Nouspr report

FOREWORD
Dear Members, Partners and Friends,
It is with my sincere gratitude that I present to you this report about
the field research on safeguarding the rights of people with
psychosocial disabilities in Rwanda; an exercise which NOUSPR
has been engaged in for the first time and has successfully
completed!
NOUSPR has been involved in awareness raising and advocacy for the human rights of
persons with psychosocial disabilities for quite some time. We organise members in groups
and support them to regain their place and status in their communities. We also advocate
for psychosocial disability to be included in the categories of disabilities in Rwanda.
The strength of our approach is that those on the front line fighting for equality and justice
for users/survivors are those who have themselves been largely invisible within society,
those who are refused a say, denied their basic human rights, have no access to education,
no right to employment, to health, no right to vote – no rights at all!
This report is a product of those who were chained to poles, abandoned in psychiatric
facilities by their relatives, disconnected from their families and pushed to the periphery of
their normal everyday life. These are the same people who have broken their silence and
gone public with powerful testimonies, with strong cases and evidence of human rights
violations and with high sprit they suggest how this situation should be reversed. I am
enormously grateful to them!
NOUSPR is grateful to The Government of Rwanda that has, for the past few years,
provided a levelled ground for marginalised groups to easily articulate their human rights
issues. The signing of the Convention on the Rights of Persons with a Disability (CRPD)
and its protocol, amending of The Constitution of The Republic of Rwanda to accommodate
the National Council of Persons with Disabilities (NCPD), the enactment of the law that
protects people with disabilities in general and the eight ministerial orders are just a few of
the many examples that shows that our Government is a Government that truly cares about
the needs of its citizens.
We recognise the invaluable contribution of Voluntary Service Overseas (VSO) and Sarah
Challoner in particular, who financed this research and using her position as Disability
Programme Manager she has been exceptionally good to the Disabled Persons
Organisations (DPOs) in Rwanda. Since NOUSPR’s inception her support has pushed
Persons with Psychosocial Disabilities thus far.
We are thankful to Mr. David Beck, Chief Executive of Action For Street Kids (ASK) who
generously contributed towards the preparations of this research, and the Open Society
Foundation (O.S.F) which earlier funded NOUSPR’s awareness raising and advocacy
project from which the need for this research was identified.
I would like to single out Mr. David McCabe, a VSO volunteer who has been our technical
advisor since September 2011 and who leaves us this September 2012, not only has he
conceived, designed, directed this research and produced this report but has also been the
self-starter of NOUSPR’s daily activities. His secret of getting things done has won him an
irreplaceable position in both the organisation and in the hearts of its members.
Though inevitably there will continue to be more ideas about the best way of progressing
safeguarding the human rights of people with psychosocial disabilities, I believe that this
report represents such an outcome that readers will understand the issue of psychosocial

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disability better and will gain the knowledge that the life of people with psychosocial
disabilities needs no replacement but support instead and that it should be provided now!
It has been a great privilege for me to chair this exercise, and I look forward to seeing our
recommendations being considered in various programs.
BADEGE Sam
Director NOUSPR

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CONTENTS:

PART 1.........INTRODUCTION

PART 2.........WHAT IS PSYCHOSOCIAL DISABILITY? - A WIDER PERSPECTIVE

PART 3.........METHODOLOGY, FRAMEWORK, DESIGN AND SCOPE OF THIS REPORT

PART 4........THE INDIVIDUAL INTERVIEWS

PART 5.....’OUR OWN VOICE’ – FOCUS GROUP TESTIMONIES

PART 6......OTHER ORGANISATIONS’ PERSPECTIVES

PART 7......COMMENTS/RECOMMENDATIONS

PART 8……CONCLUSION

ABBREVIATIONS

NOUSPR:: National Organisation of Users and Survivors of Psychiatry in Rwanda

VSO ; Volontary Service Overseas

OSF : Open Society Foundation

CRPD : Convention on the Rights of Persons with Disabilities

NCPD : National Council of Persons with Disabilities

ADD :

Ask : Action for Street Kids

DPOs : Disable Persons Organisations

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P
ART 1: INTRODUCTION (NOUSPR) established in 2007 by a
group of people with psychosocial
‘Persons with disabilities disability as a member’s organisation
represent 15% of the world’s has the following Vision and Mission.
population and many experience
discrimination, exclusion and live in VISION:
poverty, with restricted access to basic
A world in which all people with
goods and services. With a view to
psychosocial disability are treated with
addressing the discrimination and
the respect and dignity that enables
social exclusion facing persons with
disabilities, the United Nations adopted them to enjoy their human rights in all
in 2006 the Convention on the Rights aspects of their lives.
of Persons with Disabilities (The MISSION:
Convention or CRPD) and its Optional
Protocol. The Convention sets forth To advocate for and with people with
minimum legal standards to protect psychosocial disabilities and to provide
against discrimination and to promote a platform for a unified and
equality for persons with disabilities in empowered voice that is able to
all spheres of life - political, social, achieve the provision of necessary
economic, cultural and civil. The services and opportunities to have
Optional Protocol provides a means for their interests and human rights fully
individuals and groups to seek redress promoted and protected.
when these standards are not met and
for an independent committee of NOUSPR board members have, since
experts to undertake investigations the inception of the organisation, had
into serious breaches of disability anecdotal evidence through individual
rights set forth in the Convention.’ stories from members about the
(Extract from Office of the High difficulties they face on a daily basis
Commissioner for Human Rights draft but until this report had not been able
legislation handbook) to gather the information together to
support an advocacy campaign to
Rwanda is a signatory to both The address the issues. This report, using
Convention and The Optional Protocol the framework of The Convention on
and can be justifiably proud that it was the Rights of Persons with Disability
one of the first countries to sign up to (CRPD) for the design of an interview
both. Rwanda also has a Constitution schedule, has tested out what the
and disability legislation in place to board of NOUSPR knew, felt and
protect the rights of people with thought about the problems their
disabilities (Law No 01/2007of members face.
20/01/2007 Relating To the Protection
of Disabled Persons in General). The NOUSPR members have all
purpose of this report is to test whether experienced some mental illness
or not the reality for Rwandan People ranging from mild depression to very
with Psychosocial Disability in serious disorders such as Bi- Polar
everyday life matches the disorder and Schizophrenia. Many of
requirements and expectations of The the illnesses were caused by or arose
Convention, The Protocol and national during the genocide of 1994.
legislation.
The Users and Survivors movement is
The National Organisation of Users worldwide and people with
and Survivors of Psychiatry in Rwanda psychosocial disability are said to be

