Archive for January, 2012

One of the most visible differences between the developing and developed worlds is the abundance of labor and labor-intensive processes in the developing world. Nearly every day in Rwanda I observe someone doing a job that was mechanized or automated at least one or two decades ago in most parts of the developed world. The abundance of cheap labor and the unreliability of electricity here combine to create employment in tasks that are menial and sometimes downright comical. I suppose the bottom line is that when you can’t rely on machines, you rely on people. Here are some examples:

– All buses around Kigali are staffed by a driver and a conductor who collects the bus fares from passengers. The conductor also functions as the bus route display screen by shouting the bus destination at every stop.

– Every morning Kigali’s streets are full of women employed by the city to sweep the sidewalks and the streets.

– Instead of parking meters, the system of paying for parking is much more entertaining: once you have finished your business and you turn your car on, someone in a yellow vest will chase after you flourishing a ticket whose price correlates to how long you were parked. Some people believe it’s optional to stop backing up and pay.

– Cell phone airtime is prepaid here and not on a monthly plan. To reload airtime, you physically purchase a scratch card from one of the brightly-vested airtime sellers found at nearly every corner of the city. If you request, the sellers will even scratch off the gray covering to reveal the code for you.

– I believe I have seen a lawnmower once or twice, but I still want to share this example because I’m sure it wasn’t the only time this happens: I once watched a man cutting a sizable plot of grass with a pair of office scissors.

– Instead of alarm systems (or sometimes in addition to), nearly every big office and well-to-do home employs a security guard to keep watch (read: sleep) at night. Guards for homes are rarely armed, while guards for offices are from official security companies and have a night stick or gun with them.

– And now for a hybrid situation: At the airport there is an automated ticket machine where you press a button at the entrance to take a ticket. Since the machine is too far from most cars, there is often a person there to press the button for the driver and hand over the ticket. I find this hysterical for some reason.

Now I must say that at times I appreciate and enjoy the benefits provided by the human over the machine. Instead of fumbling with a MetroCard on the bus and getting flustered if I don’t have enough credit, here I can wait for the conductor to ask me to pay and sometimes I even negotiate a cheaper fare if I’m going only a few stops. Then again, if I’m transferring to another bus line I don’t get the discount that my MetroCard would accord me.

It will be interesting to see if and how fast these jobs become phased out to machines and virtual systems as Rwanda progresses towards its goal of becoming a middle income country by 2020.

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Psychology in Rwanda

At work, I recently had the exciting opportunity to manage a delegation of psychologists visiting Rwanda through the People to People program. As the official partner of People to People in East Africa, Eos Visions has received several delegations of professionals in the past few months, including family medicine doctors, nurses, dentists, lawyers, and mental health professionals. Alongside our visitors, learning about Rwanda through the lens of psychology was quite an eye-opening experience and made me aware of the importance of and acute need for psychological support and programs around the country.

To begin, I did some background research about the field of psychology in Rwanda that I believe provides a good introduction before I describe the visit: Following the 1994 genocide, trauma and shock were widespread and permeated all levels of society – individual, family, community, and nation. As would be expected, psychological destabilization affected nearly everyone who had witnessed, participated in, or survived the genocide. A 1999 study found that 80% of women in Rwanda showed signs of trauma. Even before its social fabric and institutions were destroyed over the course of the 100 days of killing, underdeveloped Rwanda was not equipped to effectively treat psychological disorders. The task of providing adequate counseling and treatment for post-traumatic stress disorder in the face of national destruction was daunting in years immediately after the genocide and even today has yet to be fully achieved. As of 2008, there were only three practicing psychiatrists in all of Rwanda. Over the past sixteen years, official health institutions and policies have developed gradually in an attempt to respond to the needs of Rwandans suffering from genocide-related trauma and other psychological disorders.

With this in mind, we began the professional program with a visit to the National Organization of Users and Survivors of Psychiatry (NOUSPR), whose name turns out to not be a mistake of English grammar. As one of the volunteer coordinators explained to us, in Rwanda many people are in fact “survivors of psychiatry” because treatment can often be just as damaging or debilitating as one’s initial condition. This is further exacerbated by the fact that laws in Rwanda are extremely discriminatory against the mentally ill, prohibiting anyone with a diagnosis of being at all mentally unstable from entering into any legal contract. Our visitors had the chance to hear the testimonials of some NOUSPR members, learn about the challenges facing mentally disabled or ill people in Rwanda, learn about the organization’s goals for conducting research, and share their own initial impressions of the state of psychology in Rwanda in addition to personal stories.

Rwanda has only one inpatient psychiatric hospital, which is located just outside of the capital in a town called Ndera. Our visitors spent one afternoon visiting the Ndera Neuropsychiatric Hospital in order to learn about the center and give a presentation on a topic that the administration had requested: a practical training on drug and alcohol addiction. One of the visitors gave this presentation, which outlined concrete tools that practitioners can use to identify and treat alcoholism and addiction. The presentation was quite well attended by around 100 of the hospital’s staff and practitioners.

In an effort to help build academic and institutional capacity in the field of mass trauma treatment, the group visited the Kigali Health Institute and three of the visitors gave a presentation on mass trauma treatment. The audience consisted of psychologists, heads of departments related and unrelated to psychology, and some administrators of the Kigali Health Institute. What emerged from the ensuing discussion is the importance of incorporating psychological principles and awareness into all fields, even those like dentistry. I had never before thought about the psychological stress that comes with the vulnerability of sitting in a dentist’s chair.

The professional program concluded with a visit to the country’s National Unity and Reconciliation Commission in order to learn about the role and consideration of peace psychology in Rwanda. Delegates enjoyed a conversation with the Executive Secretary of the NURC, Dr. Jean Baptiste Habyalimana, in addition to his colleagues. It became clear that psychology fortunately played a large role in the design and implementation of NURC activities.

Our visiting psychologists sincerely enjoyed exchanging their expertise and learning about the state of psychology in Rwanda. I’m excited to be working with some committed delegates from this group and helping them remain involved in developing the field of psychology in Rwanda. The door is now open for even more mental health professionals to build on the foundation created and questions posed by this first group of pioneering visitors.

Re-posted partially from the Eos Visions blog

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