Christine Ashimwe’s fight with killer clots

Sunday October 21 2018

Christine Ashimwe

Christine Ashimwe, founder Rwanda Clot Awareness Network and 2018 Thrombosis Ambassador of the Year. PHOTO | CYRIL NDEGEYA | NMG 

By EDMUND KAGIRE
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Determined is an understatement when describing Christine Ashimwe Gatsinzi.

She has taken it upon herself to educate the public on the risks and dangers of pulmonary embolism or deep vein thrombosis, a condition caused by the formation of blood clots in the blood vessels. Most times, it is fatal.

October 11, marked as World Thrombosis Day was also the day that the International Society on Thrombosis and Haemostasis named Ashimwe, 35, the first Thrombosis Ambassador of the Year in recognition of her efforts.

Ashimwe had a close shave with the condition — which is poorly diagnosed in sub-Saharan Africa, making it one of the leading causes of maternal mortality on the continent. She lived to educate others.

It was Ashimwe’s persistence that saved her.

On December 1, 2015, one week after delivering her third child, she woke up out of breathe and in pain. Her husband, a medical doctor, was away for further studies.

“On that fateful day I woke up struggling to breath. I became very alarmed because it felt like I was dying and my concern was that I would leave my children motherless. My newborn was still at the hospital because she was premature. She was hooked to oxygen tubes fighting for her life,” recalls Ashimwe.

Despite it being 3am, she called her husband, who advised her to drive herself to hospital immediately.

She consulted a personal obstetrician and another doctor, but neither could give her a conclusive diagnosis.

It was at the emergency room of the King Faisal Hospital that a junior doctor who was on duty that night happened to mention that that she looked like she had pulmonary embolism. A curious Ashimwe googled the condition.

“I looked up all the signs of pulmonary embolism and realised that was what I was experiencing. I had not mentioned some of the signs to the doctors like the chest pains and the persistent cough, which came on suddenly,” she recalls.

Family members who visited her in hospital had their own conclusions, from effects of the C-section to witchcraft.

After further consultation, the junior doctor informed his senior supervisor of her case and, surprisingly, the senior doctor ruled out pulmonary embolism saying that Ashimwe didn’t exhibit any signs of someone with blood clots.

Doubt

Ashimwe says the doctor’s words still haunt her, although he later apologised after medical tests confirmed the condition.

“They first did an X-ray that showed that I had pneumonia and I had water in my lungs and I pushed the doctors to do a CT-scan. It confirmed that I had multiple blood clots in both lungs,” she said.

She was then diagnosed with pulmonary embolism in the right lung, which was a result of deep vein thrombosis in her right leg, a condition known together as venous thromboembolism.

“The doctor who had doubted the first diagnosis by the junior doctor then apologised for his misdiagnosis,” Ashimwe says.

She was one of the lucky ones because of her keenness and persistence in seeking the right diagnosis.

Ashimwe ended up being admitted for a month. She says she spent the time reflecting on how no one had ever told her about thrombosis or the dangers and risks linked to it.

It is then that she realised how common the condition was considering that it had everyday risk factors such as pregnancy and childbirth, surgery and sedentary lifestyles, yet it continued to be misdiagnosed.

“I decided that something must be done and it won’t wait for anyone else but me,” she says.

Fatalities

Her efforts to educate others have to date saved a number of people who were not even aware that they had thrombosis.

“In some cases, people think they have been bewitched,” says Ashimwe, adding that there are instances when she had to push the doctors, patients and caretakers to insist on checking for blood clots.

During her hospitalisation, she learned of five women who died after childbirth from the condition because they were misdiagnosed.

Their conditions were discovered during autopsy. She also got to know of a young woman who died from clots in her blood a few days to her wedding and it was later found out that she was taking contraceptive pills containing oestrogen, which is listed as a risk factor.

The more she read on fatalities resulting from blood clots, the more Ashimwe felt moved to take action.

As soon as she was discharged, she embarked on an awareness campaign on thrombosis, starting with her colleagues. The more she talked to people, the more she became motivated to reach out to even more people.

She started paying attention to women with symptoms of thrombosis and pushed hospitals to give them proper diagnosis.

“At this point, some medics and spouses were beginning to tell the women not to listen to me. I was traumatised. But fortunately with every case that I pursued the doctors tested them and found them with blood clots,” she says.

In one case, a husband had refused to pay for a CT-scan saying he didn’t have Rwf150,000 ($169). Ashimwe paid for it because the woman was in a terrible state.

The scan showed that she had eight clots and a race to save her life began. Her remorseful husband could not believe it.

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Christine Ashimwe, 35, was born in Ntungamo, Uganda to Rwandan parents. She was educated in Kabale district, southwestern Uganda before relocating to Rwanda after the 1994 Genocide against the Tutsi.

She completed her secondary education at APRED Ndera and having excelled in science subjects, she was awarded a government scholarship to study in Morocco.

She attended the Cadi Ayyad University, Marrakech, where she graduated with a Bachelor’s degree in Life Sciences and the Environment in 2009.

She has a postgraduate diploma in Gender Studies from the University of Rwanda. She also holds a Masters of Science in Global Health Delivery from the University of Global Health Equity, Rwanda and works as a manager for environment, governance and public relations for HQ Power, a Turkish investment company that uses peat to make power in Rwanda.

In March 2016, she founded the Rwanda Clot Awareness Network, a non-profit organisation that sensitises the public on the dangers of thrombosis and the need for better and improved diagnoses.

She brought together patients and survivors, but later doctors, researchers and other partners joined in. Today, the organisation has over 100 members.

According to the Global World Thrombosis Movement, Ashimwe’s recognition as ambassador highlights her drive to shine a global spotlight on the condition of thrombosis.

"It also showcases her ability to motivate others thrombosis advocacy programmes in Rwanda and around the world through innovative approaches to raise awareness and accomplish advocacy goals," a statement from the organisation says.

In her personal battle with blood clots, Ashimwe has consulted doctors in India, Kenya and the United Kingdom.

"It no longer scares me. I am now focussing on how to manage the condition and saving the lives of others," she says, adding that her new role will be a platform for her to take the message beyond Rwanda.

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