Rwanda’s largest mental health facility, CARAES Ndera Neuropsychiatric Hospital, is operating at 116% capacity due to a sharp and continuous rise in patients, prompting calls for urgent expansion and increased financial support.
Speaking before the Parliament’s Public Accounts Committee (PAC) on Monday, Frère Charles Nkubiri, Director General of CARAES Ndera, said the facility is struggling to meet the growing demand for mental health services. He revealed that patient numbers rose by 26% in 2024, from 94,000 the previous year to over 101,000, while the hospital’s budget and infrastructure have not kept pace.
“Some departments are operating far beyond capacity,” Nkubiri said. “We need to expand CARAES Ndera. It was once a district-level facility, but now functions as a national teaching and referral hospital.”
Nkubiri attributed much of the financial discrepancies flagged by the Auditor General in the hospital’s 2024/2025 report to this patient surge, explaining that both the demand for medical supplies and the number of staff increased significantly. Staff numbers rose by 18% in the same period, each requiring resources and equipment to deliver care.
Lawmakers questioned procurement irregularities, noting that 11 out of 15 contracts reviewed were awarded without following legal procedures. In some cases, awarded tenders exceeded planned budgets by as much as 213%, contributing to an overall discrepancy of more than RWF 819 million (approximately $650,000).
Nkubiri defended the overruns, stating they were largely caused by unpredictable growth in patient numbers and an urgent need to procure supplies.
He also highlighted challenges with delayed payments from patients. “Some patients are brought by individuals who claim to be Good Samaritans and later abandon the financial responsibility,” he said.
Founded in 1968, CARAES Ndera treats patients with various neurological and psychiatric disorders, including depression, anxiety, trauma, and schizophrenia. The hospital receives patients from across Rwanda, with about 45% coming from the capital, Kigali.
The hospital has been gradually constructing new buildings using its own limited resources, but Nkubiri warned this is not enough. He urged the government to support a full-scale modernization similar to that undertaken at the University Teaching Hospital of Kigali (CHUK).
According to Nkubiri, the global mental health crisis triggered by the COVID-19 pandemic has not spared Rwanda. Cases of depression rose to 11.9%, anxiety to 8.1%, post-traumatic stress to 3.6%, severe mental illness to 1.3%, disruptive behavioral disorders to 0.8%, and suicidal behavior to 0.5%.
“We’re facing a growing mental health burden,” he said. “If Rwanda is to respond effectively, CARAES Ndera must be equipped to meet today’s needs.”
