|Rwanda - Health Sector Needs and Recommendations for the Transition Phase (Centre for Research on the Epidemiology of Disasters, 1998, 39 p.)|
Over the last decade tensions have been increasing in Rwanda. In 1990, there was a first escalation of the conflict with incursions from the north of the Ugandan border by the Rwandan Patriotic Front (RPF), mainly Rwandan Tutsis in exile from 1959. These tensions finally culminated in April 1994 with the assassination of President Habyarimana of Rwanda, followed by a genocide where Tutsis and moderate Hutus were killed by Hutu extremists.
Following the genocide, the RPF returned to take power in the country. With the victory of the RPF in Rwanda, Tutsi refugees, who had fled the country in 1959, returned3. As a consequence, more than one million Hutus fled to neighbouring countries such as Tanzania and Zaire, launching one of the biggest humanitarian operations since World War II. For a period of two years (1994-1996), the expelled government and its army (ex-FAR and the Interahamwe) controlled the refugee population in the camps, mainly in the region of the Kivu and posed a threat for the government of Rwanda. The situation was further complicated by the on-going internal conflicts in the Kivu region, where in 1996 the oppressed Banyamulenge pushed the Rwandan refugees out of the camps back to Rwanda.
3These numbered around 800,000 and are now referred to as old case-loads.
The mass influx of the refugees from the camps, together with returnees from Tanzania, increased social disruption and insecurity in Rwanda. At present, insecurity remains very acute in certain regions in the north west such as Ruhengeri, Gisenyi and Kibuye, mainly caused by the presence of Interahamwe troops. Moreover, many of the returnees from different periods have not been integrated within the social and political system and remain dependent on external aid.
Since 1994, the international community has provided 1.5 billion US$ of humanitarian aid, mostly as direct aid through NGOs. While it is generally considered that the emergency period is now over, major institutional problems are delaying the rehabilitation process and development of the country. Furthermore, civic and military insecurity has prevailed in the majority of the prefectures since January 1997 and continues to be quite serious. At the present time, the country requires a complex mix of humanitarian, transitional and developmental actions.
With new leadership in the government actively discouraging ad hoc NGO action, aid programmes are now moving towards a more planned and structural approach. This trend is followed up by the international community.