Improving mental health in Malawi

Although neurological and mental illnesses are widespread, there are only limited treatment options - this applies equally to Malawi. Therefore, DIFÄM supports mental health education for health professionals in order to improve the care of patients and to promote information on mental health in the villages.

Joyce, a young student, comes to Nkhoma Hospital in Malawi with severe abdominal pain. Because the examinations don’t reveal anything, she is sent home again. But she comes back and complains of various disorders - without her being helped. On her fourth visit to the clinic, she is examined by nurse Lombani Mhango. He has been taking additional training in mental illness and asks Joyce if there is something putting her under exceptional strain. And now she blurts it out: At the University in Lilongwe, rumor had spread that she was HIV-positive. Since then, she has been marginalized and bullied, although she has been able to refute the rumor with a negative HIV test.

This situation had put a lot of strain on her, although she had started her studies with great enthusiasm:  it is very special for a girl in Malawi to have parents financing her studies. Her parents, whom she confided in, had only advised her not to let things get her down. Her visits to the clinic were cries for help, and now nurse Lombani Mhango was able to interpret them correctly. In talks with him, Joyce managed to see and think clear again after a while, and to dissociate herself from the stressful situation. Joyce's physical symptoms improved and she went back to university. Today she is fine and she is looking forward to graduating soon.

Various causes

The causes of mental illness in resource-limited countries are manifold. Burdens like wars and conflicts, flight, natural disasters, violence against women or social exclusion are risk factors. Physical illnesses such as an HIV infection can also affect mental health. Many people think that mental diseases are caused by demons or even are a punishment of God. Accordingly, mental patients are often stigmatized and discriminated against or even hidden by their families. And especially in African countries there are huge supply gaps in medicine.

Get out of the taboo

Although neurological and mental illnesses such as epilepsy, depression and anxiety disorders are widespread, Malawi, like many other countries, has only limited treatment options. The sensitization of the population is urgently needed. Therefore, the issue of mental health is now being integrated into the existing health program of Difäm’s partner hospital in Lilongwe district.

Difäm supports training of medical staff in the field of mental illness and health. The trained professionals form teams of experts who work in the clinic and go to the villages in order to educate the population and sensitize the village elders. They regularly visit mentally ill people at their home, take medicines for them or send them to hospital if necessary. They support self-help groups for drug- or alcohol-dependent people. And they ensure that people suffering from epilepsy get the medications that are so important to them without having to spend hours walking to the nearest clinic.

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