The last time Agnes Nyiramisago saw her relatives was at the onset of the Genocide against the Tutsi – in April 1994. That’s when her husband and most of the children were killed.

Nyiramisago, 94, is the last born in a family of 10 yet she did not get a chance to see any of her siblings.

She gave birth to six children, four of whom, along with her husband, were killed during the Genocide.

The two others survived the Genocide but abandoned her and they have since lost contact.

Nyiramisago now lives with physical disability after her left leg was broken in an accident.

She can only walk with someone’s help because of old age and the disability.

She says she has lived with depression since childhood.

Nyiramisago was born in the former Mbazi commune in the country’s south (now Mbazi Sector in Huye District).

"My father died when I was in primary one, my mother got married to another man and I was raised by another person with whom we had no relationship. I remember he withdrew me from school (in primary one) to look after cattle, I feel bitter every time I remember that,” said Nyiramisago.

Many people around the world cannot understand that depression is an illness which can kill if not treated.

Elderly people are among the most affected by this disease as they are sometimes exposed to a state of loneliness, which is among its causes.

Medics define depression as a mood of disorder that causes a persistent feeling of sadness and loss of interest.

Also known as major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.

Eventually, Nyiramisago received help from a priest who used to frequent her home in Kanyinya, Gasabo for prayers.

With the help of this priest, she was later taken to a ‘sisters’ home, known in French as ‘Soeur des Amies des Pauvres’, in Gasabo District.

"I asked the priest to help me move out of my loneliness because I had no one to talk to. Since I joined the Sisters’ home, I stopped feeling depressed only that I suffer from chronic headache, heart attacks, stomachache and physical disability,” Nyiramisago said.

"Once in a while, I feel depressed and when that happens I try to cope by engaging in craft making like knitting clothes and mats but I no longer see clearly,” she added.

She is grateful to the nuns who take care of her along with other old vulnerable people. They give them all basics needed in daily life. "I thank these parents as they feed us, bathe us and help us to dress.”

Seated next to Nyiramisago are three other elderly people who share similar life stories.

Fabien Majoro, 86, has also suffered from depression.

He says that the only thing that occupies him is listening to the radio.

He has fond memories of the time he used to go out with his peers when he still had energy. He wakes up 3a.m everyday due to insomnia.

Charlotte Nyirantore, 70, started experiencing depression at a young age while in primary school after losing both her parents. Her situation worsened after she dropped out of school, she recollects.

"I was not happy even in marriage because my husband had nine other wives. My co-wives started beating me up just three months into my marriage. I was so depressed that I even tried to commit suicide but remembered it’s a sin,” she said.

Canisio Kanimba, another old man helped by the nuns, said being close to the community has helped him deal with depression.

"Eating properly and having someone to talk to is the most important thing I could wish for,” said Kanimba.

Speaking to Saturday Times, Fulgence Munyampeta, a University of Rwanda’s student in Mental Health department, who is currently conducting a thesis on the health of the elderly, explained that depression is among mental health diseases which can lead one into committing suicide.

Munyampeta, who works with the Centre for Mental Health, said that anyone can suffer from depression irrespective of their age.

Is depression curable?

According to the World Health Organisation (WHO), depression is a common mental disorder. It says that more than 300 million people of all ages suffer from depression annually.

According to Munyampeta, depression is characterised by loss of pleasure and appetite, reduced energy and loss of weight, disturbed sleep, feeling disgusted and guilty, and low self-worth.

The condition can lead to suicide at its worst, he said.

Munyampeta outlined a list of causes of depression including poverty, losing a job, losing a member of the family, failing to reach your objectives, trauma background and chronic diseases.

Munyampeta explained that depression is curable through close dialogues with a mental health doctor, but the specialist needs to first understand the state of the illness and the patient’s history.

"There are also drugs for people with depression cases that are advanced. Such a patient needs drugs that recover the hormones of the brain,” he said.

He said that various hospitals in the country, including Kigali Teaching University Hospital (CHUK), Butare Teaching University Hospital (CHUB), and several district hospitals, offer such services.

Can depression kill? "It kills if not treated, it can also make patients experience emotional disorders when interacting with other people and they can commit suicide,” Munyampeta said.

Why are the elderly most susceptible?

Munyampeta said older people tend to suffer from depression because they often live on their own. He appealed to the community, specifically civil society organizations, to be close to older people.

Francois Regis Mugwaneza, a physiotherapist specialist based in Huye, Southern Province, says physical exercises help keep depression at bay. "Doing sports ensures good blood circulation,” he says. "The elderly are also encouraged to exercise”.

Elie Mugabowishema, the president of Nsindagiza, an association of older people, said there is need to continuously help the elderly access primary healthcare.

"It is not doing them any favour, they have a right to healthcare,” Mugabowishema said.

Vedaste Ngirinshuti, the president of Saint Vincent de Paul, a local association, says helping the elderly, including giving them food, clothes and moral support, is vital to their wellbeing and longevity.

The Government of Rwanda supports older people through the Vision Umurenge Programme (VUP) through which many are given cash and health insurance.

But there is still a gap because many older people don’t receive support from the community, even those with relatives are mostly on their own, said Eugene Murekezi, a former head of Saint Vincent de Paul.

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