ABSTRACT
The coronavirus disease (COVID-19) pandemic has illustrated the wide range of preventative measures and responsive strategies of low- and middle-income countries (LMICs). LMICs have implemented lessons learned from previous periods of epidemics and uncertainties. Rwanda's pre-existing decentralized healthcare and mental health system which are in response to the mental health distress from the 1994 genocide, continues to be a formidable system that collaborate and combine efforts to address people's mental health needs. COVID-19 has heightened or exacerbated people's mental health within the country. Rwandans have been exposed to and endured adversities, yet their cultural forms of resilience serve as a mental health protective factor to also overcome COVID-19. Nonetheless, Rwanda has engaged in interventions targeting public safety, social and economic protection that specifically address vulnerable communitie's mental health needs. Lessons from preparedness for the Ebola virus disease (EVD) epidemic has contributed to Rwanda's organization and approach to combating COVID-19. Policies and best practices that were enacted during the EVD outbreak have guided Rwanda's response within the healthcare and mental health system. Coincidentally, this outbreak emerged during the 26th commemoration of the 1994 genocide against the Tutsi. Although for the first-time post genocide, Rwanda was not able to engage in public traditional forms of collective mourning and community healing, evidence of Rwandan's resilient spirit is demonstrated. Community resilience has been defined by Magis [401] as the "existence, development and engagement of community resources by community members to thrive in an environment characterized by change, uncertainty, unpredictability and surprise.". Referring to this definition, community resilience has been an interwoven into the cultural framework that guided Rwandans in past challenges and continues to be evident now. Rwanda's resilience throughout this pandemic remains through ongoing psychoeducation, community awareness of mental health concerns, collective messages of highlighting mental health support, and solidarity. The global community can gain knowledge from Rwanda's learned lessons of their past which has positioned itself to stand on its resilient values in times of uncertainty such as COVID-19 and endeavor to overcome through national cohesion.
ABSTRACT
PURPOSE OF REVIEW: There is evidence that the exposure to a major natural disaster such as the 2010 earthquake in Haiti may have devastating short- and long-term effects on children's mental health and overall development. This review summarizes what has been reported in the past 3 years (2017-2020) regarding emotional, psychological, and behavioral effects of exposure to this particular earthquake on children 10 years and older. RECENT FINDINGS: Twenty-six articles were screened, of which twenty-one were selected for final analysis. The main themes addressed in the literature over the 3 years concerned prevalence of post-traumatic stress disorder (PTSD), depression, determinants of resilience factors, prevalence of sexual violence as well as prenatal exposure, and subsequent autism behaviors/symptoms. The majority of the findings analyzed in this review on mental health in young Haitian survivors of the 2010 earthquake came from cross-sectional studies conducted in West region of Haiti, spefically Port-au-Prince. There was a paucity of longitudinal and translational data available. The results of this critical review can be used to inform disaster preparedness programs with the aim of protecting children's development and mental health, which are much needed on this disaster-prone island.
