Gone for good

Sub-Saharan Africa: the medical brain drain

Doctors and other medical professionals migrate for many reasons, but their absence seriously compromises health service delivery

A doctor with a loud hailer shouts slogans during a protest march by senior medical doctors in Harare, on December 4, 2019. – The doctors petitioned the Zimbabwe Parliament demanding improved working conditions and the reinstatement of 448 junior doctors fired for taking part in a two month long strike over low salaries. (Photo by Jekesai NJIKIZANA / AFP)

A brain drain of African medical staff over several decades has significantly depleted the continent’s health services of doctors and nurses. At the beginning of the millennium, approximately 65,000 African-born physicians and 70,000 African-born nurses were working overseas, according to a study by Michael Clemens and Gunilla Pettersson Gelander, published in Human Resources for Health in 2008, representing about one fifth of African-born physicians and one tenth of African-born nurses globally. The number of health workers who migrate abroad varies considerably from one country to another, but figures on the migration of African doctors and nurses to 30 OECD countries, published in a 2016 World Health Organization (WHO) policy brief, suggest that the trend has been ongoing.

Between 2000 and 2011, the number of African doctors who migrated to OECD countries rose by one third to 55,541, whereas the number of nurses more than doubled to 135,970. According to OECD health statistics, Nigeria led the list of African countries whose doctors were working in these countries in 2019, with a total of 10,487 as against 10,318 for Egypt and 9,509 for South Africa. On 25 May 2018, South African daily newspaper The Citizen quoted African Union statistics revealing that 75% of all trained physicians in Mozambique emigrate. The figures for other countries – Angola 70%, Malawi 59%, Zambia 57%, and Zimbabwe 51% – were also alarmingly high.

The trend is corroborated by sources on the other end of the migration flow. An article published on the Mo Ibrahim Foundation website on 9 August 2018, titled ‘Brain drain: a bane to Africa’s potential’, indicated that in 2015, the number of African-trained International Medical Graduates (IMGs) practising in the United States (US) alone reached 13,584, a 27.1% increase from 2005. In 2015, 86.0% of all African-educated physicians working in the US were trained in Egypt, Ghana, Nigeria and South Africa. A WHO report in 2013 warned that the world will be short of 12.9 million healthcare workers by 2035. The largest shortages are expected to be in Asia, but it is in sub-Saharan Africa where they will be especially acute. All regions will be competing for medical staff; and the demand will also be high in developed countries.

In the EU in 2013, the overall shortfall of health workers was estimated at 1.6 million and it was expected to increase to 4.1 million in 2030, according to Jean-Pierre Michel and Fiona Ecarnot, in an article published by the journal European Geriatric Medicine in April this year. African health systems will likely bear the brunt of this shortfall. Africa bears “more than 24% of the global burden of disease, but has access to only 3% of health workers and less than 1% of the world’s financial resources,” says the WHO. In 2011, the British medical journal The Lancet indicated that whereas high-income countries sustained a relatively high physician-to-population ratio, by recruiting graduates from developing regions, more than a half of sub-Saharan African countries were not meeting the minimum. For example, The US Central Intelligence Agency’s (CIA) World Fact book states that in 2017, only four African countries were meeting the WHO standard of one doctor for 1,000 patients: Algeria, Libya, Mauritius and the Seychelles, while Egypt and South Africa were close to it with ratios of 0.8 and 0.82 respectively.

Part of the explanation for this situation is that since April 2001, when African heads of state committed themselves in the Abuja Declaration to allocate at least 15% of their budgets to improving their health sector, by 2014 only four countries (Malawi, Ethiopia, Swaziland and Gambia) met or exceeded the Abuja target, according to a 2016 WHO report, ‘Public Financing for Health in Africa: from Abuja to the SDGs’. South Africa, Namibia, Lesotho, Burundi, the Central African Republic and Kenya were close to the 15% target, but 19 other countries had spent less in percentage than was the case in 2000. The medical staff shortage crisis affects almost every facet of public health, including child and adult mortality, maternal health, and the treatment of diseases and infections. Mortality rates in Africa’s general population are among the highest in the world, with death probability rates of 39.1% for men and 33.2% for women aged between 15 and 60.

