering. He aspired to be a medical doctor, but he entered public health largely because it required fewer years of schooling, a decision he is grateful for in hindsight.
Early in his career, while he felt lucky to work in jobs that allowed him to help support others, he could not understand why it took so long to pass new policies and design new programs.
“There are so many actors in what we do, and not everyone is in a hurry or is so motivated or sees the urgency or is committed as everyone. I used to be frustrated but now in my 18th year, I know what sticks,” he said. “Bringing so many people together takes time. You have to be strategic and make sure everyone’s level of commitment is there to achieve the goal.”
He focuses on two main strategies to get there.
“First, I focus on data because it shows the need,” he said. “Second, I focus on engagement… Once everyone is engaged and sees the progress we are making and sees the impact that it is bringing to the population, everyone is on board.”
Joseph has seen tremendous success using these strategies.
Rwanda has high rates of chronic malnutrition. While working for CARE International in the early 2010s, Joseph worked on the USAID-funded Kuraneza project, helping to develop, implement and disseminate a groundbreaking model to improve childhood health. The model was eventually adopted by Rwanda’s government nationally.
For example, many mothers in Rwanda did not have a place to leave children when they went to work in rural fields and farms. He helped organize groups of 10 households that coordinate so that each mother takes a turn staying with all the children. The mothers are trained on child development, nutrition, activities to do with the kids, how to respond to illness, and best breastfeeding practices.
After four years, the program became a part of policy in Rwanda: Kids now go to these home-based nurseries at 18 months instead of beginning time away from families at age 4. While running this program, Joseph also engaged leaders at the district level and from different ministries to work to eliminate malnutrition.
In 2014, Joseph moved to South Sudan to work with internally displaced people, providing health care and services and building the capacity of community health workers, a model that had been developed in Rwanda. He worked with several organizations including the International Rescue Committee, CARE International and the Canadian Red Cross.
He joined Vital Strategies in 2017 as a project officer for the Partnership for Healthy Cities, where he has helped the program grow to more than 70 cities. Joseph mostly focuses on 14 cities in Africa plus Amman, Jordan, helping them to develop policies that reduce noncommunicable diseases and injuries.
He is proud to cite some of the successes that the Partnership has achieved in the region: With a push from the Partnership, Lusaka, Zambia, lowered its speed limit from 60 to 40 km/h and 30 km/h in school zones. Cape Town, South Africa has taken sugary drink dispensing machines out of public buildings and made the city’s buildings smoke-free.
Another win was in Amman, where a high percentage of people smoke and the tobacco industry is powerful. With Partnership support, the city of Amman is now implementing the tobacco control act, which prohibits smoking in many public places, using the recently approved inspection protocol.
“I am passionate about my work. I love results and am a results-oriented person,” he said. “I have many pictures in my mind of the changes we have helped make.”
Joseph continues to be driven by his experiences as a child. He is the seventh child of eight in his family. Most of his family members were born in Kenya because his family had fled Rwanda in 1959 after the overthrow of the monarchy. The family returned to Rwanda in 1983, the year of Joseph’s birth, and he grew up hearing stories of what his family had gone through. However, the family lived in a safe neighborhood in Kigali, and he grew up playing soccer with many friends, while his older siblings studied in boarding schools. His father was often away for work, selling tea back to Kenya.
“During the holidays, everyone was home, eating together and telling stories. That was amazing,” he said.
Then he lived the nightmare himself, surviving the 1994 genocide as an 11-year-old, hiding in the bush and in others’ homes and watching many people die, including his own brother and friends.
At the end of the war, he lived in a refugee camp with his family. His father, who was in Kenya, thought they had died.
Those experiences shaped him and oriented his career, he said. “I didn’t ask to go through those moments, but I learned from them. It’s sometimes when I think about it again it makes me sad, losing people that I grew up with.”
Despite the horrors, the genocide helped people become stronger and more resilient, Joseph said. “We preach peace and make sure the next generation doesn’t make the same mistakes,” he said. “We have that obligation.”
At Vital Strategies, Joseph says he loves “the spirit of my colleagues” and he likes to get to know his colleagues and partners from the cities he works with on a more personal level. He travels often because in Africa it is particularly important for work to be done in person.
“They want to see me and create that bond. I have been with the cities for the last six years, and they have become family. I have visited each city. We have calls every month. We have that closeness that pushes them to come toward me when they need support.”
Joseph lives with his 8-year-old daughter, who is the center of his days. He loves their daily routine, of taking her to and from school, and helping her with homework and bedtime. On the weekends they often go biking in a nearby park. His 14-year-old son attends school in Germany, living with Joseph’s sister.
He holds a bachelor’s degree in public health from the University of Rwanda and is working on a Ph.D. in public health epidemiology.
“I have gained a lot of experience and I want to share it widely either academically, or when I retire have a consultancy firm and give what I learned to others,” he said. “I have so much to give.”