Rwanda's At-Risk Generation
Post-War Stress Saddles Youth
December 4th 2018
This is Mutobo Demobilization Center in Rwanda where once-marauding mercenaries spend months, even years transitioning from genocide to job readiness. The ex-combatants, many conscripted as child soldiers, joined the Hutu’s 100-day rampage in 1994, when they slaughtered 800,000 Tutsis and moderate Hutus, and left 100,000 orphans, 250,000 rape victims, and an entire nation traumatized for generations. Mutobo is intent on teaching them to be “good Rwandans," not tribalists.
Since steering Rwanda’s U-turn from hate violence, President Paul Kagame has done more in 25 years to advance the physical wellbeing of his people than any other leader in any other nation over the last half century. During the past 10 years, Rwandans added a decade to life expectancy, slashed child mortality in half, and cut malaria deaths by two thirds. They’ve tripled their per capita income, enrolled almost every child in primary school and nearly reached universal healthcare, astonishing feats in any region, particularly on a continent of massive, abject poverty. Yet the leaps in living standards for this East African nation have all but side-stepped the most troubling concern: mental health.
Kagame’s wager, wise to many, has outlawed tribal identification to defuse communal anger. In this Land of a Thousand Hills, where victims share rooftops with their perpetrators, it’s simply illegal to identify as Tutsi or Hutu. It might ignite what’s just beneath the surface: seething ethnic hatred. Keeping a lid on it, Rwanda’s postwar schoolbooks are devoid of the genocide; its press strictly controlled on the subject. There’s an official clamp on public consciousness: memorializing the dead is reserved for just one day a year, on the April 6th anniversary of the genocide. That observance is carefully choreographed.
In this place of post-war emotional austerity, just where do millions of traumatized Rwandans seek help? The country’s handful of trained psychiatrists simply cannot meet burgeoning needs, especially in a culture where the mentally challenged are shunned, subjected to village efforts to expel bad spirits or chained to trees. The paucity of Rwandan data on psychiatric and psychological afflictions confounds the World Health Organization. Mental health needs a mobilizing force like Yale University’s Global Health Leadership Initiative, a consortium making strides on the ground in Rwanda, sharing medical expertise, mentoring rising professionals and cultivating evidence-based treatment. International groups make a critical difference with their ability to pivot to smaller, outlying areas--exactly the kind of positioning Kagame’s decentralized healthcare system needs. At greatest risk of course, are the children who witnessed beastly, crushing violence and quickly assumed the burdens of adults. Medical studies of Rwandan youth document the troubling connection between stress, trauma and epilepsy. It's so prevalent in Rwanda, it’s epidemic. Well over a third of adults in the study suffer the neurological disorder; but among children the rate is a staggering 42 percent. Data is scarce in a country where the government put a moratorium on survivors’ post-war expressions and communities harbor age-old stigmas on mental illness.
Look at innovative mental health solutions in Rwanda, including a U.S. project training educators called Human Resources for Health Program in the Ministry of Health. Are you in the field and considering a way to get involved? Contact Partners in Health, a group based in the capital city of Kigali aimed at building sustainable health systems in recovering countries. Trying to make an impact and an income? Become a fellow with Global Health Corps, dispatcher of doctors, nurses, specialists, and technicians worldwide. Find a way to assist refugees settled in your own area; their mental health needs are likely great. Tap into local partner organizations assembled by the World Bank and UNHCR.