Valentine Murekatete, a 31-year-old resident of Kibagabaga, began noticing unusual itching on her skin in 2015. What started as a minor irritation soon turned into a burning sensation that spread in patches across her body. Unsure of the cause, she first went to Muhima Health Centre, where doctors could not identify the condition and suggested it might be HIV. After several referrals, she was finally diagnosed with psoriasis, a chronic skin disease she was told she would live with for the rest of her life. ALSO READ:Psoriasis: An incurable condition that lacks awareness, research in Rwanda Before that diagnosis, Murekatete had tried local remedies, following advice from friends who believed her condition was connected to witchcraft. “Many of my friends suggested that my skin condition might be caused by witchcraft. At one point, someone even told me to shave my head and apply local herbs all over my body, starting from the scalp, claiming it could help. I followed their advice, but it didn’t bring any relief,” she said. For years, she went from hospital to hospital, trying every treatment offered, pills, creams, and injections, but none brought effective results. In 2019, Murekatete was referred to Rwanda Military Referral and Teaching Hospital, where doctors confirmed her psoriasis diagnosis and explained that there was no cure. They prescribed topical medication and oral drugs, including Methotrexate, with caution about likely side effects such as infertility. “The doctor told me that if I take this, I might never have children,” she noted. The cream offered temporary comfort, as the dark patches on her skin would fade when she applied it but returned whenever she stopped. The treatment was costly, with one tube priced at around Rwf 90,000 and lasting less than a week. “Even with a job, it’s hard to keep up with this medication when you can’t afford it,” she said. The condition resulted in physical pain and stigma, noting that she remembers an incident while working as a house help in a Kigali home. After bathing one morning, she was still wrapped in a towel when her employer saw her skin. Shocked, the woman asked her to leave immediately and warned her not to come near her children again. Murekatete noted that dating became a challenge, as potential partners hesitated to get close or touch her, and over time she chose to step back and focus on her own wellbeing. “The discomfort is constant because when it’s hot or the sun is out, my skin itches and burns so badly, and in cold weather the patches thicken and spread even more. Living with it affects everything I do, and it wears on me physically, and emotionally. Some days it feels like it’s taking over my life,” Murekatete said. Murekatete noted that she feels isolated, often covering her body in long sleeves and jackets to hide the patches from people. She added that the emotional strain pushed her to the edge as she tried to commit suicide three times, by attempting to hang herself with a rope but each time she stopped, thinking of her younger sister and the responsibility she carried for her family. “Support means everything, I will never forget my boss -- who also gave me some tubes to apply on my skin -- at a hospital in Kigali, who encouraged me, helped me get medication, and always told me that I am confident and I make people feel good,” Murekatete said. Her friends react differently, for instance, some have no idea about her condition because she hides it under clothing, while others know and accept her without judgment. What weighs on her most is the lack of awareness about psoriasis, noting that misunderstandings and stigma make it difficult for people with the condition to seek help openly. Mutuelle de Santé (Community-based health insurance) does not cover psoriasis medications, putting treatment out of reach for many Rwandans, mostly in rural areas. Murekatete hopes the government can step in to make these medications more affordable and accessible. Despite everything, she has found ways to accept herself and keep going, noting that life can still hold meaning, and that learning to live with herself is part of moving forward. “I still dream of getting married and having children, I know the medication I take could affect my fertility, and stopping it carries risks, but I am hopeful that one day I will have a family of my own.” Pierre-Célestin Habiyaremye, President of the Psoriasis and Psoriatic Arthritis Association of Rwanda (RPAO), said that awareness about the condition is still low across the country. “Many Rwandans still don’t know much about psoriasis, even though awareness is improving, a lot of people misunderstand it,” he noted. Since 2024, Rwanda has joined the rest of the world in marking World Psoriasis Day on October 29, a day dedicated to educating communities about psoriatic diseases and advocating for those who live with them. Psoriasis is a chronic condition that causes dry, red, and flaky patches on the skin, which can itch or become painful, but according to Habiyaremye, what hurts most for those living with it is not always the skin itself, but the stigma that surrounds it. “Some people go from one doctor to another or use herbs without knowing what is really happening to them. It’s not witchcraft or a curse; people just don’t understand it. Because of that, those living with psoriasis are often isolated, and some end up depressed, even thinking about suicide,” he said. Understanding psoriasis Dr. Alice Amani Uwajeni, a dermatologist at University Teaching Hospital of Kigali (CHUK) explained that psoriasis is a chronic inflammatory skin disease with strong genetic and autoimmune links. She added that the condition can be managed, but it cannot be cured. Uwajeni explained that globally, psoriasis affects one to three percent of people, though rates vary by region. It is less common in Asia and parts of Africa and can reach up to 11 percent in Caucasian and Scandinavian populations. “Psoriasis care in Rwanda is challenging as the country has only 13 dermatologists, the disease lacks a local name, and many patients never have their cases reported,” Dr. Uwajeni explained. She added that the disease can take several forms, including plaque psoriasis, pustular psoriasis, guttate psoriasis, nail psoriasis, scalp psoriasis, and psoriatic arthritis. Apart from the skin, psoriasis can affect other parts of the body, increasing the risk of cardiovascular disease, diabetes, obesity, depression, and other conditions. “Management involves both non-medical methods, such as counseling, education, and use of emollients, and medical treatments including topical steroids, vitamin D analogues, methotrexate, phototherapy, retinoids, cyclosporin, and biologics like adalimumab and infliximab.” Dr. Uwajeni said Rwanda needs better data and awareness on psoriasis, noting that information on its prevalence and impact on patients’ quality of life is lacking. She added that efforts are being made to address this, including local dermatology training, regular reviews of essential medicines, and studies on psoriasis prevalence and patient quality of life planned for 2025–2026.