UNICEF has estimated that a child born in sub-Saharan Africa has an 8.1% probability of death before the age of five. Africa’s mortality rates are strongly related to a lack of healthcare workers within the region, a situation exacerbated by the uneven distribution of healthcare workers between urban and rural areas. Healthcare workers migrate for a variety of reasons. For many migrants, it is a personal decision. For others, it occurs in the context of cooperation agreements to train staff abroad and it is temporary. This is called circular migration and it is particularly encouraged by the European Union. Other health workers are sent abroad for training by their governments and are supposed to come back and exercise their skills back home, but end up working in European or American hospitals.

Push factors for migration include low salaries, poor living and working conditions, lack of career development opportunities, high cost of living, job and economic insecurity, and lack of social recognition. Some researchers stress a strong correlation between political instability in a country and the loss of its medical personnel. A study from the Universities of Ghana and Alberta (Canada) in 2007 found that push factors for medical personnel included an oppressive political climate, the threat of violence and the persecution of intellectuals.

Doctors tend to a child suffering from severe malnutrition sitting on his mother’s knees at the medical center of the NGO “Bien etre de la femme et l’enfant au Niger (BEFEN, Welfare of the Woman and the Child in Niger) at the Mirriah refugee camp, in the Zinder region of Niger. Mali’s March 22 military coup and the subsequent seizure of half the country by rebels have compounded the already worrying effects of a food crisis across West Africa’s Sahel region. The UN estimates the Mali crisis has forced more than 320,000 people from their homes, with 187,000 seeking refuge in neighbouring countries, including Niger — already in the grips of a new drought that has put millions at risk of hunger. AFP PHOTO / ISSOUF SANOGO (Photo by ISSOUF SANOGO / AFP)

A lack of respect from physicians, and barriers to full utilisation of specialised nursing knowledge in healthcare settings, were push factors for the migration of nurses in a Ghanaian study, according to Delanyo Dovlo, director of health systems and services at the WHO Regional Office for Africa. Another push factor is the HIV/AIDS epidemic. Nurses are particularly stressed by its impact in southern Africa. On the “pull” side, salary plays an important role. According to the United Nations publication Africa Renewal, “on average, surgeons in New Jersey earn $216,000 annually, while their counterparts in Zambia make $24,000”. Another incentive is the possibility to improve skills in the countries of destination, say researchers of the OECD Health Division, in a report on ‘Recent Trends in International Migration of Doctors, Nurses and Medical Students’, published in July 2019. Dovlo also identifies differences in the way that African doctors and nurses are recruited.

“While doctors are usually passively recruited (i.e. look for the jobs for themselves), nurses are usually actively recruited by agents, sometimes for a fee,” he says. Again, the situation varies by country and time periods. The migration of nurses from South Africa is declining, for example, partly due to a slowdown in recruitment from the United Kingdom (UK) since 2006, when new immigration rules allowed foreign nurse work permits only if employers could demonstrate non-availability of staffing from Britain and the EU. Meanwhile, migration flows have continued towards Gulf countries. The United States is the main country of destination for migrant doctors and nurses. Of all foreign-born health workers who practise in OECD countries, 42% of doctors and 45% of nurses practise in the US. The UK is the second country of destination, receiving 13% of all foreign-born doctors who practise in OECD countries, followed by Germany (11%).

This ranking is reversed for nurses, with Germany in second place (15%) followed by the UK (11%). It can be assumed that gaps in staffing significantly compromise health service delivery in sub-Saharan Africa. In Kenya, where the ratios of doctors and nurses to the population are very low (16 doctors per 100,000 and 88 nurses per 100,000), the migration of health professionals reduces the capacity of the remaining staff to attend their patients, note the authors of a paper titled ‘Migration of health workers in Kenya: The impact on health service delivery’, published in March 2008 by the Regional Network for Equity in Health in East and Southern Africa. Countries that invest in the training of health workers suffer financial losses when these professionals emigrate (including the cost of education and training). A 2018 Mo Ibrahim Foundation report on the state of public services in Africa revealed that nine countries lose about $2 billion a year due to doctors and health practitioners leaving the continent.

Destination countries, on the other hand, benefited handsomely. “One in 10 doctors working in the UK come from Africa, allowing the UK to save on average $2.7 billion on training costs, followed by the US ($846.0 million), Australia ($621.0 million) and Canada ($384.0 million). In total, these four top destination countries have saved $4.6 billion in training costs for the Africa-trained doctors they have recruited,” said the Foundation. The recruitment of African medical staff workers by high income countries has been a major concern for global health bodies for more than a decade. At the 57th World Health Assembly in May 2004, participants agreed the international migration of health personnel was “a challenge for health systems in developing countries” and urged member states to develop strategies, including better working conditions, to encourage health professionals to remain in their own countries.

