The Genocide is undeniably a horrible incident which affects all dimensions of human life. It not only physically affects survivors; the Genocide also comes with severe psychological and emotional scars. It’s been twenty-five years since the Genocide against the Tutsi happened. However, the effects of this awful event still ripple through society. Last year, Rwanda Biomedical Centre (RBC) conducted a National Survey on Mental Health; where a team of almost 75 data collectors surveyed at least 20,000 survivors among the general population. They were assessing the number of disorders such as depression, anxiety, social phobia among others. Out of the sample population, 27.9 per cent turned out to have post-traumatic stress disorder symptoms occasioned with major depression, which was at 35 per cent. Prof Vincent Sezibera, the chairperson of Rwanda Psychological Society, who works at University of Rwanda’s Centre for Mental Health College of Medicine and Health Science, points out another study carried out in 2012, noting that it also highlighted the prevalence of trauma that stood at 20 per cent among the 100,000 participants who took part in the survey. According to him, the numbers are alarming. “For instance, when you look at the post-traumatic stress disorder among the general population, the percentage was 3.6 per cent. This problem doesn’t only affect one as an individual but the economy and other aspects of the country at large,” he says. Blaise Nyiribakwe, a therapist working with International Youth Fellowship (IYF) in Rwanda as a mind education specialist, says the 1994 Genocide against the Tutsi has effects that range from social aspects to the psychological and mental aspects. “There are evident effects with the survivors. Witnessing genocide clearly depicts how damaging it is to society. Survivors tend to be anxious, terrified and scared of what happened or what could happen,” he adds. All these signs, Nyiribakwe says, are indicators that there is trauma related to difficulties survivors endured. A mourner at a past commemoration event. File Intergenerational trauma But the country is faced with a new challenge which goes beyond the trauma that was described in the past; intergenerational trauma, Sezibera notes. He says, going by the numbers that are being reported now, it is evident that those born after the Genocide, present severe trauma cases too. “There is intergenerational transmission of trauma, whereby parents pass on trauma to their offspring. There is need to understand the channel, how this is being transmitted,” he adds. ‘Prioritise mental health’ Sezibera says other challenges include the way hospitals are structured in Rwanda and globally, whereby the mental health department is always given small space in the organisational structure of most medical facilities. On this, he stresses that Rwanda, being a post-Genocide country and also taking into consideration the prevalence of cases of mental disorders, ensuring proper structuring should be a priority. Stigma, on the other hand, is still as a challenge that affects the rate at which survivors can heal from mental-related disorders. With the decentralisation of mental health units being integrated and incorporated in hospitals, however, the Ministry of Health is aiming at minimising stigma, by availing more centres where patients can seek help other than having Ndera neuro-psychiatric hospital as the sole facility for healthcare support. Support systems are also currently in place to help address these challenges. Volunteers carry a trauma victim during the commemoration event last year. Sam Ngendahimana. Louise Bajeneza, head of counsellors at AVEGA (the association of Genocide widows), says in Rwanda, at least there is a mental health facility unit that has been created in hospitals, and there are also local initiatives providing any help related to mental disorders. There are also different trainedmental health professionals.About 2,000 clinical psychologists are trained and equipped to handle different mental disorders. There are also nurses trained in mental health and a few psychiatrists. In every district, there is at least one psychologist; in total, 28 physiologists in all 30 districts. At every referral hospital, there is also one psychologist, and every health centre has at least three psychologists as well. A former FAR soldier Silas Ntamfurayishyari (right) shares his testimony. He saved many people in Bugesera during the Genocide . Sam Ngendahimana. ‘Mental health awareness vital’ Last year’s survey by RBC also indicates that 62 per cent of survivors know where to seek medical assistance in relation to mental disorders. Sezibera says many people are aware of what a mental disorder is; however, there is need to equip personnel responsible for attending to the survivors. He also notes that there is need to strategise on how to encourage survivors to go for help noting that though many know where to seek help from, few actually go there. The RBC study showed that only 5 per cent seek help. “Most of the survivors tend to think that they can handle the situation, some are just scared of the entire process thinking that opening up to their past will be painful.” editor@newtimesrwanda.com
