Over two thousand Rwandan witnesses who have testified at the International Criminal Tribunal for Rwanda can now receive medical care through the ICTR clinic in Kigali .

The same opportunity is offered to any potential or future witnesses, assisting either prosecution or defense teams.

“The witnesses find out about our clinic through the witness support services but we hope in the future they will come by themselves”, says Dr. Epee Hernandez Chief of Health Unit Kigali and Arusha.

In 1995, the Tribunal was inaugurated with a mandate to find and judge those people suspected of involvement in the Rwandan genocide. Since then, the ICTR has worked with the Rwandan government to identify witnesses willing to testify.

Most of the witnesses were affected by genocide. Some were raped – some infected with the HIV virus. Others suffer from severe psychological trauma. Whatever their medical needs, the ICTR clinic does its best to offer professional help.

But it seems some people have a negative impression of the ICTR’s medical services.

Elsie Effange Mbella, Gender Advisor in the Office of the Registrar says the issue of medical care and psychological care for witnesses especially in the area of HIV/AIDS is one of the most sensitive issues that she dealt with since she assumed office. “Many of our detractors have been under the false impression that we do not provide HIV/AIDS care for witnesses” she says. “That’s very false because we have indeed recruited medical experts to take care of medical support for witnesses including in the area of HIV/AIDS”, says Ms. Mbella.

ICTR first began protecting and supporting witnesses in 1997. In April 2004, the Tribunal set up a clinic in Kigali to provide medical care. Full-time staff now include a gynecologist, psychologists and a lab technician.

Previously, external consultants were hired. But in time, that system was considered unsuitable. According to Sylvie Becky, Deputy Chief, Witnesses and Victims Support Section, the tribunal had to pay approximately 23.000 USD to outside specialists providing medical care to our witnesses “The Registrar thought that this amount was too high and it is in the interest of the victims for confidentiality reasons – but also in the interest of the tribunal in view of our financial limitations – to set up a clinic”, says Sylvie Becky.

The clinic started a year ago and provides medical care to 226 witnesses, some on a weekly basis.

The witnesses and victims support section says 27 witnesses have been confirmed HIV positive and are receiving anti retroviral treatment

“We are also organizing on weekly basis counseling and post-counseling for HIV testing of witnesses if they volunteer”, says Elsie, Gender Advisor to the Registrar.

The first witnesses to testify at the ICTR appeared before the court in 1997. Today those same original witnesses are still receiving medical care.

A witness with concealed identity says that it is a good thing for the tribunal to give free medical care to witnesses because people usually testify out of their own will and should not expect any remuneration.

However, some witnesses still prefer the ICTR’s previous system for medical care.

Mukakinani Sarafina testified at the ICTR in 1997 she is among those who still receive medical care. “At first, when we were still under private consultants, we would get all the medicine that was prescribed to us”, she explains. “Today, if the medication you require is not among the ones that are available at the clinic, then you won’t have it and you risk dying ”.

Some witnesses are concerned that since the new clinic is located within the ICTR premises in Kigali, their confidential status as witnesses could be compromised if people see them going there for treatment.

But that argument raises another question: if being seen going into the ICTR risks confidentiality, is it relevant whether or not one receives medical treatment once inside the compound?

Members of the survivors’ association AVEGA – who regularly testify at the ICTR – say it would be better if the ICTR channeled medical services through the AVEGA clinic in Kigali .

“If they supported our clinic and our members were treated from here, members would feel more comfortable because they know the doctors here are more sensitive to their situation” explains Kayiganwa Aurea, Coordinator of AVEGA . “However, if it is not possible, we would simply hope the ICTR will protect the confidentiality of any witness who goes to ICTR for medical treatment ”.

The ICTR’s Witness Support and Protection Section says it is aware of such concerns. Sylvie Becky, Deputy Chief Witness and Victims Support Section says that her section, considering respect of confidentiality, thought it is important for the witnesses to receive medical care services directly from the ICTR staff.

So far, less than 300 of the ICTR’s 2000 witnesses living in Rwanda have attended the Tribunal’s medical clinic in Kigali for treatment.

At present, some of the others may not be aware free medical services are available, or may find it difficult for some reason to get to the clinic.

But for those who do, there is no doubt they find it helpful.

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