Primary mental health care for survivors of collective sexual violence in Rwanda

Abstract

This paper draws attention to the obligation and opportunity to respond to the mental health impacts of collective sexual violence (CSV) among genocide–rape survivors in post-genocide Rwanda. Qualitative data gathered from CSV survivors who were members of Rwandan women's genocide survivor associations are presented to illustrate how they strive to overcome adversity while seeking access to quality mental health care and using informal community mental health services. The results reveal that a system of high quality, holistic health and mental health care is yet needed to meet Rwandan CSV survivors' complex and serious health and mental health needs. Given that a rural health system, modelled on community-based, comprehensive HIV/AIDS care and treatment, is currently being implemented in Rwanda, we recommend enhancements to this model that would contribute to meeting the mental health care needs of CSV survivors while benefiting the health and mental health system as a whole within Rwanda.

Keywords:

• Rwanda
• sexual violence
• primary health care
• global mental health
• post-conflict

Acknowledgements

The research on which this paper was based was supported by a Fulbright Grant from the International Institute of Education, a National Science Foundation Doctoral Dissertation Research Improvement Grant #0514519, and a Baker-Nord Centre for the Humanities Graduate Research Assistance Grant through Case Western Reserve University. The National University of Rwanda (NUR) School of Public Health provided institutional support for this research, the Centre for Conflict Management at NUR provided safe spaces to carry out this research and the NUR Research House, particularly BIENVENU Emile, provided a supportive environment for this work. The Resilience Team members, UWAMUGUHA Clémentine, NDAMUZEYE Chrysostome, NTWARI Justice, UWINEZA Josiane, NKUSI Inga Jessica, UWAMAHORO Chantal, GASANA Marcellin and NIRAGIRE Hervé, provided invaluable assistance over the course of this project. GATETE Thierry Kevin reviewed translations of Rwandan cultural categories of illness. We are deeply grateful to the leaders and members of AVEGA-Agahozo, Tugane Umuhoza, and Abasa who shared their experiences and granted their permission to conduct this research. And we are very thankful to the District and Sector leaders in Southern Province who supported this research. We are also grateful for the willingness and skill of Hanna Garth and Zoe Agoos, who connected the authors of this paper.

Notes

1. AVEGA is an acronym for ‘Association des Veuves du Genocide’ (Association of Widows from the Genocide). Agahozo is a Kinyarwanda word that can be translated as ‘small comfort’.

2. Tugane Umuhoza means ‘We Head to the Comforter’.

3. Abasa translates as ‘those who resemble each other’.