Skip to main content
Top
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Traumatic episodes experienced during the genocide period in Rwanda influence life circumstances in young men and women 17 years later

Authors: Lawrence Rugema, Ingrid Mogren, Joseph Ntaganira, Krantz Gunilla

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

During Rwanda’s genocide period in 1994, about 800,000 people were killed. People were murdered, raped and seriously injured. This retrospective study investigated prevalence and frequency of traumatic episodes and associated psychosocial effects in young adults in Rwanda over the lifetime, during the genocide period and in the past three years.

Methods

This is a cross-sectional population-based study conducted among men and women, aged 20 to 35 years, residing in the Southern province of Rwanda. The study population, randomly selected in a multi stage procedure, included 477 females and 440 males. Data collection was performed through individual interviewing with a structured questionnaire during the period December 2011- January 2012. The Harvard Trauma Questionnaire was used to assess traumatic episodes. All data was sex-disaggregated. Differences between groups were measured by chi square and Fischer’s exact test. Associations with socio-demographic and psychosocial factors were estimated by use of odds ratios with 95% confidence intervals in bi- and multivariate analyses.

Results

The participants in this study were 3 to 18 years of age in 1994, the year of the genocide. Our sample size was 917 participants, 440 men and 477 women. Women were to a higher extent exposed to traumatic episodes than men during their lifetime, 83.6% (n = 399) and 73.4% (n = 323), respectively. During the genocide period, 37.5% of the men/boys and 35.4% of the women/girls reported such episodes while in the past three years (2009-2011) 25.0% of the men and 23.1% of the women did. Women were more exposed to episodes related to physical and sexual violence, while men were exposed to imprisonment, kidnapping and mass killings. Victims of such violence during the genocide period were 17 years later less educated although married (men OR 1.47; 0.98-2.19; women OR 1.54; 1.03-2.30), without children (men OR 1.59; 1.08-2.36; women OR 1.86; 1.11-3.08) and living under extremely poor circumstances.