In 2010, the assembly adopted the WHO Global Code of Practice on the International Recruitment of Health Personnel, which, it says, “aims to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel and to facilitate the strengthening of health systems”. One positive element of migration, however, is that African medical staff benefit from new skills abroad, which they can usefully share on returning to their countries of origin. Temporary migration for training and studies, especially when coordinated with support programmes of specialised entities like the Antwerp-based Institute of Tropical Medicine, may bear considerable benefits in designing strategies against pandemics such as AIDS, Ebola and COVID-19, and also boost research. One of the world’s top Ebola specialists, the pioneering Dr. Jean-Jacques Muyembe, practises in Kinshasa and was trained in Antwerp.

Francois Misser is a Brussels-based journalist. He has covered central Africa and Rwanda since 1981 for the BBC, Afrique Asie magazine, New African, and the German daily Tageszeitung . He is the author of several books on the DRC (Géopolitique du Congo, published in 2006 and Le Congo de A à Z , published in 2010, both with Marie-France Cros).

Rivers of arms

Democratic Republic of Congo: arms flow

Despite an arms embargo, a constant flow of weapons into the DRC from around the globe ensures that peace remains elusive

A Congolese army soldier carries a rocket-propelled grenade launcher as he walks up a road leading to the frontline on the outskirts of the provincial city of Goma in November 2008.
Photo: YASUYOSHI CHIBA / AFP

Since the withdrawal of foreign troops in 2003, the Democratic Republic of Congo (DRC) has been categorised as a “post-conflict nation”. Yet, a low-intensity war is still raging in eastern Congo and despite a UN arms embargo the flow of weapons continues unabated. In the Kivu provinces alone, over the June 2017-June 2019 period, 1,900 civilians were killed and 3,300 others were kidnapped, Human Rights Watch (HRW) and the New York University-based Congo Research Group reported in August 2019. Accordingly, some 3,000 violent incidents by more than 130 armed groups were recorded during the period. Dozens of other groups are also active in the Ituri, Upper-Uele, Tanganyika and Kasai provinces.

The main armed groups are the Ugandan led Allied Democratic Forces (ADF) and the Democratic Forces for the Liberation of Rwanda (FDLR) in addition to a myriad of Congolese Mai-Mai groups, some of which are supported by the Congolese and Burundian governments, says HRW. These groups are proliferating despite the UN arms embargo. On 28 July, 2003, UN Security Council Resolution 1493 imposed an embargo covering arms supplies and military assistance to all armed groups operating in the eastern DRC. The embargo was imposed in reaction to continued violence in Ituri and North and South Kivu after the withdrawal of foreign armies from the country the year before.

In March 2008, UN Security Council Resolution 1807 lifted all restrictions on arms transfers to the DRC government but required the notification of such shipments to the Sanctions Committee, while the embargo on supplies to non-governmental forces remained in place. Such measures are currently in force. Yet, results have been limited on the ground. Despite the embargo, and after the symbolic destruction of 100,000 firearms in Kinshasa on 21 August, 2010, 300,000 small arms were still in the hands of civilians in eastern Congo, as reported at the time by the Brussels-based Information Group on Peace and Security ( GRIP).

Enforcement of the embargo is problematic because rebels from the government’s Armed Forces of the Democratic Republic of Congo/ Forces armées de la République démocratique du Congo (FARDC) manage to buy weapons despite it, explains Jean-Jacques Wondo, an expert and analyst on DRC security issues. Criminal networks are providing ADF rebels and other groups with arms, ammunition and uniforms bought from corrupt FARDC soldiers. In 2012, according to a UN Security Council report, a network led by (FARDC) General Jean-Claude Kifwa supplied Russian-made AK-47 rifles, rocket propelled grenades and mortars as well as Belgian MAG machine guns and ammunition to the Mai Mai Morgan, in the Province Orientale.

