Infection and Social Dislocation: Wellbeing Impacts of COVID-19 on Children and Young People - Perspectives of Rwandan Leaders

1. Introduction

COVID-19, the fear it engendered, and the policy measures to manage its spread have disproportionately impacted the health and wellbeing of children and adolescents (CAs) globally (Loewenson et al., 2021; Singh et al., 2020). Across diverse contexts, CAs have become distressed. Levels of anxiety and depression have increased due to massive social upheaval, uncertainty over the future, restrictions on mobility, reduction in quality of life and fear of contracting the disease (Melendez-Torres et al., 2021; Padilla & Bernheim, 2020; Sharpe et al., 2021). Rates of child poverty, food insecurity and violence against women and children have increased, and school closures have resulted in a loss of learning (Division of Communication’s Global Content Strategy, 2020; Hope and Homes for Children, 2020; OECD, 2020; Padilla & Bernheim, 2020; Sestito et al., 2021).

As in other settings, in sub-Saharan Africa, there has been a failure to safeguard CAs; a health crisis has become a child rights crisis (Division of Communication’s Global Content Strategy, 2020; Green, 2020; UNICEF, 2021). Putting CAs’ health and wellbeing under siege from all directions, making what was already a challenging place for CAs even more challenging (Datzberger & Parkes, 2021). Long-term adverse impacts on CAs are likely not least because of deepening inequalities among CAs. Those from poorer homes have been more adversely affected by the socioeconomic impact and lost learning due to school closures than those from more advantaged homes (Araújo et al., 2021; Datzberger & Parkes, 2021; Lee, 2020), with a likely accumulation of lost learning after children return to school (Angrist et al., 2021; Kaffenberger, 2021; World Bank et al., 2021).

Informed by a critical realist paradigm (Archer, 1998; Porpora, 2015), including its commitment to social justice (Sayer, 2011), we present an intensive case study of the impact of COVID-19 on the health and wellbeing of CAs in Rwanda. Seeing it as much a social and political crisis as a medical and public health one (Connell, 2020; Haase, 2020), we offer an explanation for some of the observed impacts of COVID-19 on the lives of CAs (7–18 years). To do this, we draw on a series of 25 narrative interviews carried out with 25 local and national leaders possessing a grounded understanding of how the lives of CAs have been affected and how CA have exercised agency (or not) in the context of structural, political, and cultural changes wrought by the pandemic between March 2020 and January 2021. In doing so, we go beyond the existing research, which tells us what has happened, to develop a sociological understanding of how and why COVID-19 has had the impact it has (Archer, 2020b; Monaghan, 2020; Tinsley, 2022).

This paper proceeds in five stages. First, in line with a critical realist research process, we consider preconcepts (Belfrage & Hauf, 2017), a possible causal theory for the empirical impacts of COVID-19 on CAs. Second, we consider the Rwandan context, including policy measures taken by Government to mitigate the pandemic’s impacts. Third, we discuss our methodology and lay out the research methods used. Fourth, we describe findings setting out participant perceptions of the impacts of COVID-19 on CAs and how and why those impacts were experienced and observed. Fifth, we use retroduction to develop an explanation for the impacts, developing and refining an initial theory.

2. Pre-concepts: Anomie and COVID-19

COVID-19 is a complex epidemiological and social disaster (Delanty, 2021) that wrought unprecedented changes in everyday lives. While the reality of the crisis is extra-discursive, that is, COVID-19 exists independently of our awareness of it, discursive responses shape experiences (Belfrage & Hauf, 2017). The response resulted in what Agamben has called a state of exception (Agamben, 2005, 2021). In the name of biosecurity and health, exceptional (’unprecedented’) measures were taken that limited people’s freedoms. These included lockdowns, prohibitions on international and national travel and on meetings with relatives and friends, closure of workplaces and schools and being required to take precautions to mitigate infections. Justified on claims to scientific evidence, ’follow the science,’ wide-ranging restrictions were backed up by coercive laws to enforce staying at home, social distancing and wearing masks in public places.

Combined with these, the reality of COVID-19 created a social pandemic of suspicion, fear, uncertainty, a weakening of social bonds, and loss of trust (Pickersgill, 2020; Strong, 1990; Ward, 2021). It made the future indeterminate and shattered shared understandings of the risks we face in our daily lives, with medical science, nation-states and global governance unable to deal with the risks of COVID-19. It left people uncertain about what was safe, what news and what experts could be trusted, an uncertainty heightened by the dissemination of disinformation on social media. As a result, people lost taken-for-granted behaviour repertoires and had to develop new routines in what was described as the new ’normal’ (Haerpfer et al., 2013; Strong, 1990).

