Orphaned by genocide and AIDS, a generation poor and depressed
By Donald G. Mcneil Jr. Published: September 9, 2008

Rwanda, a country that suffered 100 days of tribal genocide in 1994 and has also been hit hard by the AIDS epidemic, is believed to have the highest percentage of orphans in the world.

Now a survey finds that depression is alarmingly common among teenage and young adult orphans there who head households and care for younger children.

The survey, conducted by Tulane University researchers working with Rwanda's national school of public health, appeared in last month's issue of The Archives of Pediatrics and Adolescent Medicine, part of The Journal of the American Medical Association.

While orphans in many African countries are taken in by relatives or neighbors, "such systems are increasingly overwhelmed" in Rwanda, the researchers found, and young people without parents or close adult relatives are having to form their own households or live on the street.

Their survey of 539 orphans ages 12 to 24 caring for others in one rural province found that 77 percent were subsistence farmers and 93 percent had less than six years of school. Almost half had eaten only one meal a day in the last week.

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More than half — 53 percent — met the criteria for depression on a psychiatric screening scale.

Seventy-six percent said their community rejected orphans; only 26 percent said they had a close friend. About 40 percent said life was meaningless or that they had lost faith in God since their parents died.

The authors suggested that large-scale interventions would be necessary "if the next generation of youth is to thrive."