When Network for Africa started work in Rwanda in 2007, a wise local woman told us people were so severely disturbed by their experiences in the genocide, it might be futile trying to train them with new skills. Psychologists say that when people endure something profoundly stressful, they may be mentally “blocked” from learning. By helping them to manage their trauma, controlling the flashbacks and anxiety, people can then learn new ways to increase their earnings.
Network for Africa’s Unique Approach
From that lightbulb moment, we set out to tackle the massive trauma we found in places recovering from conflict – Rwanda, Sierra Leone (in the aftermath of civil war and Ebola), and northern Uganda, where the notorious Lord’s Resistance Army terrorised millions of civilians for two decades, abducting thousands of people, including child soldiers. We knew it was impossible to provide a mental health professional for each vulnerable person; instead, we evolved an approach that we believe will last long after our project ends.
How we start
We take our time, finding a reliable and respected group (NGO) to be our local partner. We ask them to do a survey to identify the most important issues facing the more vulnerable people in the community. We research the studies that have measured or analysed local mental health challenges. We also ask their advice on how to adapt our training to their specific local needs and culture.
When some NGOs talk about training, they mean that their team of international staff spend perhaps two weeks teaching local people. We are not convinced this always has a lasting impact or is what is required to transform the lives of seriously traumatised people. Nor does it help local NGOs or health professionals who are struggling to serve their community with limited resources.
We train local community counsellors, medical professionals, officials and leaders to respond to mental health issues like post-traumatic stress disorder. We try to support the existing health facilities, building up their capacity to offer help to people suffering from trauma. We aim to empower local NGOs who are responding to what they know is needed in their community, rather than bringing in teams of expatriates. Not only is this practical and in tune with local culture: it is cost-effective.
Making sure we have a lasting impact
We help our local partner NGO to build a coherent team, trained and capable of delivering counselling, being role models, keeping records of each client and each group, and supporting each other so they don’t burn out. Counsellors may facilitate group and individual counselling sessions, but they may also work at community health clinics, supporting people who have been diagnosed with HIV, or assisting nurses as they identify mental health issues and epilepsy. Our partners may use radio shows so people in remote areas can phone in to raise mental health issues; or drama, to get across sensitive messages in an unthreatening manner.
It is vital to involve clan leaders, local government officials, and local chiefs, helping them understand mental health issues, epilepsy and stigma. People in positions of leadership are often best placed to challenge stigma; to let people know about the government-provided services available locally; and to get people referred to the appropriate specialists, where they exist.
Our partners are aware of the need for community sensitisation sessions, discussing mental health, HIV and epilepsy. In this way, they can tackle the stigma that prevents people seeking testing. Our partners also make people aware of services they can access. It is vital to encourage everyone to share their knowledge with family and friends. In short, the counsellors become role models in the community.