According to Wondo, the current FARDC Deputy Army Chief of Staff, Gen Gabriel Amisi, aka Tango Four, now under EU sanctions, is also supporting some rebel groups. It would appear that the strategy of senior officers in the region includes maintaining a certain level of conflict by arming rebels. The aim is to justify additional budgets for military operations, including danger money paid to the soldiers and fuel, which are siphoned off by these officers for their own benefit, explains Wondo. In September 2018, Gen-Major Jean-Luc Ijila Yav, then in charge of logistics for the FARDC, was jailed in Kinshasa following charges of embezzling ammunition and fuel, says Wondo.

On 1 March, 2018, Radio France Internationale (RFI) reported that ammunition used by the FARDC and the rebels sometimes came from the same stockpiles. The French radio report said that since 2013 several armed groups, including the FDLR, the Nyatura Mai Mai and the Patriots Alliance for a Free and Sovereign Congo, were equipped with ammunition for the AK-47 manufactured by the China North Industries Corporation (Norinco). Curiously, the radio station reported, this ammunition came from the same stockpile as the bullets fired by a policeman that killed a demonstrator on 25 February, 2018 in Mbandaka. RFI also noted the coincidence that Chinese ammunition used during the repression of demonstrations against Kabila’s third presidential mandate in January 2018 in Kinshasa belonged to the same stockpiles as those used by the ADF rebels.

Rebels have also captured weapons from the FARDC, as in October 2008 when the Rwandan-backed National Congress for the Defence of the People (CNDP) looted a FARDC military depot in Rumangabo (North Kivu) and seized large quantities of weapons. Armed groups also obtain weapons and ammunition from neighbouring states. James Bevan from the UK-based NGO Conflict Armament Research says that the Sudanese government has supplied ammunition to the DRC, a substantial amount of which was also acquired by M23 rebels, including Russian-made 2.7 x 108 mm cartridges used by the FARDC. According to a 2012 UN Security Council report, Rwanda violated the UN arms embargo by supplying arms and ammunition to the M23 group, which also procured 12.7 mm machine guns and ammunition for AK- 47s, RPGs and mortars from the Ugandan People’s Defence Force (UPDF).

FRPI rebels in Ituri Province also bartered gold for weapons with a UPDF officer. Weapons from all sorts of origins end up in rebel hands. On 16 October, 2006, Amnesty International, Oxfam International and the International Action Network on Small Arms found that rebels in Ituri were using sniper rifle bullets manufactured by the Federal Cartridge Company in the United States and 7.62 mm cartridges manufactured by the Pyrkal Greek Powder and Cartridge Company. The same company also exported ammunition to Sudan and Uganda, two countries that are among the sources of origin of weapons found in rebel hands. South African 5.56 mm R4 assault rifles sold to the Rwandan Armed Forces (FAR) before the 1994 genocide were also found in rebel hands, say UN investigators.

Serbian arms, such the 7.65 mm Zastava Model 70 self-loading pistol, were also found in Ituri in 2006, after they were delivered from Belgrade to Kigali, says Amnesty International. Prior to that, in 2004, an armed group in Bukavu were found in possession of Serbian anti-personnel mines and mortar shells, while in September 2003, the UN says, most of the weapons recovered from the UPC militia in Ituri were 3,000 Kalashnikov rifles and corresponding ammunition from China and Russia. Rebels also get supplies from other armed groups. According to the UN Security Council report of 2012, the M23 supplied weapons and ammunition to the Raia Mutomboki Mai Mai. Since the FARDC have also been accused of many human rights violations, the supply of arms to the DRC government, even if does not violate the UN embargo stricto sensu, risks stoking the fires of repression against the Congolese.

In 2016, DRC arms imports amounted to $43 million, but the amounts vary considerably from one year to another (for example, $151 million in 2010 and $2 million in 2015). According to Wondo, most of the weapons are stockpiled in the Kibomango and Mbakana camps, near Kinshasa. Only the police and the Republican Guard, which remains faithful to the former president, Joseph Kabila, have access to these weapons. The DRC has a large range of suppliers. The FARDC use Belgian-made FN FAL and FNC rifles and MAG machine guns, US-made M16s and Israeli-made Galil rifles. Russia remains one of the main suppliers with 7.62×39 mm AK-47s or the cheaper AKM-59 version, RPD light machine guns and PKM general-purpose machine guns (7.62×54 mm).

