Eastern Rwanda Research Articles

Long-Term Impact of Single Epilepsy Training on Knowledge, Attitude and Practices: Comparison of Trained and Untrained Rwandan Community Health Workers.

Objectives: To close the epilepsy treatment gap and reduce related stigma, eradication of misconceptions is importantIn 2014, Community Health Workers (CHWs) from Musanze (Northern Rwanda) were trained on different aspects of epilepsy. This study compared knowledge, attitude and practices (KAPs) towards epilepsy of trained CHWs 3 years after training, to untrained CHWs from Rwamagana (Eastern Rwanda). Methods: An epilepsy KAP questionnaire was administered to 96 trained and 103 untrained CHWs. Demographic and intergroup KAP differences were analysed by response frequencies. A multivariate analyses was performed based on desired and undesired response categories. Results: Epilepsy awareness was high in both groups, with better knowledge levels in trained CHWs. Negative attitudes were lowest in trained CHWs, yet 17% still reported misconceptions. Multivariate analysis demonstrated the impact of the training, irrespective of age, gender and educational level. Knowing someone with epilepsy significantly induced more desired attitudes. Conclusion: Despite demographic differences between trained and untrained CHWs, a single epilepsy training resulted in significant improvement of desired KAPs after 3 years. Nation-wide CHW training programs with focus on training-resistant items, e.g., attitudes, are recommended.

Nutrient Deficiencies Are Key Constraints to Grain Legume Productivity on “Non-responsive” Soils in Sub-Saharan Africa

Leguminous plants are known to require phosphorus fertilizers and inoculation with nitrogen fixing rhizobia for optimum yield but other nutrients may also be lacking. In this study, the most limiting nutrients for legume growth were determined in soils where the crops had not responded to P and rhizobial inoculation in field trials, using the double pot technique. Soils were collected from 17 farmers' fields in West Kenya, Northern Nigeria, Eastern and Southern Rwanda, South-west and North-west Sierra Leone. Plant growth and mean biomass were measured on soils to which a full nutrient solution, containing phosphorus (P), potassium (K), magnesium (Mg), sulfur (S) and micronutrients (MN) were added, and which were compared to a control (no nutrient added), and individual omissions of each nutrient. The relationship between soil properties and nutrient deficiencies was explored. Nutrient limitations were found to differ between soils, both within and across countries. Generally, each soil was potentially deficient in at least one nutrient, with K, P, Mg, MN and S emerging as most limiting in 88, 65, 59, 18, and 12% of tested soils, respectively. While K was the most limiting nutrient in soils from Kenya and Rwanda, P was most limiting in soils from Nigeria. P and K were equally limiting in soils from Sierra Leone. Mg was found limiting in two soils from Kenya and three soils from Rwanda and one soil each in Nigeria and Sierra Leone. Micronutrients were found to be limiting in one soil from Nigeria and one soil from Rwanda. Estimates of nutrient deficiency using growth and mean biomass were found to be correlated with each other although the latter proved to be a more sensitive measure of deficiency. With few exceptions, the relation between soil parameters and nutrient deficiencies was weak and there were no significant relations between deficiency of specific nutrients and the soil content of these elements. Although our results cannot be translated directly to the field, they confirm that individual and multiple nutrient deficiencies were common in these “non-responsive” soils and may have contributed to reported low yields. This highlights the need for balanced nutrition in legume production in SSA.

Soil Transmitted Helminths and Plasmodium falciparum Co-infections among School Children in Bugesera District, Rwanda: Implications for National Control Programs

Soil Transmitted Helminths and Plasmodium infections are ubiquitous with morbidity and mortality within the tropical and subtropical regions. However, the extent and consequences of STH-Plasmodium co-infection at different spatial scales are poorly understood. This study aimed at determining the prevalence of Soil Transmitted Helminths and Plasmodium coinfection, and, the impact thereof among school children in Bugesera District of Eastern Rwanda.
 Study Design: Cross Sectional Survey
 Place and Duration of Study: The survey was conducted in Bugesera district, Eastern Rwanda, between May and December 2020.
 Methodology: The survey was conducted among children between ages 5 and 18 years, across 21 randomly selected primary schools. Stool samples were collected and screened for soil transmitted helminths using Kato-Katz, while finger-prick blood samples were examined under the microscope to determine Plasmodium infection.
 Results: Overall the prevalence of A. lumbricoides, T. trichiura, Hookworm and P. falciparum was 4.43%, 0.76%, 0.16% and 3.15% respectively. On the other hand, 36.15% were co-infected with A. lumbricoides and P. falciparum. Surprisingly, the coinfection was higher 41.79%, (P<0.001) in girls than the overall coinfection prevalence.
 Conclusion: Helminthiasis and malaria remain dominant, in spite of the continuing and tremendous national control programs. The strikingly surprising higher prevalence of A. lumbricoides-P. falciparum co-infection in girls calls for additional investigations.