The sociological toolkit provides lenses that can be drawn on to begin to explain the impacts of COVID-19 on society. Here we draw on the work of the Nineteenth Century French Sociologist Emile Durkheim and specifically his theory of anomie as developed in his work on suicide (Durkheim, 1952) to explain why people respond to the crisis in the way they did. His work has been used widely to explain people’s responses to the sudden changes brought about by the fall of the former Soviet Union and the 2008 Economic Crisis (Bygnes, 2017; Haerpfer et al., 2013; Motyka et al., 2020).

Durkheim argues that sudden social change leaves people without a behaviour repertoire for navigating their daily lives; they become anomic – a collective state that weakens social cohesion and solidarity more broadly. The social norms that have guided lives are no longer appropriate, meaning there is a lack of social regulation and a weakening of social bonds or feeling of belonging. Anomie is normlessness: people’s detachment from reality, loss of purpose in and ability to navigate upturned lives, uncertainty, anxiety, and stress about the present and future where lives lack meaning outside of fear and without connection – coupled with a feeling of low and no worth, value, and agency – and being helpless to do anything about it.

The Rwandan setting

Rwanda is a least developed aid-dependent country (World Development Indicators, 2021) with poor human development, including that of CAs (Clark et al., 2020; UN Development Programme, 2021). It is one of the most rural countries globally, with over 80% of the population living in rural areas and most household dependent on subsistence agriculture supplemented by casual labouring (National Institute of Statistics of Rwanda, 2018). It remains one of the poorest countries in the world, with poverty mainly concentrated in rural areas (National Institute of Statistics, 2018).

Child poverty is high, with 60% of children living in absolute poverty (less than $1.95ppp a day) in 2017 and less than 10% of children living in households with an income above the $5.50 PPP poverty line (Silwal et al., 2020). The level of violence against children and young people is also high. In 2015/16, 27% of adolescent girls (13 – 17 years) reported having experienced physical and/or emotional and/or sexual violence in the previous year and 42% of adolescent boys (Ministry of Health, 2017). Another study found 58% of boys and 66% of girls between the ages of five and ten years reported that a parent sometimes kicked or punched them, and 46% of boys and 50% of girls that a parent had sometimes hit them with an object (Pontalti, 2013). Corporal punishment in schools is also high, with 47% of boys and 51% of girls reporting that their teacher had physically punished them the week before the survey. School enrolment is almost universal, but educational attainment is poor, with children, on average, attending school for 6.9 years but only learning as much as if they had attended for 3.9 years (World Bank, 2020).

COVID-19 transformed taken-for-granted everyday life for CAs in Rwanda as globally and with little warning. Rwanda implemented a National Preparedness and Response Plan in March 2020 to respond to perceived risks posed by COVID-19 as it first took hold (KARIM et al., 2021). Wearing masks in public places and social distancing were made mandatory, and people were advised to wash their hands frequently. Messages about COVID-19 and mitigation measures were broadcast on radio, delivered to communities by drones, and reinforced by community health workers.¹ A countrywide lockdown was imposed on 20th March 2020 but was gradually lifted from 4^th May. However, schools remained closed, and most CAs did not return to school until January 2021 (UNESCO, 2021), meaning that most lost nearly a year of schooling.

The measures left people anxious, stressed, fearful and uncertain about the future. Over 70% of the population were worried about family members and themselves catching the virus (S. Warren et al., 2020). An increase in already high rates of child poverty (Silwal et al., 2020), school closures, the increases in already high rates of domestic violence and child abuse, and the general atmosphere of fear and uncertainty had a negative impact on CAs including on their mental wellbeing (Binagwaho, 2021). Child labour increased, girls were required to do more unpaid care work, teenage pregnancy increased, and CAs became more unruly (Louis et al., 2020; Mueller & Tronick, 2019).