Currently, the FARDC are equipped with 20 T-54 and T-55 tanks, 48 T-62 tanks, about 100 howitzers of various calibres, 107 mm and 122 mm rocket launchers and as many mortars. Russia sold four Sukhoi SU-25 airfighters, MI-24 Hind combat helicopters and Mi-17 helicopters to the DRC as well as Zhuk patrol vessels for the Congolese navy. Besides, according to Wondo, in July 2015 the Republican Guard acquired from Russia T-80 M tanks, new-generation rocket launchers and ground-to-air S-300 missiles. According to the FARDC logistical services, in December 2017 the former chief of staff of the presidency, General François Olenga, purchased several Iliouchine 76 Candid and Antonov 124 Condor transport aircraft from Russia. These weapons were airlifted from Sebastopol in Russian Crimea to Kisangani between December 2017 and January 2018.

Other shipments were made by sea to the ports of Matadi and Boma. Moreover, on 23 May, 2018, Russia and the DRC signed a military cooperation agreement that included a weapons sales deal. According to Wondo, on several occasions weapons for the Republican Guard were supplied discreetly via the port of Banana without notifying the UN Mission for the Stabilisation of Congo (MONUSCO). Another important supplier is Ukraine, which, in addition to 25 T-64 tanks, has sold 50 T-55 tanks to the DRC in the past decade. In December 2015, a Congolese official delegation led by General Olenga travelled to Kiev to purchase more weapons. More recently, in early 2018, the Beltech Export company from Belarus supplied four L-39 C aircraft to the Congolese air force; prior to this the FARDC had procured Sukhoi-25K and Sukhoi-27 flanker C aircraft from Beltech.

Over the years, China has also become an important source of supply. The list includes Type 56 rifles, which are China’s version of the Russian AK-47 assault rifle RPGs, about 30 T-59 tanks and one Shanghai II patrol vessel for the Congolese navy. In 2018, the Chinese Technology Company supplied 10 Phantom DJI drones for the observation of Kinshasa, Lubumbashi and Goma. Serbian-made Zastava M92 rifles are also used by FARDC troops. The Yugoimport-SDPR company supplied Premax-39 and Nestin-class river patrol vessels at the end of 2017, which were used in an assault against the Yatkutumba Mai Mai on Lake Tanganyika in November of that year. Another company called CPR Impex Doo supplied 22,000 5;56 mm M-92 assault rifles and 120 20 mm M-55 anti-aerial guns to the Republican Guard.

In 2018, the Serbian company Privi Partizan also delivered, via the ports of Banana and Matadi, about five million cartridges for various assault rifles and for machine guns. The FARDC are also equipped with 90 AML-60 French Panhard reconnaissance armoured vehicles and 60 Panhard M3 armoured personal carriers. The air force has five Mirage 5 airfighters and Puma, Cougar and SA316 Alouette III helicopters, in addition to 12 Cessna 150 and three Cessna 310 transport aircraft. The long list of suppliers to the DRC includes Spain, which sold three Piraña patrol vessels to the Congolese navy; Brazil, which sold 19 Cascavel armoured cars; and Switzerland, which has supplied 9K32 strela-2 Rapier ground-to-air missiles. Egypt has been a provider of Misr assault rifles, used by the FARDC infantry, which are a copy of the notorious Russian AK-47, and of 20 Fahd armoured person carriers, which were delivered around 1990.

Military observers have said that a large proportion of the tanks, vessels and aircraft are not operational. One of the most controversial DRC deals has been North Korea’s secret supply in 2014 of pistols to the FARDC and to the Congolese National Police. According to an official UN document seen by Reuters news agency, North Korea also sent instructors to provide training for the Presidential Guard. This deal violated the arms embargo imposed on North Korea by UN Security Council Resolution 1874 of 2009. It also violated the arms embargo on the DRC, which requires member states to notify the Security Council Sanctions Committee of arms sales or training to the Congolese army, as stipulated in UN Security Council Resolution 1807.

Finally, the FARDC has also received domestic supplies from local manufacturer Afridex in Likasi (upper Lualaba Province), which produces AK-47 rifles and ammunition with the technical assistance of the Chinese company Norinco. According to Wondo, who claims to have accessed a confidential army report from the FARDC army chief of staff in 2016, some of the Afridex weapons and ammunition were diverted by military officers to supply local armed groups such as the Bakata Katanga militias.

François Misser is a Brussels-based journalist. He has covered central Africa and Rwanda since 1981 for the BBC, Afrique Asie magazine, New African, and the German daily Tageszeitung. He is the author of several books on the DRC, including Géopolitique du Congo (2006) and Le Congo de A à Z (2010).

