One of the most devastating events of the past quarter century was the 1994 genocide in Rwanda. Out of a population of close to 7 million people, at least 800-thousand people were killed. Many left behind were children who lost family members, and frequently one or both parents. As Rose Hoban reports, the toll is especially heavy on those children who took on the burden of caring for younger siblings.
Almost every family in Rwanda was affected by the genocide says child psychologist Neil Boris from Tulane University in New Orleans.
"Behind this came the HIV epidemic, so really it's kind of a 1, 2 punch," Boris says. "Rwanda has the highest proportion of what we call double orphans, that is, young people who have lost both parents… of any country where we feel like we have reasonable data. It's not just HIV, but it's HIV on top of the genocide."
Many of these young people were left to head households filled with younger siblings and relatives. These young people frequently have no adults who they can turn to for advice and guidance. It's a situation that Boris says has left many of them emotionally scarred.
In 2004, Boris worked with the aid organization World Vision and the Rwandan School of Public Health to study about 700 of these young family leaders who were, at the time, around 20 years old. This means many of them were about 10 years old when the genocide occurred.
Boris says they found more than half of them suffered from depression. Of the group, about two-thirds had lost both parents, a quarter of those people said that at least one parent was killed during the genocide.
"The second thing we found," he says, "was that taking care of others in the home meant that the young people themselves couldn't pursue school and only about 7% of them had even gotten to secondary school in their lives."
The researchers also found that the deeper the depression, the more these youngsters felt by were marginalized from the community, and from friends.
Many of these family groups didn't have enough food to eat. That affected their physical health, and contributed to the caregivers' depression. Almost half said they only ate one meal per day over the previous week. And more than three quarters of the young heads of household rated their health as poor or only fair.
In his survey, Boris learned that these young people had said only a quarter of them had an adult friend. After looking at this, the researchers suggested some ways to help these young households — by getting adult community volunteers to reach out to them and mentor them.
"We've shown that that alone improves depression over time, improves degree of social isolation over time, and really helped these young people as time went on," Boris says.
Boris is currently working on more ways to help these young heads of household. He says he believes that with time and assistance, the young people of Rwanda can get beyond the tragedy of the genocide and help their society recover.
His paper is published in the Archives of Pediatric and Adolescent Medicine.