The impact of school closure was profound. Schools in Rwanda, as elsewhere, are an important part of children’s and young people’s daily routine and where they socialise and meet friends. In Rwanda, most CAs attended school before the lockdown (NISR, 2018). School closures have increased learning inequalities and harmed child wellbeing (Cameron, 2021; Cameron et al., 2021; Cozzolino et al., 2020). While the Government and some NGOs organised TV and radio education broadcasts (H. Warren & Wagner, 2020), most children’s and young people’s living conditions are not conducive to study. Ownership of TVs and radios and access to the internet are the preserve of the better off, with only 14% of households owning a TV, 39% a radio (authors’ calculation from RDHS 2019/20 data), and only 12% having access to the internet (authors’ analysis of EICV V data). Many parents struggled to provide any home-schooling, lacking the necessary literacy skills or competency in English, the language of instruction from primary 1 (Failing Adult Learners: Why Rwanda’s Adult Literacy Education Is Not Delivering, 2020). In one study, only a third of parents with school-aged children thought that their children had learnt anything from the radio broadcasts, with children from poorer homes, children with disabilities and girls being the least likely to have benefited (Cozzolino et al., 2020).

3. Methodology

Research question

The research questions were: How has COVID-19 and the public health measures taken to control the spread of the virus impacted the health and wellbeing of CAs in Rwanda? How has the interaction of COVID-19 and the measures taken to mitigate its impact and the nature of the context produced these outcomes?

Theoretical framework

Critical realism combines a realist ontology, a philosophical position that sees the world as consisting of natural and social objects and structures that make events occur but cannot be observed and exist Independent of our perceptions, theories, and constructions, with an interpretivist epistemology that recognises that all knowledge of these is socially constructed, historically contingent and shaped by our perspectives and beliefs (Danermark et al., 2019; Sayer, 2010). Blending a realist ontology with an interpretive epistemology, critical realism provides an enquiry framework that is evolving and broad but has a common core. It has a ’depth ontology’ that distinguishes between the ’real’ but unseen structures - powerful, objective, enduring relation and distribution of resources among social positions; the ’actual’ things or events; and the ’empirical’ observations or observations or experiences of these. Unobservable structures cause observable events, and the social world can be, albeit imperfectly, understood if we understand the causal mechanisms that generate these events, that is, make them happen. We know that the ’real’ exists because it has observable effects (Mills, 1959). Changes in the empirical occur when the interaction of knowledgeable agents with their structural context trigger mechanisms that change the structural context in which they live their daily lives.

Around this, critical realism sees social reality as an ’open system’ with multiple overlapping and interacting mechanisms that provide the context for each other and which may reinforce or conflict (Byrne, 1998). From this position, meaning, behaviour, and social structure are all real phenomena, and the relationship between them is one of interaction, interdependence, complexity and recursive connection (Archer, 1998; Sayer, 2010). Social structures condition how actors make sense of their social situation and the possibilities to exercise agency (Archer, 2008). Agency can trigger mechanisms that recreate or transform those social structures (Archer, 1998, 2008; Danermark et al., 2019).

Critical realism uses retroduction - what must be ’true’ for the event to be possible - to uncover ’generative mechanisms’ capable of causing what is observed/experienced by identifying the actual processes that lead to specific outcomes in particular contexts (Sayer, 2010). All explanations (theories) are seen as provisional, partial, and open to change, iteration, and adaption

Research design

We used a qualitative impact evaluation developed by critical realists (Copestake et al., 2019; Maxwell, 2012a) to enable us to address how and why COVID-19 impacts the CAs’ lives, that is, to move from description to explanation. As critical realists, we agree that there are causal processes but reject the Humeian successionist theory of constant conjuncture that does not go beyond observable regularities (Maxwell, 2012b; Mohr, 1999). We also argue that it is necessary that causal efficacy is extended to beliefs, values and interactions and not just restricted to physical objects and events (Archer, 2008; Sayer, 2010). We inferred causal explanations through retroduction from participants’ accounts of how and why changes had occurred in children’s and young people’s behaviour since the outbreak of COVID-19. We ask what must ’the real’ be like for the changes in children’s wellbeing that have been observed, rejecting the view that COVID-19 and the public health measures taken to contain it provide a sufficient causal explanation by themselves. COVID-19 and the public health measures were introduced into an open system where numerous mechanisms are at work interacting with each other to influence empirical outcomes (Edgley et al., 2016).

To do this, we carried out qualitative research using narrative interviews with local leaders and national experts involved with CAs to uncover what impacts they thought COVID-19 was having on the wellbeing of young people and how and why it was having this impact (Brönnimann, 2022; Danermark et al., 2019; Tikly, 2015). We asked critical realist framing and questions such as "How has COVID-19 impacted CAs living in your community?" and probed to explore how it had impacted different groups of CAs in the community (Brönnimann, 2022).