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‘Users’ if they have experienced difficult and if the fear of social
mental illness and are still undergoing disapproval delays the diagnosis then
medical treatment or are on a stable the treatment may be less effective.
management programme. Those that The strain of carrying the stigma of
have overcome their illness and come mental illness often results in other
out the other side of the services being medical complaints and ultimately
able to manage their condition are said even in suicide.
to be ‘Survivors’ of psychiatry.
Whether or not they are ‘Users’ or The view that Mental Disorder is the
‘Survivors’, everybody that has fault of the individual is widely held and
experienced mental disorder faces even well educated people can be
prejudice, stigma, discrimination and dismissive and insulting and this
often abuse. This negative social increases the reluctance of people to
attitude is the basis of why the term come forward and ask for help thus
psychosocial disability is used. making diagnosis and treatment more
difficult.
Mental Disorder (Mental Illness) shows
itself in many ways but is usually The lack of understanding stretches to
accompanied by erratic thoughts, the family and community as well
actions and emotions but the culture which leads to being made fun of,
in Rwanda along with medical training shunned, blamed and criticized for
separates the issues of the mind and being sick.
body. The reality, however, is that
chemical activity in the brain and Mental illness is still widely
genetic factors can play a big part in misunderstood and stigmatized in
Mental Disorder. Mental Disorder can Rwanda. In many cases, these
be treated with medication, alternative disorders are neither diagnosed nor
therapies and this treatment coupled treated despite the sufferers seeking
with family and community support can medical attention repeatedly for
be very effective. various symptoms. Many end up
overusing the medical system with
Mental Disorder is generally seen by repeated treatment for typhoid,
Rwandan society as the fault of the malaria, headaches, insomnia, chest
individual losing control and not as an problems, gastro-intestinal conditions,
illness that can affect anyone of us. backache and many other symptoms
This attitude can go as far as calling that mask the mental illness.
people ‘mad’ and even thinking they
are possessed by evil spirits that can The outcome of mental disorders is
be exorcised. good when treatment is started early,
so many of these conditions progress
The outcome of these attitudes is that to critical stages and have poorer
Mental Disorder is not viewed as an outcomes due to the delay in seeking
illness that can be treated but more as treatment.
an affliction that is the fault and
responsibility of the individual. Mental Illnesses, as opposed to
intellectual disabilities which in most
This view that it is the individual’s fault cases are irreversible and sufferers
can mean that people with Mental need permanent support to cope with
Disorder try to hide their illness or to life, affect previously healthy people
suffer in silence. Diagnosis can be and are largely treatable. In spite of

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their illness, persons with mental  High levels of ignorance exist
illness can go on to live productive within families
lives if they can get proper treatment
and management.  There is a lack of recognition of
the ranges of experiences
What NOUSPR knows: between men and women
 That action should not be based
 There is a disability law in on the government’s figures –
Rwanda that protects the rights we need to think about
of people with disability as well NOUSPR’s evidence and data
as a commitment by the
Government to the CRPD and
its protocol What NOUSPR feels:

 The category of psychosocial  Psychosocial disability is not
disability is not separately generally understood
defined in the legislation  The social model of
psychosocial disability is not
 It is estimated that 28% of the recognised
population of Rwanda has a
form of psychosocial disability  PWPSD do not know their
(based on a national survey and rights
compares with the World Health
Organisation‘s estimate that
25% of the world’s population
What NOUSPR thinks:
will at some point in their lives
suffer from mental disorder).  That PWPSD should be
consulted on services and
 There is no gender breakdown treatment
of sufferers
 That the recognition of the
 People in Rwanda diagnosed Human Rights of people with
with ‘Mental Disorder’ by a Psychosocial Disability is
‘Certified Doctor’ are barred NOUSPR’s most important
from parts of the electoral priority
processes  Without including PWPSD there
will not be 100% development
 There are low levels of with respect to the Economic
awareness in general Development and Poverty
Reduction Strategy (EDPRS)
 Policy makers don’t understand
the (psycho)social model  Something should be done
now
 PWPSD know what is right for
them

This report is a collation of the experiences of 200 people with psychosocial disability
in their everyday lives and a collection of the views of 12 representatives from other
organizations

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 Every User/Survivor shall be
free from any and all human

P
ART 2:
rights abuses – no user/survivor
WHAT IS PSYCHOSOCIAL shall be subjected to any
DISABILITY? – A WIDER physical, sexual or emotional
PERSPECTIVE: abuse

The introduction to this report  Every User/Survivor shall be
explained an overview of what free from all forms of
NOUSPR understands Psychosocial discrimination – no
Disability to be in Rwanda. It is worth user/survivor shall be subject to
considering, however, a wider view of housing, employment,
Psychosocial Disability in order to put economic, educational, racial or
this report in a wider international and cultural discrimination
national context.  Every User/Survivor shall be
There is no agreed definition of granted self determination and
psychosocial disability and indeed the right to make informed
those people dedicated to a medical choices – no user/survivor shall
model of mental illness may well be denied the right to make
dispute that psychosocial disability educated decisions affecting
exists at all. NOUSPR believes in the their lives including full informed
reality of psychosocial disability as participation and full informed
espoused by the World Network of consent in all mental health
Users and Survivors of Psychiatry ‘treatment’ matters; additionally,
(WNUSP) and by The Pan African users/survivors shall have the
Network of Users and Survivors of opportunity to fully participate in
Psychiatry (PANSUP). NOUSPR is a the planning, policy
member of both organizations. development, evaluation and
research of mental health
WNUSP established 32 guiding services
principles at a general meeting of their
World Conference and General  Every User/Survivor shall be
Assembly in Kampala, Uganda in granted self determination and
March 2009, to describe their the right to make informed
approach to resolving the issues that choices – no user/survivor shall
people with psychosocial disability be denied the right to make
face and in doing so inferred what educated decisions affecting
psychosocial disability is without their lives including full informed
coming up with an agreed definition. participation and full informed
Even within the disability movement consent in all mental health
there is no common understanding ‘treatment’ matters; additionally,
through a definition. The following are users/survivors shall have the
some of the principles agreed and all opportunity to fully participate in
32 principles can be accessed on the planning, policy
www.wnusp.net development, evaluation and
research of mental health
 Every User/Survivor shall be services
treated with the same basic
respect and dignity afforded to  Every User/Survivor shall be
all persons granted full legal and political

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civil rights – no user/survivor ‘The purpose of the present
shall be denied the right to Convention is to promote, protect and
participate fully in society, ensure the full and equal enjoyment of
including the right to participate all human rights and fundamental
in political processes, practice freedoms by all persons with
one’s religion, free speech and disabilities, and to promote respect for
to petition their governments their inherent dignity.
 Every User/Survivor shall have Persons with disabilities include those
the right to refuse any and all who have long-term physical, mental,
‘treatments or procedures’ no intellectual or sensory impairments
user/survivor shall be subjected which in interaction with various
or coerced or forced into barriers may hinder their full and
psychosurgery, sterilisation, effective participation in society on an
over-medication, psychiatric equal basis with others.’
drugging, chemical restraints,
physical restraints, insulin This article in its definition of persons
shock, electro shock or inpatient with disabilities includes those who
or outpatient commitment have Mental Impairments but does not
These principles whilst indicating an specifically refer to those people with a
approach that is taken by users and Psychosocial Disability. It also includes
survivors organisations worldwide, do people with Intellectual Impairment but
not necessarily help the general it does not go on to define what that
understanding and awareness of the may be. Intellectual Impairment covers
disability and in order to do this it is a wide range of Cognitive Impairments
perhaps helpful to look at the concepts such as Down’s syndrome and other
of Mental Disorder (Mental Illness and forms of Intellectual or Learning
Mental Impairment) and Mental Health Disability. This is self -evidently
as described in the CRPD and by the laudable but does not help when
World Health Organisation (WHO) and writing legislation or in the planning
then put those alongside the and delivery of services as, on many
perspective of Psychosocial Disability occasions, the difference between a
as viewed by the Users and Survivors Mental Illness originating disability and
of Psychiatry Organisations. a Cognitive Disability and the need for
a different approach to services is not
In looking at the concepts and the fully understood by planners and
language used to describe a condition legislators let alone by the public in
in the CRPD, WHO and Users and general.
Survivors of Psychiatry Organisations
it will be seen that the principles of The Users and Survivors movement
equality for all people with disability believes that Article 1 of the CRPD
are consistent but the actual nature of clearly covers Psychosocial Disorder
the condition attached to the language but the movement does not see people
with Cognitive Impairments as
used can be interpreted differently.
automatically living with Psychosocial
For example: Disability as well. People with
Cognitive Impairments can and do also
Article 1 (CRPD) on occasions have a Psychosocial
Purpose Disorder, like any other part of the
population but that would arise from a

