During the 1994 genocide against the Tutsi, mortality rates due to genocide violence were far in excess of other public health emergencies including malaria and HIV/AIDS.
Many people were tortured, killed and others raped. The whole country was full of body remains and blood leaving the environment in a total mess.
While many people died of injuries, a sizeable number of people died of several health hazards including starvation.
People could not get clean water and food, there was no health follow up of the sick and many vulnerable groups such as babies, young children and aged people perished.
Genocide may include a direct assault on public health as it was during the 1994 genocide. During this situation, public health came face to face with genocide when acts were committed to destroy the public health of the population, thereby threatening to destroy people through inflicting serious harm to their health.
Food, fuel, electricity, running water, and medical supplies were cut off from the Tutsi. Since many things are essential to public health, including housing, nutrition, sanitation, and access to public health, any acts committed to destroy and seriously undermine the conditions needed for health are potentially acts of genocide if they are committed against a specific group of people in a population.
During this period, serious contagious diseases such as hepatitis infection increased because the sanitation systems no longer worked properly.
Many young children suffered from malnutrition, and the combined effects of malnutrition, cold, and lack of adequate medical care led to increased illness and deaths.
It is important to mention that the immediate and long range health consequences of genocide included the effects of infectious diseases, organ system failure, and psychiatric disorders, conferring an increased burden of disease on affected populations for subsequent generations.
Our analysis suggests that genocide is one of the most pressing threats to the health of populations in the twenty-first century.
Advances in the public health discipline of violence prevention gives proof and provides for approaches to primary genocide prevention based on epidemiological methods.
In 2010, as Rwandans remember their beloved ones who perished and disappeared in the 1994 genocide, it is timely to reconsider the prevention of catastrophic violence within a full trajectory of health promotion principles.
We need to design and come up with a mechanism that follows, explores the global nature, health consequences, and possible preventive options for genocide as one of the most destructive forms of human violence, and seeks to answer the following questions.
I think we can apply public health approaches to violence prevention as primary prevention for genocide.
We can also develop an approach to the primary prevention of genocide based on established public health, as well as use of violence prevention methods derived from a variety of high risk settings.
The assessment of current violence and injury prevention models for suitability in the prevention of extreme, population wide violence. The analysis of morbidity and mortality information to quantify the impact of genocide on the health of populations is also important.
In addition, making an inventory of the known societal risk factors for genocidal violence, identification of the theorized, modifiable attitude based risk factors for genocidal behaviour within a population health model, and assessment of existing projects targeting primary violence and injury prevention in high risk jurisdictions, for future adaptation within a structured public health approach is vital for the population.
Scientific research advances on violence and injury prevention now make it possible to consider primary genocide prevention from public health based solutions.
International health organisations and NGO’s need to take into consideration the impact of violence and injury on global health, and bringing violence prevention into high relief as an international public health priority.