The facts are stubborn

Rwanda: the genocide archives

Amid mounting calls for an honest investigation into the Rwandan genocide, the UN and certain governments appear to be opposing full disclosure

A group of Rwandan refugees walk past a pile of machetes and axes confiscated by the Zairean army on July 16, 1994 in the border city of Goma. (Photo by PASCAL GUYOT / AFP FILES / AFP)

“Everyday we learn to forgive,” President Paul Kagame told a commemoration of the 25th anniversary of the Rwanda genocide in Kigali in April this year, “but we do not want to forget.” Yet, 25 years after the 1994 genocide against the Tutsis in Rwanda, full disclosure and recognition of responsibility for what happened, particularly as regards members of the international community, are still outstanding. The International Criminal Tribunal on Rwanda (ICTR), established in 1994 and dissolved 2015, dealt with the planners and the architects of the genocide. Almost two million people accused of helping to perpetrate the genocide were tried before the traditional Gacaca courts between 2001 and 2012. But questions of international responsibility remain unaddressed. Moreover, investigators, researchers and historians face obstacles in the way of establishing the truth. In June 2014, the Rwandan government established the Rwanda Archives and Library Services Authority (RALSA).

Yet despite pledges by international leaders to fully investigate what happened, members of the public elsewhere in the world still have only limited access to evidence about the genocide. UN Security Council deliberations on Rwanda, the Clinton White House papers and French and Belgian government documents remain classified. Apparently, this applies even to international court decisions. This year, the executive secretary of Rwanda’s National Commission for the Fight against Genocide, Jean-Damascène Bizimana, asked for, but was not granted, access to the ICTR archives. Olivier Nduhungirehe, to everybody, including survivors of the genocide, students and researchers,” he told Africa in Fact. What is clear is that the UN and certain governments are opposing full disclosure. During his speech earlier this year, Kagame paid a special tribute to the Czech ambassador, Karel Kovanda, who, he said, “joined colleagues from New Zealand and Nigeria to call for action to stop the genocide despite the indifference of more powerful states.”

He was probably referring to some of the five permanent members of the Security Council. While the massacres were occurring, three of the Big Five – France, the UK and the US – resisted the use of the word “genocide”, says British journalist Linda Melvern, author of the book A People Betrayed: the Role of the West in Rwanda’s Genocide, first published in 2000 and updated in 2009. To be sure, the UN is in a delicate position. Its inability to deal effectively with the genocide is still very much resented, and not only by Rwandans. No UN flag was flown at an homage ceremony in Kigali on 8 April, 2019 for 10 Belgian peacekeepers who were brutally beaten and shot to death by Rwandan government soldiers on 7 April, 1994. This despite the fact that the Belgian soldiers were members of the UN mission in Rwanda (UNAMIR). Their former comrades were outraged at their government’s order to the peacekeepers to surrender.

“Many of the Belgian soldiers had wanted to stay in Rwanda to prevent even greater slaughter and were humiliated by the government’s decision to withdraw them,” according to an OAU report of 7 July, 2000 by an international panel of eminent personalities. The former soldiers were also critical of the UN, which, they said, systematically underestimated the threats the Belgian blue helmets faced from Hutu extremists. “The withdrawal meant that they were viewed as cowards, and morally irresponsible ones as well,” reads the report. “It is not surprising that many of them threw down their blue berets in disgust upon their return to Belgium. Others, in full view of the television cameras, pulled out their knives and slashed the berets into ribbons.” According to Melvern, the New Zealand ambassador, Colin Keating, told her that “non-permanent members of the [Security] Council were kept in the dark about what was happening”. Cables sent to the UN secretary-general’s office by UNAMIR’s field commander, the Canadian general Roméo Dallaire, did not reach the council.

They stayed in the secretary-general’s office on the 38th floor of the UN building in New York, she says. For whatever reason, Boutros Boutros-Ghali kept those cables to himself. Yet these cables included essential information. One was a fax General Dallaire sent to his superior, General Maurice Baril, at the UN Department of Peacekeeping Operations (DPKO) in New York, on 11 January, 1994. According to the OAU report, Dallaire warned that a militia commander who he had met “has been ordered to register all Tutsi in Kigali. He suspects it is for their extermination. Example he gave was that in 20 minutes his personnel could kill up to 1,000 Tutsis”. Despite this, Kofi Annan, then chief of peacekeeping operations, denied Dallaire permission to seize arms caches revealed by the informant. Moreover, Boutros-Ghali changed existing procedures regarding the transmission of information to the Security Council, determining that officials could brief the council only with his express permission, Linda Melvern discovered.