9

superimposed Mental Health issues on conflict or any other reasons which
top of their Cognitive Impairment. may cause disability.
There is a complexity here that leads
to great difficulty for those trying to Codes and Laws of Rwanda - Ministry
plan and deliver appropriate services. of Justice
This complexity makes it even more http://www.amategeko.net/display_rubr
difficult to raise awareness of the ique.php?ActDo=all&...
general public and to sensitise them to
An order of the Minister in charge of
the needs of people with Psychosocial
Health shall determine modalities of
Disorder and people with Cognitive
how disabled persons are put in basic
Impairment as well. categories according to their
disabilities in order to help various
organs to guarantee them special
The Rwandan Law No 01/2007 of rights they require.
20/01/2007 – Relating to the
Protection of Disabled Persons in (The Ministerial Order N° 20/18 of
general is even less helpful on the 27/7/2009 defines mentally
question of Psychosocial Disability. In disabled people only as recognised
fact it is not referred to at all either disability category among the
through reference to Mental Disorder ‘other’ disability category in
(Mental Illness) in the main text of the Rwanda.)
legislation or the five categories
defined as disabled in the Ministerial The WHO’s description of Mental
Order. The legislation states: Disorder (Mental Illness) and Mental
Health may offer an easier way to
Article: 1(of the Rwandan Law on understand Psychosocial Disability.
Disability)
‘‘Mental disorders comprise a
This law protects disabled persons in broad range of problems, with
general. different symptoms. They are
Without prejudice to provisions of this generally characterized by some
law, there may be instituted particular combination of abnormal thoughts,
laws protecting persons who are emotions, behaviour and
disabled due to various circumstances. relationships with others.’’ (World
Health Organisation)
Article: 2(of the Rwandan Law on
Disability)
In this law, disability shall mean the Some examples of Mental Disorder
condition of a person’s impairment of (Mental Illness):
health ability he or she should have  Schizophrenia
been in possession, and consequently
leading to deficiency compared to  Depression
others.
 Disorders due to drug abuse
In this law, a disabled person is any
individual who was born without  Bi – Polar Disorder ( manic
congenital abilities like those of others depression)
or one who was deprived of such
 Post Traumatic Stress Disorder
abilities due to disease, accident,

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 Eating Disorders (e.g. Anorexia, relevant just as much to Rwanda as
bulimia) anywhere else in the world.
 Anxiety Disorder ‘’Mental disorders contribute more
to disease burden and disability in
Some facts about Mental Disorder ( developing countries than any other
Mental Illness): category of non-communicable
disease, yet only a small minority of
 There is no single cause of the
people with mental disorders in
different types of disorder
these countries have access to
 All of them can be treated mental health services. The need is
high, and care is inadequate,” (Ban
 They can be managed, not just Ki – Moon, Secretary General of the
in institutions but also in the United Nations October 2009)
community
The WHO Mental Health definition is
 Many conditions can be cured- also relatively straight forward and
e.g. Depression and Anxiety certainly assists in understanding the
Disorder concept of Psychosocial Disability.
 Mental Disorder is not Mental Health is:
necessarily constant or
permanent "A state of complete physical,
mental and social well-being and
(The last fact is particularly important not merely the absence of disease.
as a Cognitive Impairment is constant It is related to the promotion of
and permanent even though the well-being, the prevention of mental
effects of that disability can still be disorders, and the treatment and
reduced with support from others) rehabilitation of people affected by
mental disorders.’’. (World Health
Who can suffer from Mental Disorder Organisation)
(Mental Illness)?
Therefore Psychosocial Disability can
 Anyone and everyone be viewed in the following way:
 It is estimated that one in four  Whereas Mental Disorder is
people throughout the world has seen as entirely medical issue,
or will suffer from mental Psychosocial Disability takes as
disorder in their lifetime (WHO) its starting point the concept of
 Mental Disorder (Mental Illness) Mental Health as not just the
appears everywhere in the absence of disease but a state
world, irrespective of wealth, of complete well being of the
ethnicity or religion individual

The importance of the scale and  Psychosocial Disability occurs
problem of Mental Disorder (Mental just as much because of
Illness), particularly in developing society’s attitudes to treatment
countries, has been recognised by the and support of the individual as
United Nations (UN) in a speech made it does because of the nature of
by Banki-Moon, Secretary General, the Mental Disorder (Illness)
UN in 2009 and his comments are itself

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social rather than a medical model of
This view of Psychosocial Disability is disability and which require the
shared not just by Users and Survivors integration of the fields of mental
Organisations but also by leading health law, non-discrimination, and
academics and in some countries by legal capacity…… “
leading politicians. It is these views
that NOUSPR would want to put
forward in Rwanda. For example at a This view forms the basis of
recent International Disability Summer NOUSPR’s view on how to help
School (Gallway June2012) people Psychosocial Disability and
conference in Ireland, The President of it is with this view in mind that we
The Irish Republic, Michael D. Higgins collected the information in this
said in his opening address report.
“ … I will seek to achieve an inclusive
citizenship where every citizen
participates and everyone is treated
with respect …

P
ART 3: METHODOLOGY,
…..In fact, it has been the case that FRAMEWORK, DESIGN
until relatively recently persons who
AND SCOPE OF THIS
experienced mental illness were
largely invisible within our society – REPORT:
sometimes denied their basic human We do not claim that this report is a
rights and warehoused in institutions scientific view or measurement of the
disconnected from the community – experiences of people with
pushed to the margins, the periphery Psychosocial Disability in Rwanda.
of normal everyday life…. Rather it is a collection of the stories of
... We must seek to move to a culture the personal experiences of those
of assisted citizenship, where a people. The way in which the
member of society with a mental information has been collected is
disability may receive appropriate based in Qualitative Research
support in making decisions without Methodology.
relinquishing their right to actually  Qualitative research aims to
make that decision themselves. In this provide an in-depth
way we can ensure that freedom of understanding of the social
choice is not withheld from those with world of research participants
mental disabilities and that society through learning about their
relates to them in a way that does not social and material
diminish their right to exercise legal circumstances, experiences,
capacity…. perspectives and histories.
... By depriving citizens of the right to (Ritchie and Lewis, Qualitative
represent themselves and to make Research Practice 2003)
important decisions regarding their  Qualitative research is not
lifestyle and their medical care we fail based on statistically
to promote their inclusion in society representative samples and so
and we contradict the principles to does not produce statistically
which we should aspire; principles significant findings.
which espouse the upholding of a

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 Participants are selected in a  16 NOUSPR members were
non-random way, according to trained in research
characteristics of most interest methods/interviewing
to the particular study. In this
purposive sampling, the criteria  An interview schedule was
used to select participants are agreed at two meetings with
more important than the number members of
always based on a small NOUSPR/Researchers based
number of people taking part. on the areas agreed from the
CRPD
 Qualitative research is almost
always based on a small
number of cases. In reporting,
qualitative research does not
use numbers; any experience or
perspective has value
regardless of how often or
seldom has it appeared.

