Ourgrations

Rwanda: A Trail of Tears

Historians claim that the Rwandan genocide ended on July 18th, 1994 shortly after the Tutsi Rwandan Patriotic Front (RPF) gained control of the Rwandan capital of Kigali and declared the war over. But the extremist Hutu Interhamwe continued their killing even after they put the machetes down—they killed people emotionally. One million people died during that period of genocide, but millions more died mentally and emotionally as they struggled to deal with the events that had transpired. These survivors experienced long-lasting psychological distress that continues to inhibit their cognitive and emotional abilities today. The Hutus completed their objective, leaving a trail of tears to haunt Rwanda for years to come.

The psychological effects on the survivors of the genocide were extensive and severe. Victim assessment has shown evidence of severe depression, post-traumatic stress disorder (PTSD), and a wide array of anxiety and behavioral disorders related to violence exposure. These disorders may include acute stress disorder, obsessive compulsive disorder, panic disorder, separation anxiety, conduct disorder, agoraphobia, social phobia, attention deficit disorder, and oppositional defiant disorder (Balaban 176). One study found that even ten years after the genocide, survivors experienced shame, a lower self-confidence, PTSD, depression, and feelings of hatred or revenge (Schaal & Elbert 95).

PTSD was especially prevalent among young people; though 79% of the victimized children in one study reported experiencing all the symptoms of PTSD, 100% of the survivors claimed to have suffered at least three of the 17 classified symptoms as defined by the Diagnostic and Statistical Manual of Mental Disorders (Schaal & Elbert 97). Generally, PTSD results from viewing or experiencing a traumatic, life-threatening event. The most severe cases are those in which a child witnesses the murder of his or her parents, or the child believes that there is a serious threat to his or her survival (National Center for Post-Traumatic Stress Disorder). Since brutal murders and horrific mutilations surrounded the victims on a daily basis, some psychological responses are expected and even necessary for closure. However, PTSD is an additional outcome that occurs when these feelings of anger, sadness, and confusion are not dealt with, but rather left to fester inside. It is the result of a lack of treatment and support. Of course, professional treatment and family or community support are precisely what Rwanda did not have following the genocide that left the nation dazed and confused.

When given the factors influencing the likelihood of developing PTSD after a traumatic event, it should be no surprise that all of the genocide survivors experienced the disorder to some extent. According to the National Center for Post-Traumatic Stress Disorder, PTSD is most likely to develop when the trauma was lengthy and intense, the victim lost someone he or she was close to, the individual had little or no control over the event, and little or no support was given following the trauma. Schaal & Elbert’s study of 68 Rwandan orphans following the genocide showed that 97% of them saw dead or mutilated bodies, 88% were a victim of an attack or looting, 77% witnesses someone else’s brutal death, and 41% witnessed the murder of their own parents. The genocide was controlled and orchestrated by high-ranking political and ethnic leaders—making it a matter completely out of their control. And very few survivors received therapeutic or emotional support afterward (Schaal & Elbert 98).

Extensive study concerning the correlation between PTSD and other biological or circumstantial factors has shown that three groups are especially prone to suffer from PTSD due to the Rwandan genocide: older children, females, and children living in child-headed households (CHH). Older children are more likely to suffer than younger children or adults because they have the cognitive capacity to understand what is happening around them, but they do not yet have the mental ability to appropriately deal with the event. Females are often the primary victim of sexual abuse and/or rape—thereby increasing their chances for traumatic experience and PTSD. And children who live in child-headed households are forced to deal with responsibilities they are not yet ready for—increasing their emotional burden. Since they’re usually living in the same house as their parents’ and/or siblings’ murder, daily reminders of the event often push them to develop PTSD (Schaal & Elbert 105).

The symptoms of PTSD and other anxiety-based disorders limit the victim’s ability to perform everyday tasks and function smoothly. Common effects include: the inability to express feelings or engage in meaningful relationships, irritability, insomnia, reactivity, feelings of hopelessness or despair, and problems concentrating or paying attention (National Center for Post-Traumatic Stress Disorder). In short, PTSD causes cognitive and emotional impairment which may influence learning capacity and virtually every aspect of the individual’s life. Since older female children represent the future of Rwanda, serious attention must be paid to intervening and providing these survivors with the best possible help and treatment.

Following the genocide, a few organizations attempted to establish programs for this very purpose—the treatment of psychological distress and disorders among survivors. Just three months after the end of the war, the United Nations Children’s Fund (UNICEF) combined with the Rwandan Ministry of Rehabilitation and several other nongovernmental organizations collaborated to form the Trauma Recovery Program. This community-based program aimed to train Rwandan professionals in child development, trauma and grief theory, and listening skills in order to identify and care for trauma in young children. Through the Trauma Recovery Program, thousands of teachers, orphanage workers, social workers, and health care providers gained the tools necessary to recognize and treat PTSD and other trauma-based disorders.

In 1995, the UNICEF worked with the Ministry of Education in Rwanda to establish a National Trauma Center in Kigali. The Center worked to provide outpatient treatment, training of trainers, development and sharing of trauma information materials, and a place to conduct research and educate the public about genocide exposure.

These programs have proven effective to some degree in treating trauma among survivors. With this treatment, the patients may be able to someday lead normal lives once again. In the end, however, no organization or treatment can completely remove the heartache of losing a family member, eliminate the desire for revenge against the killers, or erase the painful image of a parent’s violent murder. That must come from within.

As one Rwandese put it, "International assistance can be given by providing assistance and guidance, but healing is a cultural thing and must be done by us" (International Response).

Works Cited

Balaban, Victor. (2006) Psychological Assessment of Children in Disasters and Emergencies. Disasters. 30(2) 178-198.

Dyregrov, Atle; Gupta, Leila; Gjestad, Rolf & Mukanoheli, Eugenie. (2000) Trauma Exposure and Psychological Reactions to Genocide among Rwandan Children. Journal of Traumatic Stress. 13(1) 3-21.

Friedman, Matthew. (2008) What Is Posttraumatic Stress Disorder (PTSD)? Retrieved April 2, 2008 from <http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_what_is_ptsd.htmi>.

Pham, Phuong N.; Weinstein, Harvey & Longman, Timothy. (2004) Trauma and PTSD Symptoms in Rwanda. The Journal of the American Medical Association. 292(5) 602-612.

Schaal, Susanne & Elbert, Thomas. (2006) Ten Years after the Genocide: Trauma Confrontation and Posttraumatic Stress in Rwandan Adolescents. Journal of Traumatic Stress. 19(1) 95-105.

Unknown author. (1995) The International Response to Conflict and Genocide: Lessons from the Rwanda Experience. Retrieved April 2, 2008 from <http://www.um.dk/Publikationer/Danida/English/Evaluations/1997_rwanda/b4/c8.asp>.