Recommendations from the workshop on long-term care, palliative care, autonomy and independence, may 24, 2018

NSINDAGIZA Organization, considering the integration of the elderly in the implementation of the SDGs, organized on May 24, 2018 a high level workshop on long-term care, palliative care, autonomy and independence for older persons. The workshop was organized in collaboration with the Rwanda Bio-medical center, National Commission of Human Rights, with the support of MINALOC and HelpAge International, and different actors in palliative care, human rights institutes, Government and Civil Society attended the workshop and the MINALOC addressed the opening remarks. After the presentation made by NSINDAGIZA Organization, RBC, SDGC/Africa and the National Commission of Human Rights, the participants agreed on the following recommendations:

1. The Government of Rwanda and non-governmental organizations, to include in their programs to educate and give ability to the elderly, so as to help them reduce their pain and that they may be able to age gracefully.
2. RBC/MoH ought to raise community awareness on the existing palliative care to the people and put in consideration the elderly in particular.
3. The Government and non-governmental organizations should conduct the researches on the livelihood of the elderly, so as to promote the rights and welfare of older men and women and create awareness based on evidences.
4. The Ministry of Health to fast-track the in-service training and awareness for health professionals on how to take care of the elderly
5. The Ministry of Health to train specialists in gerontology and geriatric and establish geriatric services in all public hospitals and clinics
6. The Government of Rwanda to comply with the international and regional instruments/measures/mechanisms related to the rights of older persons and plan to attend annual meeting of the UN Open-Ended Working Group on Ageing (OEWG) that should be attended by the Government, the National Commission of Human Rights and the elderly representatives
7. The Government of Rwanda to fast-track signing and ratification of the African charter on the rights of the elderly (2016), putting in action the Madrid Plan of Action on ageing (2002) and to submit the due reports concerning the above.
8. The MINALOC to speed up the national elderly policy, and advocate for the mainstreaming ageing among all the sectoral policies, such as MoH, MIDIMAR, MINAGRI, MIGEPROF, SDGs implementation…
9. Civil Society and Private Sector to put into consideration the elderly in all their programs.
10. Put in place policies that will enable the older men and women of the society to take decisions on their own and be able to participate in programs to build the family and the country as a whole
11. The Government of Rwanda and civil society to increase community awareness on the violence against the older men and women and to celebrate the World Elder Abuse Day, every June 15th
12. Non-governmental organizations to work hand in hand with the Government in the celebration of the International Day of Older Persons, October 1st.
13. Put in place policies to make known the Law of the responsibilities of children towards their parents and the consequences of failing to do so.

Kigali, May 24, 2018

Elie MUGABOWISHEMA, President of NSINDAGIZA

Ageing Demands: Older persons claim specific care, activists on policy gap, Government finds no gap

“I am tired now, you have made me talk for long and it is good for me but I am tired. I like having someone attending to me for a talk as I usually spend entire day alone.”

Retired Pastor Naasson Hitimana.

Activists advocate for particular policies

Well over 10 years through Age Demand Action (ADA), rights activists have advocated for international convention on the rights of older persons, participation of older persons in governments’ decisions that affect them and having choice about their lives in their respective families.

There is still a lack of international convention and local policies about the rights and welfare of older persons.We are urging the Government of Rwanda to set up particular platforms through which older persons can channel their concerns as children, youth, women and people with disabilities have theirs.

Most of older persons suffer serious depression and stigma resulting from isolation and creating space for them to participate in the country and family’s life would be the best solution as well as developing effective social protection schemes for older persons.

Madeleine Nirere, the Chairperson of National Commission for Human Rights, Told igihe.com that after the recent outreach in which the commission learnt about lack of proper protection of older persons, the commission recommends government to develop a policy on eldercare and support existing charitable centres for older persons.

She added that considering the frailty of older persons, they deserve special care, saying that Rwanda should ratify and implement obligations in international and regional instruments on older persons’ rights and protection.

Ms Nirere stressed that older persons’ close and extended family members, neighbours, close government entities and Rwandan society at large should take responsibility of eldercare.

