AS MACHETE-WIELDING militiamen rummaged swamps and bushes, houses and churches hunting for Tutsi during the 1994 Genocide against the Tutsi, Cecile Umurazawase, 37, was among those being sought to be killed.

The woman who describes herself as a ‘devout catholic’ made a pledge to God that if she escapes the killers, she would do something to help the most vulnerable people in society.

Fortunately, when the Rwanda Patriotic Army ended the bloodshed, Umurazawase was among the few people who were still alive and kicking.

Today, she still believes her faith was part of what saved her from the blood-thirsty militias.

But though she survived the 100 days of slaughter, the trauma of losing dozens of her relatives and friends haunted her and her pledge almost sunk into oblivion.

It was not until 2010 that Umurazawase remembered that she had committed to do something for the community.

That was after she came across a mentally disabled woman who looked dejected  and poverty-stricken.

She says whenever she would leave her home on the outskirts of Huye town to a church in the city centre for prayers, she would meet the woman, a haunting reminder that compelled her to do something.

She later decided to take care of the woman. And as she took the old woman to a psychiatric hospital in Butare and kept looking after her, Umurazawase embarked on a difficult journey to look after those rejected by society; the mentally disabled.

Tough task

"As I looked after the woman, I realised that people with mental problems face stigma and a lot of health challenges. I resolved to do something for them,” she says.

Four years earlier, Umurazawase had graduated with a Bachelor’s degree in Social psychology from the then National University of Rwanda and was in position to best understand how she could help the mentally-disabled people.

In 2011, Umurazawase resigned from her job at the University Teaching Hospital of Butare (CHUB) where she had been working as a psychologist.

"I wanted to dedicate enough time to the vulnerable,” she says as she explains the rationale behind her decision to quit a paying job.

"Unfortunately, many people looked at the decision as weird,” she recalls.

"Many people thought I had run mad because I was  spending my days with mentally disabled people. But inside me, I knew what I was doing was noble and impactful to society.”

Umurazawase says people with mental disorders face stigma from their relatives and community, which condemns them to deplorable lives on the street and deprives them of their right to medical care.

That is one of the reasons she started an initiative that supports such individuals, she says.

The same year she quit her job, Umurazawase started a campaign to mobilise support for the mentally-disabled people, many of whom had been living on the streets in Huye town or wandering in the town and its neighbourhoods, without any hope for treatment.

At first, she approached Huye District authorities and after days of discussion, she was able to get dozens of health insurance cards for the mentally-disabled people.

She would also later approach several individuals and institutions, including the Parliament, seeking advice and support.

Following the consultations, she decided to set up a local not-for-profit organisation that advocates for the rights of the mentally disabled individuals.

She would later name her organisation the Health Care Foundation (HCF-Twite ku Buzima); emphasising the need to access health services for the needy.

Later, she would include other people with serious health ailments, including those affected by diabetes.

Helping the ‘neglected’

 "People with mental disabilities face one of the most challenging situations ever but, unfortunately, the community generally tends to abandon them,” Umurazawase says.

"It is time we all stand together to support them, help them get treated and re-intergrate them into the community.”

Umurazawase still works with Huye District authorities and the Police to identify and support people with various mental disabilities.

She conducts routine visits to the city and its outskirts in search of mentally-disabled people who are then taken to a local psychiatric centre for treatment.

Apart from championing for access to medical care, Umurazawase is also investing into supporting the social reintegration of former mentally-disabled individuals.

 The psychologist-turned-social-activist is also investing efforts in transforming the socio-economic status of the beneficiaries by equipping them with various practical skills, mainly tailoring and crafts-making.

They are also encouraged to join small community-based savings and credits groups, locally known as Ibimina, to facilitate their economic growth and social integration.

She sensitises the public about the benefits of supporting people with mental disabilities and avoiding stigmatising them. 

"If the public could understand that mental illness could affect anyone and that these people need their support, then we wouldn’t be seeing anyone of them on the streets,” Umurazawase says.

She adds: "I am determined to carry on with this struggle despite the many challenges we are facing.”

Lack of funds

So far, about 259 people are benefiting from the programme. They include mentally disabled people and some of their relatives.

Some of them are still under medical treatment while others, after recovering, are learning tailoring and craft-making skills.

To carry out her interventions, Umurazawase depends mainly on money from her own pocket and ‘little’ support mainly from well-wishers who sympathise with her cause.

But the support remains extremely limited compared to the needs of the patients.

But she insists her resolve will never fade away and calls upon the public to support her cause. 

Mental illness in the country has mostly been blamed on drugs.

Figures from Rwanda’s top mental health facility, Ndera Neuropsychiatric Hospital, show that in just four years, patients who checked into the facility with alcohol and drugs induced mental illness almost tripled.

In 2009, the hospital treated 440 patients with substance abuse related ailments, and by 2012, the number had risen to 1,099.