Sampling

We sampled 25 leaders, 15 local and 10 nationals, with a working knowledge of children and young people as they were more likely than the CAs themselves to observe changes across the CA population within their remit and more likely to be looking for general explanations rather than individual experiences. We were interested in how CAs’ behaviour and wellbeing had changed, and how and why these changes had come about. The local leaders were from five communities, three in rural and two in urban areas located across the country, with expert knowledge of what was happening, especially to CAs in their communities. At the national level, we interviewed representatives of four NGOs/INGOs working with CAs and six national stakeholders, including representatives of the Ministry of Health, the Ministry of Education, and a development partner interested in CAs based in Kigali. The context in which CAs live their lives differs markedly between the majority living in rural areas, where most live, and urban areas, especially Kigali (National Institute of Statistics of Rwanda Ministry of Health & The DHS Program, 2021; NISR, 2018). Kigali has all the facilities of a modern city, a low poverty rate, a healthier and better-educated population and higher-quality health and educational facilities.

Tools and Data collection

The interview agenda was designed to understand the impact of Covid-19 on CAs and how and why it had that impact. However, to avoid framing and influencing the respondents’ answers, we started by asking them about the impact of non-communicable diseases on CAs and had follow-up agenda items on CAs’ wellbeing and the impact of Covid-19 on their wellbeing. Researchers were trained to steer the conversation so that participants talked about CAs’ wellbeing and the impact of Covid-19 on their wellbeing if they did not spontaneously mention them.

The research team developed an interview agenda in English, which was translated by a native speaker into Kinyarwanda and checked for accuracy by a second native speaker. Differences were resolved by discussion. Due to COVID-19 restrictions at the time of data collection and safety obligations to data collectors and participants, we conducted audio-recorded telephone interviews. The interviewer was trained in conducting the interviews by the research team and supervised during the interviewing by author 2. Interviews were transcribed verbatim and translated into English. Translated transcripts were independently checked for accuracy.

Ethical approval, data management and handling

Ethical approval for the research was obtained through the ethical review procedures of the University of Aberdeen and the National Ethics Committee, Rwanda. An information sheet for participants was read to all those invited to participate in the research. Those who agreed to participate (none refused) were asked to give informed verbal consent, which was recorded. The data management plan, designed to protect the confidentiality and assure the anonymity of participants, adhered to the requirements of the University of Aberdeen and the National Ethics Committee, Rwanda, and was approved as part of institutional ethical approvals.

Data analysis

We analysed data thematically, looking for narrative causal statements, drivers, outcomes and attribution about the main changes in CAs’ lives due to COVID-19 and to what changes were attributed (Barbieri et al., 2017; Salloukh, 1996; Sayer, 2010). This enabled us to trace process causality within the immediate physical and social context that CAs lived their daily lives. We started by describing the causal statements, drivers and outcomes identified by participants. We then used retroduction to identify the causal structures that provided the most plausible explanation of the mechanisms that accounted for the empirical observations.

4. Impacts on children and adolescent health and wellbeing

Participants told us that parents had also lost direction; they did not understand what was happening and what the future would bring. This left them feeling helpless, which had a negative influence on their children. The sudden change in economic circumstances was also seen as causing an increase in disagreements among parents and an escalation in domestic violence and violence against children. Poverty was also seen as making people desperate and ready to take risks they may not otherwise have done:

The pandemic started all of a sudden, and there was panic in general. When the pandemic began, everyone was scared and wondering what would happen (local leader, rural)

Previously, everyone was working, and then everyone was at home, which caused conflicts between husband and wife and the children. I can testify that physical punishment has increased against children as well as against women (male leader teacher, urban)

COVID-19 has driven us into poverty and has made people fearless and desperate, and ready to take any risks (male executive director of a national NGO)

Children and young people also felt unsettled and insecure because of the sudden changes in the economic situation of their households. This applied to most children, including those from better-off homes. This, combined with the lack of school discipline and more relationship problems at home, caused anxiety and more young people engaging in risky behaviour, including using cannabis and injectable drugs. As local leaders explained:

Children suffer from a lack of proper care because of family conflicts and relationship problems, which leads them into drug abuse. (Male local leader, rural).

Some take cannabis, others use needles, others are becoming alcoholics, and the alarming consequence is that many become addicted to drugs, and others are disoriented and confused. We are noticing many drug addicts wandering the streets in urban areas and near the border (Female local leader, rural).