FRAMEWORK FOR THE
RESEARCH: Training of researchers

The framework for the research is  Particular attention was given to
based on the United Nations Gender and other Disability
Convention on the Rights of Persons issues with each set of
with a Disability and the areas covered questions containing a sub set
were: asking specifically about the
effect on the respondents of
 The Legal/Justice System gender and/or additional
 Accommodation disability had had on their
experiences
 Education
 50 individual interviews were
 Health Care conducted with people with
psychosocial disability
 Employment
 12 interviews/written responses
 Participating in the public and were carried out with other
cultural life and the recreation, stakeholders
leisure and sporting
opportunities in the community  Five Focus/Enquiry groups
were held in Gisenyi,
Nyagatare, Gitwe and Kigali (2)
DESIGN AND SCOPE OF THE  The same interview schedule
RESEARCH: was used for a basis of
discussion in the focus groups
 A Literature Study was carried
and the responses recorded
out
(150 people attended in all –
50% women and 50% men)

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P
ART 4: THE INDIVIDUAL 5. Subject to the provisions of this
INTERVIEWS: article, States Parties shall take all
appropriate and effective measures
to ensure the equal right of persons
with disabilities to own or inherit
THE LEGAL/JUSTICE SYSTEM: property, to control their own
financial affairs and to have equal
Article 12 (CRPD) access to bank loans, mortgages
Equal recognition before the law and other forms of financial credit,
and shall ensure that persons with
1. States Parties reaffirm that disabilities are not arbitrarily
persons with disabilities have the deprived of their property
right to recognition everywhere as
persons before the law. Rwandan Law on Disability (article
3) states on the same subject:
2. States Parties shall recognize
that persons with disabilities enjoy Every disabled person shall be
legal capacity on an equal basis entitled to equal rights with others
with others in all aspects of life. persons before the law. He or she
shall be respected and be entitled
3. States Parties shall take to human dignity.
appropriate measures to provide
access by persons with disabilities Article 13 (CRPD)
to the support they may require in Access to justice
exercising their legal capacity.
1. States Parties shall ensure effective
4. States Parties shall ensure that access to justice for persons with
all measures that relate to the disabilities on an equal basis with
exercise of legal capacity provide others, including through the provision
for appropriate and effective of procedural and age-appropriate
safeguards to prevent abuse in accommodations, in order to facilitate
accordance with international their effective role as direct and
human rights law. Such safeguards indirect participants, including as
shall ensure that measures relating witnesses, in all legal proceedings,
to the exercise of legal capacity including at investigative and other
respect the rights, will and preliminary stages.
preferences of the person, are free
of conflict of interest and undue 2. In order to help to ensure effective
influence, are proportional and access to justice for persons with
tailored to the person's disabilities, States Parties shall
circumstances, apply for the promote appropriate training for those
shortest time possible and are working in the field of administration of
subject to regular review by a justice, including police and prison
competent, independent and staff.
impartial authority or judicial body.
The safeguards shall be Rwandan Law on Disability on this
proportional to the degree to which subject states in Article 8 that:
such measures affect the person's
rights and interests. A disabled person shall have the right
to legal representation like any other

14

person in courts of law as determined when such a case is between
by law. someone with mental illness and
another “normal” person, it is always
The State shall determine the decided in the favour of the latter.
modalities of providing legal aid to the Take for example a case which I even
needy disabled persons who are not raised to the president of the republic
able to get legal representation.1 during his last visit here in 2008, I told
him that there is a family land that I am
Various organs shall facilitate the
legally entitled to but some other
disabled persons in acquisition of the
people had grabbed it forcefully; upon
required services at any time it is
hearing that the president instructed
considered necessary.
the local leaders to solve my problem,
but up to now I have not got my land.
And the only excuse they give to
themselves and to others who
question about that unfairness is that I
RESPONSES BY INDIVIDUALS ON am a mad person!’ (Male – age 36,
THE SUBJECT OF LAW AND married unemployed)
JUSTICE:
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
‘The justice system is not only ‘Most leaders equate mental illness
supposed to give us freedom of with uselessness and when you are
expression it also has the looked at in that way, you have no
responsibility to put laws in place that right whatsoever. I will give you 2
protect our entire human rights, but if examples beginning with my own
such laws are not there e.g. the right to experience, when my father’s property
vote and be voted for, where does it was being shared I was not considered
leave us? It is only an organization like as his child. I had to battle it out in
CARITAS that has been able to build courts but in vain. The second
some houses for People with example is of another lady who after
Psychosocial disabilities, but why getting mental illness was chased
doesn’t our government include us in away by her husband; her brothers
economic development initiatives that also never wanted her in their families.
are there for other citizens? Why can’t She became homeless despite the fact
we be given medical insurance cards that she had her inheritance (a big
since we are the ones who are most chunk of land) which her brothers were
effected and constantly ill?’ (Male – farming freely. She was so destitute so
age 51, married with six children, that at one time when she was a sleep
unemployed) in the bushes at night dogs came and
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ started eating her child. If it was not for
‘I think the laws and in fact all the legal the intervention of passersby the child
system exists only for the people other would have been eaten by the dogs
than us who have mental illness. Even completely. The authorities were not
the easiest case one could think of, ignorant of the unfairness of her
husband and her own brothers. But
what did they do? Nothing! It is only a
1
Codes and Laws of Rwanda - good hearted doctor who, after
Ministry of Justice learning about her sad story, took her
http://www.amategeko.net/display_rubr to Ndera hospital and took charge of
ique.php?ActDo=all&... her treatment and she has now
recovered. There is no justice for

