She joined the Internal Macedonian Revolutionary Organization and by 1901 was the head of the woman's section.

[1] Rusinska helped found a hospital at the house used by Metody Patchev, who had recently died fighting the Ottomans.

The hospital continued to operate and the local mayor arranged for free milk to assist them.

After the unsuccessful uprising, the two were not arrested, but moved to Bulgaria where Rusinska returned to teaching in the village of Skravena.

[1] The end of the war did not achieve their political ambitions, and the area was ceded again to Serbia.

Her husband worked as a carpenter whilst she taught and coped with pneumonia.