Joyeuse Majyambere lived in Gishushu, a Kigali City suburb in 1994. At the dawn of the year, the perpetrators of the 1994 Genocide against the Tutsi started setting up bases around their neighbourhood. By March, things were getting edgy.

"I got home one evening and found they had put up their flag in our neighbour’s compound. My husband came back later in the night; he had miraculously escaped death at the hands of militiamen wielding machetes. They cut him badly,” she recalls. 

"It didn’t stop there though; they came back the next day and beat us up. I still have scars on my back,” Joyeuse adds, stretching a hand to massage her back. 

Joyeuse and her husband were rushed to the hospital and treated. They were lucky to survive. 

"By then all the injured in Kigali were treated from King Faisal Hospital because those who were taken to Central University Teaching Hospital of Kigali didn’t make it; they were killed there,” she says.

After the treatment, Joyeuse sought refuge at a church in Rugende with her family hoping for better security. On arrival at the church, they were greeted by the news of the death of President Juvenal Habyarimana in a plane crash. 

"Everything went cold that evening. Unfortunately for me, I was pregnant and I sadly watched my children and husband getting killed in the church,” she says.

Much as Joyeuse survived death, she wasn’t in the best condition as she had a lot of cuts on her body. 

"I was dead even though I was still breathing. My baby died in the womb because I wasn’t eaten and the tragedy was gripping. I lost a lot of blood; my wounds were septic because of lack of care for them.”

"But God had other plans for my life because after spending days waiting for death to take me—I had given up on life—the next thing I saw were The Rwanda Patriotic Army (RPA) liberators. They rushed me to present day Rwamagana District hospital in Eastern Province for treatment,” she adds. 

Joyeuse was treated and given where to stay but life wasn’t the same for her. 

"I could have plans of going to church but whenever I venture to a place of worship, the bad memories come back flooding. There were days I could get up at night screaming, I try to flee the home thinking people were coming to kill us,” said Joyeuse. 

Saved from claws of death

It wasn’t until Joyeuse joined other women who faced the same trauma that she calmed down and settled. 

"When I met women that faced the same problems as I did, I talked to them and got to know God. That was the breakthrough in my life. I am now happy and I even take care of some orphans and I have my joy and peace again,” she says, smiling. 

Phillip Nkusi was nine by the time his family was torn apart by perpetrators in Rukira Sector, Ngoma District, where they lived on a hill. 

"It was so sad to see our own neighbours, people we often shared a cup of milk with, storm our home and ask us to put our hands up. With machetes in their hands, they ordered my parents lie on the floor as one militiaman held me by the neck,” Nkusi recalls. 

His father tried to stand up and challenge the neighbours-turned-killers, but he was silenced by a deep cut on his neck. Luckily, Nkusi escaped the massacre in the home and fled to his relatives in Gahima Cell in Kibungo Sector, Ngoma District. 

"There were like four roadblocks, but, luckily, I managed to pass and get to the other side. I found the house all broken down. No windows and doors. Households were scattered. The whole house had been turned inside-out. As I walked out, I was blocked by someone who came running inside and he had a machete in his hand,” he says. 

However, the proverbial nine lives of the cat in Nkusi were no exhausted. He made a run for his life and the machete caught him on the shoulder, but the effect was not deadly. 

"I fell down and tried to crawl on my back then the killer kicked me in the face. His boots were splattered with blood. The next time I came around, I was with a man I don’t know in Bukoba [a town in northwest Tanzania on the western shore of Lake Victoria]. I was treated,” Nkusi recalls.

With the cut on his shoulder and hand, Nkusi can’t stretch out his hand or shower himself, though this wasn’t the only effect he got. 

"Luckily, I am done with school but before, I couldn’t stand being taught by a teacher who is of different tribe. I always judged people upon their tribe and hated others. I never settled and sleeping was an issue, even sleeping pills failed to get my eyes closed,” he says. 

With the message for reconciliation trumpeting across the country, Nkusi found peace from talking to other survivors and feels like a whole new person now that he has his own family and loved ones. 

Research on trauma

Between May and July 2010, researchers from the Department of Psychology, University of Konstanz, Konstanz, Germany, were in Muhanga District in Southern Province to study the level of trauma exposure, psychopathology, and risk factors for post-traumatic stress disorder in survivors and former convicts.

Survivors reported that they had experienced on average 12 different traumatic event types in comparison to ten different types of traumatic stressors in the group of former prisoners. 

"The worst events reported by survivors were mainly linked to witnessing violence throughout the period of the Genocide, whereas former prisoners emphasised being ‘physically attacked’, referring to time spent in refugee camps or to their imprisonment,” the findings showed.

"In the parent generation, when compared to former prisoners, survivors indicated being more affected by depressive symptoms.”

Ian Karera, a psychiatrist at Alpha Clinic in Nyabugogo, says people who are traumatic as a result of violence usually present symptoms such as lack of appetite, insomnia, nightmares, isolation and general confusion.

"When you witness all your loved ones being put to brutal death, and you are left alone, perhaps, in dire poverty, your brain is naturally overwhelmed , making it dysfunctional in the long run,” Karera says.

He adds that people who have physical scars or lost body parts as a result of violence are usually vulnerable to low self-esteem.

"When they look at other people who are normal, it fills them with a sense of jealousy; leaving them feeling less of humans,” the psychiatrist adds.

Trauma therapy

Karera says it is important for people who are traumatic to have of plenty of sleep, exercise, have a balanced diet, desist from stressful work, alcohol and drugs as this helps them recover faster.

Jean Gakwandi, the director of Solace Ministries Rwanda, a Christian charity engaged in rehabilitating Genocide survivors, says they offer trauma healing sessions to these victims.

"Immediately after the genocide many people were left with a sense of loss, discouragement and hatred, so we came up to offer them a shoulder;by offering counseling services.”

According to Yves Nyamushanja, the community development facilitator of Solace Ministries, 7,200 goats and 325 cows have been given out to survivors since 2004 as part of efforts to reintegrate them back into society.

"We understood that it was difficult for victims to recover if they were still hit by certain problems like poverty. This is why we decided to devise sources of income for them,” Nyamushanja says.

Besides counselling and other needs to the survivors, the NGO also provides those found to be HIV-positive with free anti-retrovial drugs as well as other HIV counseing and care.

Yvonne Kayitenshonga , the dead of Mental Health Division at Rwanda Biomedical Centre (RBC), says the Ministry of Health has a national taskforce made up of about 15,000 community-based health workers to handle Genocide-related trauma cases.

She adds that they regularly carry out training of all medics at hospitals and health centres countrywide to equip personnel with skills to handle trauma cases.