Depression in the heart of Africa: 100 days, A million scars.
(“Pinterest Rwandan Flag Painted on Face”)
Growing up in a country like Rwanda, whether it matters to you or not, no matter where you come from, you will more often than not hear about what happened in the 1994 Genocide. It’s not going to end up like the usual happily ever after stories or imigani (like we call them in Kinyarwanda) for a child that occasionally ended like “the rabbit learned his lesson, and from that day onwards he stopped lying ” well, No. I was told it was the most horrifying thing to watch an expecting mother be split into two halves and the baby to be pestled to death, neighbors killing each other with machetes in the most brutal manner, blood against blood in the name of ethnicity and divisionism for each other. In 100 days of human-incited damnation with nobody in the nation safe, these actions’ consequences had to be reflected in the post generation’s mental health.
“Depression is like a war, you either win or die trying” Unknown.
The (World Health Organization, 2018) defined Mental Health as an individual’s well-being in realizing one’s ability to cope with the typical shortcomings of life and be productive and contribute positively to the community. It’s not only not having a disease but also the fact that one’s well-being is not at stake. One not well mentally affects how he or she interacts with people in society, how one handles their career, and how they cope with stress and any discomfort, and that’s why it matters. For several African communities, Rwanda included, mental health has been known to have many stigmas attached to it. There is increasing concern over people not sympathizing with a mentally ill person because they impart value to the patient and believe that the person lacks the will power to pull himself or herself up and is just not making an effort. People having mental disorders are looked down upon by the rest, considered to be unproductive, useless, incompetent, and mainly worthless, sometimes possessed. The disgrace often experienced by people with a mental illness is, more often than not, more destructive than the disease itself.
“To be human is to understand that our shortcomings don’t define who we are” AM.
It’s a depressed WORLD
At present, psychological and mental health behaviors have profoundly affected the world, covering 10% of the population worldwide(Kinshore, 2011). Previous studies have reported that among some of the vulnerable people most affected by this situation, a considerable number of these are the youth. Some of the most common mental health-related analyses are psychiatric disorders, psychological disorders, trauma, post-traumatic stress disorder (PTSD), and depression. In comparison with neighboring countries, Rwanda’s trauma prevalence is high, and I would like to believe the 1994 Genocide is one of the major contributing factors. I am evaluating the data associated with depression as the most common among all these disorders.
“Depression isn’t a personality, never settle with a sad character” AM.
The MEMORIES that haunt us
Once, we had a house help lady called Vestine in her early 20s. She always shared with my elder siblings and me what happened to her during the 1994 Genocide. Vestine was about seven then, and She said she had to live in a tunnel full of pests and insects for three days and three nights saved by her mother, who sacrificed herself having heard footsteps of the perpetrators from the other side as she ran so they wouldn’t find them where they were hiding. She heard her scream as she ran and seconds later echos from gunshots following her mother’s screaming. It was close to the annual memorial event in April, and she would relive those moments and have nightmares and screamed at night, saying, “Mwiruke baraje kutwica” which translated to “run they’re coming to kill us.” My parents had to fire her because she scared my smaller siblings in their sleep, and I never heard from her ever since.
“There is more to your diagnosis than a moment of weakness,” AM.
Globally, more than 264 million people of all ages suffer from depression. It’s also considered a primary cause of psychiatric disorder worldwide and a significant contributor to the overall global disease burden. Research shows that women are more affected by depression compared to men. It may cause the person to suffer greatly and perform poorly at work, at school, and in the family. Depression, at its worst, can lead to suicide. Suicide is the second leading cause of death among 15 29-year-olds; almost 800 000 people die every year due to suicide. It has two main types: recurrent depressive condition and Bipolar affective disorder. Both can be chronic (over a long period), especially if the diseased doesn’t get the required attention(World Health Organization, 2020)
“It’s a disorder, not a decision” Unknown.
The SCARS still live on
Twenty years after the Genocide, its scars still live on: one in four Rwandans suffers from post-traumatic stress disorder, and nearly one in every six adults suffers from depression. Difficulties in treating this high burden of mental health illnesses are made more challenging by access to professional health care and the stigmas around mental health.
