As Rwanda continues to observe the 32nd commemoration of the 1994 Genocide against the Tutsi, the country once again turns its attention to remembrance, dignity, and collective healing. Over the past three decades, Rwanda has made remarkable progress in rebuilding not only its institutions but also its social fabric. Yet, the persistence of trauma-related cases during each commemoration period is a reminder that healing is not a finite process. It is continuous, evolving, and deeply human. Recent data from the Rwanda Biomedical Centre (RBC), ahead of Kwibuka 32, reinforces this reality. During the Kwibuka 31 commemoration period, 266 people were supported for trauma across different levels of care, including those assisted at commemoration sites, those admitted to health centres, and those referred to hospitals. Beyond the 100 days, the need for care does not subside. Over the past year alone, up to March 2026, RBC supported approximately 1,755 individuals through continued psychosocial follow-up and care. These figures, while lower than in previous years, point to a system that is working more effectively, but also to needs that persist beneath the progress made The data further shows that the majority of those affected are aged 35 and above, reflecting the long-lasting impact of the Genocide on those who experienced it firsthand. At the same time, only a small proportion of cases, estimated between 2 and 5 per cent, require referral to specialised mental health facilities. This suggests that most cases are being managed at community level through structured support systems, including psychosocial first aid, health centres, and district hospitals. It is a testament to Rwanda’s investment in decentralised care, but also an indication that mental health support must remain embedded within communities to remain effective. What these numbers ultimately reveal is not simply a decline in cases, but a shift in how trauma is experienced and addressed. Rwanda has moved from a phase of acute crisis response to one that emphasises continuity of care, early intervention, and community resilience. However, the presence of over a thousand individuals requiring sustained support within a single year highlights the depth of the challenge that remains. The persistence of trauma is shaped by multiple factors. For many survivors, the psychological wounds of 1994 have not fully healed. Post-traumatic stress disorder continues to affect individuals in ways that can be triggered by remembrance activities, personal loss, or changes in life circumstances. In addition, broader social and economic realities such as poverty, chronic illness, and family conflict can compound emotional distress, particularly during commemoration periods when memories are most vivid. At the same time, Rwanda is increasingly confronting a more complex and less visible dimension of trauma: its transmission across generations. Young people born after the Genocide are growing up within families and communities where the past is ever-present, even when it is not explicitly discussed. The emotional weight carried by survivors can, in subtle and sometimes unintended ways, shape how younger generations understand themselves, their history, and their place in society. This emerging reality calls for a broader and more forward-looking approach to mental health. It is no longer sufficient to focus only on those who directly experienced the Genocide. There is a need to strengthen interventions that support families, encourage open and balanced communication, and equip young people with the tools to process history without inheriting unresolved trauma. Our history is painful, heavy, and at times frightening, but it is ours. To turn away from it is to lose a part of ourselves. As youth and young people, we carry the responsibility to remember, to understand, and to pass on the truth with courage and dignity. What the next generation knows will come from us. So we learn, even when it hurts. We speak, even when it is hard, and we can seek help, because our mental health matters too. Rwanda’s approach to mental health has already laid a strong foundation for this. The integration of psychosocial support into community health systems, the use of group-based follow-up care, and the involvement of community health workers and volunteers have all contributed to improved outcomes. The presence of mental health services at commemoration sites, supported by trained personnel and referral systems operating day and night, demonstrates a level of preparedness that reflects both experience and commitment. This approach aligns closely with global best practices as articulated by the World Health Organization (WHO), which emphasises accessible, community-based, and integrated mental health care. It also reflects Rwanda’s broader national vision of building a resilient and inclusive health system that leaves no one behind. However, sustaining and expanding these gains requires continued investment. Mental health services are often underfunded globally, despite their critical role in overall well-being and development. In Rwanda, the case for investment is particularly compelling. Mental health is closely linked to social cohesion, productivity, education, and the country’s long-term development trajectory. Addressing trauma is therefore not only a matter of individual well-being, but of national importance. There is also a strong case for strengthening partnerships. Government leadership has been central to the progress made so far, but the scale and complexity of mental health needs call for a collaborative approach that includes civil society, development partners, and community-based organisations. Each has a role to play in expanding access, innovating interventions, and ensuring that support reaches those who need it most. For organisations like HDI, this presents an opportunity to deepen engagement in mental health as part of a broader commitment to health, human rights, and social development. Integrating mental health into programmes that address gender, youth, and vulnerable populations allows for a more holistic response that recognises the interconnected nature of these issues. For development partners, investing in mental health in Rwanda is not starting from scratch. It is about strengthening a system that already demonstrates impact, scalability, and strong national ownership. Supporting such a system offers the potential for meaningful, measurable outcomes, while also contributing to broader goals of resilience and stability. At the same time, there is a need to continue building evidence. Ongoing research into the long-term and intergenerational effects of trauma will be critical in shaping future interventions. Understanding how trauma evolves, how it is transmitted, and how it can be effectively addressed will allow Rwanda to remain at the forefront of innovative and context-specific mental health care. The role of public awareness and responsible communication also remains vital. Media, institutions, and communities all have a responsibility to ensure that discussions around trauma are handled with sensitivity, accuracy, and a focus on support and resilience. Encouraging people to seek help, promoting peer and family support, and providing clear information about available services are all essential components of an effective mental health response. As Rwanda marks the 32nd commemoration of the 1994 Genocide against the Tutsi, the conversation around mental health must therefore move beyond the question of whether services are needed. The data already provides that answer. The question is how to sustain, strengthen, and adapt these services to meet both current and future needs. The 1,755 individuals who received continued care over the past year, are not just numbers. They represent lives navigating the long shadow of history, supported by systems that must remain responsive, compassionate, and adequately resourced. And these are only those RBC was able to record. Rwanda has shown that it is possible to build a comprehensive mental health response in the aftermath of profound trauma. The challenge now is to ensure that this progress is not only maintained, but expanded in ways that reflect the evolving nature of need. Sustained investment in mental health services is not simply about addressing the past. It is about safeguarding the future. It is about ensuring that survivors continue to receive the care they deserve, that younger generations are supported in understanding their history without being overwhelmed by it, and that communities remain resilient in the face of shared memory. In this ongoing journey of healing, the commitment to improving mental health must remain unwavering. It is a commitment not only to those who experienced the Genocide, but to the continued strength and unity of Rwanda as a whole. The author is a medical doctor working with Health Development Initiative (HDI).