Prevalence and associated risk factors for hepatitis B and C viruses among refugee populations living in Mahama, Rwanda: A cross-sectional study.

As part of the integration of refugees into Rwanda's national hepatitis C elimination agenda, a mass screening campaign for hepatitis B (HBV) and hepatitis C (HCV) was conducted among Burundian refugees living in Mahama Camp, Eastern Rwanda. This cross-sectional survey used data from the screening campaign to report on the epidemiology of viral hepatitis in this setting. Rapid diagnostic tests (RDTs) were used to screen for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) among people of ≥15years old. We calculated seroprevalence for HBsAg and anti-HCV by age and sex and also calculated age-and-sex adjusted risk ratios (ARR) for other possible risk factors. Of the 26,498 screened refugees, 1,006 (3.8%) and 297 (1.1%) tested positive for HBsAg and Anti-HCV, respectively. HBsAg was more prevalent among men than women and most common among people 25-54 years old. Anti-HCV prevalence increased with age group with no difference between sexes. After adjusting for age and sex, having a household contact with HBsAg was associated with 1.59 times higher risk of having HBsAg (95% CI: 1.27, 1.99) and having a household contact with anti-HCV was associated with 3.66 times higher risk of Anti-HCV (95% CI: 2.26, 5.93). Self-reporting having HBV, HCV, liver disease, or previously screened for HBV and HCV were significantly associated with both HBsAg and anti-HCV, but RDT-confirmed HBsAg and anti-HCV statuses were not associated with each other. Other risk factors for HBsAg included diabetes (ARR = 1.97, 95% CI: 1.08, 3.59) and family history of hepatitis B (ARR = 1.32, 95% CI: 1.11, 1.56) and for anti-HCV included heart disease (ARR = 1.91, 95% CI: 1.30, 2.80) and history of surgery (ARR = 1.70, 95% CI: 1.24, 2.32). Sero-prevalence and risks factors for hepatitis B and C among Burundian were comparable to that in the Rwandan general population. Contact tracing among household members of identified HBsAg and anti-HCV infected case may be an effective approach to targeted hepatitis screening given the high risk among self-reported cases. Expanded access to voluntary testing may be needed to improve access to hepatitis treatment and care in other refugee settings.

A Public Bad Game Method to Study Dynamics in Socio-Ecological Systems (Part II): Results of Testing Musa-Game in Rwanda and Adding Emergence and Spatiality to the Analysis

This article is the second in a series of two and presented findings from field-testing an experimental boardgame (Musa-game) with banana farmers in four villages in Eastern Rwanda. The conceptualization and design of the Musa-game were described in Part I. Musa-game gives insights into how farmers’ individual and collective decision-making and actions regarding management of a public bad interplay with other factors and characteristics of the socio-ecological system (SES). A public bad is a non-rivalrous, non-excludable issue that causes loss of social-welfare of individuals and communities. The method contributes contextual understanding about the emergence of phenomena that arise from the interactions between human and non-human actors. Musa-game was framed to study one public bad challenge in particular: the infectious crop disease Banana Xanthomonas Wilt disease (BXW). Findings increased the knowhow about the emergence and governance of conditions that hinder or enhance the spread of infectious diseases like BXW. Analysis of qualitative and quantitative data suggested that individual farmers’ actions were influenced by perceptions of risk, affecting both individual and collective disease management. Additionally, the used experimental treatments allowed us to evaluate the influence of communication on risk-governance strategies. It appears that a combination of possession of technical knowledge about the disease, opportunities to communicate about the disease, and a collective disease management strategy enables the best individual actions and collective performance.