“All the information that went to the council came through Boutros-Ghali,” she says. In a report dated 21 April, the then secretary general did not mention mass killings, preferring to describe Rwanda as being in “a civil war”. Why did Boutros-Ghali restrict the information that went to the council? According to Melvern, it might have been because he was beholden to the French president, Francois Mitterrand, who had supported his election. To settle the question, she says that access to documents and the telephone records from Boutros- Ghali’s office will be necessary. According to Melvern, the permanent members of the UN Security Council refused for weeks to admit that a genocide was taking place. The British ambassador to the UN told the council that it would become “a laughing stock” if it described the events in Rwanda as a genocide, she says. And France also resisted the use of the word “genocide”. Some see France as bearing more responsibility for the international failure to act because of its direct involvement in the region.

Accordingly, access to the French archives has been a sensitive point for years. In 2015, the French president, François Hollande, declassified documents related to the genocide, including minutes from secret defence meetings and files of advisers to the president at the time, François Mitterrand. Researchers and historians would be granted access to the documents on request. Yet gaining access to those archives has proved extremely difficult. A former Belgian senator, Alain Destexhe, who published an essay on the genocide, told Africa in Fact that he was denied access to both Mitterrand’s archives and those of the defence ministry – supposedly because his “profile did not meet requirements”. Researchers also complain that only a fraction of the classified documents have surfaced so far. That might change. In April this year, President Emmanuel Macron appointed a commission of academics to carry out a two year investigation into the role of the French army in the genocide.

The commission will have access to presidential, diplomatic, military and intelligence archives. Kigali’s reaction was rather positive. But the problem, Alice Urusaro Karekezi, a researcher at the University of Rwanda’s Centre for Conflict Management, told the Kigali-based daily newspaper The New Times is that the commission does not include a single recognised expert on Rwanda. Moreover, access to Mitterrand’s archives was to be granted at the discretion of their custodian, Dominique Bertinotti, who told news agency Agence France-Presse in April this year that her approval is not “automatic”. Independent or inexperienced researchers will be confronted by staunch opposition from the French military establishment and officials who were in office in 1994, who deny that France holds any responsibility for the tragedy. The issue is so sensitive that it caused a controversy during the European elections campaign in May this year.

A claim by Raphaël Glucksmann – director of a documentary on the genocide and head of the Socialist Party list in the election – that Mitterrand had been an “accomplice” in the genocide triggered a letter of protest signed by 23 former ministers. Yet “the facts are stubborn”, as Kagame says. Prior to the genocide, France had been an important supporter of the Hutu regime in Kigali. According to a January 1994 report by Human Rights Watch (HRW), France was one of the regime’s main arms suppliers, along with Egypt and South Africa, before and after the war began between the Hutu-dominated government and Kagame’s Tutsi-dominated Rwandan Patriotic Front (RPF) in October 1990. France’s contribution included mortars, artillery, armoured cars and helicopters – in addition to providing military advisors to the Rwandan Gendarmerie and armed forces, according to HRW. According to Melvern, French military training extended to the presidential guard, which is thought to have initiated the genocide.

Moreover, France did not suspend its supplies of arms to the government after the imposition of a UN embargo on 17 May, 1994. Five shipments of artillery, machine guns, assault rifles and ammunition provided by the French government were sent to government forces based in Goma (in then-Zaire) in May and June of that year, according to a May 1995 report by HRW. Meanwhile, a French military operation between June and August in 1994, codenamed “Turquoise”, nominally under the UN, is another controversial issue. France portrayed Turquoise as a humanitarian mission to hide its support of the genocidaires, claimed Captain Guillaume Ancel, a French army veteran who served in the operation, in a 2018 memoir. Any declassification of US documents would also likely result in embarrassing revelations – in particular, as regards responsibility for the downsizing of the UN force that General Dallaire outlined in his book on the genocide, Shake Hands With the Devil (2003), and its tragic consequences.

