The issue came up on July 14, 2025, during a hearing where PAC members reviewed the Auditor General’s report for the fiscal year ending June 2024. The report revealed several weaknesses in the hospital’s management of funds, especially in how tenders were issued and implemented.

MP Marie Claire Uwumuremyi, a member of PAC, noted that out of 15 tenders audited, worth a total of Rwf 2 billion, 11 had irregularities, meaning 73% did not comply fully with procurement laws. Some contracts also cost significantly more than what had been planned, with one tender exceeding its original budget by 213%.

She said, “This is why we asked you to explain how these irregularities happened and why there is such a large overspending, despite the clear laws regulating public funds.”

In response, Frère Charles Nkubiri, the Director General of CARAES Ndera, attributed the overspending to a sharp and unexpected increase in patient numbers, which forced the hospital to buy more medicine and equipment and hire more staff.

“Patient numbers increased by 26% in 2024 compared to 2023. This means more beds, more medicine, more staff all of which pushed up costs beyond what we initially budgeted,” he explained.

Frère Charles Nkubiri, the Director General of CARAES Ndera

In 2023, the hospital received 94,000 patients; in 2024, the number rose to more than 101,000. Currently, CARAES Ndera operates at 116% of its capacity, putting extra strain on its facilities and resources.

Frère Nkubiri also said that the number of staff increased by 18% last year to cope with the rising demand for mental health services. About 45% of the hospital’s patients come from Kigali, which has expanded significantly since the hospital was built in 1968.

“Our hospital was designed as a district facility back then, but today we are a teaching and referral hospital. We urgently need expansion and modernization to match the city’s growth and our national role,” Nkubiri said.

He added that delays in payments by some patients or local governments also put pressure on the hospital’s finances.

The Auditor General’s report shows that the COVID-19 pandemic has left lasting impacts on mental health in Rwanda, with more people seeking treatment for depression, anxiety, and trauma. Current figures show that depression affects about 11.9% of the population, severe anxiety 8.1%, post-traumatic stress disorder 3.6%, while serious mental disorders stand at 1.3%.

Frère Nkubiri said that, like the University Teaching Hospital of Kigali (CHUK) which is relocating to larger premises in Masaka, CARAES Ndera also needs major investment to expand its infrastructure and services to keep up with the country’s growing mental health needs.