Preferences for tree fruit market attributes among smallholder farmers in Eastern Rwanda

AbstractThe increasing demand for high‐value agricultural products such as fresh fruit presents opportunities for farmers in developing countries due to their higher market value compared with traditional staple crops. This study uses data on trust, risk, and time preferences obtained through behavioral experiments, combined with a discrete choice experiment to understand their effect on farmers’ choices of marketing attributes, collecting data from 252 farmers from Eastern Rwanda. The results reveal that farmers, overall, have positive attitudes toward collective marketing channels with guaranteed immediate payments, written contracts, provision of inputs, credit, and training, a personal relationship with a buyer, and low investment costs. Additionally, farmers with lower levels of risk aversion were found to have a greater preference for immediate payment than farmers with higher levels of risk aversion. Farmers with higher future orientation are more likely to choose contracts that guarantee inputs and/or services and written contracts, and they attach lower relative importance to immediate payments than farmers with lower future orientation. Farmers with higher trust levels attach lower relative importance to immediate payments, written contracts, and a personal relationship with a buyer than farmers with lower trust levels.

Rethinking Communal Land Governance in the Great Lakes Region of Central Africa

In the Great Lakes region of Central Africa, land-use rights underwent profound changes following processes of colonization, commodification and conflict, leading to an increased individualization and privatization of tenure. Despite these evolutions, customary tenure continues to be described as a common-property system managed through a strong hierarchical and tribute-based land allocation mechanism. This central place of the commons in policy discourses either stems from a romantic, often Western, notion on communal land governance or from a neoliberal privatization discourse that frames communal land governance as chaotic and non-productive. In this article, we will use cases from Eastern DRC, Burundi and Rwanda to demonstrate how communal land governance has always existed in the region, but in modalities that do not correspond to the notions found in policy discourses. These cases demonstrate how the memory and the actual practice of communal land governance continues to play a role in contemporary land access negotiations. Through a process of institutional bricolage, the discourse of the, often imaginary, commons is used by different actors to legitimize the restructuring of land claims in their favour. Hence, the commons do not correspond to an idealized or normative situation, but they are rather a starting point to rethink land governance in a contextualized socio-historical perspective.

Performance Evaluation of Hand-Move Sprinkler Irrigation System: A Case Study in Rwanda

This study was carried out with the main objective of evaluating the efficiency of the government-funded irrigation project equipped with hand-moved portable sprinkler irrigation system in the Nyagatare district of eastern Rwanda. The study was performed in maize field irrigated by a sprinkler irrigation system during the 2014 agricultural season. Catch cans experiments were used to assess the efficiency of the current field irrigation sprinkler system. Performance indicators such as coefficient of uniformity (CU), distribution uniformity (DU), Potential application efficiency of the low quarter (PAElq), pressure variation along laterals, delivery performance ratio (DPR), evaporation and wind drifts losses were analysed. The Christiansen equation was used to measure the CU. The results of this study revealed that the coefficient of uniformity, uniformity of distribution and efficiency of water application of the method were 84.7%, 88% and 88% respectively. These experimental findings indicated that the performance of existing hand-move sprinkler irrigation system was satisfactory. The study put forward performance guidelines and advices for the designers and managers of sprinkler irrigation systems to achieve optimum performance.

Risk factors for the incursion, spread and persistence of the foot and mouth disease virus in Eastern Rwanda

BackgroundIdentification of risk factors is crucial in Foot-and-mouth disease (FMD) control especially in endemic countries. In Rwanda, almost all outbreaks of Foot-and-Mouth Disease Virus (FMDV) have started in Eastern Rwanda. Identifying the risk factors in this area will support government control efforts. This study was carried out to identify and map different risk factors for the incursion, spread and persistence of FMDV in Eastern Rwanda. Questionnaires were administered during farm visits to establish risk factors for FMD outbreaks. Descriptive statistical measures were determined and odds ratios were calculated to determine the effects of risk factors on the occurrence of FMD. Quantum Geographic Information System (QGIS) was used to produce thematic maps on the proportion of putative risk factors for FMD per village.ResultsBased on farmers’ perceptions, 85.31% (with p < 0.01) experienced more outbreaks during the major dry season, a finding consistent with other reports in other parts of the world. Univariate analysis revealed that mixed farming (OR = 1.501, p = 0.163, CI = 95%), and natural breeding method (OR = 1.626; p = 0.21, CI = 95%) were associated with the occurrence of FMD indicating that the two risk factors could be responsible for FMD outbreaks in the farms. The occurrence of FMD in the farms was found to be significantly associated with lack of vaccination of calves younger than 12 months in herds (OR = 0.707; p = 0.046, CI = 95%).ConclusionsThis is the first study to describe risk factors for persistence of FMDV in livestock systems in Rwanda. However, further studies are required to understand the role of transboundary animal movements and genotypic profiles of circulating FMDV in farming systems in Rwanda.

