Yvonne Uwayezu was just 10 years old when the horror of the 1994 Genocide against the Tutsi unfolded.

The Genocide, which claimed the lives of over one million innocent people in 100 days, caused severe psychological and emotional wounds, leading to disorders like depression, anxiety, and social phobia, among survivors.

The traumatic killings that Uwayezu witnessed deeply impacted her psychologically, resulting in her current need for medication.

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To deal with these psychological effects, she created a singing group called ‘Twiyubake’, which translates to ‘rebuild ourselves’, aimed at enhancing their resilience. The group writes songs centred on themes of hope, unity, and reconciliation.

"I committed to seeking a solution since we have been stigmatised for so long because of the psychological effects we faced. People call us different demeaning manes. My singing group helps us fight to restore our hope and show that we are also able. If society can destroy us, we can rebuild ourselves in such a way,” she said.

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Forty-year-old Uwayezu studied hospitality in high school and said that given any job, she could do it. "Life without morale is dead. Stigma has hurt us a lot. People are biased about people with mental health issues, but you can take medication and survive,” she said.

The singing group is invited to different events to perform their songs.

"The Catholic parish in Gikondo gave us a room for our rehearsals. We perform the songs at Caraes Ndera,” she said.

Caraes Ndera is a referral hospital for psychiatry in Rwanda.

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"It is an opportunity for us to contribute to healing other people with psychological effects. Our songs have different messages including taking medication as recommended by doctors,” she said.

The group is also a member of "Ihumure Cooperative-Gikondo” comprising women with psychosocial disabilities in Kigali who supplement their income by creating handicrafts in Gikondo sector of Kicukiro District.

"This means that we have to build ourselves both financially, morally, and psychologically. This is because people do not give us jobs,” Uwayezu.

Vestine Uwingabire does handicrafts by making pearls into different decorations at Ihumure Cooperative-Gikondo—the cooperative comprises Genocide survivors with psychological effects and other community members.

"When I make one piece I get Rwf500 from the cooperative. These handicrafts keep us together so that we are not absorbed by trauma and loneliness,” she said.

Celine Mukakarira, the leader of Ihumure Cooperative-Gikondo, said: "Genocide against the Tutsi psychologically affected survivors. But it doesn’t mean that those with psychological effects are not able to do anything. They are able. Bringing them together is part of therapy.”

Mental illness among Genocide survivors

During the 1994 Genocide against the Tutsi, over a million people lost their lives in three months. Survivors were left in shock and deep sorrow, mourning the loss of their loved ones, and many endured dehumanising atrocities like rape.

According to the Rwanda Biomedical Centre (RBC), depression prevalence is at 11.9 per cent within the general population, and as high as 35.6 per cent are Genocide survivors.

Naphtal Ahishakiye, Executive Secretary of Ibuka, the umbrella organisation of Genocide survivors, said there are two types of people dealing with mental illness.

The first category consists of people who occasionally break down based on a particular incidence, while the other category is of people who live with mental illness and are assigned psychologists who deal with them daily.

According to the Ministry of National Unity, and Civic Engagement, the government has spent over Rwf417 billion to support Genocide survivors in different ways over the past 30 years.

Out of this, the ministry noted, Rwf46 billion, has been spent on medical treatment for Genocide survivors suffering from trauma and chronic diseases.

What mental health experts say

According to Jane Abatoni Gatete, a clinical psychologist and counsellor, stigma, and social problems such as unemployment, poverty, and violence should be prevented given that they are among the factors that activate trauma or psychological effects among Genocide survivors.

"Trauma and psychological effects can be treated. However, when treatment delays, people with psychological effects develop psychosomatic illnesses. That is when they start taking medication,” she said.

These psychosomatic illnesses include lack of sleep, hypertension, respiratory ailments, gastrointestinal disturbances, migraine and tension headaches, pelvic pain, impotence, frigidity, dermatitis, and ulcers.

"In the process of trauma treatment or coping with trauma, the community should avoid stigma. Ignorance in the community worsens stigma, as they misinterpret the reactions of people with psychological effects and people do not recover from psychological effects. Due to stigma such people cannot get jobs,” she explained.

Abatoni said Genocide survivors, orphans, and widows need psycho-social protection programmes to be able to cope with psychological effects.

"Imagine you are a Genocide orphan, widow, or survivor in general and you are unemployed, hungry, and children drop out of school. Lacking such basic needs activates trauma,” she said.

Psychosocial well-being or protection and mental health require access to other rights, such as health, education, clean water and sanitation, shelter, and livelihood.

"That is why partners, government, and community members should work together to support vulnerable Genocide survivors. Once treated, given care, and psychosocial protection, survivors with psychological effects can be very productive. Small income-generating activities can be created for them. Their basic needs really need to be covered,” she added.

Celestin Mutuyimana, a psychologist, said there are various ways the community can assist survivors in overcoming their traumatic experiences.

"The first way to support those persons is to help them regain the meaning of life ‘Icyanga cy'Ubuzima’ and vitality ‘Baho’. Because they experienced painful experiences, they can on different occasions feel that life has no sense. To help these people regain their meaning in life and vitality as community members, the community should acknowledge their sufferance, involve them in community work, support them in social activities and help them make new friendships, do not stigmatise them, and make connections to available opportunities,” he explained.