Caring for the aged in Rwanda is the subject of a new report by AVEGA AGAHOZO, the genocide widows association. With 87 per cent of respondents on incomes of below 10,000 RWF (14USD) per month, what are the support mechanisms required that effectively engage public and private sectors, civil society and communities, families and friends, in supporting our elders? Yet again AVEGA is one of the first to investigate and provide solutions on an important issue for Rwandan society – how does Rwanda deal with its ageing population, in particular those who cannot rely on traditional family support, due to the far-reaching consequences of genocide.

AVEGA has long been a pioneering force in developing innovative projects for the most vulnerable in areas such as healthcare, HIV, trauma counselling, legal support and income generation/micro finance activities for the poorest genocide widows. Its programmes have often spawned wider community involvement and linkages with government, providing best practice models that have impact far beyond its primary remit.

Nearly 20 years after the Rwandan Genocide, many widowed survivors are ageing and are facing a range of challenges that have lead to a very severe decline in their quality of life. AVEGA aims to restore hope and life to Genocide widows through advocacy, healthcare, counselling, social work and economic empowerment programmes, with the ultimate aim of reintegrating them into society. This new report, based on a sample of 1462 elderly widowed survivors, explores the challenges and potential solutions to government, NGOs and society at large.

The AVEGA survey was carried out in 2013 on aged, widowed survivors of the 1994 Rwandan Genocide against the Tutsi. The aim of the survey was to examine whether the care currently available to this group adequately meets their needs, and to make recommendations for how the current situation could be improved. The report makes the following key recommendations:

– the adoption of a multi-disciplinary care strategy. This will enable the provision of care for elderly survivors in their own homes, independent living communities, or care homes, depending on the level of care required by the individual.

– the creation of discussion groups within communities to assess the problems facing elderly survivors of the genocide and identify long term, sustainable solutions. AVEGA and local authorities would supervise this process.

– that the Rwandan Government should work alongside AVEGA and other NGOs to create and deliver solutions specifically targeted at elderly widowed survivors in a coordinated manner. A national network/forum should be established to address such issues, with AVEGA playing the key facilitating role.

Title:  “Current State of Care for Elderly Widowed Genocide Survivors in Rwanda”

Published: AVEGA AGAHOZO , December 2014

Financial Support: Survivors Fund

Key summary points are as follows:

1. A survey was carried out on aged, widowed survivors of the 1994 Rwandan Genocide against the Tutsi. The aim of the survey was to examine whether the care currently available to this group adequately meets their needs, and to make recommendations for how the current situation could be improved.
2. In Rwanda, care for the elderly is primarily provided within the family structure, as there is no comprehensive care system in place in the country. However, the devastating impact of the Genocide has meant that many elderly widowed Genocide survivors do not have any living relatives able to care for them.
3. Furthermore, as they grow older, their need for and reliance on care will increase.
4. The results of this survey will be used to aid and inform the creation of sustainable, long-term projects to provide the necessary assistance to elderly survivors, as well as the elderly in Rwanda on a more general level.
5. AVEGA AGAHOZO, a non-governmental organization based in Rwanda founded in 1995 by fifty widows of the genocide, carried out the survey. It aims to bring hope to survivors of the genocide, in particular widows, orphans, bereaved parents, the elderly, and the handicapped.
6. The survey targeted a group of 1462 elderly widowed survivors living in Rwanda, of which 455 were randomly selected. The questionnaire consisted of 67 questions. Other actors involved in care for the elderly were also consulted in the course of the study and a literature review was conducted.
7. Within the group of respondents, 96% are female, and 80% live in rural areas.
8. 89% are aged 70 years and over
9. Around 60% have no surviving relatives.
10. Over 65% of respondents had some difficulty or needed help with the most basic physical tasks of daily living, such as walking a 100 meters.
11. 89% reported health problems and chronic illness.
12. Illiteracy in the group is high, with over 90% reporting that they had never attended school.
13. Nearly 75% of respondents are in need of direct support and a regular carer.
14. 60% stated that their houses need rehabilitation.
15. 98.2% of respondents were either very unsatisfied or unsatisfied with their lives.
16. There is a higher incidence of poverty among older widowed survivors, than in the general population – 87% of respondents had monthly household incomes of below 10,000 RWF (14USD).
17. These characteristics highlight the fact that individuals in this group are at risk of social and economic exclusion, as well as isolation and loneliness.
18. The results of the study also demonstrate that elderly, widowed survivors of the Genocide are an especially vulnerable group whose needs are undergoing change, and that these needs are not being wholly addressed.
19. Governmental and non-governmental support to elderly genocide widows is largely uncoordinated. Local government tends to delegate responsibility for elderly survivors to survivor organizations, which do not have the funding or capacity to provide the support needed.
20. Positive self-perceptions in the community of elderly widowed survivors are low, as are self-confidence levels amongst this group, despite the fact that the aged often make a positive contribution to the community as care givers to the younger.
21. The housing and healthcare needs of this group of respondents can be divided broadly into three categories: A) Those without chronic illness who could be helped to live independently; B) Those with chronic illnesses and some surviving relatives who could receive care within their community; C) Those with chronic illnesses and no surviving relatives who require palliative care from outside the community.