BasicNeeds operates in two areas in Tanzania: Mtwara region and the capital, Dar es Salaam.
In Tanzania there are very few mental health services. Mental health treatment is only provided in large hospitals and this makes it very difficult for people in deprived rural areas to access treatment. This means there is a focus on institutionalising patients, rather than treating people in the community. There are only six Psychiatrists in the whole country working in the public sector. This lack of care means that many mentally ill people prefer to visit traditional healers or are forced to wander the streets rather than go into a hospital.
It is estimated that there are 2.5 million people with mental illnesses but only a fifth of these get professional treatment.
In Mtwara there are only three psychiatric hospitals for the whole region and no mental health support is provided at the local level. Even within these units, care is poor. There is no central office to oversee the coordination of care and Psychiatric staff are often misused. In Newala district there are four psychiatric nurses: two are administrators, one is a store keeper and the other is a tutor at the nursing school. In Tandahimba district there are no psychiatric nurses. There are no psychiatric doctors at all in the region.
No money is allocated to treat mental illnesses from either regional, district or community organisations. This situation forces mentally ill people to turn to traditional healers as their only source of health care.
In Dar es Salaam, mental health care is not a priority. Only a few mentally ill people get treatment, generalist staff are untrained and the small team of psychiatric nurses are highly demoralised by the lack of resources to do their job.
Through out the country the increasing HIV/AIDS pandemic is causing a lot of mental health problems. There is a direct link between HIV/AIDS and mental illness, as people naturally suffer mental trauma when they are diagnosed with the disease. The death of a loved one can also cause emotional damage and stress, especially if they were the main provider for a poor family.
We have found a lot of children who care for mentally ill relatives with little or no support as their parents have died from the HIV/AIDS pandemic and they have no one left to turn to.
There is also a large problem with the supply of appropriate medication. Mental health is not a priority for the government because mentally ill people do not contribute towards the cost of their medication so the central purchasing authority does not buy sufficient drugs to meet the demand. The drugs they do buy are old and are not the modern drugs that are more effective at treating mental illnesses because these cost a lot more. The few drugs that are available are not dispensed from the local level, forcing people to travel great distances to receive their medication.
The stigma attached to mental illness is the main reason why mental health is not a priority. Policy makers are indifferent to mental health and there is a lot of stigma from communities. Mental illnesses are seen as the result of witchcraft or a curse on a community because of poor education. The stigma attached to a mental illness does not just stay with the person affected by it, but it covers all of the individual’s family as well. This means that mentally ill people are often cast out from their families so that they can avoid the shame.
The people we help in Tanzania are very, very poor and this presents lots of problems. For example, many are living on the brink of hunger and starvation. This means they have no way of coping with the increased appetite that medication causes. Without the correct amount of food, the medication doesn’t work and the mentally ill people can’t get better.
We work with a lot of mentally ill people who don’t have enough skills to get a job so we give them skills training. This improves their chances of getting work and bringing in a vital income to their families.
Since December 2005, we have treated a total over 10,000 mentally ill people in Mtwara and over 1,000 mentally ill people in Dar es Salaam. We have managed to make a large impact in Dar es Salaam in a very short space of time because we have successfully managed to train generalist health staff who make home visits in mental health diagnosis and follow-up visits.
We work closely with partner organisations, who help us reach out to help mentally ill people far beyond the limits of our organisation.
Malembo Makene, Programme Coordinator
Plot 20 Luthuli Road, PO BOX 12864, Dar Es Salaam, Tanzania
Tel: +255 22 2127051 Fax +255 22 2127048
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