At the end of 2007, MSF ended its activities in Rwanda after 16 years in the country.
MSF's work had included assistance to displaced persons, war surgery, programs for unaccompanied children and street children, support to victims traumatised by the conflict, programs to improve access to health care, responding to epidemics such as malaria, cholera, and tuberculosis, and projects linked to maternal and reproductive health.
MSF was one of the only aid organisations to remain in Rwanda during the genocide, where we provided medical assistance. However, our doctors soon realised that providing medical care was not enough; doctors alone cannot stop a genocide. Shocked by the international community’s refusal not only to recognise the slaughter as genocide but also to intervene to save lives, MSF went public. A high-profile witnessing campaign ran across Europe, culminating in the handing over of a report on the genocide to the United Nations. The subsequent collective lack of action remains one of the most shameful episodes of recent years.
In the months following the massacres, MSF gradually expanded its activities across the country, focusing particularly on displaced and unaccompanied children and supporting health structures that were close to collapse. Massive medical assistance was also provided to some two million refugees who had fled the killings and were now living in precarious camps in Congo (formerly Zaire) but also Burundi and Tanzania.
The need for MSF to bear witness impartially was unabated. Staff denounced intimidation and atrocities both in a camp and in Gitarama prison, leading to the expulsion of some MSF teams and the withdrawal of others. Essential work continued elsewhere in Rwanda and, particularly that along the borders, was to prove essential in 1996 when fighting in Congo sparked a massive return of hundreds of thousands of Rwandan refugees to the country.
As the 1990s drew to a close, the situation in Rwanda gradually moved from emergency intervention to reconstruction and development. MSF teams continued their work, addressing the new challenges of rebuilding the healthcare infrastructure, providing mental health support to traumatised survivors, helping the country cope with the surge of HIV /AID S cases, working to improve maternal and reproductive health and responding to epidemics and other emergencies. Over the years, the capacity of local systems and the involvement of other external actors have allowed MSF’s gradual handover and withdrawal.