Conclusion

The participants in this population-based study witnessed or experienced serious traumatic episodes during the genocide, which influenced their life circumstances 17 years later. Such traumatic episodes are however still taking place. The reasons for this need further investigation.
Appendix
Available only for authorised users
Literature
1.
go back to reference Gourevitch P: We Wish to Inform you That Tomorrow we Will be Killed with our Families: Stories from Rwanda. 1998, New York: Farrar, Straus and Giroux Gourevitch P: We Wish to Inform you That Tomorrow we Will be Killed with our Families: Stories from Rwanda. 1998, New York: Farrar, Straus and Giroux
2.
go back to reference Schaal S, Weierstall R, Dusingizemungu JP, Elbert T: Mental health 15 years after the killings in Rwanda: imprisoned perpetrators of the genocide against the Tutsi versus a community sample of survivors. J Trauma Stress. 2012, 25 (4): 446-453. 10.1002/jts.21728.CrossRefPubMed Schaal S, Weierstall R, Dusingizemungu JP, Elbert T: Mental health 15 years after the killings in Rwanda: imprisoned perpetrators of the genocide against the Tutsi versus a community sample of survivors. J Trauma Stress. 2012, 25 (4): 446-453. 10.1002/jts.21728.CrossRefPubMed
3.
go back to reference Prunier G: The Rwanda Crisis: History of a Genocide. 2005, New York, NY: Columbia University Press Prunier G: The Rwanda Crisis: History of a Genocide. 2005, New York, NY: Columbia University Press
5.
go back to reference Cohen M, H. d’Adesky, A. C. Anastos K: Women in Rwanda: another world is possible. JAMA. 2005, 294 (5): 613-615. 10.1001/jama.294.5.613.CrossRef Cohen M, H. d’Adesky, A. C. Anastos K: Women in Rwanda: another world is possible. JAMA. 2005, 294 (5): 613-615. 10.1001/jama.294.5.613.CrossRef
6.
7.
go back to reference Zraly M, Nyirazinyoye L: Don’t let the suffering make you fade away: an ethnographic study of resilience among survivors of genocide-rape in southern Rwanda. Social Sci Med. 2010, 70 (10): 1656-1664. 10.1016/j.socscimed.2010.01.017.CrossRef Zraly M, Nyirazinyoye L: Don’t let the suffering make you fade away: an ethnographic study of resilience among survivors of genocide-rape in southern Rwanda. Social Sci Med. 2010, 70 (10): 1656-1664. 10.1016/j.socscimed.2010.01.017.CrossRef
8.
go back to reference Levers L, Kamanzi D, Mukamana D, Pells K, Bhusumane D: Addressing urgent community mental health needs in Rwanda: culturally sensitive training interventions. J Psychol Afr. 2006, 2: 261-272. Levers L, Kamanzi D, Mukamana D, Pells K, Bhusumane D: Addressing urgent community mental health needs in Rwanda: culturally sensitive training interventions. J Psychol Afr. 2006, 2: 261-272.
10.
go back to reference Neugebauer R, Fisher PW, Turner JB, Yamabe S, Sarsfield JA, Stehling-Ariza T: Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide. Int J Epidemiol. 2009, 38 (4): 1033-1045. 10.1093/ije/dyn375.CrossRefPubMed Neugebauer R, Fisher PW, Turner JB, Yamabe S, Sarsfield JA, Stehling-Ariza T: Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide. Int J Epidemiol. 2009, 38 (4): 1033-1045. 10.1093/ije/dyn375.CrossRefPubMed
11.
go back to reference Dyregrov A, Gupta L, Gjestad R, Mukanoheli E: Trauma exposure and psychological reactions to genocide among Rwandan children. J trauma Stress. 2000, 13 (1): 3-21. 10.1023/A:1007759112499.CrossRefPubMed Dyregrov A, Gupta L, Gjestad R, Mukanoheli E: Trauma exposure and psychological reactions to genocide among Rwandan children. J trauma Stress. 2000, 13 (1): 3-21. 10.1023/A:1007759112499.CrossRefPubMed
13.
go back to reference Pham PN, Weinstein HM, Longman T: Trauma and PTSD symptoms in Rwanda: implications for attitudes toward justice and reconciliation. JAMA. 2004, 292 (5): 602-612. 10.1001/jama.292.5.602.CrossRefPubMed Pham PN, Weinstein HM, Longman T: Trauma and PTSD symptoms in Rwanda: implications for attitudes toward justice and reconciliation. JAMA. 2004, 292 (5): 602-612. 10.1001/jama.292.5.602.CrossRefPubMed
22.
go back to reference Bolton P, Neugebauer R, Ndogoni L: Prevalence of depression in rural Rwanda based on symptom and functional criteria. J Nerv Mental Dis. 2002, 190 (9): 631-637. 10.1097/00005053-200209000-00009.CrossRef Bolton P, Neugebauer R, Ndogoni L: Prevalence of depression in rural Rwanda based on symptom and functional criteria. J Nerv Mental Dis. 2002, 190 (9): 631-637. 10.1097/00005053-200209000-00009.CrossRef
23.
go back to reference de Fouchier C, Blanchet A, Hopkins W, Bui E, Ait-Aoudia M, Jehel L: Validation of a french adaptation of the Harvard trauma questionnaire among torture survivors from sub-Saharan African countries. Eur J Psychotraumatol. 2012, 10 (3): 3402-19225. de Fouchier C, Blanchet A, Hopkins W, Bui E, Ait-Aoudia M, Jehel L: Validation of a french adaptation of the Harvard trauma questionnaire among torture survivors from sub-Saharan African countries. Eur J Psychotraumatol. 2012, 10 (3): 3402-19225.
24.
