EXPOSURE TO GENOCIDE AND RISK OF SUICIDE IN RWANDA: A POPULATION BASED- CASE-CONTROL STUDY

INTRODUCTION: In Rwanda, it is estimated that one million people were killed during the 1994 genocide leaving the country shattered and its socio-economic fabric completely destroyed. Traumatic events such as wars and genocide have been linked to post traumatic stress disorders and depression leading to suicide. The aim of the study was to investigate whether effects resulting from genocide were predictors of suicide in Rwanda.

METHODS: We conducted a population-based case-control study. Suicide victims were matched to three living controls sex, gender and village of residence. From 1^st June 2011 to 31^st May 2013, 162 cases and 486 controls were enrolled in our study countrywide. Information was prospectively collected from the police, local administrators and study subjects’ family members.

RESULTS: After adjusting for significant covariates, having been charged with genocide related crimes was found to be a predictor for suicide in Rwanda compared to Rwandans with no such characteristic (OR: 6.4,CI: 1.7-24). Being a genocide survivor, having been physically or sexually abused during genocide, having lost a first-degree family member to genocide were not significantly associated with risk of suicide.

CONCLUSIONS: Nearly 20 years post-genocide, these findings demonstrate that genocide perpetrators are experiencing severe psychological disturbances that require appropriate psychological care so as to fully reintegrate them into the Rwandan society. Given the large number of genocide perpetrators, if this problem is not timely addressed, the residual consequences could result into a serious public health burden in a near future.