Minister of State in charge of Social Affairs and Social Protection at the Ministry of Local Government,Dr Alvera Mukabaramba,Told igihe.com that government does its best to support all vulnerable people and older persons constitute the majority of beneficiaries of social protection schemes such as cash transfer under Vision 2020 Umurenge Programme (VUP) and Community-Based Health Insurance (Mutuelle de Santé).

“Not all elderly persons need support. Some are receiving their pension while others have children or other family members supporting them. We are working on a comprehensive social protection policy considering together all categories of the disadvantaged as the current policy will expire in 2018,”Dr Alvera Mukabaramba said.

Dr Mukabaramba urged young people to save for their old age, saying that every working Rwandan, not only monthly salary earners but also informal sector actors including those on government support schemes, has to save for pension as a sustainable solution for ageing demands.

“Government seeks to strengthen pension scheme and poor people who will join the scheme will receive government’s incentives according to law which is now in Parliament. Meanwhile, children should not forsake their old parents and government will intervene where necessary,” Dr Alvera Mukabaramba said.

Report on the volunteers training

UNIVERSITY OF RWANDA VOLUNTEERS OF NSINDAGIZA ORGANIZATION WORKSHOP REPORT

CENTER FOR MENTAL HEALTH HUYE CAMPUS

The participants to the workshop, Huye May 1, 2017

INTRODUCTION

NSINDAGIZA Organization in collaboration with Center for Mental Health, organized the workshop held on 1st May 2017 in Huye at the Center for Mental Health. The workshop was attended by 21 participants (14 Males and 7 Females). .

I. OBJECTIVES OF THE WORKSHOP

  • To raise awareness of the UR students on the situation of elderly persons at different levels
  • To explain the organization and its mission
  • To explain the operation of the support groups
  • To establish a club of volunteers in Huye

II. PARTICIPANTS

  • UR students, volunteers of NSINDAGIZA
  • HABARUGIRA Augustin, Center for Mental Health delegate
  • IZATURWANAHO Félicien ,President of Clinical psychology Students Association of Rwanda (CPSAR)
  • Elie MUGABOWISHEMA, President of NSINDAGIZA Organization
  • Félicien MULINDA, President of NSINDAGIZA Huye
  • MUKARURINDA Zaïnabu, President of Ngoma support group
  • Gisèle BANKUNDIYE, Board member

III. WELCOME REMARKS

In his opening remarks Mr. HABARUGIRA Augustin, representing the Center for Mental Health, on behalf of the center, applauded NSINDAGIZA organization and its volunteers who participated in the workshop for raising their voices and joining their hands in promoting the rights and welfare of the elderly persons in Rwanda and beyond. He ensured the collaboration and full support of the center to the organization.

IV. TOPICS DISCUSSED

I. Elderly overview

In his presentation, Mr. Fulgence MUNYAMPETA, one of the UR students in clinical psychology and intern in Center for Mental Health, showed clearly the statistics of elderly situation globally and in Rwanda.

According to his presentation, in 2050 the older person will be triple to about 1.5 billion representing 16 percent of the world population (WHO, 2012).

In Rwanda, according to the RPHC4, there are 511,738 elderly persons (60 and above) living in Rwanda out of a total population of 10,515,973 inhabitants. The elderly thus represent 4.9% of the total resident population.

Data from the four Rwandan censuses indicate that the proportion of old people first increased from 4.8% in 1978 to 5% in 1991 dropped again slightly to 4.3% in 2002 and has only minimally increased to 4.9% in 2012.

Therefore, He concluded by saying that the increase in the number of old people requires the programs and measures of assisting them in their long journey in old age.

II. Organization and its mission

Elie MUGABOWISHEMA, the Founder and President of NSINDAGIZA Organization, explained the mission and vision of the organization.

He said that after observing the problems and challenges older persons face (loneliness, Chronicle illnesses including NCDs and, HIV/AIDS, poverty, psychological problems,) he met with other few people to discuss what to do with older persons. The first General Assembly, held on 20th July 2014, initiated the Organization named “NSINDAGIZA” in Kigali Sector, NYARUGENGE District with 31 members and the committee of 7 members was put in place, with an objective of Promoting the rights and welfare of the most vulnerable older persons in Rwanda. Elie emphasized clearly the role and responsibilities, the qualities and the benefits for the volunteer and shared the power point presentation containing all related information. He concluded by calling upon the volunteers to join hands for the advocacy of elderly persons in Rwanda and beyond, and invest their time, talents and treasures in the promotion of elderly persons through sensitization of the community and capacity building of elderly persons.

