In 2012 I began working with Global Health Initiatives on hospital projects in rural Rwanda. Although the focus of their work is orthopedic surgery, this particular facility was in desperate need of attention. We launched a new design and construction division to start working on the hospital complex. The first project involved an abandoned isolation ward, centrally located and built in the 1930’s. I quickly discovered my roles were to encompass those of structural engineer, architect, landscape and interior designer. Available for construction were only local materials and methods, and local labor force. Although it took 3 years, the pediatric ward was completed in June of 2015. We then begin the programming and design for a new surgery center built in the location of another centrally located structure, of which only the foundation remains. Construction is pending as we embark on Project #3: rehabilitation of the original hospital for a maternity center. The benefits of this work goes well beyond facility improvements. The impacts on local people, an adjacent orphanage and its children from the genocide, as well as community and economic benefits have resulted in an experience of a lifetime.