“The United States almost single-handedly blocked international action in Rwanda [for] six weeks prior to the genocide, which might have prevented the bloodbath altogether,” says the above-mentioned OAU report. The US State Department even refused to scramble the broadcast of RTLM Radio, a Hutu extremist media outlet that incited killing during the genocide, according to Melvern. Half a million lives could have been saved if UNAMIR had had sufficient air support and logistical and communication capabilities, concluded Scott Feil, a former US army career officer, in a 1998 report to the Carnegie Commission on preventing deadly conflict. In April this year, more than 300 French academics, historians and citizens signed an open letter questioning Macron’s refusal to appoint suitably qualified experts – including Hélène Dumas, the only French researcher who speaks Kinyarwanda, and Stéphane Audoin-Rouzeau, a prominent historian of the first world war and author of a book titled Une initiation Rwanda (2017) – to the commission that is to investigate France’s role in the genocide.

In April this year, lawyers representing relatives of victims killed at Biserero in Rwanda between 27 and 30 June, 1994 by Hutu militias after the French army abandoned them there, called for access to the French Ministry of Defence archives for the French judges who were to investigate this tragic event. During a meeting with President Macron, another group, the Ibuka association of survivors, whose name means “remember” in Kinyarwanda, also called for the declassification of official French archives concerning the genocide. Former French military members who served in Rwanda during the 1990- 1994 period are claiming that the French government of the time worked closely with the Rwandan Hutu regime. Ancel, the former French army officer mentioned earlier in this article, claims that Turquoise, a French-led UN operation supposedly aimed at ending the massacres, was in fact intended to prevent the RPF from capturing Kigali. The aim was to return control of the capital city to the government, the former officer claims in his recent book, Rwanda, la fin du silence (Rwanda: the end of silence).

In another book, General Jean Varret, who headed the French military mission in Rwanda between October 1990 and April 1993, says that both Rwanda’s president at the time, Juvénal Habyarimana, and the French embassy ignored his warnings that the Rwandan military was planning to massacre Tutsis. The commission of inquiry will find it difficult to ignore these claims. The quest for the truth about the Rwanda genocide has been long, but the pressure is mounting. Researchers of the Rwandan genocide – academics, journalists, survivors, and French activists fighting for the decolonisation of France’s relationship with Africa and with the Rwandan government – are calling for open access to the genocide archives. The full truth of what happened then has yet to be established, they say. This includes vital information concerning the accountability of members of the international community.

Reply from the Spokesman of the Secretary-General of the United Nations

The United Nations has tried to ensure that there is justice for the crimes committed in Rwanda during the genocide, and it has looked at its own actions during that period, mostly notably through the Carlsson Commission, which issued its own report on the UN’s responsibilities in 1999. The UN has followed up on those recommendations in our effort to ensure that what went wrong in Rwanda will never be repeated. The statement from the article that “investigators, researchers and historians face obstacles when attempting to establish the truth” with respect to access to the archives of the ICTR is not supported by the facts. The Arusha branch of the International Residual Mechanism for Criminal Tribunals manages the archives of the ICTR. Its access policy is guided by the basic principles of openness and transparency, balanced with the obligation to maintain the confidentiality of classified information, including classified judicial records. The International Residual Mechanism cannot provide members of the public with access to the confidential records of the ICTR. The Judicial Records and Archives Database is accessible through a website (https://jrad.irmct.org/search. htm) containing approximately 850,000 pages of judicial records and 22,000 hours of audiovisual recordings of judicial proceedings. The physical location of the archives therefore does not impose an impediment to accessibility with respect to users in Rwanda. On average, each month, over 3,600 records are accessed, 10.5 access requests are responded to, and approximately 80 visitors are accommodated by the Archives and Records Section in Arusha. The claim in the article that access to the ICTR archives was denied to Rwanda’s National Commission for the Fight against Genocide and to personnel of the Permanent Mission of Rwanda to the United Nations is also unfounded. The International Residual Mechanism in Arusha has not received any request from Rwanda’s National Commission for the Fight against Genocide. One request was received from the Permanent Mission of the Republic of Rwanda to the United Nations, and it was responded to on the same day that it was received.

François Misser is a Brussels-based journalist. He has covered central Africa since 1981 and European-African relations since 1984 for the BBC, Afrique Asie magazine, African Energy, the Italian monthly magazine Nigrizia, and Germany’s Die Tageszeitung newspaper. He has written books on Rwanda and the DRC. His last book, on the Congo River dams, is La Saga d’Inga.
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