III. Volunteerism

Gisele BANKUNDIYE, one of board members on her side, emphasized the terms volunteering (Gukorera ubushake) and to be committed (Gukorana ubushake) and the benefits of both. From different views from the participants, volunteering is to work without any material compensation whereas to be committed refers to work with willingness, strength and courage. Although there is no tangible compensation, there is internal motivation from working with the older persons because it is always helpful to realize the results of your effort. She shared her experience working as a volunteer from 2014, including fundraising for the activities related to the promotion of the rights and welfare of elderly persons, and she concluded by saying that it is not a shame nor a loss to invest in the improvement of the lives of the elderly.

Mr.KABALISA Arsene, Executive Secretary of Ngoma Sector in his welcome remarks.

IV. Working in groups

Felicien MULINDA, the President of NSINDAGIZA in Huye district, shared his experience of how after he met with Elie, he came and started to mobilize some key people in Huye and formed a local committee which is not fully functional as he immediately got an accident and was not able to sustain the team. Fortunately, he had at that time shared the idea with some older women in Ngoma Sector, who started a support group which is fully functional. He expressed his joy at seeing the commitment of the support group members and how the group is growing up, with the support of local leaders including the Vice Mayor in charge of social affairs.

After his speech, Mr Felicien handed over to Zaïnabu MUKARURINDA, the President of the support group- who shared her experience on how to be together as the old people changed their lives. They are 26 members (old women) who meet every Thursday to share their feelings and the effects of aging. In order to be able to help each other by solving some financial issues, they decided to contribute 200frw/week for gathering their capacity and self-sustainability. They opened a bank account in SACCO and they use the money to help whichever member could meet a problem. She concluded by saying that this group helped them overcome the loneliness, anxiety of their future lives, depression and some other social problems.

V. WORKSHOP OUTCOME

From the different opinions of greatly pleasured participants, they thanked the leadership of NSINDAGIZA Organization for thinking about them and helping them to understand how elderly persons could be assisted in their long aging journey and how they could be assisted to overcome the problems and challenges they face in their daily lives.

Pre-test and Post-test

Prior to the workshop, the participants did a test to evaluate their level of understanding the concept of aging in the beginning and did the same test at the end to evaluate the outputs of the workshop.

Therefore, in comparison to both tests, there was a big difference between the initial and end results. The participants increased knowledge on who is elderly, their challenges, how they should be assisted and how they could be involved in that process, they discovered the international, regional and national materials, they discovered the gap existing in Rwanda and also understood how the elderly person should be assisted in and the areas they need the assistance and support. (Biologically, psychologically and socially).

The question that had the same result in both tests is what asked whether there are documents they know about old people. All of them answered that there are no written documents about old people they knew.

2. Topic discussed outcome

The participants courageously agreed to be the volunteers, sustain the group, to be the agents of change in society by organizing the community awareness campaigns to improve the lives of elderly persons and advocate for them. As university students, they decided to use different measures in advocacy including:

  • Educating the community on how to sustain the lives of elderly persons in their neighborhoods,
  • Formalizing the UR students NSINDAGIZA club in Huye campus and creating others in other campuses as well as in neighboring high schools,  
  • Using ICT and social media to widely spread the advocating messages for the rights and welfare of elderly persons,
  • Conducting researches on the situation of elderly persons in Rwanda and encouraging the graduates to consider elderly situations in their dissertations,
  • Supporting their respective communities to create elderly support groups and youth  NSINDAGIZA youth clubs,
  • To be involved in the organization of key social events in Huye, such as; the International Day of Older Persons on October 1st, HIV and AIDS on December 1st, health campaign in the first week of April and campaign on rights on June 15th.
  • Keep supporting the existing elderly support group in Huye and create other in Ngoma Sector.

