Ruth Uwineza experienced first-hand the horrors of the Rwandan genocide.

She was just 11 when her parents and eight of her nine siblings were slaughtered in the frenzy of killing that claimed the lives of as many as a million people across the country in 1994. Uwineza and one sister somehow survived, but more than a decade after coming to Toronto as a refugee, she’s still haunted by the bloodshed and suffers flashbacks and overwhelming anxiety whenever she has to deal with authorities.

Her post-traumatic stress disorder — her family and supporters say — is why it’s been a huge struggle for Uwineza to become a Canadian citizen.

For seven years she has tried to pass the citizenship exam and failed three times, despite encouragement from her two children who’ve been helping her study and prepare notes, sometimes in their native Kinyarwanda language, so she could memorize everything she needs to know for the test.

But each time she walked into the test centre and looked at the questions on the paper, she says she tensed up and her brain would go “empty.”

“I would feel really fearful, have blackouts and forget everything,” said Uwineza, 36, who came to Canada in 2007 under a private sponsorship. “I feel helpless and frustrated. I want to be a full Canadian.”

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After her first two failed attempts to pass the test, Uwineza was referred for a psychiatric assessment in 2017 by the Parkdale Community Health Centre, which is helping her with her citizenship quest.

It was there that Uwineza was diagnosed with post-traumatic stress disorder, a condition that makes it difficult for her to cope with day-to-day functions. She still struggles with the events of 1994, when as many as a million minority Tutsis, including her family, and moderate Hutus, perished during a three-month killing spree.

Dr. Susan Franchuk of the Parkdale Community Health Centre said the symptoms of PTSD affect Uwineza’s ability to learn and complete the citizenship examination, regardless of format.

“Undertaking the examination (written or oral) would cause unnecessary distress for this patient who is already struggling significantly with mental health difficulties,” Franchuk concluded in her report, part of the submission to ask the immigration department to grant Uwineza citizenship by waiving the test requirement.

Despite her plea for a waiver, immigration officials insisted on scheduling her to yet another citizenship exam last month. Uwineza, again, failed and left in despair.

Immigration officials said all waiver requests are processed by local officers and Uwineza’s case is being handled according to the department’s procedure.

“All applicants are invited to the citizenship test and the interview to review original documents and confirm the applicant’s identity. It is the applicant’s right to take the test up to three times, before the department reviews their waiver request,” said immigration spokesperson Brianna Lessard.

“If the applicant prefers to have (their) waiver request reviewed without taking the test, that is the client’s decision.”

Lessard said Uwineza’s application is currently in a queue for a hearing where an officer will assess the severity of her medical condition and hear why she should be exempted from the test. The department is currently studying barriers immigrants face in acquiring citizenship and the report is expected to come out in 2020.

Permanent residents between the ages of 18 and 54 are required to have spent at least three out of five years in Canada before they take the citizenship test, which consists of 20 multiple-choice questions on history, geography, the economy, government, laws and symbols. They must answer 15 questions correctly to pass. If they fail twice, they are referred to a citizenship judge who will ask them questions orally, including about their knowledge of Canada. If the judge refuses to grant citizenship, the person must apply again.

Although the majority of waiver requests are ultimately granted, lawyers say applicants are made to do the test regardless because officials don’t look at any medical evidence until after applicants fail the test and are referred to an oral interview.

“Even with fulsome submissions of evidence, our clients, nonetheless, must go through the conveyor belt,” said Jennifer Stone, staff lawyer at Neighbourhood Legal Services in downtown Toronto. “It’s really health harming. One of our (Afghan) clients had a panic attack the night before the exam. He left home at 10 and didn’t come back. He was later found by police and sent to hospital.”

In the department guidelines, officers are advised to check on a waiver applicant’s work, education and travel history and if the person has a driver’s licence in order to assess if a disability or disorder hinders their ability to pursue other goals.

“Ruth indicated from the outset that she was seeking a waiver on medical grounds and supported this with expert psychiatric evidence,” said Toni Schweitzer, Uwineza’s lawyer. “She also requested not to be required to write the test, which was also supported with expert psychiatric evidence.

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“Her requests were ignored and she was asked to write the test. Only after failing was she offered an opportunity to discuss her waiver request,” said Schweitzer. “Why could this not have been done at the outset of the process as Ruth requested?”

At Toronto’s Chinese and Southeast Asian Legal Clinic, executive director Avvy Go said asking for an exemption from the citizenship test can be a difficult and long, drawn-out process that can take years. One of the clinic’s clients, a schizophrenic patient, was made to take the test despite a waiver request and he just freaked out and refused to show up for the exam in February, she said. A new waiver request is now under review.

“In any other human rights context, if you have a disability, a public office will accommodate you for the undue hardship you face,” said Go. “But citizenship is considered a privilege to be conferred. So even if you beg them for an exemption, immigration doesn’t see an obligation to accommodate you.”

Uwineza, whose son is now 19 and daughter 8, said she doesn’t want to wait two more decades to reach 55, when she’ll be eligible for an age exemption from the citizenship test.

Citizenship test waivers

2011: 181 requested & 165 granted

2012: 170 requested & 166 granted

2013: 117 requested & 105 granted

2014: 184 requested & 182 granted

2015: 179 requested & 169 granted

2016: 1,208 requested & 1,042 granted

2017: 378 requested & 308 granted

2018: 269 requested & 232 granted

2019 (up to April): 129 requested & 117 granted

Source: Immigration, Refugees and Citizenship Canada

Correction - June 12, 2019: This article was edited from a previous version that misstated Ruth Uwineza’s age during the 1994 Rwandan genocide.