The breast removal case that didn't make it into media

It was two years since I had started covering the case of a woman in her forties who sought Rwf300 million ($300,000 then) in compensation for her removed breast.

By Kelly Rwamapera

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I was standing in the car park near the waving national flag, looking at an elegant Kigali courthouse, Gasabo Intermediate Court (second instance court), on 11 March 2021 at 8 a.m.

The courthouse shone serenely in the morning beams of light piercing through the mild mist.

It had been two years since I started covering the case of a woman in her forties who sought Rwf300 million ($300,000 at the time) in compensation for her removed breast.

The case involved King Faisal Hospital with Dr Lynette Kyokunda (a doctor I had encountered in other court cases), whose diagnosis wrongly concluded that the woman had breast cancer.

Without a second diagnosis, Rwanda Military Hospital relied on the eight-month-old medical report from King Faisal Hospital and carried out a mastectomy operation that removed the breast without another medical examination.

I began following this case in 2018 when I was still at The New Times. The newspaper editors did not like the story. I started reporting on the case after I moved to The East African newspaper in 2019.

I was an editor at Kigali Law Tidings when I attended the March 2021 hearing. No other journalist dared to report on the dramatic negligence case against two leading public referral hospitals in the country.

Self-censorship is not uncommon among media practitioners in Rwanda. Some journalists remain unsure whether they possess enough basic information on the practice to guide their discretion in deciding what to pursue as journalists.

Many journalists feared the case because of the name Rwanda Military Hospital. However, I had nothing to fear in writing about a case heard in public, in a courtroom.

It was my third time attending this case after it had suffered twelve postponements, and the lawyers of both parties were complaining about the unnecessary delays.

In the courthouse lobby

I ascended the white stairs into the courthouse lobby, passing many frustrated looks and ambitious hopes of obtaining justice from the courthouse.

I proceeded to the courtroom doors to read schedules on pieces of paper stuck on the narrow metallic white doors, 2.8 feet wide.

I sat near the courtroom door, waiting for the hearing time. Lawyers passed by me, their black gowns swinging in the cold air, moving from door to door, checking the courtrooms where their clients' cases would be heard.

A young woman and a man in janitorial clothing hurried past, one carrying a CPU and the other a monitor, trying not to get entangled in the cables sweeping the ground before them.

They struggled to open the courtroom door while handling the CPU and monitor simultaneously for about a quarter of a minute before entering the courtroom, proceeding to the bench, and leaving the computer there.

The court clerk arrived later to install the computer.

I did not know whether the court lacked sufficient computers and had to share the few available or whether the computers were not safe in the courtrooms, requiring them to be stored elsewhere and returned every morning.

The handwriting in the courtroom

Along with about seven people, many of whom were lawyers, I sat in the courtroom waiting as they joked about past experiences in their profession.

Whenever I am in a courtroom, I take time to read what is written on the backrests of benches and walls.

If you enjoy reading comments on a story, you might understand why I am interested in reading what the audience writes or scratches onto the furniture or walls in a Rwandan courtroom.

In most upcountry courts I have visited, I have seen psalmic thanks such as "Thank you, Lord," "My enemies have been defeated," and other words of contentment written or scratched everywhere in response to the justice delivered in court.

However, in Kigali courtrooms, you find curses, particularly against the country's justice system, government officials, or judges, in the desperate and angry tones of writers exhibiting their defeated protest against an unjust court decision.

On the wall skirting, I saw a statement: "F**k Rwanda, it is so absurd." The writer continued to curse some government officials: "...you'll be held accountable."

Similar statements were scattered throughout, as in other Kigali courtrooms, before I published this story in 2021. After that, all Kigali courtrooms where criminal offences are handled replaced wooden benches with metallic ones, making writing impossible.

The judge interrupted my reading of the writings on the wall. We all rose as she swept with honour through the audience to the bench with the court clerk.

I do not understand why there is no announcement when the jury enters Rwandan courtrooms to create a more formal atmosphere with a greater sense of respect.

In East African courtrooms, a bailiff first announces, "All rise," and the gallery stands before the bailiff adds, "This court is in session." The jury then enters the bench and orders the attendees to "be seated."

The court session

We were over a dozen, sparsely seated on the crimson benches, unlike occasions when hearings are held in one of the courthouse’s small offices, requiring attendants to listen from the narrow corridors outside the door.

This had happened multiple times at various courthouses in Kigali. Sometimes, when numerous hearings were scheduled, every available room was used, including offices.

Particularly in this breast removal case, which started in 2019, it had been handled by two different judges, and in one hearing, we had to stand in the corridors.

It defied logic that a case involving two leading referral hospitals, some of East Africa’s most prominent medical practitioners, and a compensation claim of up to Rwf300 million was handled by a single judge jury.

The first judge postponed the case multiple times until his scheduled transfer, leaving the case unresolved.

One day, the second judge left us in the courtroom, went to consult the court’s president in his office, spent some time there, and returned with a decision to punish the lawyer for delaying the case.

It was the first time I had seen a judge leave the courtroom to consult others outside and return with a decision.

I believe she violated her independence in the case.

In the hearing, we expected a ruling on the objection submitted by the King Faisal Hospital lawyer. Instead, the judge spent time reading from her computer, asking the lawyer questions about the experts’ report that had already been addressed in the previous session.

I grew bored and returned to reading the "comments" that marred the white wall skirting and the bench backrests until the lawyer raised his voice in protest against the judge’s "interrogation."

"Your Honour, I came here to contend with my fellow lawyers, not this honourable court. Let the lawyers contend with me on the matter," the lawyer said.

"We are all not medical professionals," another lawyer intervened. "The experts' report must first be decided on by this honourable court. It is primary to determine whether the report is admissible due to the objection submitted by one of us."

The judge ignored the arguments and instead asked the victim's lawyer:

"Of the two—King Faisal Hospital and Kanombe (Rwanda Military Hospital)—who do you think should incur the compensation, and at what percentage if they are to share?"

I leaned back and looked at the honourable judge in disbelief at her question, which implied a decision had already been made and that the victim's lawyer had the authority to determine the fate of King Faisal Hospital and Rwanda Military Hospital.

I do not think the lawyer was the right person to determine the responsibility of each hospital. The court should have ordered medical experts to submit their expertise on the responsibilities of each institution, according to medical rules and ethics.

The judge then asked the lawyers for their positions on the experts’ report. The lawyers referred her to their previous arguments, emphasising the importance of ruling on King Faisal Hospital’s objection.

The hearing continued in obscurity for five hours until the judge announced that the case would be decided on 9 April 2021.