Two PhD students are among the thousands of students to graduate during today’s third graduation ceremony at the University of Rwanda.
The New Times talked to them about their thesis.
Siméon Sebatukura, is a lecturer in clinical psychology at the University of Rwanda (UR)’s College of Medicine and Health Science.
His thesis recommends empowering caregivers with know-how on mental healthcare provision for effective mental health services.
He is graduating with PhD in Clinical Psychology.
His thesis is titled “Analysis of the Practice of Mental Healthcare in Hospitals of Rwanda”.
He started his research in 2011.
The 57-year old has been a lecturer at UR since 2009.
He said, in 2008, at one of the district hospitals, he saw a nurse who was responsible for mental health, which means that she was playing the role of a psychiatrist without the necessary knowledge.
He said she had many patients to take care of as she was alone in the entire hospital.
He said Rwanda has made good progress in this area compared to other countries in Sub-Saharan Africa as it has decentralised mental health services at each district hospital, with each having a mental health unit.
Before the decentralisation in 2006, there was only the Neuro-psychiatric Hospital of Ndera which was offering mental healthcare.
However, he noted that there is a need to increase the number of clinical psychologists and avail psychiatrists at each district hospital who can work with psychiatric nurses who have been largely assuming mental healthcare responsibilities.
“I wanted to assess the then newly decentralised, newly created mental health units in all hospitals which were headed by nurses, and my hypothesis shows that there were many challenges,” he said.
He said the first mental health complications, his research found out, are respectively epilepsy, schizophrenia, depression, Toxicomania- strong physiological and psychological dependence on a drug- and psychosomatic disorders- a mental disease that manifests physically.
According to the National Institute of Mental Health, Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality.
He said the research findings indicate that 4 out 5 people in Sub-Saharan Africa who have mental problems do not go to health facilities for treatment.
His thesis was supervised by Prof Pierre Fillipo from the Catholic University of Leuven in Belgium and Prof. Vincent Sezibera.
Sebatukura noted that his research recommendations are very significant in regards to improving mental health care.
The recommendations include training and empowering caregivers in terms of mental healthcare because they are with patients most of the time.
He noted that there is also need to avail mental health services to health centres to increase people’s access.
He said there is a need to increase the number of mental health unit workers because there are hospitals with only one worker.
Assistant Commissioner of Police Wilson Rubanzana
His thesis is titled “Exposure to effects of genocide as a risk factor for intentional death in Rwanda: A forensic epidemiological investigation.”
Forensic medicine is the branch of medicine or health science that helps justice sector investigation in regards to health matters. This kind of medicine helps establish the cause of death through post-mortem.
Rubanzana said he had had to use forensic epidemiology- the use of scientific method in investigating the unnatural deaths in post-Genocide Rwanda.
Epidemiology studies diseases and health threats.
He is a lecturer of forensic epidemiology at the University of Rwanda.
He said some suicide and homicide cases could be associated with the effects of the 1994 Genocide against Tutsi, yet there had not been scientific research to prove it.
Rubanzana said it was the first time in the country one has studied suicide and homicide, in context to the Genocide.
He was enrolled at the University of Rwanda (UR) and studied at Oregon Health Sciences University in the United States through a partnership with the UR.
His thesis was a compilation of three papers in three renowned international journals, namely British Medical Journal, British Medical Central, and Journal of Interpersonal Violence.
One paper was on suicide, second on homicide victimization, and the third on homicide perpetration.
The 52 year old collected data for his research in 2011 and in 2013.
He said forensic epidemiology can be used to study rape, traffic accidents, toxic substances and anything related to criminal investigation that harms human life.
It started after bioterrorism emergence in 2001. According to Wikipedia, Bioterrorism is terrorism involving the intentional release or dissemination of biological agents. These agents are bacteria, viruses, or toxins, and may be in a naturally occurring or a human-modified form.
Rubanzana is also the Head of Huye Isange Rehabilitation Center.
“I wanted to scientifically analyse and investigate thoroughly the factors causing or associated with suicide or homicide in Rwanda,’ he noted.
“I used a method of combining forensic medicine and criminal investigation. This practice, called forensic epidemiological approach, consists of collecting results from autopsy and going to the field to get data from criminal investigators, the Police and treat it in a scientific method ,” he said.
“When the Police conducts investigation and says that a person was killed by a given agent, it is not based on scientific method. For it to be scientific method- based, you should have a large sample and identify different risks in other cases in existing literature so as to make a study,’ he said.
“For example, when there is a food poisoning in a given hotel and people start vomiting, the Police can rush to look into the issue to ascertain the cause…but doctors scientifically ascertain the cause,” he said.
He said it is also challenging to know whether the poisoning was done intentionally or unintentionally, which justifies the need for forensic doctors to demystify the phenomenon and know who is responsible.