"I started drinking alcohol and quickly became a very heavy drinker," says Funzirani, who lives with his family in Malawi. Although his parents disapproved, he attended a construction school. "But every time I received my salary, I bought alcohol with it - and then work was history for a while. I stopped eating, behaved like a madman and slept in the graveyard and was eventually shunned by everyone."
In 2021, Funzirani learned about the mental health project promoted by Difäm Weltweit. He took part in a withdrawal therapy and in the meetings of the self-help groups for people addicted to drugs or alcohol. After rehabilitation, he was able to start working again. "Today I am doing very well, I live with my family again, go to work regularly and have never touched a drop of alcohol since." As a dry alcoholic, Funzirani now even works in addiction prevention and looks after patients with a similar fate.
Breaking out of the taboo
Although neurological and mental illnesses such as epilepsy, depression and anxiety disorders as well as alcohol and drug addiction are widespread, there are enormous healthcare deficits in Malawi. For example, there are exactly two registered psychiatrists and two psychologists in the whole country - for 18 million inhabitants. They are operating in one state-run psychiatric hospital and two Catholic psychiatric hospitals. The lack of care structures, frequent misdiagnoses and a lack of awareness among the population about mental disorders lead to stigmatisation and discrimination against people with mental disorders. Traditional healers are therefore usually the first to be contacted for mental illness. The healers, the patients and the communities believe that a mental illness is caused by spiritual possession or witchcraft and that it is not a medically treatable condition. As a result, those affected receive inadequate or inappropriate treatment that does not alleviate the symptoms or the illness, but instead further aggravates their condition. Violence, alcohol or drug abuse, suicidal behaviour and ostracism are possible consequences.
This is why DIFÄM is committed to building mental health care structures for correct diagnoses and effective treatments. Raising awareness among the population is also urgently needed in the fight against stigmatisation and discrimination. Therefore, the issue of mental health has been integrated into the existing health programme of DIFÄM's partner hospital in Lilongwe District.
In this hospital, DIFÄM supports training of medical staff in the field of mental illness and health. The trained professionals form teams of experts who work both in the clinic and in the villages. There they educate the population and sensitise the local people to handle mentally ill people in a rational way, because especially at village level mental illnesses are often associated with witchcraft and magic.
They regularly visit mentally ill people at home and bring them medication or arrange for hospitalisation in an emergency. They accompany self-help groups for people addicted to drugs or alcohol and provide them with medication. Above all, however, they ensure that this topic is de-tabooed and that people with mental disorders are reintegrated into the community.
