Empowering Communities: The Success of Rwanda’s D-Free Project in Combating Diarrheal Disease

An initiative in Rwanda’s Gisagara district has led to a remarkable reduction in cases of diarrheal disease. The D-Free project, founded by Jennifer Choi in collaboration with the Medical Students’ Association of Rwanda (MEDSAR) as the implementing partner, targeted one of Rwanda’s most persistent public health issues—diarrhea, which is a leading cause of death among children under five in the country.

Globally, diarrhea causes 525,000 deaths annually, with poor hygiene, unsafe drinking water, and inadequate sanitation being the primary contributors. In Rwanda, rural areas are particularly vulnerable due to limited access to clean water and sanitation facilities. The D-Free project aimed to address these challenges by combining community health education, practical interventions, and the distribution of essential hygiene resources.

Jennifer Choi, the Team Leader of the Prevention Team for the D-Free project, played a crucial role in developing campaigns and educational materials aimed at preventing diarrheal disease as well as collaborating with local health authorities and community health workers.

Her leadership and creativity were key in crafting messages and tools that resonated with the local community, ensuring the interventions were not only effective but also sustainable in the long term. Although originally from South Korea, she collaborated virtually with the team in Rwanda throughout the project across borders and effectively led the Prevention Team. Her commitment to community empowerment and culturally relevant solutions was evident throughout the project.

Reflecting on the success of the initiative, Jennifer Choi stated, “Our goal was to create a model that could be replicated in other high-risk areas, and seeing the positive changes in Gisagara village has been incredibly rewarding. The collaboration with MEDSAR and the community’s enthusiasm have been key to our success.”

Through targeted efforts in Gisagara village, a high-risk area with poor access to clean water, the D-Free project mobilized local health authorities, community health workers (CHWs), and medical students to deliver a multi-faceted intervention. The project’s key successes included extensive hygiene training, the distribution of water filters, and a marked improvement in sanitation practices across the community.

One of the project’s standout achievements was its holistic approach. Community engagement was central to its success, as local leaders and CHWs worked alongside the project team to ensure that the interventions were culturally relevant and sustainable. This collaboration fostered a sense of ownership among residents, further contributing to the project’s positive outcomes.

The impact of the D-Free project was evident to the community members. One resident shared, “Our children used to swim and drink from the swamp, but after learning about the health risks, we are now committed to providing them with safe water using the filters provided.” Another beneficiary highlighted the improvements to their household: “My toilet was not covered, and we lacked proper handwashing facilities. Now, with a roof over the toilet and a new handwashing station, we can maintain hygiene and prevent disease.”

Beyond material distribution, the project emphasized education as a powerful tool for behavior change. Practical demonstrations on handwashing and safe water handling improved community knowledge and practices. Post-implementation surveys revealed a significant decrease in diarrhea cases, particularly among children, and a widespread adoption of improved hygiene practices.

Local leaders were also enthusiastic about the results. “Thanks to the community’s support, we have seen 15 additional modern toilets built and 10 families equipped with water filters. This will help us become the first village in the district with improved hygiene and reduced cases of diarrhea,” the village leader proudly shared.

However, the project was not without its challenges. Logistical hurdles, cultural resistance, and resource limitations tested the team’s resilience. Despite these difficulties, the D-Free project thrived due to the team’s adaptability and their innovative approach to problem-solving.

The success of the D-Free project offers valuable lessons for future public health initiatives. It underscores the importance of community involvement, culturally appropriate interventions, and continuous monitoring and evaluation to ensure lasting impact. By engaging local leaders and utilizing local knowledge, the project not only improved health outcomes but also empowered the community to take charge of its own well-being.