3. UR NSINDAGIZA Group Committee

The participants committed to join hands in advocating and raising awareness through different actions, and decided to elect their committee as follow:

No

NAMES

POST

CONTACTS

1

Julienne MUKABAHIZI

President

0781119408

2

NTWALI léo Charté

V/President

0784000559

3

MUHORAKEYE Oliviette

Treasurer Secretary

0783933070

4

MUNYAMPETA Fulgence

1st Advisor

0782225940

5

KANEZA Mariam Nadia

2nd Advisor

0728363022

Felicien IZATURWANAHO, president of clinical psychology students Association of Rwanda in his speech thanked the organization and committed to keep supporting the team and providing any support in his competencies.

v3
Felicien IZATURWANAHO, Clinical psychology students Association of Rwanda

Finally, the President of the organization, Elie MUGABOWISHEMA, thanked the participants for their opinions, ideas, commitment and promised them his full support and collaboration in all activities promoting the rights and welfare of the most vulnerable elderly persons in Rwanda.

Report of the Rwanda Leave No One Behind National dialogue, January 19, 2017

The Guest of honor to Rwanda National Dialogue, Dr Octave Semwaga, MINAGRI

In 2015 world leaders came together and made a historic promise. They signed up to 17 Global Goals – the Sustainable Development Goals (SDGs) – that have the potential to end poverty, to reduce inequality and to tackle climate change in 15 years. At the heart of the goals is a commitment to ensure that ‘No One is left behind’ and that no goal is considered met unless met for all.

On 19th January 2017, In Kigali, Ubumwe Grande Hotel was held a Rwanda Leave No One Behind National Dialogue, organized by NSINDAGIZA Organization, in partnership with other civil society organizations working with the most vulnerable people, with the support of Leave No One Behind Partnership.

In her opening remarks Madam Beatrice UWIMBABAZI, on behalf of the Mayor of the City of Kigali) has argued that civil society plays a big role in the development of the country; she continued saying that the city of Kigali is ready to collaborate with whichever organization (local or overseas) wants to give hand to the development of our country; she welcomed the participants and opened officially the dialogue.

The dialogue was attended by 58 participants (29 M and 29 F) representing different Government agencies, Rwandan civil society organizations, academic institutions including university researchers and teachers, church based institutions, International NGOs and the representatives of different categories of people including older persons, widows/widowers, women and girls, persons with disabilities, historically marginalized people, older people in centers, pensioners, people in rural areas, people living with HIV and those with Non-communicable diseases, youth, etc.

Elie MUGABOWISHEMA, Chairperson of Rwanda Leave No One Behind (LNB) Network, and President of NSINDAGIZA

The Chairperson of LNB Network, Mr Elie MUGABOWISHEMA has explained in details the aim of this dialogue as to search a solution of maintaining a sustainable development to different categories of people (elders, persons with disabilities, Historical marginalized people, etc) basing on the 17 sustainable development goals (SDGs) with their principle to leave no one behind; This is an opportunity to discuss on who is being left behind, why and what to do in order to make accessible, inclusive and suitable all services related to SDGs. He said that we are lucky that our country was among the best in the implementation of MDGs which gave Rwanda an opportunity of hosting the SDGs Center for Africa.

The Chairperson has shared with the participants the guiding questions for the dialogue:

  • Who are facing difficulties to access to different services?
  • Who is responsible at government level, for helping those who are being left behind?
  • Who is responsible at civil society level, for helping those who are being left behind?
  • What can we do to help those who are being left behind?

He even shared the country profile based on the existing data and the summary of the results of local dialogues conducted in 11 districts prior to the national dialogue. After his speech, followed the testimony of one caregiver to older persons, one representative of older persons, one representative of persons with disabilities at the same time infected by HIV and at old age, and one representative of historically marginalized people. All the testimonies pointed the common challenge of misunderstanding of caregivers and service providers about how to treat those people and also they’ve asked whether there can be a special advocacy for their well being. Especially on health, education, economy and see how they can rebuild confidence to those people who are being left behind.