Numerous reconciliation opportunities have been put to place, including an annual commemoration during which people can publicly share their stories and listen to other people’s testimonies. In addition to that, a series of village-level hearings were established in 2002 known as Gacaca trials (Mahr and Campbell, 2016)
Rwanda’s government has tried working in partnership with the Ministry of Health to advance the quality of mental health care to everyone providing effective means in rural low-income settings—showing support for Rwanda’s plan to integrate mental health into the primary health care package (Munyandamutsa et al., 2012)
One of the outstanding achievements is having mental health services integrated into Mutuelles de Sante, which is accessible to each citizen in Rwanda. All these are steps to achieving a community of individuals with stable and constant mental health the government of Rwanda has tried to put into practice to date. (Partners in Health, 2020)
It’s a personal routine for someone to help try to heal or overcome depression, and that’s why there are several tips on how this can be done.
“Depression isn’t a choice, but stigma and ignorance are” Matt Haig.
There’s HOPE for a generation with healthy minds
In my opinion, for a country like Rwanda to heal from its scars and touch the lives of people like Vestine, it’s going to take more than general counseling, free anti-depressant applications, public testimonies, and furthermore. Yes, these have played a massive role in bringing down the numbers but so much more needs to be done. There is a call to action primarily focused on Rwanda’s youth to help each other’s mental health(Mukamana, 2019). This should be centered around breaking the stigma around receiving mental health support in Rwanda to increase the social availability of all Rwandans at large, gaining enough knowledge about one’s mental health status because them being mentally active does contribute to the growth of the country. Encouraging the youth to be part of the movement #YourMentalHealthMatters in raising mental awareness, then last but not least being there to support the survivors who don’t have people close to them as a result of the Genocide (providing them the necessities). Our way forward is to have a generation with stable and healthy minds, and it takes the whole community to support each other in this battle against depression in the heart of Africa.
- . “Mental Health: Strengthening Our Response.” Who.Int, World Health Organization: WHO, 30 Mar. 2018, www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response.
- Mahr, I.-L., Campbell, C., 2016. Twenty Years Post-genocide: The Creation of Mental Health Competence among Rwandan Survivors Through Community-based Healing Workshops: Creating mental health competence. J. Community Appl. Soc. Psychol. 26, 291–306. https://doi.org/10.1002/casp.2263
- “Depression.” World Health Organization, World Health Organization: WHO, 30 Jan. 2020, www.who.int/news-room/fact-sheets/detail/depression.
- “Mental Health. 2020” Partners in Health Inshuti Mu Buzima, www.imb.rw/mental-health. Accessed 11 Oct. 2020.
- Munyandamutsa, N., Mahoro Nkubamugisha, P., Gex-Fabry, M., Eytan, A., 2012. Mental and physical health in Rwanda 14 years after the genocide. Soc. Psychiatry Psychiatr. Epidemiol. 47, 1753–1761. https://doi.org/10.1007/s00127-012-0494-9
- Mukamana, Donatilla, et al. 2019 “A Community-Based Mental Health Intervention: Promoting Mental Health Services in Rwanda.” Innovations in Global Mental Health, 2019, pp. 1–17, link.springer.com/referenceworkentry/10.1007%2F978-3-319-70134-9_36-1, 10.1007/978-3-319-70134-9_36-1. Accessed 11 Oct. 2020.
- “SPONSORED: Addressing Mental Health Challenges in Rwanda.” The New Times | Rwanda, 8 Apr. 2017, www.newtimes.co.rw/section/read/210381. Accessed 11 Oct. 2020.
- “NIMH » Depression.” Nih.Gov, 8 Nov. 2019, www.nimh.nih.gov/health/topics/depression/index.shtml#part_145396.
- Kishore, J., Gupta, A., Jiloha, R.C., Bantman, P., 2011. Myths, beliefs and perceptions about mental disorders and health-seeking behavior in Delhi, India. Indian J. Psychiatry 53, 324–329. https://doi.org/10.4103/0019-5545.91906