Using talk to tackle Zimbabwe’s mental health crisis

Years of economic hardship and inadequate health services in Zimbabwe have contributed to a mental health crisis. But one unique project is using talking therapy to help thousands of people who would otherwise have been left untreated. “Some of the myths include witchcraft… people think they are possessed with evil spirits,” says Dr Dixon Chibanda,

Dr Chibanda says the simple act of talking can make a huge difference to a person's life

Dr Chibanda says the simple act of talking can make a huge difference to a person’s life

Years of economic hardship and inadequate health services in Zimbabwe have contributed to a mental health crisis.

But one unique project is using talking therapy to help thousands of people who would otherwise have been left untreated.

“Some of the myths include witchcraft… people think they are possessed with evil spirits,” says Dr Dixon Chibanda, a psychiatrist in the capital, Harare, explaining the traditional beliefs which persist among many over the causes of mental illness.

“But we know there is overwhelming evidence to show that when someone is mentally ill, whether they have common mental disorders or schizophrenia… it is a medical condition which can be controlled.”

The World Health Organization’s estimates that one in four people will suffer mental health problems at some point in their lives, the figures for Africa would run into the hundreds of millions.

‘Overwhelmed’

Dr Chibanda co-founded the Friendship Bench, a network of community health workers, volunteers and specialists, about a decade ago when Zimbabwe’s economic turmoil was at its worst.

The programme works by training non-professional carers in talking therapy techniques, so that they can provide treatment.

“We have managed to show that we can train lay health workers to deliver… structured psychotherapy in Africa and produce amazing results,” he says.

The initiative has reached 10,000 people so far, but Dr Chibanda hopes the number will increase to as much as 50,000 people each month once the scheme rolls out nationwide.

“There is lack of awareness of what can be done for people who are mentally ill… not only in Zimbabwe, but in the rest of sub-Saharan Africa,” he says, referring to the absence of both diagnosis and treatment for such illnesses in many parts of the continent.

“Some people in our society who are living with HIV and Aids, unemployed, without access to health care, with a child who is unable to go to school,” he says.

“They are overwhelmed and they do not know which problem to start working on.”

Family rejection

The simple act of talking can make a huge difference to a person’s life, Dr Chibanda insists.

Friendship Bench carers use a programme of talking therapy called “Vazukuru”, meaning “nephew” in the local Shona language.


The three stages of Vazukuru talking therapy

  1. Kuvhura pfungwa – Opening up the mind
  2. Kusimbisa – Uplifting the individual
  3. Kusimbisisa – Further strengthening

The treatment is broken down into different stages so that patients can understand the root cause of the mental health issues before trying to find solutions.

“‘Kuvhura pfungwa’ is the first thing that we do; we open up a person’s mind,” Dr Chibanda explains.

“From opening a person’s mind, we uplift the person, and once they are in a situation where they can deal with the problem, we can then strengthen them. That’s ‘Kusimbisa’.”

“After that, we provide further strengthening which is called ‘Kusimbisisa’,” he told the BBC.

One of those who received help from the scheme is Chipo, a mother of four living in a Harare township.

‘Locked out’

Chipo, which is not her real name, was a victim of domestic violence, and went into a depression that presented mental challenges, which she says reduced her to a “laughing stock” in her community.

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