An open dialogue to all participants has started after a short break, the participants discussed about the questions listed above, many of the participant showed the challenges that make one group of people to be left behind such as:      

  • Poverty
  • Loneliness for older people
  • Education background
  • Lack of the acknowledgement of the community they belong in.
  • Lack of the policy on the rights and welfare of older people

The participants closed the discussions by recommending the following:

  • Integrate social inclusion in all the programs developed by both the Government and its Civil society organization partners
  • Emphasize on changing the mindset and taking care of all and leave no one behind.
  • Empowering on reaching water and sanitation to the most vulnerable people.
  • Increasing health friendly services for all, initiate geriatric services in all referral and district hospitals and train health professionals on the basic knowledge on gerontology.
  • Free of charge medical treatment for older persons suffering from NCDs and HIV
  • Increase evidence based advocacy by conducting researches and elderly situational assessment.
  • Emphasize on NDI UMUNYARWANDA (I’m Rwandan) program for all.
  • Maintain this LNB coalition in order to unite our effort for effective advocacy.
  • Accelerate the National Policy on the rights and welfare of older persons
  • Translate the SDGs into Kinyarwanda and disseminate them to larger population.
  • Train and teach the categories of the most vulnerable about their rights.
  • The participants have argued that such dialogues should be organized as frequent as possible in order to share all innovative ideas.

As it is not easy to satisfy all the SDGs at the same time, the top 5 priorities have been identified:

  1. Ensure healthy lives and promote well-being for all at all ages
  2. End poverty in all its forms everywhere
  3. End hunger, achieve food security and improved nutrition and promote sustainable agriculture
  4. Ensure availability and sustainable management of water and sanitation for all
  5. Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all

In his closing remarks, the Guest of honor, Dr Octave SEMWAGA, the Director General of Strategic Planning and Programs Coordinator at MINAGRI, thanked the civil society for their contribution to the implementation of the SDGs in collaboration with the Government of Rwanda. He encouraged the Rwanda LNB Network to sustain for the SDGs lifelong and keep advocating for Social integration across all the programs developed both by the Government and Civil Society organizations. He ensured the full support of the Government to however who will be implementing the SDGs, especially those in line with MINAGRI, these recommendations will be taken into account in the budget of next fiscal year.

The picture of all the participants at the LNB National Dialogue, Kigali January 19, 2017

REPORT ON THE RWANDA LNB LOCAL DIALOGUES

INTRODUCTION

Due to the rise of cases of lack of service acquisition by some citizens, due to discrimination based on tribe, age and social status among others, the Nsindagiza organization in partnership with other concerned organizations put together a team to investigate these cases, their causes and come up with the most appropriate solutions. They were allocated one month, starting from 1st December 2016, in which they were to have made a report of their findings.

The full time members of the team were:

  • Abewe Mukesharugo Bienvenue.
  • Iranejeje Shema Shekillah.

We were helped by the staff of the Rwanda LNB network member organizations in their respective zones.

METHOD USED.

We used questionnaires and local dialogues in cases of illiteracy which high in rural areas.

FINDINGS.

MOST DISCRIMINATED AGAINST GROUPS

We found out that the groups that receive least services in most areas include:

  • The elderly
  • The historically marginalized people
  • The mentally ill
  • The poor

REASONS FOR THEIR DISCRIMINATION

The reasons we got for their discrimination include:

  • Their tribe
  • Their economical state
  • Level of education
  • Age
  • Mental health
  • Income generating activities (Potters)

IN WHAT WAYS THEY ARE DESCRIMINATED

  • Isolation
  • Loneliness
  • Stigma

SERVICES THEY LACK

  • Food
  • Shelter
  • Training
  • Electricity
  • Jobs
  • Pension money

SERVICES THEY GET

  • Water
  • Education
  • Security
  • Transport and communication
  • Freedom of voting
  • Right to join any organization
  • Medical

MOST NEEDED SERVICES

  • Food
  • Shelter
  • Electricity
  • Training

THE ROLE THEY MAKE IN MAKING LAWS CONCERNING THEM

Most of the victimized citizens take no part in making the laws that concern them.

CONCLUSION.

The first place we did our research was among the historically marginalized people, commonly known as the Batwa group. Most inhabitants, being potters, face great discrimination based on both their tribe and their occupation. They live in underdeveloped areas, since even the most educated among them do not take steps towards developing their home area, due to the discrimination they face whenever they try. Although they got help from well wishers, like a donor who built a school for their children, some do not attend due to lack of the money required for lunch by their parents. This affects them tremendously. About only four homes out of a hundred have electricity, hence the need for improved electricity in the region.

