Rwanda is situated in east-central Africa. Rwanda is situated in east-central Africa


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Rwanda is situated in east-central Africa.

  • Rwanda is situated in east-central Africa.

  • With a population of just over 11 million Rwanda remains one of the most densely populated areas in Africa.

  • The population is young and predominantly rural.

    • More than 80% of the population lives in rural areas, engaging in subsistence agriculture (NSIR & Macro International 2006).
  • The population consists of three main ethnic groups: Tutsi, Hutus and Twa.



The genocide of 1994 led to the mass slaughter of almost 20% of the population of Rwanda and large numbers of refugees and displaced persons.

  • The genocide of 1994 led to the mass slaughter of almost 20% of the population of Rwanda and large numbers of refugees and displaced persons.

    • The majority of Hutus which constituted approximately 85% of the population turned on the Tutsis who were only about 12% of the population and moderate Hutus, killing an estimated total of 800 000 people (Madsen 1999; Prunier 1995).
  • At present, the country is ranked 152 out of 169 countries on the human development index (UNDP 2010).



Poverty is widespread, with the 2010 Human Development Report indicating that 77% of the population lives on less than $1.25 a day (UNDP 2010).

  • Poverty is widespread, with the 2010 Human Development Report indicating that 77% of the population lives on less than $1.25 a day (UNDP 2010).

  • The high burden of health problems continues to threaten the country’s economic and social progress and also undermines any attempts at redressing poverty.

  • Projections suggest that the process of aging will continue to increase in the next few decades. This is supported by the ageing data for the period 1997 to 2002.

    • In 1997 the number of older people was 428 300, and increased to 627 427 in 2002 (Sangano, Nsanzabaganwa and Mpyisi 2003).


The number of older men and women in Rwanda has been steadily increasing and most (64%) of the ageing population reside in rural areas.

  • The number of older men and women in Rwanda has been steadily increasing and most (64%) of the ageing population reside in rural areas.

  • Women constitute a larger share of the older population than men.



The specific aim of the study was to deepen understanding of the experiences of older people in the rural areas in a country that is emerging from conflict.

  • The specific aim of the study was to deepen understanding of the experiences of older people in the rural areas in a country that is emerging from conflict.



The study was conducted in two rural areas in Rwanda.

  • The study was conducted in two rural areas in Rwanda.

  • Most parts of the areas are not readily accessible by public transport and most households do not have access to electricity or safe drinking water.



The study relied on qualitative data collected from in-depth interviews

  • The study relied on qualitative data collected from in-depth interviews

  • 20 in-depth interviews

    • 10 men
    • 10 women


The elderly choose to live in the rural areas because they have an emotional attachment to the land.

  • The elderly choose to live in the rural areas because they have an emotional attachment to the land.

  • Some have lived their whole life in the rural area and they cannot see themselves moving in their old age.

  • Others do not want to live in the towns because they have no social networks in the towns, especially those who were left alone following the genocide.



Some elderly are forced to live in the rural areas in order to ensure their independence.

  • Some elderly are forced to live in the rural areas in order to ensure their independence.

  • They do not have any form of support in the urban areas. In addition, rural areas are more affordable than urban areas.

  • However, this does not mean that they are not aware of the advantages of urban living.

    • Urban areas have better basic services and amenities than rural areas.


The thing I like about the rural area is that I own my own big house here, but what I dislike now is that people in the village are always forgotten by the government when it comes to service delivery, people in the main cities are the only ones considered. For example, we do not have electricity here, clean water, and tarred roads, but in the city these services have been delivered long ago, our children do not go to school because the nearest school is nearly 15 kilometer. So growing older in the rural areas means dying quickly because you do not get what you want”

  • The thing I like about the rural area is that I own my own big house here, but what I dislike now is that people in the village are always forgotten by the government when it comes to service delivery, people in the main cities are the only ones considered. For example, we do not have electricity here, clean water, and tarred roads, but in the city these services have been delivered long ago, our children do not go to school because the nearest school is nearly 15 kilometer. So growing older in the rural areas means dying quickly because you do not get what you want”



It is clear that the migration of the youth to the urban areas has had positive spinoffs for the elderly.

  • It is clear that the migration of the youth to the urban areas has had positive spinoffs for the elderly.

    • The remittances sent by their children living in the urban areas were important to the survival of the elderly since many were not able to engage in physical labour and as a result they could not grow their own food.
  • In Rwanda the rural economy is heavily dependent on agriculture which is labour intensive, using traditional farming methods.

  • Older men and women were not physically strong enough to work on the land therefore they were more susceptible to poverty.



Most reported that they spent most of their time at home and was too physically weak to engage in domestic chores.

  • Most reported that they spent most of their time at home and was too physically weak to engage in domestic chores.

  • Years of poverty have also weakened them physically leading to their inability to function independently.

  • The elderly who did not have children expressed a sense of hopelessness for the future.

  • Among the numerous challenges men and women faced they reported that the loss of close family members was the most devastating in their lives.

    • All the older men and women reported that they had lost at least one close family member.
    • Most of the deaths occurred during the 1994 Rwandan genocide


Many had lasting memories of the genocide because they felt it led to the destruction of the social fabric of the community.

  • Many had lasting memories of the genocide because they felt it led to the destruction of the social fabric of the community.

    • They lost not only their belongings but also close family members and friends.
    • The genocide irrevocably changed their community because members were not as willing to help each other as they were before the massacre.
    • The genocide left them with a feeling of distrust which continued to plague them and instilled a sense of fear in them.
    • In addition, the conflict led to the destruction of infrastructure, particularly health services.


….before the genocide I was very happy with my wife and children. During the genocide, I lost my wife, and some of my children, and these changes have affected my health negatively. Since then I started having high blood pressure and other unknown sicknesses that I never had before

  • ….before the genocide I was very happy with my wife and children. During the genocide, I lost my wife, and some of my children, and these changes have affected my health negatively. Since then I started having high blood pressure and other unknown sicknesses that I never had before



The elderly continue to live with the devastating effects of the war.

  • The elderly continue to live with the devastating effects of the war.

  • In the aftermath of the genocide there have been some efforts to provide psychosocial support to the population.

  • However, in resource constrained countries that have undergone conflict there are often limited resources to help build human capacity, promote social ecology and strengthen the culture and values of a community, upon which psychosocial well-being is heavily dependent.

  • Furthermore, extreme poverty may also add to the feelings of hopelessness and lack of emotional wellbeing experienced by survivors of war and conflict.



Almost two decades after the genocide there is still a need for health services that address the underlying trauma experienced by the elderly and its impact on their ability to function in society.

  • Almost two decades after the genocide there is still a need for health services that address the underlying trauma experienced by the elderly and its impact on their ability to function in society.




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