title: Primary mental health care for survivors of collective sexual violence in Rwanda.
abstract: This paper draws attention to the obligation and opportunity to respond to the mental health impacts of collective sexual violence (CSV) among genocide-rape survivors in post-genocide Rwanda. Qualitative data gathered from CSV survivors who were members of Rwandan women's genocide survivor associations are presented to illustrate how they strive to overcome adversity while seeking access to quality mental health care and using informal community mental health services. The results reveal that a system of high quality, holistic health and mental health care is yet needed to meet Rwandan CSV survivors' complex and serious health and mental health needs. Given that a rural health system, modelled on community-based, comprehensive HIV/AIDS care and treatment, is currently being implemented in Rwanda, we recommend enhancements to this model that would contribute to meeting the mental health care needs of CSV survivors while benefiting the health and mental health system as a whole within Rwanda.
authors.affiliation: Department of Epidemiology, School of Public Health, National University of Rwanda, Kigali, Rwanda. zralym@muohio.edu
authors.forename: Maggie
authors.initials: M
authors.lastname: Zraly
authors.forename: Julia
authors.initials: J
authors.lastname: Rubin-Smith
authors.forename: Theresa
authors.initials: T
authors.lastname: Betancourt
mesh_terms: D000884:Anthropology, Cultural; D019548:Crime Victims / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000209:etiology / Q000523:psychology; D006708:Homicide / Q000523:psychology; D006801:Humans; D007390:International Agencies / Q000191:economics / Q000458:organization & administration; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards / Q000600:supply & distribution; D011247:Pregnancy; D011275:Pregnancy, Unwanted / Q000523:psychology; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D011902:Rape / Q000523:psychology*; D019035:Rural Health Services / Q000458:organization & administration / Q000592:standards; D012432:Rwanda; D017741:Survivors / Q000523:psychology*; D014857:Warfare