Another place we visited nearby experienced issues of lack of freedom of expression. Despite the government’s good will, policies and sensitization, whenever one of them succeeded in achieving a leadership position, there would be cynical comments from the community asking how a person from clay (based on the occupation) would bring about development, or how one who had no food for her family would feed a whole village.

In another area, the main problem faced was lack of jobs. There are too many jobless people around and without any hope in finding jobs, mainly due to lack of proper education.

The elderly do not receive nearly enough pension money. The little they get is sent through banks, which deduct over half of their fee, leaving them with next to nothing. Adding the transport fee to get to the banks, the aged end up without any benefit from their prior services to the government. Some of them however do not get any help from the government, because the local authorities claim that if an elderly has a child over eighteen years of age, they need not get any more help since their child will care for them. However, when the children grow up, most leave their homes, leaving their aging parents alone with no one to care for them. Some of the diseases they suffer from are unknown to health professionals since they do not specialize in that field, hence are not treated. Some doctors even have the nerve to discourage the aged by asking them why they are struggling yet they are just awaiting death. There is an urgent need of geriatric services, training of health professionals on how to work with older people

In another region, the citizens have small pieces of land but have little or no fertilizer and they lack enough money as down payment for the fertilizers loaned to them by the government. They also have very poor shelters as shown below

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We would recommend more awareness to be created since it was so saddening to find out that over 99% of the people we talked to have no idea what the Sustainable goals of the United Nations are.

RECOMMENDATION.

We would recommend more awareness to be created since it was so saddening to find out that over 99% of the people we talked to have no idea what the Sustainable goals of the United Nations are.

Another idea would be to build homes for the aged and appoint people to care for them since they are neglected, and also establish training colleges in caring for the aged and treating their diseases.

The pension money allocated to the aged should be increased as the value of money reduces since they get the same amount as forty years ago, yet value changes. Ways to get the money to them should also be come up with, since they are weak.

When registering those who are alive, the person is required to be present in person. However, some of the elderly have nobody to take them there.. The local authorities, therefore, should appoint individuals to go from home to home where the aged live to confirm their presence, so that they may receive the services they are due.

Discrimination should be greatly discouraged and equality promoted among all, irrespective of age, gender, tribe, mental and physical health, for a better tomorrow.

In areas where people need fertilizers, less money should be asked for in order to loan it since the higher the amount is, the less people who can afford it. Public awarance and training should also be carried out more often and to wider audiences.

Since some children suffer due to their parents’ poverty, the schools set up with free education should also provide food to promote equality.

Challenges

The main challenge we faced was that the overall coordinator , Abewe Mukesharugo Bienvenue, got involved in an accident and lost consciousness. All the data, report and all the supporting documents for the money used during the research we had conducted was stolen, and we were unable to recover them. This report, as a result, is all from what I can recall from our research.

Another challenge was that due to the poor transport facilities, we mostly used motorcycles, the drivers from whom we could not get invoices, hence no clear evidence of how the transport expenses were consumed

SUMMARY OF NUMBERS

DATE

DISTRICTS

NUMBER OF DIALOGUES/FGD

NUMBER OF PARTICIPANTS

NUMBER OF FACILITATORS

6th-8th December 2016

Kamonyi

Nyaruguru

Huye

1

1

2

6

7

12

IRANEJEJE Shema Shekillah

ABEWE Mukesharugo Bienvenue

12th-16th  December 2016

Musanze

Rubavu

Bugesera

Nyarugenge

Gasabo

1

1

1

1

2

7

8

10

5

13

 IRANEJEJE Shema Shekillah

ABEWE Mukesharugo Bienvenue

 

20th-21st December 2016

Nyamagabe

 

7

 

140

IRANEJEJE Shema Shekillah

ABEWE Mukesharugo Bienvenue

GASHUMBADamascene

Olive

22nd-23rd

December 2016

Ruhango

Kicukiro

2

36

Alex

Drocella

 

 

19

244