There is need to boost mental health facilities in terms of experts and resources if the issue of mental illness and disability is to be dealt with adequately, the National Commission for Human Rights (NCHR) has said.

While delivering the commission’s 2016/2017 annual report, earlier this week, the Chairperson of NCHR, Madeleine Nirere, told senators and MPs that though mental health patients had been taken off the streets and given medical insurance, there was still an issue of imbalance between doctors and patients.

"In its evaluation, the commission visited CARAES Ndera and its subsidiaries CARAES Butare and Kicukiro-based Centre Icyizera to evaluate the issues regarding mental illness and mental disability and we found out that there were few psychiatrists as compared to the number of patients that the hospital receives on a daily basis,” she said.

CARAES is the government-owned national Neuro-Psychiatric Hospital.

Besides the issue of doctors, Nirere said that the facilities were struggling with funding owing to debts owed to them by districts as well as lack of psychiatric medication in district hospitals.

She also pointed out that private pharmacies don’t accept Mutuelle de Sante (health insurance) yet that’s what most of the patients use.

Social Stigma

Nirere said that there was still an issue of social stigma whereby some members of society prefer to lock up patients, deny them food, physically abuse them and, in some cases, sexually abuse them.

"There is an issue of stigma where even when a patient is fine, society continues to refer to them as ‘insane’ yet it is an illness that can heal like the others,”she said.

MP Constance Rwaka Mukayuhi said that it was time that the government paid off the debts owed to the facilities.

"I would like to thank the partners of CARAES Ndera that help the government to look after those who are vulnerable. However, though the government supports these institutions, I feel that there is need to boost the support that they get because they are really supportive.

"The issue of, for instance, the debts at CARAES Ndera has been ongoing for years. We encounter it year in year out. I would like to ask the Ministry of Finance to put these debts in their plans soon. These debts are slowing them down yet these institutions have goodwill,” she said.

The debts accrued by government total Rwf165m and are split into three categories.

The bulky part of the debt stems from the amount that districts all over the country owe the hospital–between 2012 and 2013 of bills incurred by patients that were brought by district security forces, according to the Ministry of Health.

 There is also money whose figures were not easily obtained owed by patients, some local and others foreign that were brought to the hospital from streets and had no identification or even insurance. This particular date runs between 2014-2016.

Mukayuhi also touched on the issue of stigma.

"I would also like to request the commission to consider starting a campaign that will be educating people to drop the stigma that they subject mentally ill people to, the same way we did it for people with HIV. We need to teach our people to be more compassionate, and caring,” she said.

In comparison with neighbouring countries, Rwanda’s trauma prevalence is high.

This is attributed to the consequences of the 1994 Genocide against the Tutsi which left large segments of the population constantly struggling with mental disorders.

Statistics show that among the people with mental disorders, close to 99 per cent witnessed violence, while 31 per cent were either raped or sexually assaulted.

The outcome of this was a massive burden of Post-Traumatic Stress Disorder (PTSD) and depression among other mental disorders.

There are also other causes of mental health disorders like genetics, psychological and the social reasons.

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