15

mentally ill people in the current legal ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
system.’ (Female – age 49, married ‘In so far as I am concerned there is no
with five children, unemployed) legal system or justice to protect me, if
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ they do exist they are for the normal
‘I don’t know anything about the legal people. I get harassed and beaten
system; neither do I know any rights when I am just out of my family and I
for people like myself. What right can get no one to report to. I am shouted at
you have when you are socially and teased even by the local leaders
rejected?’ (Female – age 51, widow, themselves.’ ((Male –age 24, lives with
lives with her sister, her own two parents and siblings, unemployed)
children and her sister’s four children, ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
unemployed) ‘I am not allowed to vote or be voted
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ for, I don’t have rights to my property,
‘I don’t know any rights that protect me none listens to my point of view be it in
neither do I know any laws.’ (Female – meetings or other gatherings. I am not
age 43, married with three children, in any way treated with respect and
unemployed) the legal system has not come to my
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ rescue.’ (Female – age 35, single,
‘I once bought a forest with someone lives with children, unemployed)
who promised to give me a legal ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
contract of sale but after a time he ‘Police has rounded me up many
started denying that anything exists times, sometimes I got beaten and
between him and I this was after I had taken to prison but I could later be
paid and we had had an agreement on released.’(Male – age 24, lives in a
a small piece of paper awaiting to go charitable institution, unemployed)
to the authorities and pay the ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
sale/purchase tax. When I called for ‘The problems are that I am not
the attention of authorities, every one listened to. I tried to go back where I
referred to my “madness”. And that was born to claim my parent’s property
was it. I lost.’ (Female –age 52, but I was dismissed and not listened to
married with children, unemployed) by authorities.’(Female – age 24,
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ single, one child, unemployed)
‘I can’t be accepted (for a contract). ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
Period. Even in my family can’t allow ‘Legally I am not protected for
me to enter into a contract unless I am whenever I have problem with
given a representative. For instance I someone none believes that the other
went to my family ( birth place) to claim person has wronged me. They always
my inheritance but I was denied maintain that I am mad and because of
possession of the plot that my parents that I am the trouble causer.’ (Male –
had left for me on the pretext that I am age 52, married, four children,
mentally unfit. (Female – age 44, unemployed)
widow, four children, unemployed) ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ ‘Whenever I get any problem with
‘There is no justice for people like me. someone I am not listened to and
I am not in any way respected as a therefore I am not protected by the law
human being. I am just called mad and neither am I considered by the legal
it makes me feel more mad.’ (Male – system in place.’ (Female – age 28,
age 45, single, homeless, married, one child, unemployed)
unemployed) ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞

16

‘The legal system does not care about community, with choices equal to
people with psychosocial disability. I others, and shall take effective and
wish you would make advocacy about appropriate measures to facilitate full
the plight of people with psychosocial enjoyment by persons with disabilities
disability so that the society becomes of this right and their full inclusion and
aware of our rights. For even us participation in the community,
ourselves do not know the laws that including by ensuring that:
are supposed to protect us.’ (Female –
age 42, single, lives with children, (a) Persons with disabilities have the
unemployed) opportunity to choose their place of
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ residence and where and with whom
‘I don’t know anything about justice; they live on an equal basis with others
they take me as a mad old lady even and are not obliged to live in a
when I want justice say for example if particular living arrangement;
a neighbour grazes his animals in my
gardens I don’t get necessary (b) Persons with disabilities have
attention. They maintain that I am access to a range of in- residential and
mad.’ (Female – age 66, widow, lives other community support services,
with orphaned grand-child, including personal assistance
unemployed) necessary to support living and
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ inclusion in the community, and to
prevent isolation or segregation from
the community;

(c) Community services and facilities
for the general population are available
on an equal basis to persons with
disabilities and are responsive to their
needs.

There is no direct comparison to this
article the Rwandan Law on Disability:

RESPONSES BY INDIVIDUALS ON
THE SUBJECT OF
ACCOMMODATION:

Focus Group participants ‘I have problems finding where to live;
everyone calls me a mad woman. It is
not easy for me to get a house to rent
even when I have money. Some
ACCOMMODATION: landlords chase me out of their houses
when they find out that I have
Article 19 (CRPD) psychosocial disability even my
Living independently and being husband abandons me when I get into
included in the community mental health crisis. No one visits me
and none welcomes me in their
States Parties to this Convention families. However, when I am stable I
recognize the equal right of all persons try to participate in all community
with disabilities to live in the activities including UMUGANDA

17

(social community work) despite the always care about me when I am in a
negative attitude. (Female – age 35, crisis. With our neighbours, it is a
married, one child, lives with three different case, those who know
relatives) (because I try to hide it) isolate me,
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ even those who are supposed to be
‘I live with family members. But at this my friends- the age mates, don’t
age, I wish I had my own house, consider my existence when they have
however, given the attitude of people parties they don’t invite me. I am not
around me I can’t even think of looking informed of community meetings and
for one.’(Female –age 28, single, two most times I don’t participate. They
children, lives with siblings, take (it that you) are a useless person.’
unemployed) (Female – age 28, single, lives with
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ siblings, employed)
‘It was not easy for me. After the ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
genocide our house had been ‘I live with my Dad and wherever he
destroyed. When I returned to my shifts to I go with him. Neighbours are
place no one wanted to receive me not good to me they don’t welcome me
back, I stayed at a distant relative’s in their families, even my step mother
place but she was also not comfortable does not like me she always shouts at
with my disability. I tried to get a small me. It is only my brother who
house to rent but none could allow me sympathizes with me. He looks for my
in his house. They said that I won’t pay shoes and cleans them when I am
them emphasizing on my “madness’’ going to school in the morning and
but because I have my own land the finds some skin lotion for me. My Dad
government later assisted me to get provides money for my medicine and
where to live’ (Female –age 66, widow, he also pays for my hair cutting. I
lives with grandchild, unemployed) notice that whether in the family or with
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ neighbours I am not liked like other
‘Because this is not my place of birth, people are. And know it is because I
they call me derogatory names and am sick. This disturbs me so much so
they don’t welcome me in their homes. that I wish to die, may be then I may
My children are harassed and for any have some rest from the negative
slight mistake say if my child fights attitudes that I experience.’ (Male –
with theirs I get kicked out of their age unknown, single, lives with family,
house and it takes me long to get unemployed)
another house to live in for they all say ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
that I am mad. The community attitude ‘I never experienced any problem of
is so sickening as no one gives you a getting where we are living now, it is
respect as a mother or as a fellow only our neighbours who are not happy
human being. Neighbours and the with us. They don’t say it loud but we
landlords are all alike they share the can feel it.’ (Male – age 40, married,
same understanding about me “the three children, unemployed)
mad woman”.’ (Female – age 44, ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
widow, six children, unemployed) ‘I started living in this place since
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ 1968, it is only of recent that the
‘I have had no problem with authority requested me that I should
accommodation because I live with my shift and join others in community
brothers and sisters in our parent’s villages (UMUDUGUDU) but I have no
house. They have a good financial capacity to do so.
understanding of my illness and they
18

