PTSD remains a significant public health problem in Rwanda 14 years after the genocide. Facilitating access to appropriate care for all those who need it should be a national priority.

This study, supported by the Rwandan Ministry of Health and the World Health Organization, was conducted in 2005 to determine the prevalence of epilepsy and its sociocultural perception in Rwanda, as well as epilepsy-related knowledge and practices of health-care professionals (HCPs). A cross-sectional, nationally representative survey was conducted throughout Rwanda by trained investigators. Participants were recruited by random cluster sampling based on the organization of administrative units in the country. Overall, 1137 individuals (62% from rural areas) were interviewed. The prevalence of epilepsy was estimated to be 49 per 1000 people or 41 per 1000 for active epilepsy. Onset of epilepsy before the age of 2 years was reported in 32% of the cases. Family history of epilepsy, head trauma, and premature delivery were reported in 53%, 50%, and 68% of the cases, respectively. Most (68%) patients did not receive any medical treatment for epilepsy; 21.5% had received some form of traditional treatment. According to responses from the general population, people with epilepsy should not be entitled to schooling (according to 66%), to work (according to 72%), to the use of public places (according to 69%), or to marriage (according to 66%). Furthermore, 50% believed that epilepsy was untreatable, and 40% thought that it was transmissible. Of the 29 HCPs interviewed, the majority knew the definition of epilepsy and status epilepticus, as well as basic treatment options and side effects. However, 90% believed that treatment was only necessary in the first week after a seizure. Living with epilepsy was associated heavily with stigma, and a significant treatment gap (68%) was identified. Following this study, numerous actions have been taken by the Rwandan government, the Rwandan League Against Epilepsy, and several nongovernmental organizations to increase awareness about epilepsy and to close the treatment gap. An overview of these activities is provided.

In Rwanda, the annual commemorations of the genocide are associated with an increase in the level of collective traumatic crises whereby many people participating in commemoration activities present various symptoms, including emotional distress and re-experiencing traumatic events of the 1994 genocide. These sudden crises normally last between 30 and 120 minutes and can affect hundreds of people at big commemoration events. They are accompanied by a degree of urgency that disturbs the whole assembly. This article briefly presents an overview of these crises and highlights the results of a study on the effects of a supportive-expression group intervention in the post-crisis period for people who experienced these collective traumatic crises. The study compares the therapeutic progress made by a group of people who participated in a supportive-expression group therapy program as compared to those who did not receive the intervention. The study suggests that the supportive group intervention can improve the overall psychological wellbeing of people who experienced collective traumatic crisis even though it was ineffective for some symptoms.

Culturally different civilian populations exposed to mass trauma may differ with respect to their long-term mental health outcome, including comorbidity, symptom profile and health perception.

From the 7 th to the 13 th April, Rwanda commemorates annually the genocide perpetrated against Tutsi in 1994. This second week of April is annually associated in Rwanda with an increase in traumatic crises whereby many people participating in commemorating ceremonies present with various symptoms, including re-experiencing traumatic events of the 1994 genocide. This paper presents and discusses the results of a study on a supportive-expressive group therapy model implemented by mental health nurses in a rural setting for people who experience repeated traumatic crises in the context of the genocide commemoration in Rwanda. Even though the supportiveexpressive group therapy was found ineffective for a series of variables studied (the number of crises presented in following commemorations, PTSD and depression symptoms), the results show that the intervention improved significantly the wellbeing of participants in terms of reduction of loneliness feelings and some negative emotions.