Long-Term Groundwater Level Prediction Model Based on Hybrid KNN-RF Technique

Reliable seasonal prediction of groundwater levels is not always possible when the quality and the amount of available on-site groundwater data are limited. In the present work, a hybrid K-Nearest Neighbor-Random Forest (KNN-RF) is used for the prediction of variations in groundwater levels (L) of an aquifer with the groundwater relatively close to the surface (&lt;10 m) is proposed. First, the time-series smoothing methods are applied to improve the quality of groundwater data. Then, the ensemble K-Nearest Neighbor-Random Forest (KNN-RF) model is treated using hydro-climatic data for the prediction of variations in the levels of the groundwater tables up to three months ahead. Climatic and groundwater data collected from eastern Rwanda were used for validation of the model on a rolling window basis. Potential predictors were: the observed daily mean temperature (T), precipitation (P), and daily maximum solar radiation (S). Previous day’s precipitation P (t − 1), solar radiation S (t), temperature T (t), and groundwater level L (t) showed the highest variation in the fluctuations of the groundwater tables. The KNN-RF model presents its results in an intelligible manner. Experimental results have confirmed the high performance of the proposed model in terms of root mean square error (RMSE), mean absolute error (MAE), Nash–Sutcliffe (NSE), and coefficient of determination (R2).

Effect of land terracing on soil physical properties across slope positions and profile depths in medium and high altitude regions of Rwanda

Although land terracing is promoted as a management practice for effective soil conservation in hilly areas, construction of terraces causes changes in soil properties. This study evaluated the effect of land terracing on some soil physical properties across slope positions and profile depths in medium and high altitudes of eastern and north-eastern Rwanda. Soil samples were collected from top, middle and bottom slopes of four year-old terraced and non-terraced lands. Results showed that soil textures were mainly sandy clay loams. At medium altitude, silt (19.6, 18.6%) and hydraulic conductivity (237.9, 129.8 mm h−1) were significantly ( p < 0.05) higher in terraced than non-terraced land, while clay (29.2, 27.8%) and total available water content (TAWC) (222.2, 201.7 mm m−1) were higher in non-terraced than terraced land. At the high altitude, hydraulic conductivity (194.3, 124.1 mm h−1) was higher in terraced than non-terraced land, while soil bulk density (1.42, 1.35 g cm−3) and TAWC (251.6, 235.3 mm m−1) were higher in non-terraced than terraced land. Terracing increased silt content and hydraulic conductivity, and slightly decreased clay and water retention capacity. These changes are important in soil water and fertility management, and therefore need to be considered when using terraced lands.

Long-Term Impact of a Mission-Based Surgical Training Rotation on Plastic Surgery Capacity Building in Rwanda

Short-term, high-volume surgical training experiences can lead to successful skills transfer and be an effective method of training surgical providers in low-resource settings. However, immediate skills acquisition does not guarantee long-term performance of surgical procedures by trainees. This study aims to determine the long-term impact of a short-term plastic surgery training rotation (STR) on general surgeon contribution to plastic surgery capacity building in Rwanda. A retrospective survey study was conducted. Surveys were distributed to credentialed general surgeons who previously participated in the Operation Smile STR in Rwanda. Questions focused on exposure to procedures during the rotation and current practice demographics. The percentage of current practice volumes dedicated to plastic surgery was mapped to demonstrate participant contribution to plastic surgery capacity in the country. Surveys were distributed remotely. Surgeon respondents previously participated in the STR at the Rwinkwavu District Hospital, a primary level hospital in eastern Rwanda. All 8 prior participants of the STR who completed residency and are currently practicing as general surgeons in Rwanda were included. Six out of 8 prior participants completed the survey (75.0%). All respondents work as general surgeons in governmental hospitals around the country. Up to 75% of surgeon caseloads are dedicated to plastic surgery procedures. Half of respondents work in regions without a credentialed plastic surgeon. Exposure to cleft and congenital hand surgery during the rotation did not lead to durable performance in practice. All participants felt the rotation improved their performance in multiple core competencies. Participation in a short-term plastic surgery training experience in Rwanda was associated with increased long-term surgical capacity in the country through a task-sharing model. A mission-based rotation may provide sufficient exposure for basic plastic surgery procedures, but does not provide enough volume or time to durably teach more complicated surgeries such as cleft repair. Further studies are needed to determine how longer durations of training exposure impacts long-term performance of plastic surgery procedures.

