Kirkpatrick and Eunson (Dec 10, P 1641) are right to call for prompt justice for the perpetrators of the genocide to promote reconciliation of a Rwandese nation polarised by the murder of up to a million men, women and children. Unfortunatley the Belgian journal, Trait-d’Union, which is dedicated to promoting reconciliation and is partly funded by Oxfam, allowed key members of the government that conducted the genocide a public platform from which to air their views.
Both Bonneux (Dec 17, p 1689) and Vis and colleagues (Oct 1, p 957) have independently championed a hypothesis accounting for the genocide that some, not least the perpetrators, will find more comfortable than the truth. They claim uncontrolled population growth provoked the genocide because 20 years ago mathematical models predicted “complete collapse of the population” in the 1990’s. As with all significant human events many factors contributed but the principal cause for the genocide was evil men acting to save their own skins. Those implicated in unpunished political crimes over decades – for instance those named by the International Commission on human rights abuse that visited Rwanda in 1993 including the Rwandan government, realised what effect the establishment of democracy and justice promised by the Arusha Peace Accord would have on their future. Those murdered in the genocide were Hutus politically opposed to the government and Tutsis – the holocaust was meant to leave Rwanda a nation wholly committed to the ideology of Hutu extremism, not better fed.
Two senior members of the government that orchestrated the murder were doctors. The President, Dr Théodore Sindikubwabo is a paediatrician and the Minister of Health was Dr Casimir Bizimungu. Dr Sindibukwabo comes from Butare, Rwanda’s only university town and its intellectual centre. The massacres in Butare préfecture (county) were delayed two weeks by the Tutsi préfet and the independence and compassion of the local population … but that peace was to be illusory. As the UN’s special rapporteur, Professor Réne Degni-Segui, reported to the Secretary General of the UN, on April 19th Dr Sindibubwabo spoke on the radio calling for the killing of "accomplices" in Butare.2 That night the Presidential Guard flew into Butare, dug pits, filled them with burning tyres and pushed Tutsis into them. They also executed Tutsis near the University over the next three days, killing thousands. The préfet and his family were of course killed and, ultimately, more massacres took place in Butare préfecture than almost anywhere else because so many had previously flocked there from neighbouring regions. Is it possible to imagine more abhorrent employment for doctors?
Lastly, although Kirkpatrick and Eunson are correct to say no study of the psychological effects of genocide on survivors has been published we carried out a survey of psychological morbidity as part of a human rights investigation of the massacres in Rwanda.3 The results (publication in preparation) using a WHO validated Self Report Questionnaire on 248 adults and adolescents in an area where massacres lasted two weeks but free from conflict for nearly three months, showed a caseness rate approaching 90% .
1. Trait-d’Union. Issue 5. November 1994. Belgium.
2. Boutros-Ghali B. Letter UN Secretary General to President of Security Council. 1/10/94. Para. 66.
3. Rwanda 1994 – a report of the genocide. Physicians for Human Rights (UK). 1994.
Peter Hall , MBBS, MRCPI, DGM..
Andrew Carney, MRCPsych.
Physicians for Human Rights (UK)