My neighbours don’t respect me at all ‘It was not easy for me. After my house
even those who pretend to be friendly was sold, I could not easily get where
can’t invite you in their parties.’ to settle, they chased me from house
(Female – age 60, single, three to house even without a warning. I can
children, unemployed) remember my wife and I once paid a
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ man 3 years rent in advance but after
‘I started living where I live in 1996. It one year he tried to chase us from his
is my brother’s house house and when we resisted he
I have no problem with my brother. I reimbursed our money.’ (Male – age
pay his rent timely.’ (Male – age 51, 52, married, six children, unemployed)
married, four children, unemployed ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
with own piece of land) ‘Because mental illness is associated
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ with evil spirits most landlords see
‘It is normally not easy for someone to renting their houses to people with
rent out his/her house to a “mad” psychosocial disabilities as giving evil
person. At times you have to be spirits a sanctuary in their homes. So,
careful when you are looking for a their either hike prices or refuse to rent
house and make sure that none out their houses to us.’ (Female – age
detects your mental status, or if you 42, married, five children, unemployed)
have someone “normal” to get it for ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
you, much better.’ (Male – age 42, ‘My husband covers me in such
married, unemployed) matters, He is the one who rents the
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ house we live in. Our previous
‘People don’t like being with me. landlords were very harsh and when
Before I came back here on our family they discovered that I was mentally ill,
property which I inherited from my they chased us out of the house and
parents, I was constantly moving from spread the roomer to other landlords,
place to place looking for My husband had to go far off and
accommodation; once I got one I looked for a house where they didn’t
would be chased before long. know me.’
Landlords used give me more ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
headache than my illness, if I would
miss to pay my rent by a day or two,
they would say that I will not pay them EDUCATION:
and therefore chase me a way.’ (Male
– age 56, married, six children, Article 24 (CRPD)
unemployed) Education
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
‘I got this illness in 2009, I had already 1. States Parties recognize the right of
a house to live in and a cultivatable persons with disabilities to education.
land, hover, even though we are in a With a view to realizing this right
village, other people with mental without discrimination and on the basis
illness that I know do not get of equal opportunity, States Parties
accommodation easily. Most of their shall ensure an inclusive education
big problem is poorness and again the system at all levels and life long
attitudes.’ (Male – age 49, married, six learning directed to:
children, own land)
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ (a) The full development of human
potential and sense of dignity and self-
worth, and the strengthening of

19

respect for human rights, fundamental this end, States Parties shall take
freedoms and human diversity; appropriate measures, including:

(b) The development by persons with (a) Facilitating the learning of Braille,
disabilities of their personality, talents alternative script, augmentative and
and creativity, as well as their mental alternative modes, means and formats
and physical abilities, to their fullest of communication and orientation and
potential; mobility skills, and facilitating peer
support and mentoring;
(c) Enabling persons with disabilities to
participate effectively in a free society. (b) Facilitating the learning of sign
language and the promotion of the
2. In realizing this right, States Parties linguistic identity of the deaf
shall ensure that: community;

(a) Persons with disabilities are not (c) Ensuring that the education of
excluded from the general education persons, and in particular children,
system on the basis of disability, and who are blind, deaf or deafblind, is
that children with disabilities are not delivered in the most appropriate
excluded from free and compulsory languages and modes and means of
primary education, or from secondary communication for the individual, and
education, on the basis of disability; in environments which maximize
academic and social development.
(b) Persons with disabilities can
access an inclusive, quality and free 4. In order to help ensure the
primary education and secondary realization of this right, States Parties
education on an equal basis with shall take appropriate measures to
others in the communities in which employ teachers, including teachers
they live; with disabilities, who are qualified in
sign language and/or Braille, and to
(c) Reasonable accommodation of the train professionals and staff who work
individual's requirements is provided; at all levels of education. Such training
shall incorporate disability awareness
(d) Persons with disabilities receive the and the use of appropriate
support required, within the general augmentative and alternative modes,
education system, to facilitate their means and formats of communication,
effective education; educational techniques and materials
to support persons with disabilities.
(e) Effective individualized support
measures are provided in 5. States Parties shall ensure that
environments that maximize academic persons with disabilities are able to
and social development, consistent access general tertiary education,
with the goal of full inclusion. vocational training, adult education
and lifelong learning without
3. States Parties shall enable persons discrimination and on an equal basis
with disabilities to learn life and social with others. To this end, States Parties
development skills to facilitate their full shall ensure that reasonable
and equal participation in education accommodation is provided to persons
and as members of the community. To with disabilities.

20

There are three articles in the some teachers started calling me a
Rwandan Law on Disability relating to mad girl and this got me disoriented
Education: such that I lost interest in whatever the
teachers were teaching . And when I
Article: 11 started using mental drugs and
because of my absence from school
A disabled person has the right to while in a crisis, my school marks fell
appropriate education in respect of the remarkably- this together with the
nature of his or her disability. attitudes from teachers and students
made me quit school.’ (Female – age
The Government or centres which
28, single, lives with siblings,
cater for disabled persons who are not
unemployed)
able to study with others, shall provide
with them modalities to study in a ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
specialised school and shall have ‘In education, it is not easy especially
qualified and trained teachers and when I get sick- this has made me
appropriate equipment. repeat the same class every other
year. I have got so disappointed so
The Minister in charge of Education that I don’t see a good future before
shall, basing on basic categories of me. The only good thing is my good
disability determined by the Minister in teacher who comforts me and
charge of Health, determine modalities encourages me to continue- But I am a
of facilitating the needy disabled slow learner.
persons in ordinary schools and in With an exception of my inability I don’t
specialised schools in case of failure to face any other problem. Fellow
study with others. students here don’t harass me and my
teachers are good to me. I have never
Article: 12 sensed any bad attitude towards me
while here at school.’ (Male – age
A pupil or a student with disabilities
unknown, lives with mother, father and
that do not enable him or her to sit
siblings, unemployed)
exams with fellow schoolmates or in
the same manner as others is entitled ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
to the right of sitting for exams in a ‘I told you and as you can hear me
special manner. speaking, I am almost dumb. Some
teachers, who are not compassionate
Article: 13 towards me, don’t make an effort to
listen to my questions as a result they
The Minister in charge of education don’t explain to me. My dumbness is
shall determine modalities of an injury to the wound.’ (Male – age
facilitating the needy disabled persons 17, lives with mother and siblings, at
in pursuing education. school)

∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
RESPONSES FROM INDIVIDUALS ‘I like schooling, even now if I got a the
ON THE SUBJECT OF EDUCATION: school environment needs to be
‘When I was at school, students used without harassment of people with
to isolate me. I never had friends disabilities and the teachers need to
however much I tried to look for some. be understanding. I had studied up to
They could call me names and It’s P.6 and I had 3 years in a plumbing
where I was named a mad girl- even

21

course.’ (Male – age 40, married, three ‘I stopped studies when I was in senior
children, unemployed) two, but if I can get a chance I can go
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ back to school, I once went to
Rwamagana in a school of people with
‘I studied up to Primary 3 when I psychosocial disability and participated
started to be attacked by epilepsy. My in a classroom for a while, I found out
illness and stigma that I started that I got good marks. My problem is
experiencing while at school made me only lack of financial capacity
dull I could not learn anything however otherwise, I may go back to school.’
much I tried to be attentive.’ (Female – (Male – age 52, six children,
age 60, lives with one child and two unemployed)
grandchildren, works own land) ‘I never went to school’ (Female – age
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ 39, married, five children, unemployed)
‘I never went to school.’ (Male – age ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
51, married, four children, works own
land) ‘My illness came after 1994 genocide I
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ had left school long ago.’(Female –
age 52, married unemployed)
‘I finished my primary level but ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
because of my drug addiction I never
continued I decided join street life ‘I finished primary level education, but
where I could be able to get drugs.’ because of my epilepsy I never
(Male – age 27, lives in an institution, managed to go further than that.’ (Male
unemployed) – age 27, single, lives with mother and
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ seven siblings, unemployed)
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
‘I stopped my studies in primary 2 due
to lack of school fees and other school ‘I finished primary school and I did
necessities’ (Female age 19, single, no construction technical training for three
family, lives with friend, employed) month.’ (Male – age 52, married, three
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ children, unemployed)
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
‘The attitudes about people with
mental illness are everywhere even in ‘I studied up to primary six and by then
schools teachers and fellow students I had not had this illness.’ (Female –
tease and call you names whenever age 33, married, three children,
they find out that one has got mental unemployed)
illness and that is precisely what ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
stopped me from continuing my
education.’ (Male – age 36, married ‘When I started getting sick I was in
unemployed) Primary six but due to the students
and teachers attitudes towards me I
‘I studied long before I got this problem could not continue. The Head teacher
of illness, to primary 5.’ (Male, married, told me not to go back to school until I
six children, unemployed) would get healed. I got more
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ depressed when I got chased out of
the school.’ (Female –age 27, single,
‘I never went to school.’ (Male - age lives with mother, unemployed)
49, married, six children, unemployed) ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞

22

HEALTH: standards for public and private health
care;
Article 25 (CRPD)
Health (e) Prohibit discrimination against
persons with disabilities in the
States Parties recognize that persons provision of health insurance, and life
with disabilities have the right to the insurance where such insurance is
enjoyment of the highest attainable permitted by national law, which shall
standard of health without be provided in a fair and reasonable
discrimination on the basis of disability. manner;
States Parties shall take all
appropriate measures to ensure (f) Prevent discriminatory denial of
access for persons with disabilities to health care or health services or food
health services that are gender- and fluids on the basis of disability.
sensitive, including health-related
rehabilitation. In particular, States There are three articles in the
Parties shall: Rwandan Law on Disability relating to
Health:
(a) Provide persons with disabilities
with the same range, quality and Article: 14
standard of free or affordable health
care and programmes as provided to The Government shall facilitate a
other persons, including in the area of disabled person in getting medical
sexual and reproductive health and care and prosthesis and orthesis
population-based public health appliances if required.
programmes;
Article: 15
(b) Provide those health services The Government has an obligation to
needed by persons with disabilities provide medical care to a needy
specifically because of their disabled person and it shall provide
disabilities, including early prosthesis and orthesis appliances if
identification and intervention as required.
appropriate, and services designed to
minimize and prevent further Article: 16
disabilities, including among children
and older persons; Each centre or association that caters
for the disabled persons is obliged to
(c) Provide these health services as have a department responsible for
close as possible to people's own examination of trauma as well as
communities, including in rural areas; physico-social counselling.

(d) Require health professionals to
provide care of the same quality to RESPONSES FROM INDIVIDUAL
persons with disabilities as to others, INTERVIEWS ON THE SUBJECT OF
including on the basis of free and HEALTH:
informed consent by, inter alia, raising
awareness of the human rights, ‘I once went to Ndera hospital when I
dignity, autonomy and needs of experienced mental crisis but due to
persons with disabilities through negative effects of the drugs they
training and the promulgation of ethical administered to me, I can’t go back for

23

treatment. I rather go for prayers in the with psychosocial disabilities) where I
church when my situation deteriorates. was injected with some medicine that
I went by myself because my husband got me sleep. When I woke up the next
had abandoned me and my day, I was dizzy and foaming, I was
neighbours always call me a mad given some other tablets which got me
person. No one cares about me, even hungry and powerless, I later escaped
at the hospital I got neglected until I and since then I have not gone back to
started shouting louder for help. I was the hospital.’ (Male – age 45, single,
then injected with a very strong homeless, unemployed)
medicine that made me sleep ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
unconsciously and when I woke up I
was powerless, foaming and more ‘At present I am stable, but the
hungry than ever. From then on I problem is that even when I am
feared going back. I went by myself suffering from other types of illness, I
because my husband had abandoned am forced to take mental illness drugs.
me and my neighbours always call me I cannot be listened to even when I
a mad person. (Female – age 35 know I am right. It disturbs me a lot
years, married, lives with husband, when my family members tie me up
one child and other family members, and take me to the community centre
works as a construction aid when for mental disability treatment even
stable) when I feel I am suffering from another
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ disease.’(Male - age 26, lives with
father, mother and seven siblings,
‘I am now stable, the only problem that never been employed)
I experience is getting medicine when I ‘∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
am under mental crisis, my mental
medicine is not covered under the I have a healthcare card, unfortunately
present health care program ( mittuelle it does not cover the type of medicine I
de santé) if I may constantly get use; and as a result I am most of the
medication, I think my situation may time in a mental crisis; my family
stabilize permanently.’ (Female – age members at times spend their money
57 years, married, lives with husband trying to get my type of medicine and
and six children, unemployed) this increases their rage against me
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ saying that I am the source of family
problems.’(Female - age 28, single
‘It all started when I was about to get parent, two children and lives with four
married, It started with a severe siblings, never been employed)
headache. My head ached me until I ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
started running around at times crying,
my girlfriend chucked me and ‘It is not an easy task getting
everybody else started saying that I medication, we used to get medication
was mad. My parents sold the little from Kigali but it is quite far from here,
property that I had including my land at times when I am in a crisis, I am
and goats trying to get some treatment given only aspirin. The health centre
for me; I first went to local healers but medical attendants don’t care about
to no avail, as my situation went from me whenever I try to explain to them
bad to worse, I was grabbed by that their medicine is not effective. I
neighbours and family members and lost my mental stability because of the
put into ropes and taken to Ndera 1994 genocide, sometimes I stabilize
(national referral hospital for people but whenever something like seeing

24

someone with scars or during the medicine. I went into immense mental
genocide commemoration period crisis such that I was taken back
occurs, then my situation deteriorates. forcefully and I was injected with a
I am only comforted by being with my medicine that made me unconscious.
association members with whom I I hate to remember that experience.
share problems. The association These days I am o.k. I no longer get
counsels us and it encourages us to severe headaches on a daily basis, I
share our challenges. If I try to go to am in a cooperative with some of my
Kigali to look for proper medicine, it friends who have the same problem
costs me a lot and this leaves me with and by keeping together with my
nothing to eat. Again when I am not at friends I have improved.’(Female - age
home my grandchild remains alone he 44, widow, lives with her five children
worries so much that I might die when and one adopted child, unemployed)
I leave him alone.’(Female – age 66, ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
widow, lives with orphaned grandchild,
unemployed) ‘My Dad gives me money for
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ medication, the only problem is when I
find too many people at the hospital
‘Medical personnel around here don’t and I get delayed while waiting for the
care about me when I visit the hospital doctor. Otherwise I don’t experience
for my illness, they tout that I am mad any other problems at the hospital
and mindless. When I ask for a problem.
transfer letter to another hospital, they What pleases me is how I am
don’t give it to me. At times, they may improving because of the medicine I
give me aspirin and tell me that that is get I no longer have serious headache
all. There used to be a project that like it used to be. I am not so o.k. now
paid for my medication and even that because I still use drugs but I have
of my children. They would pay for my been relieved. And I hope I will get
transport to Kigali when going to the cured.’(Male – age unknown, lives with
national referral hospital of Ndera his father and his father’s wife,
where I would be treated but now I student)
don’t know where it went. I am poor ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
and I can’t afford to do it by myself. I
have even failed to raise money to ‘I got mental illness when I was a child
purchase (mittuelle de santé ) a and I am also disabled in a leg, this
medical insurance card. was due to the injections I got when I
A certain doctor in Ndera who knew was being treated for my mental
me used to treat me well. He was illness. My 2 sons also have mental
gentle and good to me he would listen illness; the first one is 11 years old and
to me and give me some tablets that the second is 9 years old. We go to
calmed me down but since I no longer hospitals for treatment, however, at
have means to go to Kigali, I can’t present I don’t have mituelle de santé
trace him. In fact his attention and care (a medical insurance card) mine
were more of a medicine to me than expired but I will soon pay for its
the tablets he gave me. renewal.
A certain doctor in our local health What is good is that I have improved-
centre ignored me when I had visited my life is not like it was when I was still
the hospital for medication, I quarrelled young; the medicine that I use has
with him but he could not relent until I made me improve a lot. Again the
left and went back home with no