Climate Smart Agriculture? Governing the Sustainable Development Goals in Sub-Saharan Africa

This paper examines the political economic and governance challenges faced by African governments in operationalizing Climate-Smart Agriculture (CSA) as part of their pursuit of the United Nations Sustainable Development Goals (SDGs). There is a need to enrich our understanding of the diverse contexts and ways in which governments will have to navigate and address the inevitable choices and conflicts, synergies and trade-offs that will characterize efforts to simultaneously implement these global goals. Here we seek to develop an account of why and how countries are managing the interrelationship between SDGs, particularly those associated with food security and climate action. We develop explanations for the diversity in approaches and provide an initial assessment of what the consequences are for policy and practice. The analysis is informed by the contrasting experiences of four Eastern African countries, Kenya, Tanzania, Ethiopia, and Rwanda, as they seek to build more “climate resilient” food and agricultural systems that are compatible with achieving the SDGs.

Seroreactivity to Chikungunya and West Nile Viruses in Rwandan Blood Donors.

Introduction: Chikungunya virus (CHIKV) and West Nile virus (WNV) have previously been reported from several African countries, including those bordering Rwanda where they may have originated. However, there have been no serosurveillance reports from Rwanda regarding these two viral pathogens. In this article, we present the first study of immunoglobulin G (IgG) seroreactivity of CHIKV and WNV in Rwandan blood donor samples. Methods: Blood donors from Rwanda (n = 874) and Sweden (n = 199) were tested for IgG reactivity against CHIKV, using an in-house enzyme-linked immunosorbent assay with the E1 envelope protein fused with p62 as antigen, and against WNV using a commercial kit. Data on mosquito distribution were obtained from the 2012 assessment of yellow fever virus circulation in Rwanda. Results: Seroreactivity to CHIKV was high in Rwanda (63.0%), when compared with Swedish donors, where only 8.5% were IgG positive. However, a cross-reactivity to O'nyong'nyong virus in neutralization test was noted in Rwandan donors. No significant difference in WNV seroreactivity was found (10.4% for Rwandan and 14.1% for Swedish donors). The relatively high seroreactivity to WNV among Swedish donors could partly be explained by cross-reactivity with tick-borne encephalitis virus prevalent in Sweden. Donors from the Eastern Province of Rwanda had the highest IgG reactivity to the two investigated viruses (86.7% for CHIKV and 33.3% for WNV). Five genera of mosquitoes were found in Rwanda where Culex was the most common (82.5%). The vector of CHIKV, Aedes, accounted for 9.6% of mosquitoes and this species was most commonly found in the Eastern Province. Conclusions: Our results showed high seroreactivity to CHIKV in Rwandan donors. The highest IgG reactivity to CHIKV, and to WNV, was found in the Eastern Province, the area reporting the highest number of mosquito vectors for these two viruses. Infection control by eliminating mosquito-breeding sites in population-dense areas is recommended, especially in eastern Rwanda.

Characterization of the Beekeeping Value Chain: Challenges, Perceptions, Limitations, and Opportunities for Beekeepers in Kayonza District, Rwanda