go back to reference Oruc L, Kapetanovic A, Pojskic N, Miley K, Forstbauer S, Mollica RF, et al: Screening for PTSD and depression in Bosnia and Herzegovina: validating the Harvard trauma questionnaire and the Hopkins symptom checklist. Int J Cult Ment Health. 2008, 1 (2): 105-116. 10.1080/17542860802456620.CrossRef Oruc L, Kapetanovic A, Pojskic N, Miley K, Forstbauer S, Mollica RF, et al: Screening for PTSD and depression in Bosnia and Herzegovina: validating the Harvard trauma questionnaire and the Hopkins symptom checklist. Int J Cult Ment Health. 2008, 1 (2): 105-116. 10.1080/17542860802456620.CrossRef
25.
go back to reference Mollica R, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J: The harvard trauma questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis. 1992, 180 (2): 111-116. 10.1097/00005053-199202000-00008.CrossRefPubMed Mollica R, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J: The harvard trauma questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis. 1992, 180 (2): 111-116. 10.1097/00005053-199202000-00008.CrossRefPubMed
26.
go back to reference Shoeb M, Weinstein H, Mollica R: The Harvard trauma questionnaire: adapting a cross-cultural instrument for measuring torture, trauma and posttraumatic stress disorder in Iraqi refugees. Int J Soc Psychiatry. 2007, 53 (5): 447-463. 10.1177/0020764007078362.CrossRefPubMed Shoeb M, Weinstein H, Mollica R: The Harvard trauma questionnaire: adapting a cross-cultural instrument for measuring torture, trauma and posttraumatic stress disorder in Iraqi refugees. Int J Soc Psychiatry. 2007, 53 (5): 447-463. 10.1177/0020764007078362.CrossRefPubMed
27.
go back to reference Fadnes LT, A Tylleskär, T: How to identify information bias due to self-reporting in epidemiological research. Int J Epidemiol. 2009, 7: 2- Fadnes LT, A Tylleskär, T: How to identify information bias due to self-reporting in epidemiological research. Int J Epidemiol. 2009, 7: 2-
28.
go back to reference Smith D: The psychocultural roots of genocide: legitimacy and crisis in Rwanda. Am Psychol. 1998, 53 (7): 743-753.CrossRefPubMed Smith D: The psychocultural roots of genocide: legitimacy and crisis in Rwanda. Am Psychol. 1998, 53 (7): 743-753.CrossRefPubMed
29.
go back to reference Human Rights Watch: Justice Compromised. 2011, New York: The Legacy of Rwanda’s Community-Based Gacaca Courts Human Rights Watch: Justice Compromised. 2011, New York: The Legacy of Rwanda’s Community-Based Gacaca Courts
30.
go back to reference Schaal S, Elbert T: Ten years after the genocide: trauma confrontation and posttraumatic stress in Rwandan adolescents. J Trauma Stress. 2006, 19 (1): 95-105. 10.1002/jts.20104.CrossRefPubMed Schaal S, Elbert T: Ten years after the genocide: trauma confrontation and posttraumatic stress in Rwandan adolescents. J Trauma Stress. 2006, 19 (1): 95-105. 10.1002/jts.20104.CrossRefPubMed
31.
go back to reference Rieder H, Elbert T: Rwanda - lasting imprints of a genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners and their children Confl and. Health. 2013, 7 (1): 6- Rieder H, Elbert T: Rwanda - lasting imprints of a genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners and their children Confl and. Health. 2013, 7 (1): 6-
32.
go back to reference Brown DW, Anda RF, Edwards VJ, Felitti VJ, Dube SR, Giles WH: Adverse childhood experiences and childhood autobiographical memory disturbance. Child Abuse Negl. 2007, 31 (9): 961-969. 10.1016/j.chiabu.2007.02.011.CrossRefPubMed Brown DW, Anda RF, Edwards VJ, Felitti VJ, Dube SR, Giles WH: Adverse childhood experiences and childhood autobiographical memory disturbance. Child Abuse Negl. 2007, 31 (9): 961-969. 10.1016/j.chiabu.2007.02.011.CrossRefPubMed
33.
go back to reference Braaf R, Meyering I: The Gender Debate in Domestic Violence: The Role of Data. Australian Domestic and Family Violence Clearinghouse. 2013, Sydney: The University of New South Wales, Issue paper 25, May 1–23 Braaf R, Meyering I: The Gender Debate in Domestic Violence: The Role of Data. Australian Domestic and Family Violence Clearinghouse. 2013, Sydney: The University of New South Wales, Issue paper 25, May 1–23
35.
go back to reference Guest G, Bunce A, Johnson L, Akumatey B, Adeokun L: Fear, hope and social desirability bias among women at high risk for HIV in West Africa. J Fam Plann Reprod Health Care. 2005, 31 (4): 285-287. 10.1783/jfp.31.2.285.CrossRefPubMed Guest G, Bunce A, Johnson L, Akumatey B, Adeokun L: Fear, hope and social desirability bias among women at high risk for HIV in West Africa. J Fam Plann Reprod Health Care. 2005, 31 (4): 285-287. 10.1783/jfp.31.2.285.CrossRefPubMed
Metadata
Title
Traumatic episodes experienced during the genocide period in Rwanda influence life circumstances in young men and women 17 years later
Authors
Lawrence Rugema
Ingrid Mogren
Joseph Ntaganira
Krantz Gunilla
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-1235

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue