Abstract
The coronavirus disease (COVID-19) pandemic has illustrated the wide range of preventative measures and responsive strategies of low- and middle-income countries (LMICs). LMICs have implemented lessons learned from previous periods of epidemics and uncertainties. Rwanda's pre-existing decentralized healthcare and mental health system which are in response to the mental health distress from the 1994 genocide, continues to be a formidable system that collaborate and combine efforts to address people's mental health needs. COVID-19 has heightened or exacerbated people's mental health within the country. Rwandans have been exposed to and endured adversities, yet their cultural forms of resilience serve as a mental health protective factor to also overcome COVID-19. Nonetheless, Rwanda has engaged in interventions targeting public safety, social and economic protection that specifically address vulnerable communitie's mental health needs. Lessons from preparedness for the Ebola virus disease (EVD) epidemic has contributed to Rwanda's organization and approach to combating COVID-19. Policies and best practices that were enacted during the EVD outbreak have guided Rwanda's response within the healthcare and mental health system. Coincidentally, this outbreak emerged during the 26th commemoration of the 1994 genocide against the Tutsi. Although for the first-time post genocide, Rwanda was not able to engage in public traditional forms of collective mourning and community healing, evidence of Rwandan's resilient spirit is demonstrated. Community resilience has been defined by Magis [401] as the “existence, development and engagement of community resources by community members to thrive in an environment characterized by change, uncertainty, unpredictability and surprise.”. Referring to this definition, community resilience has been an interwoven into the cultural framework that guided Rwandans in past challenges and continues to be evident now. Rwanda's resilience throughout this pandemic remains through ongoing psychoeducation, community awareness of mental health concerns, collective messages of highlighting mental health support, and solidarity. The global community can gain knowledge from Rwanda's learned lessons of their past which has positioned itself to stand on its resilient values in times of uncertainty such as COVID-19 and endeavor to overcome through national cohesion.
Highlights
OF RWANDAKnown as the “land of a thousand hills,” Rwanda is a lowincome mountainous country located in East Central Africa
We posit that there are some cultural values specific to the Rwandan people that serve as anchors for such transformation, that we perceive as the Rwandan resilience
The mental health outlook for Rwandans as with previous periods of trauma, uncertainty and disasters have been to engage in collective cooperation and mutual aid, knowing that the journey for better days and success is achieved through unity and self-sacrifice with the hope of a better tomorrow for all Rwandans
Summary
Known as the “land of a thousand hills,” Rwanda is a lowincome mountainous country located in East Central Africa. Patel et al (37)’s review on the community resilience definition found no consensus on what such a culture would look like within our communities Rather they noted that there is a wide range of components that have been proposed within the general notion of community resilience that are worthwhile to explore in the Rwandan context, namely they are: Local knowledge: factual knowledge acquired by the community as it relates to a disaster; community networks and relationships: community connectedness and cohesion; health: The pre-existing physical and mental health of a community and “delivery of health services after a disaster;” resources: tangible and intangible resources that are available and fairly distributed in the community; economic investment: post-disaster direct and indirect economic costs, assessment of community needs and potential for economic growth; preparedness: the active involvement at the individual, family, community and government levels to engage in planning, risk management and preparedness initiatives; mental outlook: meaning making, attitudes, feelings, and points of views after a disaster that affect a community’s outlook through “hope, adaptability, ”and “acceptance of uncertainty and change” The mental health outlook for Rwandans as with previous periods of trauma, uncertainty and disasters have been to engage in collective cooperation and mutual aid, knowing that the journey for better days and success is achieved through unity and self-sacrifice with the hope of a better tomorrow for all Rwandans
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