A survey was undertaken to characterize the honey production value chain and identify the challenges, limitations, and opportunities for beekeepers in Kayonza District, Eastern Rwanda, in light of the stagnation of the apiculture industry. The majority (86%, n = 100) of the beekeepers were adult males. Most of the respondents (71%) lacked primary level education. The majority of the hives were made from hollow tree logs (40%), tree barks (12%), banana leaves/bark (11%), cow dung (8%), mud (7%), grass (6%), tree leaves (6%), and the rest (20%) were improved beehives, particularly Langstroth hives. The hive pests encountered were hive beetles (25%), small black ants (19%), wax moths (12%), lizards (8%), termites (7%), birds (6%), mites (3%), and mice (2%). Fifty-five percent of the respondents hung their hives on trees to prevent pest invasion with 95% effectiveness, 25% frequently smoked their hives with 85% effectiveness, 16% cleared the bushes around apiaries with 55% effectiveness, and 4% used traditional plant insect repellents with 35% effectiveness. Forty-one percent of the respondents lacked adequate information on beekeeping, 25% had inadequate time to work on apiaries, 24% had inadequate technical knowledge and implements, and 10% needed additional labour for managing apiaries. Based on the results of this study, beekeeping in Kayonza is still largely traditional, characterized by the use of antiquated production methods and underutilization of available marketing channels. Perceptions in the district are that beekeeping is for the poor and illiterate. Challenges and limitations of beekeeping in Kayonza District include lack of education, gender bias, pests and diseases, absconding and swarming of bees, high costs, and lack of modern apicultural equipment. However, the potential for developing beekeeping enterprise (opportunities) is immense given the abundance of wild bee populations, possibility of women participation, abundance of honey collection centres (market), and availability of technical support from Government and development agencies. In conclusion, this study advocates the need for intervention measures to educate and promote production and marketing of quality honey, tackle pest and disease for beekeepers and boost Rwanda’s apiculture industry.

Causes of death and predictors of childhood mortality in Rwanda: a matched case-control study using verbal social autopsy

BackgroundRwanda has dramatically reduced child mortality, but the causes and sociodemographic drivers for mortality are poorly understood.MethodsWe conducted a matched case-control study of all children who died before 5 years of age in eastern Rwanda between 1st March 2013 and 28th February 2014 to identify causes and risk factors for death. We identified deaths at the facility level and via a community health worker reporting system. We used verbal social autopsy to interview caregivers of deceased children and controls matched by area and age. We used InterVA4 to determine probable causes of death and cause-specific mortality fractions, and utilized conditional logistic regression to identify clinical, family, and household risk factors for death.ResultsWe identified 618 deaths including 174 (28.2%) in neonates and 444 (71.8%) in non-neonates. The most commonly identified causes of death were pneumonia, birth asphyxia, and meningitis among neonates and malaria, acute respiratory infections, and HIV/AIDS-related death among non-neonates. Among neonates, 54 (31.0%) deaths occurred at home and for non-neonates 242 (54.5%) deaths occurred at home. Factors associated with neonatal death included home birth (aOR: 2.0; 95% CI: 1.4–2.8), multiple gestation (aOR: 2.1; 95% CI: 1.3–3.5), both parents deceased (aOR: 4.7; 95% CI: 1.5–15.3), mothers non-use of family planning (aOR: 0.8; 95% CI: 0.6–1.0), lack of accompanying person (aOR: 1.6; 95% CI: 1.1–2.1), and a caregiver who assessed the medical services they received as moderate to poor (aOR: 1.5; 95% CI: 1.2–1.9). Factors associated with non-neonatal deaths included multiple gestation (aOR: 2.8; 95% CI: 1.7–4.8), lack of adequate vaccinations (aOR: 1.7; 95% CI: 1.2–2.3), household size (aOR: 1.2; 95% CI: 1.0–1.4), maternal education levels (aOR: 1.9; 95% CI: 1.2–3.1), mothers non-use of family planning (aOR: 1.6; 95% CI: 1.4–1.8), and lack of household electricity (aOR: 1.4; 95% CI: 1.0–1.8).ConclusionIn the context of rapidly declining childhood mortality in Rwanda and increased access to health care, we found a large proportion of remaining deaths occur at home, with home deliveries still representing a significant risk factor for neonatal death. The major causes of death at a population level remain largely avoidable communicable diseases. Household characteristics associated with death included well-established socioeconomic and care-seeking risk factors.

"We are the memory representation of our parents": Intergenerational legacies of genocide among descendants of rape survivors in Rwanda.