Young ones who usually had food and clothes and lacked nothing are unsettled when problems suddenly come about, and they start to feel uneasy and get anxious (female schoolteacher, urban)

Others saw a pathway from lack of care to taking drugs, to becoming mentally ill, and anxiety leading to severe mental health problems via drug use, as key NGO and local leaders, male and female, laid out:

There is evidence showing how what is happening in a family may affect children, including violence within a family and a negative parenting style that will also affect young children’s development and functioning, leading to poor mental health (male representative of a mental health NGO, Kigali).

Children suffer from a lack of proper care because of family conflicts and relationship problems, which leads them into drug abuse. Drug abuse, in turn, can result in mental health problems (local male leader, rural).

Suppose CAs are suffering from anxiety, and they start to cope with drug abuse. In that case, they will also develop other mental health disorders such as schizophrenia and psychosis and lose their future (female representative of a national children’s NGO, Kigali).

Some participants thought a lack of social mixing negatively impacted children’s and young people’s mental wellbeing. Being unable to go to school and socialise with their friends was seen as likely to cause depression. Others thought that it was not just a lack of mixing with friends at school but not being able to visit relatives, go to weddings or, more generally, mix with members of their community:

I certainly believe that all these challenges that I mentioned: not attending school and being able to mingle with other children, directly affect mental health for young people and children (representative of Ministry of Education, Kigali).

Others thought it was not just a lack of mixing with friends at school but also not being able to visit relatives, go to weddings or, more generally, mix with members of their community.

Restrictions have affected family visits and gatherings -------, which can make someone feel depressed or lonely (Executive Director, health NGO, Kigali).

Nevertheless, across participants, the major impact on health and wellbeing was said to be an increase in depression. Rising poverty and school closures were said to be the causes of this. Participants expanded, deciphering pathways to mental illness and mental health challenges. A number pointed to a pathway from domestic violence to depression.

I certainly believe that all these challenges I have mentioned, such as not attending school and being unable to mingle with other children, directly affect the mental health of young people and children (Executive Director of Health NGO, Kigali).

Other health impacts included pregnancy in young women. Even in normal times, it is not possible for young women under 18 years to be prescribed contraception in Rwanda, and although abortions are possible if the health of the mother or child is at risk, they are difficult to obtain. When the lockdown started, and schools closed, some young people began to cohabit and start a family. Other young women become pregnant because of casual sex with young men. Others were lured by ’sugar daddies,’ older men who seduce girls and young women into having sex with them by promising them gifts and money. This had negative consequences for girls and young women who became pregnant and often dropped out of school and struggled to bring up their children:

They are deceived by adults, which causes them to have unplanned pregnancies. The second thing has to do with what I said about the children that became pregnant because they were not in school. We have now reached a time when the children that became pregnant during COVID are giving birth, and it is challenging for them to take care of their newborns (teacher, rural).

5. Discussion and conclusions

COVID-19 has been likened to a breach experiment comparable to the ones that Garfinkel devised for his students to uncover the rules of everyday life (Drury & Stokoe, 2021; Scambler, 2020). COVID-19 and the measures taken to contain it led to a sudden change in taken-for-granted rules and routines of everyday life for CAs in Rwanda as elsewhere. They were expected to obey new ways of behaving, such as not going to school, and adopt behaviours that had not been normative such as wearing a mask, social distancing, and frequent handwashing, in a wider context of fear, existential threat, unease, anxiety and spiralling poverty, violence and drug misuse.

Durkheim’s concept of anomie helps us to understand why COVID-19 has had the impacts it has had on CAs. The measures taken to control the spread of the virus resulted in the total disruption of the ’taken-for-granted’ of everyday lives. Many CAs, like their parents and other community members, were left without a behavioural repertoire for navigating their everyday lives in the ’new normal.’ However, it does not enable us to explain how the CAs responded to Covid-19 and how the interaction of their agency with the changes wrought by Covid-19 triggered mechanisms that changed the context (the complex laminated social system) in which they lived their lives. Durkheim’s theory remains, however, at the empirical level and does not provide an adequate explanation of how CAs handled the crisis (Alderson, 2021; Maxwell, 2012a). It collapses agency into law-like regularities that determine and control individuals’ behaviour. There is a lack of attention to relations of inequality and differences; structured ways of acting, thinking, and feeling are seen as general throughout society and acting as external constraints over people. Durkheim emphasises the role of society in causation and neglects individual and group agency (Archer, 2020a). In situations where there is no established ’right thing to do,’ CAs had to decide what to do, with very little help from established repertoires of norms. What they decided often changed their worldview - their understanding of correct/appropriate behaviour and what their behaviour taught them/said about their own ’nature’. In addition, he does not take into account the complexity of the social world, that the world is a multiplicity of structures, an ’open complex adaptive system’ that evolves as a result of mutual interaction (Byrne, 1998).

