Refugee Camp in Rwanda 1988

Discouragement and Insecurity as Health Threads

Von Myriam Brunelli / Medicus Mundi International MMI

There was a mass exodus from Burundi to Rwanda following the serious, bloody deeds of August 14 and 15, 1988, Thousands of people sought refuge: entire families, mothers leading children by the hand, carrying them on their shoulders, in their arms, and many, deep within their wombs. They had a bundle on their heads, which was all they managed to gather from their abandoned homes.

This river of people flowed into five camps in tents prepared by the Red Cross: Muheru, Gatarara, Mashenyi, Curusi and Kirarambogo. Medicus Mundi Italia was entrusted with the Masheny camp and its roughly 4,500 refugees.

Many of them came from Kiremba, where the hospital built by the Diocese of Brescia had been a point of reference for many years. It was a great comfort for them to find people who knew their language well: doctors, nurses, and an obstetrician who had already done all they could for them in Kiremba. Kiremba especially focused on health care education and it was comforting to see that among the very few things they brought, many refugees had brought their vaccination cards. Many children had been vaccinated and this was especially precious due to measles. In Africa and especially crowded places such as refugee camps, measles can cause high mortality among children.

Involving refugees

The camp had been set up fast and furiously and there had not been time to prepare enough latrines. The refugees themselves helped create more. The Red Cross and High Commission for Refugees brought us what was needed for these people to survive (victuals, wood, etc), while Medicus Mundi Italia human resources dealt with health. The whole time we stayed there, we guaranteed the presence of a doctor, an obstetrician [midwife], an animator, and one male and one female nurse. The male nurse stayed in our tent even during the night. Some nurses from Burundi that had been among the refugees, were involved in the health care assistance.

One tent had been set up for examinations, one for treatment and a smaller one for one or two adult patients who needed a saline drip due to serious dehydration. We had 200 or 300 patients a day, many of them children. Each day some children sat a couple of hours on the ground with their mothers in our tent. We wanted to keep an eye on them to make sure the mothers fed them one spoon at a time to of rehydrating solution. It was difficult to resort to intravenous rehydration, and it was only used for the more serious cases. The most frequent pathologies, and unfortunately often lethal ones, were diarrhea, measles, and malaria. Medicus Mundi Italia had sent medicine for first aid; this was followed by materials sent by the Red Cross later.

We had to go the Butare to the headquarters of the High Commission for Refugees of the Red Cross every eight or ten days, to refurbish our supply of medicine, report on the situation in the field, and receive information on directives which were given to all the people in charge of the various camps from time to time.

An empty box became a little car

Our human resources were housed in a rural hospital run by German missionaries in Gakoma, the closest inhabited center to the camp (4 km). One of our doctors also collaborated with the doctor in charge of the hospital for especially complicated surgery and treating the most serious patients. Since they could not be treated in the camp, we transported them to Gakoma.

A missionary father was also always present in the field (the White Fathers). He had been expelled from Burundi a while back and he was happy to help the people from Burundi, where he had spent so much time. He organized teachers and catechists to educate the children. The children were kept busy all morning long with a blackboard and a piece of chalk, under the guidance of their teachers who were in turn refugees. The entrance to the camp was a wide, steep slope; the children and teenagers spread out there for their school. Every morning it was like arriving in a large amphitheatre of a classroom, where we found all these children, unaware of the tragedy they were living through. This also came through in the ease they had at finding something to be happy: an empty box became a little car, a tin can could be rolled along the bumpy terrain, a bundle of rags cold be kicked like a ball. Unfortunately, these children had grown up in a hostile environment, but they still knew how to take every chance to be happy. Simultaneously, a sewing center was organized (under a tent as well) first by a Marist nun and then by our animator.

These two initiatives also helped us in the health care field. Indeed, after the initial period of disorientation and adapting to camp life, the greatest danger that also affected the refugees’ health, was the discouragement and insecurity that had pervaded them. They had been deprived of everything and they were completely unmotivated, inactive, and without prospects for the future.

Sudden change of the situation

Life went on however, and children were born in their temporary homes. Even though the camp had our examination rooms, these women were accustomed to facing the harshness of life. They preferred to give birth in their tents, communicating joy and hope to all their family members. This was a lesson for us in the simple serenity of life even in situations that seemed to be hopeless.

At the beginning, we thought it would take at least a year before the refugees would reenter Burundi; that situation changed suddenly. After an agreement over a peace plan for the two ethnic groups in Burundi (Tutsi and Hutu), between the delegations of the governments of Burundi, Rwanda and the Democratic Republic of Congo, a certain calm had been established in Burundi. The only people who seemed to be in danger were teachers, catechists and students. The authorities felt the rest of the population, whether uneducated or in difficult economic straits, could reenter. The representatives of the Burundian government came to the camps to invite the refugees to return home.

After the first sputtering departures, the people in charge of the various camps were called together by the Red Cross in November 24. They expected a massive reentry of refugees, and they informed us that the camps would be closed by the end of November. Upon our departure, 15 patients remained at the hospital in Gakoma. They were still in precarious health conditions, and waiting for the Red Cross to take them back to Burundi as soon as possible.

Although the joy of returning to their homeland was visible on the faces of these refugees, you could also see pain for the people they would not have found there. They were uncertain, incredulous and they were afraid of not finding their homes and their loved ones; they were sad about the prospect seeing their own vegetable gardens destroyed. This long, slow column was mainly made of children and women whose last gifts from Medicus Mundi they bore on their heads: a woolen blanket to protect their small ones and a zinc bucket.

*Myriam Brunelli leitete als Ärztin während vieler Jahren das Labor für klinisch-chemische Analysen am Kinderspital von Brescia.