Uwamaliya Philomène, Smith Grahame
a Mental Health Nursing/Faculty of Education, Health, and Community , Liverpool John Moores University , Liverpool , UK.
b Allied Health/Centre for Collaborative Innovation in Dementia , Faculty of Education, Health and Community, Liverpool John Moores University , Liverpool , UK.
Issues Ment Health Nurs. 2017 Apr;38(4):361-367. doi: 10.1080/01612840.2017.1280574.
Rehabilitation remains a significant concern among survivors of the 1994 genocide in Rwanda. Rehabilitation falls under tertiary prevention, which is a core function of public health. Despite efforts to introduce various rehabilitation programmes for genocide survivors in Rwanda, these initiatives have often proved inadequate in meeting their long-term needs. The failure of the Rwandan Government, international community, United Nations, and other Non-Government Organisations (NGOs) calls into serious question their commitment to international human rights laws. Rehabilitation should be regarded as a free-standing human right for genocide survivors and a human rights-based approach to the rehabilitative process should incorporate measurable outcomes based on an agreed ethical framework. The author calls upon the international community to reiterate its concerns about genocide survivors and reaffirm its commitments to human rights. The main issues discussed in this article are: the long-term needs of survivors of the 1994 genocide; what is already provided, and the gaps; how Stucki's Rehabilitation Cycle framework (a problem-solving tool) can help improve current provision; the role of the international community, NGOs, and genocide survivors' organisations in advancing rehabilitation; and the need for a human rights-based approach to rehabilitation. A strong recognition of the right to rehabilitation is crucial. An ethical framework related to the human rights-based approach should also assist in setting outcomes that can be measured against agreed standards, ensuring: rights that have been violated are identified; the accountability of each service provider in promoting rehabilitation; rehabilitation which is inclusive and non-discriminatory; participation by encouraging collaboration with survivors rather than doing things for them; and empowerment by enabling survivors to understand their rights and have the confidence to challenge or question when their rights have been violated.
康复仍是1994年卢旺达种族灭绝幸存者面临的一个重大问题。康复属于三级预防范畴，而三级预防是公共卫生的一项核心职能。尽管卢旺达为种族灭绝幸存者推行了各种康复项目，但这些举措往往被证明不足以满足他们的长期需求。卢旺达政府、国际社会、联合国及其他非政府组织（NGO）的失败，严重质疑了它们对国际人权法的承诺。康复应被视为种族灭绝幸存者一项独立的人权，基于人权的康复进程方法应纳入基于商定道德框架的可衡量成果。作者呼吁国际社会重申其对种族灭绝幸存者的关切，并再次确认其对人权的承诺。本文讨论的主要问题包括：1994年种族灭绝幸存者的长期需求；已提供的内容以及存在的差距；斯图基的康复周期框架（一种解决问题的工具）如何有助于改善当前的服务提供情况；国际社会、非政府组织及种族灭绝幸存者组织在推进康复方面的作用；以及基于人权的康复方法的必要性。对康复权的强烈认可至关重要。与基于人权的方法相关的道德框架也应有助于设定可根据商定标准进行衡量的成果，确保：确定被侵犯的权利；每个服务提供者在促进康复方面的问责制；具有包容性且不歧视的康复；通过鼓励与幸存者合作而非替他们做事来实现参与；以及通过使幸存者了解自己的权利并在权利受到侵犯时有信心提出质疑或询问来实现赋权。