The participants explained the impact of COVID-19 on CAs from the reality of COVID-19 and the threat it poses to human health through several interacting mechanisms that changed the context in which CAs lived their daily lives. These included an increase in poverty, malnutrition and hunger, a lack of routine because of the closure of schools, a loss of income-generating activities for both parents and some older children, a lack of supervision because parents are unable to take over supervising their children during school closures, and a loss of connection with relatives, friends and the community more generally. Many CAs were left without structure and meaning to their lives, and there was an increase in reports of depression, drug use, early childbirth, and violence among CAs.

However, our data analysis shows that CAs were trying to make sense of the world, exercising agency and making choices, albeit within significant constraints in different structural contexts. Different groups of CAs interacted with the same changes in different ways mainly because of the differences in the context in which they live their lives. These differences were mainly along axes of inequality and differences, age, gender, socioeconomic circumstances of parents and whether CAs lived in a rural or urban area and depended on knowledge, flexibility, and opportunity. Given this, the CAs’ behaviour can be seen as a rational and meaningful response to the uncertainty of the situation they found themselves in.

To understand the real and the causal mechanisms triggered by Covid-19 and CAs agency in response to the changes in the context in which they lived, we need to ask what the world must be like for the observable outcomes to have occurred. In Rwanda, as elsewhere. CAs are not a uniform group; multiple and interacting inequalities divide them. These are not just differences, but hierarchies of power and subordination, overlapping systems of structural inequalities that constrain and enable the opportunities CAs have to exercise agency both nationally and globally (Maestripieri, 2021; Walby, 2007).

COVID-19 and the mitigation measures taken to control it reflected and exacerbated this system of inequalities, exposing existing vulnerabilities and amplifying social differences into the future because of the scaring effects (Maestripieri, 2021; Walby, 2007). CAs are, for example, unlikely to make up for lost schooling, CAs who do not return to school will not fulfil their potential, and some of the CAs who started taking drugs will have become habituated to them. COVID-19 has not just revealed the structural weakness of the health system but of education, social protection, child protection, employment, family, and financial systems. The pathway to (adverse) impacts of COVID-19 on CAs is conditioned by these institutions and their interactions, together with structural inequalities.

While the data revealed a stark picture of the grounded realities of CA lives during the early part of COVID-19, the pandemic has also laid bare and intensified multiple and interacting pre-existing inequalities locally, regionally, and globally (Nolan, 2021). For CAs, their development takes place in a complex web of family, community, peer group and school as influenced by the broader institutional structure and culture and powerful global influences and shifts that differentially influence socioeconomic and cultural conditions in all countries globally (Bhaskar & Danermark, 2006; Hickel, 2017a; Langan, 2018a; Patton et al., 2016).

Rwanda, although politically independent, continues to contend with multifaceted and multi-layered forms of neo-colonialism and economic dependency on the Global North (Mossallem, 2017; Toussaint, 2020). In implementing mitigation measures to fight COVID-19, Rwanda depended on international financial institutions and OECD Development Partners for financial support and donors in the Global North for healthcare resources.

The deep underlying generative mechanisms of the (negative) impact of COVID-19 on CAs in Rwanda are the neo-liberal policies of global governance which perpetuate the maldistribution of resources across the world (Hickel, 2017b; Scambler, 2018) and within Rwanda. The Covid-19 pandemic and the responses to it reproduced and reinforced prevailing inequalities in power and economic inequalities (Mccann et al., 2022; Stein & Rowden, 2022). Since the 1980s, international institutions like the World Bank and the International Monetary Fund and major donors such as the USA, the European Union and the United Kingdom have tied foreign aid, concessional loans and free-trade agreements to countries in the Global South, downsizing the government sector, opening their economies to foreign direct investment from investors in the Global North, and exporting raw materials and low cost manufactured goods to the Global North and importing high value manufactured goods from the Global North thereby building up large trade deficits (Langan, 2018b; Slobodian, 2018; Stein & Rowden, 2022). The finance for development that flows to countries in the Global South is estimated as half the financial flows from countries in the Global South to the Global North (Griffiths, 2015). The consequence has been that many countries in the Global South, including Rwanda, have become locked into neo-colonial patterns of trade and production that have widened economic inequalities and resulted in a failure of development.