Stigma Aggravating Mental Health Challenges in Rwanda

 

If human rights activists believe that stigma is something the Rwandan community has left behind, they need to think twice.

 

The testimony of Maniriho Jean Bosco, a resident of Musanze district who has a mental disability is an indication that a lot yet needs to be done for society to understand that everyone deserves the same respect and care, whatever the case.

Maniraho has spent fifteen difficult years following his mental case which started in the last 15 years and deteriorated over time.

It all started when he was in Senior 3 and the damage was to such an extent that he had to stop his studies by the time his classmates were going to sit the Ordinary Level exams (O’ Level).

A family of well-wishers, however, found it important to intervene and took him for medication. After a couple of years, he returned to school and finished Senior 6 and got a certificate in Accountant, hoping to make it good use.

Alas! He did not know what the community held for him; the stigma was awaiting him because on every door he tried to knock no one was able to at least give him a benefit of the doubt.

He was considered a “useless, harmful person that cannot be trusted with anything”, yet he had the capacity to work.

 

Over time, Maniriho struggled and started a business selling shoes in Musanze town. He was even able to build a home.

“I worked hard to achieve this milestone. Due to stigma, landlords used to chase me from their house, saying that they could not have business with a mad person, yet I owed them no single coin,” he said.

Despite Maniriho making it in life, he still experiences stigma every now and then.

After realizing that he could do something to support the case of people with mental challenges, he approached relevant institutions to allow him to start an organization.

“I tried to form a support group of people with mental health challenges in Musanze district but the project was never approved by competent authorities, including RBC, RGB, and the Ministry of Health,” he said.

When the hope to achieve this dream vanished, he contented himself to use informal paths and still helped. He put three patients on his bill and supported their medication journey at NderaPsychiatric Hospital and he is happy with the achievements thus far.

Maniriho meets challenges here and there, and this includes the rights to association, where, last time he was denied his contributions from a tontine.

However, all was relatively manageable until recently when he sought a religious wedding service and his pastors refused to bless the marriage, even though, he was legally married according to Rwanda’s provisions.

“I felt humiliated and reacted violently. Church mates dragged me out and beat me up fiercely, something I will never forget,” he said in a friendly reminder that “it all starts with those who take people with mental problems as animals, people who are capable of anything; mad.”

Finding a solution

After noting the misconceptions about mental health and related difficulties that peers in Mental Health face in the community, including but not limited to rape, early pregnancies, physical abuse, community/family stigma and rejection, and poverty among others, former psychiatric patients decided to take action and created a National Association known as OPROMAMER.

Claver Hagirimana Executive Director of OPROMAMER remarks that “although the government has established mental health institutions up to the level of health centers, there are many patients who still cannot afford appropriate medical cost”.

“We are still campaigning to raise awareness about Mental Health Institutions because a trained mental health worker appointed by the ministry needs to be provided with all the necessities to be able to do their jobs,” he said.

“Stigma is a severe issue, our members are abused, they have no right to property, no respect at work, or at school, and some are denied the right to marriage, legal representation, among others,” he said.

According to Hagirimana, it has been 10 years since they advocated for a law that would address these challenges, but it is still in the pipeline.

 

 

OPROMAMER is working to change behavior about mental health and to reduce the significant burden of stigma faced by mental health peers in Rwanda as well as empowering them through community initiatives such as saving groups that enable members to access small loans and pay basic services such as school fees and healthcare insurance.

In addition, the association advocates for peers’ rights by engaging different persons and institutions to mainstream mental health care and reduce discriminatory policies and acts.

Who cares about the sick? 

On top of the stigma, medical support for people with mental challenges has attracted the attention of the community to support them.

“We are making a loss because some patients are brought by police who pick them up wandering in the streets or were abandoned by their families. We treat them because it’s our duty but after our service, there is no one to pat the bill,” said the Director General of Caraes Ndera, Frére Charles Nkubili.

“The hospital cannot do alone without the help of well-wishers and the government.”

The Executive Director of the Umbrella Association of People with Mental Illness (NUSPR- Ubumantu), Rose Umutesi, confirms that there is still violence against people with this illness.

“We have children who do not know their fathers because their mothers were raped. We have those who are deprived of their property because they are mentally challenged, but still, if they take the medicine as required, they can make serious decisions for themselves, not everything a person with a mental illness does is unworthy,” she said.

The Minister of State at MINISANTE, Dr.  YvanButera says that a lot is being done to improve services for people with mental illness.

“Rwanda has decentralized the services meant for people with mental problems up to health centers, with specialized staff available,” he said.

“We have established other centers in Ndera, CenterIcyizere, Huye, Isange, and Gasabo which is coming soon.”

According to Maniriho, life can be good if people with mental cases access medication as required. Whenever he was able to follow medical advice and afford needed treatment, all went well.

The only worry to him is that this time, medical subsidies towards similar cases are shrinking, which may affect their lives much more negatively.

Twahirwa Umumarashavu Janat.