Medecins Sans Frontières (MSF) has called on donors to support mental health activities in order to address challenges affecting mentally ill patients in Zimbabwe.
By Philemon Jambaya
Speaking during the World Health Day commemorations that coincided with the official opening ceremony of the Harare Central Hospital Psychiatric Unit in Harare recently, MSF Head of Mission, Abi Kebra Belaye, appealed to the donor community to finance neglected mental health activities.
“We see individuals with mental illness and their families suffering in silence. We also see that the donor community seems to have forgotten this group of people and their suffering,” said Belaye.
MSF has made considerable contributions to mental healthcare in Zimbabwe through supporting the construction of Harare Psychiatric Hospital.
The organisation has built Out-patient department (OPD) at Harare Hospital which is made up of six consultation rooms, a pediatric consultation room, patient reception block, pharmacy, waiting area and staff meeting room.
MSF also supported the hospital with funds for renovation of the acute admission and In-patient Department (IPD) ward accommodating up to 100 patients.
However the organisation believes their support is not significant as the hospital is still grappling with critical shortage of psychotrophic drugs, lack of human and financial resources among other challenges.
“The most urgent challenges in mental health care in Zimbabwe include critical shortages of psychotropic drugs; a lack of human and financial resources; a lack of funds to maintain mental healthcare facilities; the ongoing social pressure of stigma and discrimination; and an absence of mental health education,” said Belaye.
Also of concern is the shortage of mental healthcare specialists including psychiatrists, psychologists, mental health nurses, and occupational and speech therapists. In addition to critical shortages of these essential specialists, the concentration of these few specialists is in Harare, and not the rural areas, where they’re desperately needed.
In 2016, MSF worked with World Health Organisation (WHO) and Ministry of Health and Child Care (MOHCC) to launch the WHO mental health Gap (mhGAP) intervention guide as well as providing training to approximately 120 non-mental health specialized nurses as well as the Zimbabwe Prisons and Correctional Services (ZPCS).
The mhGAP trainings emphasized capacity development of registered general nurses, providing them with a basic understanding of mental health as well as how to provide treatment, care and support. This training addresses a critical mental health gap at the community level.
“These nurses are now taking the lead in the management of mental health care in their institutions,” said Belaye.
In addition to the mhGAP training, MSF has contributed to cutting-edge mental healthcare in Zimbabwe by piloting the community psychiatry model of care in 13 polyclinics in Harare in collaboration with the City of Harare health department. This model involves decentralising treatment, care and support for people living with mental illness at local clinics and enables them to remain with their communities and families while receiving care.
“Community psychiatry makes it easy for patients to access treatment closer to their homes,” said MSF Harare Psychiatric Project Coordinator, Omer Abdalla.
“MSF is particularly delighted that the MoHCC has today launched the mental health discharge plan guidelines that will be used when patients are discharged from the tertiary institutions to the community level. We hope the discharge plan will help patients to adhere to their treatment and will create clear patient referral pathways,” he said.
As a part of its contribution to decentralized mental healthcare, MSF introduced a discharge team to follow-up on discharged patients in Harare’s surrounding communities to ensure that patients continue to receive care even when they are released from the hospital and return to their communities. MSF has also worked to ensure that this care includes access to psychotropic drugs.
“I used to collect my medication from Harare Central Hospital Psychiatric Unit, but now I can collect it from Mufakose clinic, close to where I stay,” said Blessing, a mental patient.
MSF started its mental health project at the Harare Central Hospital Psychiatric Unit in October 2015 and is currently working to improve the quality of diagnosis, treatment, care and support to psychiatric patients in Harare in collaboration with the MoHCC, City of Harare Health department, Friendship Bench, and ZPCS.