Two decades have passed since Rwanda witnessed the Genocide against the Tutsi in which about one million people were killed. Furthermore those who survived the holocaust were left with many problems to grapple with including health issues.

For instance a large number of survivors sustained physical injuries with some suffering permanent disability after losing one or more limbs, their eye sight or hearing ability. Many survivors are still traumatized by what they experienced during those dark days.

But that is not all. According to a UN study, about quarter a million women were raped during that period and many of them acquired HIV infection as a result. Unknowingly, these women passed on the virus to their partners and children conceived during that time hence increasing the prevalence of HIV. This has led to affected individuals getting sick in their prime of their lives due to opportunistic infections and many dying while young. It has also created social as well as economic problems for the survivors and their living family members. To cope with a child born out of ethnic hatred and rape, to cope with a chronic infection occurring for no fault of the individual is not easy.

These women have also suffered from chronic pelvic infections as a sequel to sexually transmitted diseases acquired when raped. Carcinoma of the cervix has also emerged in women survivors at a later age due to chronic pelvic infections.

Issues of mental health are equally large in magnitude, most important being post traumatic stress syndrome (PTSS). It is said to be a set of symptoms and signs which individuals experience after witnessing or experiencing something beyond human imagination. Many persons who are survivors of the brutal killings have been experiencing unexplained palpitations, sense of fear, insomnia, nightmares, breathlessness and chest pain since that time. They visit hospitals seeking consultation for their problems; many tests are done and repeated several times with no conclusive results because there is no existing physical problem. The symptoms remain persistent or repetitive.

The genocide against the Tutsi also gave birth to many single mothers who are struggling to raise the children alone. Add this to the mental stress and anxiety they are already undergoing and life becomes tough.

The apparent outcome of these physical and mental problems is rise in prevalence of non communicable diseases like hypertension and or diabetes unlike in other countries where the cause is usually obesity and lack of exercise. For instance a person living in a village walks considerable distance in his daily routine, is not obese, does not consume lot of saturated fat like cheese and butter yet he suffers from high blood pressure or diabetes. The Government has taken very good measures for physical and mental rehabilitation of the genocide survivors including care of the health problems. Successful efforts have been made to rehabilitate them and take the country and people forward. Combined efforts of all concerned will definitely see an end to these problems in few years.

Dr. Rachna Pande is a Specialist in internal medicine

E-mail-rachna212002@yahoo.co.uk