The 1994 genocide against the Tutsi in Rwanda subjected thousands of women to rape as part of a range of other genocidal atrocities. This article explores what it means in everyday life to be a descendant of such mothers. A qualitative study was conducted in eastern Rwanda. The twelve respondents, all descendants of genocide-rape survivor mothers, participated in focus group discussions and semi-structured interviews. Topics focused on different aspects of the intergenerational transmission of trauma and the mitigation of this transmission by the psychosocial support from which their mothers benefited. The phenomenological method as developed by Giorgi (2012) was used to analyze the transcripts. All respondents, regardless of their birth circumstances, are marked by growing up with a severely traumatized mother. Children conceived during rape are specifically marked by the absence of a perpetrator father unknown to them, the others by the lack of many (extended) family members. They all benefited from the psychosocial support provided to their mothers. Genocidal rape causes specific kinds of suffering and specific identity problems for the children born as a consequence of genocide-rape. However, even if the children were not conceived during the rape, their level of suffering is similar. The effects of the intergenerational transmission of trauma related to the 1994 genocide against the Tutsi in Rwanda should be recognized among all youth deeply affected by it. Appropriate policies and programs should be designed and implemented to moderate the effects and strengthen resilience to ensure a peaceful future on an individual, interpersonal, and inter-relational community levels.

Validating the Global Surgery Accessibility Indicator: Comparing Geographical Modeling to Patient Reported Travel Times to a Rural District Hospital in Eastern Rwanda

Validating the Global Surgery Accessibility Indicator: Comparing Geographical Modeling to Patient Reported Travel Times to a Rural District Hospital in Eastern Rwanda

English

Irish potatoes are an important crop only promoted in cool and high moist conditions of Rwanda. This study explored the productivity of Irish potatoes varieties under increasing nitrogen fertilizer applications in drier agro-climatic conditions of the eastern Rwanda. Potato seeds mass-selected from locally-grown varieties in the region surrounding Kibungo town (-2.160897&deg;, 30.543591&deg;) were planted under rain-fed conditions, during the March to June agricultural season of 2015, in the three experimental farms of the University of Kibungo at Karenge, Mugesera and Rwamagana, respectively located in Kibungo town, 30 km West and 50 km North of Kibungo town. The most performing three varieties were tested again in 2016A season (October to January, 2016) at Kibungo and Rwamagana. For each season, and at each farm, four nitrogen application rates (0, 60, 120, and 180 kg N ha-1) were tested. Phosphate and potash were supplied in sufficient amounts of 150 kg P2O5 ha-1 and 60 kg K20 ha-1, respectively. No fertilizers were applied on the control treatment. A split plot design and three replicates were used with varieties in main plots and nitrogen in sub-plots. Plant growth rate, shoot counts, tuber calibration, and total and market potato tuber yields were monitored. Four varieties yielded 10 tons ha-1 or more of total potato tuber yields in 2015B season. Three of them, namely Kirundo, Gasore, and Peko varieties, were re-tested in 2016. Over the two seasons, Kirundo variety stood out with 12.8 and 10.5 tons ha-1 of total and marketable tuber yields, respectively. All the varieties significantly responded to nitrogen fertilizer. However, Kirundo variety, respectively yielded 22 tons and 17 tons ha-1 of total and market potato tuber yields under 120 kg N ha-1 during the 2016A season. Irish potato can therefore be grown and produce substantial yield in eastern Rwanda, provided that appropriate nitrogen fertilization and seed quality are available. Key words: Irish potatoes, varieties, nitrogen, yields, fertilizer, rates.

A new blind snake of the genus Letheobia (Serpentes: Typhlopidae) from Rwanda with redescriptions of L. gracilis (Sternfeld, 1910) and L. graueri (Sternfeld, 1912) and the introduction of a non-invasive preparation procedure for scanning electron microscopy in zoology.

A new species of blind snake in the genus Letheobia is described from Akagera National Park in eastern Rwanda. The new species is most similar to species of the L. gracilis complex, particularly L. gracilis and L. graueri. It differs from all other species of the genus by a unique combination of morphological characters, including the highest number of middorsal scale rows (834) and the most extreme elongation (total-length/midbody-width ratio 131) of all species in the genus and of any species of snake in the world; 22-22-22 longitudinal scale rows; snout in dorsal profile rounded, in lateral profile bluntly rounded with an angular horizontal edge ventrally; rostral broad, posteriorly rounded; eyes invisible; supralabial imbrication pattern T-0; tail short (1.3 percent of total length) with an apical spine; and a pink life colouration. The holotype of the new species was collected in gallery forest at a lake shore surrounded by savanna at 1300 m elevation. We produced scanning electron microscope images of the heads of the investigated specimens applying a liquid-substitution preparation procedure which does not require coating or drying and thus does not irreversibly damage the investigated samples. The obtained images allow an easy and more accurate examination of the scalation.