Doing Public Health Differently

Growing up in a country decimated by genocide and full of foreign aid workers, Joyeuse Senga assumed the world had everything to teach Rwanda. But some of the most profound lessons she learned about change turned out to be homegrown.

Born just two years after the 1994 genocide against the Tutsi in her country, Senga has seen suffering and inequity all her life. She was raised with a strong sense of social justice honed by visits to underserved communities with her parents. She saw that a doctor could help one person at a time, but a public health researcher could uplift the health of entire populations – if they could understand how to translate evidence into real, lasting change.

So it was no surprise that Senga decided to pursue studies in global and public health – first as an undergraduate at Alabama’s Samford University, and then as a Mastercard Foundation Scholar at McGill.

The Mastercard Foundation Scholars Program is the largest scholarship and leadership initiative of its kind in Africa. Since 2013, the Mastercard Foundation has partnered with McGill to offer full scholarships to more than 160 talented young leaders from Sub-Saharan Africa along with leadership training, experiential learning opportunities, and more.

“I’ve always been passionate about working with people and advocacy, but I really wanted to explore the social, cultural and economic context that impacts someone’s health,” says Senga, a diabetes researcher who graduated from McGill last year with a master’s degree in public health. “Even at McGill, I was doing a lot of work in Parc-Extension, really immersing myself in community-based work, and that gave me the foundation to understand how we can do public health differently.”

Living in a high-poverty state like Alabama, and later working with communities in Montreal that struggled for basic needs like housing, proved to be an eye-opening experience. This added to Senga’s growing realization that wealthy countries didn’t have all the answers for Rwanda – that to bring lasting change, solutions needed to be designed in full partnership with the communities they served.

While a student at McGill, Senga worked with young people in her community on the idea for Ubugeni Bwomora (Art That Heals) – a program they established in 2023 that helps Rwandan youth build self-confidence and tackle the mental health challenges of living with HIV. This expanded into the Friends Career Center, which serves vulnerable youth with both mental health and career development support. By co-designing the effort with participants themselves, she achieved lasting results in a short time: youth who once felt hopeless began attending university or working in a trade. One participant now operates a fruit stand in her small village. Another is opening a bakery.

Youth living with HIV in Rwanda have access to life-saving medications, but many suffer from depression and hopelessness, she says. Some youth stop treatment, feeling that they have no future.

Senga found the perfect partner for the initiative in Agape Ishimwe, a young visual artist living with HIV. Together, they decided to create a space for youth to talk about the often-taboo topic of mental health.

“We’re using an art-based approach to bring not only healing but confidence as well,” she says. “And then we ask how we can help them to support themselves economically. Sometimes that’s further education, and sometimes it’s buying them five chickens to start selling eggs.

“It was in my heart to work with my community, but I knew that it had to be different,” she adds. “It had to be co-designed. I approached the Mastercard Foundation, and they were very receptive. They were really willing to listen.”

The Foundation operates the Mastercard Foundation Scholars Entrepreneurship Fund to support Mastercard Foundation Scholars Program Alumni to relieve poverty through entrepreneurship. This generous support made Senga’s dream a reality. But there was one more essential reason it succeeded where others fail: Senga’s hard-won realization that communication is a two-way street; that trust-building can’t be rushed – and nothing good can happen without it.

That insight came to her while living in Rwanda between her undergraduate years at Samford and her master’s studies at McGill. Over the course of two years at home, she learned to talk less and listen more to the people she most wanted to help.

“I think there’s a misconception that you’re going back home with knowledge to save your country,” says Senga. “But I really got humbled by a lot of the communities I talked to. They said, ‘you’re the people who get the education, and instead of coming back to work with us, you tell us what to do.’

“I learned that trust-building has to be at the centre of everything we do.”

The power of believing in people is a lesson Senga knows well. She is eager to return to sub-Saharan Africa one day to work in health policy. But for now, she feels a strong responsibility to help uplift her community from half a world away – in tribute to the many people who have lifted her up.

“How many African youth get the opportunities I’ve had in my life?” she asks. “Very few. It’s because every step of the way, someone said, ‘hey Joyeuse, I believe in you. And every time I remember what others have done for me, that’s the motivation I need to give back to those who are coming after me.”