AS I start the New Year tending my patients at New York Hospital-Cornell Medical Center, I can't stop thinking about the women of Rwanda. Hearing from women in the new government of Rwanda who visited the United States last month renewed the concerns I had this summer when I went to Rwanda and to refugee camps in Zaire to help the thousands of displaced families, women, and children.
During this time when we celebrate the family, I fear for the families camped on the border of Zaire, with nothing but plastic tents to keep them dry. One farmer told me a story I was to hear similar versions of again and again. He left his house, animals, and farm when he fled from Rwanda. With his wife and four children he crossed into Zaire, where they had no shelter from the rain. He is afraid that if he returns he will be accused of being a traitor. He told me, with tears in his eyes, ``We now live worse than our animals at home.''
I am still haunted by his story and the terrible destruction I witnessed. I am also bewildered by the international response. Pouring millions of dollars into the refugee camps in Zaire is a terrible waste of money because the relief operation is being taken over by the former members of Rwanda's extremist Hutu government, which is charged with orchestrating the deaths of more than 500,000 Tutsis and more-moderate Hutus.
Rwanda's former military is preventing all but a trickle of people from returning home. In and around Goma, refugees have been bludgeoned to death by the military for talking about returning to Rwanda. No registration of families has taken place yet because the military will not allow it.
A few months ago, the militia-men caused riots when we attempted to give out food, plastic sheeting, and other basic materials to mothers and children. Now, they exert their power by demanding direct distributions. Before allowing aid organizations to give food or medicine to the civilian population, the former military demands its share.
Because the former Rwandan military is really running the camps, the operational procedures of the United Nations High Commissioner for Refugees (UNHCR) are not being followed. Specifically, the UNHCR's Guidelines for the Protection and Care of Women and Children point out that in any refugee setting, women and children are more vulnerable than others to exploitation and violence. UNHCR urges aid organizations to set up distribution systems so that women are among the first to receive food and medicines, which they use to keep their children and other family members alive. But Rwanda's former government isn't interested in preserving families. Aid groups cannot follow UNHCR guidelines because of the danger of physical violence against their workers and others.
Meanwhile, inside Rwanda a new government is working to restore order and rebuild a devastated country. This is where international aid should be sent. Refugees will return to Rwanda if there is a reason to return.
Jeanette Kagame, the wife of the vice president of Rwanda, after discovering thousands of her countrywomen had been widowed and left homeless, founded a nonprofit organization, the Rwandan Women's Solidarity Association. She has traveled around her country, interviewing women displaced from their homes and villages and creating projects to help them help themselves. Many of these women witnessed the slaughter of their families just months ago.
Mrs. Kagame, who visited the US last month, says the women are asking her, ``Why should we live? We have lost our homes, husbands, children ... What is there to live for?'' She tells them they must struggle on, caring for whoever in their families is left.
The association is creating rehabilitation projects involving farming, brick building, construction, sewing, and other activities. In addition, Kagame hopes to organize a national reconciliation project. She envisions a nationwide series of seminars and discussions, conducted by trained professionals, which will address the difficult questions of ``What happened?'' and ``Why?''
Kagame is not naive. There is a sadness in her eyes and a softness in her voice when she tells us, ``Reconciliation may not be possible for many people. Many women know who killed their husbands, have seen their neighbors wielding machetes. But if we do not begin to discuss the genocide, we will never be able to put this behind us.''
I will pray for her in her struggle, and for all of the families living in border camps and in the devastated villages of Rwanda. There are times when I cannot go to sleep at night thinking about them. But when I hear about organizations such as Kagame's, I am reminded of the beauty and resilience of the human spirit. My New Year's wish is that we all, in whatever ways we can, support the efforts of those who rebuild, and spurn the demands of those who tear down. The Opinion/Essay Page welcomes manuscripts. Authors of articles we accept will be notified by telephone. Authors of articles not accepted will be notified by postcard. Send manuscripts by mail to Opinions/Essays, One Norway Street, Boston, MA 02115, by fax to 617 -450-2317, or by Internet E-mail to OPED@RACHEL.CSPS.COM.