Beatrice Gasengayire, a 52-year-old survivor of the 1994 Genocide against the Tutsi says after losing most of her family members, her life made a turn for the worse.

The Genocide happened when she was staying in Butare, in the Southern province.

Her story is a wrenching one that entails events that almost claimed her life. But with God’s Grace, she was miraculously saved by a Hutu friend who hid her and her two children from the killers.

 "We witnessed women and young girls being raped, others were killed and their bodies were thrown into rivers. It was so horrific and very hard for a human being to comprehend what was happening,” she narrates.

She was lucky to be among the first people RPF rescued and that’s how she managed to survive.

Nonetheless, her journey after survival is still a heart wrenching one. The dark memories are fresh in her mind and this is making it hard to get over the past.

She however says that the counselling sessions she attended helped her and now she is slowly recovering.

Fanny Gikundiro, a mother-of-two, is another survivor. She lost her father and other members of her family during the Genocide, her mother too was also left disabled.

"My father took me to a nearby orphanage and that’s how I managed to survive. I later came to know that my mother had also survived and we reunited,” she says.

Gikundiro has also been battling trauma for a long time because of witnessing the massacre that women, children, and other innocent people went through.

For her case, she used to isolate herself from others and most of the time she would cry uncontrollably.

Living with trauma for many years without knowing was a very big challenge, for she didn’t know how to deal with the varying emotions she had, she says.

It was after she was introduced Martial arts for Justice - enhanced resilience training that Gikundiro embarked on her recovering process.

"I learnt a lot through these self-defence classes. They helped me find a way of coping with trauma because the different therapies and other psychological techniques I had used for so many years were not effective,” she says.

Therapy is very vital

Prof Vincent Sezibera, the chairperson of Rwanda psychological society, working at University of Rwanda Centre for Mental Health College of Medicine and Health Science, says trainings such as martial arts contributes to healing for people with post-traumatic stress syndrome.

He however notes that this form only cannot be considered as treatment per se without use of other therapies.

This is a supporting mechanism for the healing process and it’s vital to any PTSD sufferer. PTSD can affect a person in different forms, this is why it needs different approaches. This is the best way to heal the condition, Sezibera explains.

He adds that people with this condition go through physical and painful sensations, accumulation of toxic residual physiological changes, and loss of control of their body image among others, which also need other forms of therapy for complete treatment.

"Exercises help the patient to focus and regulate their emotions as well as bring attention to what is happening to their bodies,” he says.

Sezibera says when it comes to diagnosis, they use a standardised instrument indicator.

He says women tend to manifest more symptoms than men explaining that this doesn’t mean that women are more vulnerable to PTSD than men.

"This happens because in most cases, men’s symptoms are internalized while for women it’s externalized,” he says.

State of PTSD

With survivors, PTSD prevalence is considerably similar between male and female. With regards to age, the younger group has the lowest prevalence of PTSD whilst the older group presents a slightly higher prevalence.

Sezibera says that PTSD is inversely associated with the level of education of the respondents whereby respondents who have a lower education level present the highest prevalence as compared to those with a higher education level that present a lower prevalence.

In terms of location, referring to the recent study by Rwanda Biomedical Centre (2018 Rwanda Mental Health), City of Kigali has the highest prevalence compared to other provinces followed by Western Province.

In Rwanda, at least there is a mental health facility unit that has been set up in hospitals. There are also local initiatives availing any help related to mental disorders.

There are about 2,000 clinical psychologists fully trained to handle different mental disorders. Nurses and psychiatrists are also trained in mental health disorders.

In every District, there is at least one psychologist; in total, there are 28 physiologists in all 30 Districts.

Whereas, in every referral hospital, there is also one psychologist and with every health centre there are three psychologists as well.

A closer look at PTSD

According to experts, anyone who has experienced or witnessed a situation that involves the possibility of death or serious injury, or who learns that a close family member or friend has experienced a traumatic event, can develop a post-traumatic stress disorder.

Master Dean Siminoff, president of Martial Arts for Justice and creator of the Enhanced Resilience Training, says a traumatic event can leave people with many symptoms, but it is important to understand the cause of these symptoms and how the body’s nervous system reacted during this traumatic event.

He explains that when trauma happens, our nervous system is designed to fight or freeze. Traumatic symptoms after an event are generally related to the freeze or immobility response of our nervous system and this is sometimes what is referred to as PTSD.

PTSD has become a common diagnosis. One question we can ask is why do some people ‘bounce back’ more quickly than others from a traumatic event? he says.

Siminoff consequently adds that this happens because people are different noting that the ones with a resilient nervous system tend to bounce back quickly from trauma.

He also notes that often someone suffering from trauma symptoms has a nervous system which is in a state of activation that is either heightened or depressed.

"In Enhanced Resilience Training, the goal is to virtually reset their nervous system to a healthy state of responding more naturally to daily life,” he says.

Enhanced Resilience Training incorporates some traditional trauma therapies with mind body exercises, deep breathing techniques and empowerment exercises.

In a 2012 social psychiatry and psychiatric epidemiology study in Rwanda, PTSD was still highly prevalent in the Rwandan population, 18 years after the 1994 Genocide against the Tutsi.

The study indicated that PSTD was strongly associated with depression, with manifestations of psychic trauma.

Experts say not every traumatised person develops ongoing chronic or even short-term acute PTSD, and that not everyone with PTSD has been through a traumatising experience. Some experiences, like the sudden death of a loved one can cause PTSD.

The symptoms, they say usually begin early, within three months of the traumatic incident, but sometimes, they begin years later, and that these symptoms always last longer than a month and can be severe enough to have effects such as interfering with relationships.

editor@newtimesrwanda.com