"My entire family was slaughtered in the massacres of 1994,” the lady started. "For four months, I survived alone, running from swamp to swamp, hiding in shrubs and abandoned homes, all the time hiding from the killers.” This was the testimony of Helen, a survivor of the 1994 Genocide against the Tutsi.

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Such an account is not an isolated case. Helen is one of the more than 95,000 children who were left orphaned in the wake of those fateful 100 days. With over a million dead and countless survivors affected by unimaginable physical and psychological violence, the 1994 Genocide has cast a long shadow over the mental health of many Rwandans.

A legacy of trauma

In 1995, a national trauma survey revealed that over 90% of children aged 8 to 19 had experienced at least one traumatic event. The accounts were harrowing. They included: witnessing the savage death of a relative, hiding among corpses, rape, forced displacement and much more.

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Exposure to these events compromised the brain and mental health of millions. A study undertaken 15 years later highlighted that 26.1% of the Rwandan population suffered from post-traumatic stress disorder (PTSD), while 22.7% suffered from depression.

Yet, the Rwanda Biomedical Centre notes that less than 5% of people afflicted with these conditions seek clinical care. This is despite the country’s continuous efforts to expand mental health services.

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Therefore, it is imperative that we address widespread misconceptions about mental health which may deter individuals from seeking the care they need. This is of utmost importance especially as we progress through the commemoration period given that mental health challenges can become more acute during this time.

Misconception 1: Mental health is not as serious as physical health

Many people would not think twice about seeing a doctor if they had diabetes or a dislocated bone. But this is often not the case when it comes to issues affecting mental health. While there is little doubt about the effectiveness of treatment for physical conditions, many still believe that mental health care cannot help them. This is, in part, due to limited awareness that mental health conditions, like physical ones, are caused by observable disruptions in body functions, particularly in the brain.

Take PTSD, for example. Following traumatic events, the brain’s threat appraisal and memory networks can become dysregulated. Consequently, the hippocampus, which is a part of the brain that helps to process memories, may struggle to distinguish past from present events. The amygdala, which helps to detect danger, may become overactive and continue to trigger fear even in safe environments. This explains why people afflicted with PTSD often experience flashbacks and are constantly on edge even when they are no longer in danger.

These are not simply emotional reactions that one can overcome on their own. Similar to how you need a physician to treat diabetes, there are healthcare professionals who are trained to deliver appropriate therapy needed to restore normal brain functions.

Misconception 2: Mental health conditions only affect those directly exposed to trauma

Another common misunderstanding is the belief that only those who were directly exposed to the horrific events of the 1994 Genocide can develop mental health conditions related to it. This view is often manifested in dismissive statements levied against young people such as, "You were not there.”

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However, this overlooks a large body of evidence which shows that the effects of trauma can be passed down from one generation to the next. For example, a 2014 study found that children born to women targeted during the Genocide showed higher levels of PTSD and depressive symptoms compared to children whose mothers lived overseas during that time. Both groups of children were born after the Genocide had ended.

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These findings underscore how the impact of the Genocide is not merely confined to those who lived directly through it. Indeed, younger generations also need mental health care so that they, too, can heal from wounds that may have formed even before they were born.

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You are not alone

In his remarks earlier this week, President Paul Kagame told the country, "To all survivors, know that you are not alone. We stand with you always.” The commemoration period invites us to be proactive in reaching out and comforting schoolmates, colleagues, and neighbors whose only family left is the nation of Rwanda.

This period challenges us to unlearn the pervasive belief that suffering in silence is a sign of strength. It highlights how sharing our stories, even the parts that hurt, is a powerful tool for healing. It also reminds us, in the words of our President, that "We owe future generations more than survival.” This may mean pursuing professional help in order to break the cycle of intergenerational trauma.

Seeking mental health care is not a sign of weakness. It is a bold step to claim the right to thrive – the right to live in peace and dignity not only for ourselves but also for generations to come.

The writer is a Rhodes Scholar and a PhD student in Clinical Neurosciences at the University of Oxford’s Centre of Global Epilepsy. For comment and feedback, please email charite.gloria@balliol.ox.ac.uk.