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Genocide Rape Trauma Management: An Integrated Framework for Supporting Survivors

Mukamana, Donatilla, PhD, RN; Brysiewicz, Petra, PhD, RN; Collins, Anthony, PhD; Rosa, William, MS, RN, LMT, AHN-BC, AGPCNP-BC, CCRN-CMC

doi: 10.1097/ANS.0000000000000177
Evidence Informed Practive

During the 1994 Rwandan genocide, rape was widely used as a strategic weapon against Tutsi women. More than 20 years later, many of these women are still suffering devastating psychological, social, and physical effects of these experiences and remain in need of effective interventions that address their complex trauma. This article develops the theory of genocide rape trauma management as a conceptual framework for promoting the holistic health and recovery of female genocide rape survivors. A qualitative study using grounded theory explored the lived experiences of genocide rape survivors and led to the development of this model. The need for a contextually appropriate model is highlighted, with historical and current data regarding the Rwandan context and the experiences of genocide rape survivors. The research details the complex dynamics of emotional, physical, existential, and psychosocial sequelae related to genocide rape trauma, and how these interact with both local community and broader political attitudes toward survivors, as well as the serious interrelated economic challenges and limitations in current public health and welfare services. The research demonstrates the necessary elements of a holistic approach encompassing a synergistic combination of skilled psychological care, self-help strategies, collaborative support groups, community education, social reintegration, advocacy, accessible medical care, and economic empowerment. These interacting elements form the basis of the theory of genocide rape trauma management, offering an encompassing integrated framework that can be adapted to, and evaluated in, other similar contexts.

School of Nursing & Midwifery, University of Rwanda, Kigali, Rwanda (Dr Mukamana); School of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa (Dr Brysiewicz); Language, Media and Communication, Durban University of Technology, Durban, South Africa (Dr Collins); Department of Social Enquiry, La Trobe University, Melbourne, Australia (Dr Collins); and University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania (Mr Rosa).

Correspondence: Donatilla Mukamana, PhD, RN, School of Nursing & Midwifery, University of Rwanda, Kigali, Rwanda (

The authors are thankful to the Rebuilding Health in Rwanda project for its financial support. Special thanks are addressed to the participants of the study. The authors acknowledge the intellectual and editorial assistance provided by Dr Tonda Hughes while writing this manuscript and Samuel Byiringiro for his technical expertise in making improvements to the graphic representation of the framework found in Figure 1.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.