When the Rwandan genocide began in 1994, Laurence Niyonagire fled her village eight months pregnant, carrying her two-year-old toddler on her back. Over the next hundred days, the Hutu ethnic majority killed 800,000 Tutsis, including Niyonagire’s parents and six siblings, as the international community stood by. After the massacres stopped, Niyonagire finally returned to her village two months later but couldn’t sleep, her mind trapped in a vicious cycle, replaying past horrors. “I walked into the road hoping a car would hit me, so I could die and pass away like the others,” she says.
Every Rwandan over age 30 has a genocide story, haunted by extreme physical and psychological violence. But in 1994, there were no mental health nurses, psychologists, psychiatrists, or any real healthcare system, according to Darius Gishoma, mental health division manager at the Rwanda Biomedical Center. Today, however, Rwanda’s mental health system is internationally acclaimed, a model for decentralizing services and integrating community-based solutions.
The United States isn’t recovering from a genocide, but its mental health landscape is nonetheless dire, with one in five adults living with mental illness. Still, most Americans struggle to access care, since the U.S. only has 25,000 psychiatrists but needs 65,000 more, per a December 2023 report. And for those left out by the healthcare system, there’s limited community-based resources to find support, or prevent minor mental health conditions from spiraling out of control.
Read the rest of the story at National Geographic.