If you have never visited a psychiatric hospital before, you may have your own notion about what goes on there. The idea of being around mentally ill people has many thinking it is not safe. In Rwanda, Caraes Ndera Neuropsychiatric Hospital, a referral hospital for neuropsychiatric disorders, or mental disorders, is one such place. Established in 1968 by the Brothers of Charity, an international religious congregation, following a request by the Government of Rwanda and the local Catholic Church, the hospital’s first patients were received in 1972. According to the hospital’s website, the adopted approach was to develop quality mental health services rooted in the social and cultural context of Rwanda. A day at the hospital A typical working day at Ndera starts at 6am. Nurses check in on patients, and help get them ready for the day. Breakfast is served at 7am, together with the first dose of medicine. After which, a general patients’ and doctors’ meeting is held at 9am to discuss matters concerning patients’ well-being and comfort. At 10am, the doctor on duty goes on a check-up tour among the patients, following-up on their progress. As check-up continues, others head to what is called ‘occupation therapy’, where they play different games, do various exercises, and work on projects based on one’s condition and preference. Dr Bizoza Rutakayire, a psychiatrist at the hospital. Photo/Willy Mucyo Lunch is then served at noon, with the second dose of medicine, followed by afternoon naps for patients, but some opt for other relaxation activities, like listening to music or watching TV programmes. The check-up by the doctors and nurses of a specific patient goes on from 2pm to 4pm. The daytime shift doctors and nurses are then replaced by an equally friendly team for the night shift that starts at 5pm, and their prime job is to observe the patients. 6pm is dinner time, with the third dose of medicine after which, they watch the news on TV. Bed time is scheduled for 8pm. Contrary to what some people think, calmness and discipline characterise the behaviour of the patients here. Notions about medical staff using extra big needles, muscular bodyguards standing at the doors of patients, and hysterical behaviour, are simply that, notions. “I made friends here. I feel understood and cared for, it helps me in a way that I will be able to trust people again,” said one of the patients I spoke to who asked for anonymity. “This place has taught me how to forgive those who hurt and abused me at home,” shared another. Religious activities are also encouraged, but all patients have general service on Sunday with a priest. Many weekend activities involve getting together, sharing stories and praying, all the while following treatment. More than just a hospital Ndera also provides training and supervision of other health care services throughout Rwanda. It is integrated into the national mental health policy and actively participates in the decentralisation of mental health care. It has two more branches in Huye, Caraes Butare, and in Kicukiro, Psychotherapeutic Centre Icyizere. It also has a specialised service of neurology, a clinical psychology service, HIV/AIDS care service, community care service and customer care service. Both female and male patients are received and cared for at the hospital with respective rest rooms and residences for both. People with mental illness are admitted in separate sections, depending on the condition of the patient. There’s also a special needs section, ‘Kundwa Home’, designed for children (aged between 3 to 17) with mental illnesses. Treatment involves bio, which deals with medication, psycho which deals with counselling, and social which deals with the social aspect of the patient, including family, colleagues or any other person close to them. According to Dr Bizoza Rutakayire, a psychiatrist at the hospital, around 90 per cent of the patients heal and are able to return to a normal life. The medical team and caretakers, qualified and compassionate, are determined to help people with mental illness, and play an extremely important role in prevention, diagnosis, treatment and rehabilitation of patients.