Albert Ndayisaba (left), PIH’s manager of social and economic support programs in Burera District, Rwanda, walks with breast cancer survivor Elisabeth Nyiramana* (center) after a visit to her home in March 2017. National emphases on unity, poverty reduction and community-based care have fueled Rwanda’s revival over the past 25 years. (Photo by Cecille Joan Avila / Partners In Health)

Choosing Hope: 25 Years Since Rwanda’s Genocide Against the Tutsi

Partners In Health
Partners In Health
Published in
6 min readApr 30, 2019

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The executive director of PIH in Rwanda reflects on the country’s progress, spirit, and challenges, after April’s annual remembrance.

April 7, 2019, marked the 25th commemoration of the Genocide against the Tutsi in Rwanda. For the country, that day and the entire month of April is a time of deep sorrow from past memories, and contemplation about where we are going in the future, as a nation. At a personal level, this period comes every year with a mix of feelings: dismay and sorrow for the lives innocently lost; shame and disbelief that such horror was done by Rwandans; and hope, determination, and awe at how much we have achieved in the past 25 years, as a nation and as individuals. I am always impressed by our resilience and the difficult decisions we’ve had to make through the years, highlighting the wonderful sides of humanity.

As I reflect on all of this, I note that our country, our people, chose hope over despair. This is the strength in what remained for our country.

The atrocities committed raised several inevitable questions: How had such an intense level of hate risen through years of politics that promoted division — driving perpetrators to turn on their lifelong neighbors, friends, and even their family members? After such a tragedy, could our country ever heal? Could we ever live together again, side by side? After the Genocide, when one looked at the state of the country, the preponderance of such queries in our minds and feelings in our hearts could have driven us to feel helpless, and hopeless. However, our story did not end in 1994. As His Excellency President Paul Kagame often says: “We chose to stay together, we decided to be accountable to ourselves, and we chose to think big.”

The indomitable spirit of Rwandans, who have made these choices of unity and thinking big, is apparent from the highest level of government down to ordinary Rwandan citizens, who live heroically, emulating the true spirit of unity. I can give you three stories of ordinary Rwandans choosing to live with integrity — before, during, and after the Genocide against the Tutsi — heroically dedicating their lives to the fight against hate and ethnic discrimination.

Before: An old man had three sons who were members of the Rwandan Patriotic Front, and they had all perished in a fierce battle as the freedom fighters rebelled against the divisionist regime in the early ’90s. When the man heard of their death, he called on his younger and only remaining son to take up the mantle left by his heroic brothers, as there was still a need for more people to fight. He asked his son to honor them and join others on the battlefield for a free and equal Rwanda. The old man and his beloved son chose freedom.

During: A young girl risked her life to take care of a Tutsi child that she found among dead bodies. At a young age, she became the mother of a baby who was supposed to be her enemy.

Another story would be in 1997, when students from the Nyange secondary school refused to cower when a militia group attacked their school and wanted them to separate by ethnic group. These students chose instead to die together. These heroes chose unity.

After: When refugees decided to come back home, and the survivors decided to forgive those who had killed, they all decided to stay together. They chose reconciliation. My own parents and many other Rwandans quit their stable jobs abroad in order to serve, and spent the first years after the Genocide rebuilding their country in harsh and uncertain conditions. They chose to think big, and be accountable for the reconstruction and progress of our nation.

Nadine Kamikazi (left) holds one of 23-year-old Odette Mukandanga’s 3-week-old twins, in May 2018 at Rwinkwavu District Hospital in Kayonza District, Rwanda. Maternal and child health has vastly improved in Rwanda over the past two decades. (Photo by Cecille Joan Avila / Partners In Health)

Looking back, 25 years now, it is very apparent that a country that experienced the worst side of humankind now has become a global beacon of development and progress. Rwanda has only managed to rebuild a much stronger nation through its deep emphasis on unity, reconciliation and poverty reduction. The achievements are clear to see. Economically, Rwanda has grown by leaps and bounds, with a GDP that has surged from about $750 million USD in 1994 to more than $9 billion in 2017. In addition, the poverty rate has plummeted from about 70% in 2000 to lower than 40% in 2015. Guided by principles of equity, the government of Rwanda has been implementing evidence-based health policies, which is resulting in substantial progress toward universal health coverage.

Rwanda also has been a leader in Africa, and the entire world, in meeting the United Nations’ health-related Millennium Development Goals, with achievements including steep declines in child and maternal mortality over the past two decades. Rwanda’s leadership has continued with progress toward the updated Sustainable Development Goals, which the U.N. set in 2015.

This list is not exhaustive, to say the least, and in no way means we have grown comfortable with our achievements. There is still a lot of work to do, and the gaps and challenges remain enormous. But the inspiration, the commitment, and the desire to face them are more intact than ever. This is because every Rwandan is familiar with the darkness of the past — we know what hate, inaction, and complacency can do. Never again! We will continue to work hard to ensure that there is prosperity, peace, and health, thus creating a better life for the generations to come. Furthermore, we will do this to honor the brave souls that were lost, some innocently or in the battlefield, for us to have the free and beautiful country we enjoy today. Their sacrifice was not in vain.

Of course, Rwanda’s progress has faced some detractors, groups that work hard to deny what happened and obscure the roots of the hate. I am saddened when I see that humanity does not learn from its tragedies; the rise of hate speech and far-right movements in Western countries, terrorism in the name of religion, gender-based violence, and more. We should be firmly fighting all kinds of hatred and divisive ideologies, so that we do not see what happened in Rwanda repeated elsewhere in the world.

Dr. Joel Mubiligi, executive director of Partners In Health in Rwanda, in his office in Kigali in March. (Photo by Mike Lawrence / PIH)

What we need to champion most are equity and inclusiveness, focused on quality health care, education and socioeconomic development for all.

I believe that, today, Rwanda is a global example of strength after tragedy. We have learned this the hard way, but the lessons have been invaluable. What we have learned, 25 years on, is that the way forward is clear: unity, equity, and ambition for a shared prosperity. This is what is required from us as human beings, and it is very possible. I have reason to believe in Rwanda’s possibilities every day, when I see the spirit and passion of my co-workers at PIH-Rwanda, and the resilience of the people we are honored to serve.

Dr. Joel Mubiligi is executive director of Inshuti Mu Buzima, as Partners In Health is known in Rwanda. He joined PIH in 2011, to serve as clinical director for Burera District. He stepped away from PIH in 2014 to work for the Rwandan Ministry of Health for 18 months, as medical adviser to the Human Resources for Health Program. He then returned to PIH and served as director of clinical programs, deputy chief medical officer in charge of primary health care, and chief medical officer, before assuming his current role in 2018.

*Name changed for privacy.

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Partners In Health
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