25

current health insurance system has protection from harassment, and the
made it easy for me to get medication. redress of grievances;
People with mental disabilities are not
given due attention in the hospitals, (c) Ensure that persons with
most of hospitals and health care disabilities are able to exercise their
centres don’t have mental health labour and trade union rights on an
professionals and we get lined up with equal basis with others;
other people while waiting for a doctor
as if we have the same illness.’(Male – (d) Enable persons with disabilities to
age 40, married with three children, have effective access to general
occasionally employed when stable) technical and vocational guidance
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ programmes, placement services and
vocational and continuing training;

EMPLOYMENT: (e) Promote employment opportunities
and career advancement for persons
Article 27 (CRPD) with disabilities in the labour market,
Work and employment as well as assistance in finding,
obtaining, maintaining and returning to
1. States Parties recognize the right of employment;
persons with disabilities to work, on an
equal basis with others; this includes (f) Promote opportunities for self-
the right to the opportunity to gain a employment, entrepreneurship, the
living by work freely chosen or development of cooperatives and
accepted in a labour market and work starting one's own business;
environment that is open, inclusive and
accessible to persons with disabilities. (g) Employ persons with disabilities in
States Parties shall safeguard and the public sector;
promote the realization of the right to
work, including for those who acquire a (h) Promote the employment of
disability during the course of persons with disabilities in the private
employment, by taking appropriate sector through appropriate policies and
steps, including through legislation, to, measures, which may include
inter alia: affirmative action programmes,
incentives and other measures;
(a) Prohibit discrimination on the basis
of disability with regard to all matters (i) Ensure that reasonable
concerning all forms of employment, accommodation is provided to persons
including conditions of recruitment, with disabilities in the workplace;
hiring and employment, continuance of
employment, career advancement and (j) Promote the acquisition by persons
safe and healthy working conditions; with disabilities of work experience in
the open labour market;
(b) Protect the rights of persons with
disabilities, on an equal basis with (k) Promote vocational and
others, to just and favourable professional rehabilitation, job
conditions of work, including equal retention and return-to-work
opportunities and equal remuneration programmes for persons with
for work of equal value, safe and disabilities.
healthy working conditions, including

26

2. States Parties shall ensure that (Male –age 45, single, homeless,
persons with disabilities are not held in unemployed)
slavery or in servitude, and are
protected, on an equal basis with ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
others, from forced or compulsory
labour. It is not easy to get a job. Looking for
a job calls for having a certain level of
There are three articles in the financial capacity, when you consider
Rwandan Law on Disability relating to necessities such as transportation,
employment: photocopies of one’s documents and
the telephone calls one has to make, it
Article: 18 becomes quite difficult. In addition
No discrimination of any form shall be when one has been labelled mad, one
subjected upon a disabled person in cannot even be recommended by any
matters related to employment. one for a certain job.
Lack of money (makes it difficult) to
However, a disabled person shall be facilitate me in applying for vacancies
given greater access to employment but more especially employers
opportunities than any other citizen in negative attitudes towards me.
case of equal capacities or in case of We get very low wages and at times
equal marks in competition. not being paid at all.
Being a psychosocially disabled man
Article: 19 equals to being no man at all in this
society. You are neither a child nor a
In case of necessity and only due to
woman but just a useless mad
interest of employment, a disabled
something.’ (Male – age 36, married
person shall be entitled to a conducive
unemployed)
employment environment that does not
detract the nature of his or her ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
disability. ‘I look for a job like others but I rarely
Article: 20 get employed, where I get it at times it
comes as an act of benevolence on
An Order of the Minister in Charge of the part of one who gives it to me and
labour in his or her attributions shall yet I work like others and at times
determine the modalities of facilitating more than they do simply because
the disabled persons in matters related losing a job hits me harder than those I
to access to employment opportunities work with and therefore I try hard to
impress my employer.
. I have met outright rejection- without
even testing my capability while others
RESPONSES BY INDIVIDUALS ON
are either interviewed or simply
THE SUBJECT OF EMPLOYMENT: employed.
‘None can employ me since they say I am There are many problems including
Mad. I only survive on handouts. But when sickness, not being paid and worst of
I am stable, I am very strong and I help all being discriminated against while at
people carry their luggage and other the work place.’(Male – age 40,
heavy things in a local market. At times married, three children, unemployed)
they give me food or promise to pay me ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
later which they don’t do at most times.’

27

‘I work in shop where I get paid 10,000 decided to quit before I could make
RWF/ Month and it is my friend who many enemies.
got me the job. Before this I used to I never looked for any other job since
work as a house girl on a less salary. then.
When I suffered from this disease, I Fellow employees mocked me and the
was working as a house girl I was then employer used this as an excuse for
replaced and chased away it took me not paying me when I wanted my
some time to get another job. wages so it made me quit the job.’
I am worried that if I get a mental crisis (Male – age 49, married, four children,
I might be chased from the job unemployed)
sometimes I close the Shop and go to ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
the hospital to look for the medicine
and I get worried that that will also be ‘Ever since I got this illness, people
a basis for losing my job.’ (Female – don’t respect me. I tried so many times
age 19, single, no family, employed) to look for a job but I could not get one.
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ I now participate in NOUSPR’s women
basket weaving group.
‘I used to work as a house constructor At times people would make empty
and this type of job is usually done in promises to me. I would follow up on
cooperation with other constructors, their promises but in the end they
but since when I got this illness my would tell me that they had no job.
fellow workmates isolated me, they no In the group where we weave
longer call me for any work. handcrafts, I have not met any
Employers don’t trust me; they don’t problem; instead, we share our illness
accept that I can do their work so they experiences and when one has not
simply ignore my requests to work for taken her drugs, we remind each other
them. (I suffer) Mockery and verbal when one has to take her drugs. If we
harassment.’ (Male –age 37, married, would get market and be able to get
six children, unemployed) some good income; I would not think
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ of looking for a job somewhere
else.’(Female –age 33, married, three
‘I have not tried to search for a job. I children, unemployed)
only take care of my ill child.’ (Female ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞
–age 42, married, six children,
unemployed)
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞

‘I meet challenges here and there
because a number of people know my
condition and because of my low level
of education I can’t easily be employed
by any one.
I have been rejected and have never
had a job.’ (Female – age 33, married,
3 children, unemployed)
∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ Craft display at EXPO

‘I once worked at a certain building site
but I soon started getting into problems ‘I used to dig in other peoples gardens
with other workers because of my low for money or for food, but I was
level of anger management skills, I continually underpaid or even at times
28

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