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SOCIAL CONDIT.
A new experiment by MSF/Belgium in coping with mental health problems
Professor André Mavinga recently visited Belgium in order to gain further experience and knowledge of what is presently taking place in the field of mental health. His visit was sponsored by the organisation, Doctors without Frontiers (MSF)/Belgium. Professor Mavinga has organised a mental health programme in Kisangani, and recently took part in a seminar, where participants, psychologists and doctors evaluated Kisangani’s mental health programme following the six-day war.
Professor Mavinga underlined the programme’s specificity, namely that psychologists go out among people traumatised by last year’s fighting in Kisangani. This is different from medical practice in other countries where the victims usually visit the specialists in the hospitals. Professor Mavinga also took the opportunity of discussing with his colleagues such issues as patient-doctor relationship, group therapy and the support which the psychologist can offer the patient.
Kisangani’s experience
What actually happened in Kisangani? Military action took place in the city from 5-10 June 2000, when the invading Rwandan and Ugandan troops battled it out among themselves to see which side would control the city. The population suffered terribly both physically and mentally, and once hostilities had ended, MSF/Belgium organized a four-day training programme for Kisangani’s doctors, psychologists and sociologists, so that they could come to the help of the city’s traumatised population.
Yes. The population was indeed traumatised, depressed and was no longer capable of coping with life. So, a specialised team from among the city’s medical practitioners who had followed the training programme, went out among the people to see what could be done to help them. Their mission was to help Kisangani’s citizens return to a normal way of life and once again have confidence in themselves. The people had to be given new self-assurance; they had to be encouraged to talk through their experiences; they had to be provided with psychological support; they had to be helped to overcome the shock of their experiences and to be shown that a better future is possible.
In Africa, whenever somebody is in distress, he/or she is helped by the kindhearted presence of another person who provides encouragement and consolation. Kisangani’s outward-reach mental health programme is thus consistent with our African customs and traditions.
Kisangani’s mental health programme for the traumatised, operates within various well-defined sectors: Families, schools and among displaced persons. Each medical unit consists of three people — a supervisor and two practical helpers. They meet with families of those who have been killed or wounded or whose homes have been badly damaged, and try to provide them with psychological support.
In the schools, they are confronted with extremely traumatised pupils, suffering from the effects of war. They also go out among displaced people who are living in military camps or in public buildings, frequently under deplorable conditions.
A first approach is to get the war victims to talk about their experiences and about what they are presently suffering. Only then can the visiting medical unit offer advice and psychological help. The unit usually brings along some kind of practical help in the form of a parcel of soap, biscuits and school stationery. Medicine is also distributed in district health centres and in hospitals.
After each visit, the visiting unit prepares medical records for each patient, so that a follow-up visit can be made every three months to check on how things are going. From the records and visits, the medical unit can diagnose the most frequent diseases related to war-caused trauma — insomnia, gastritis, hypertension, difficulties in concentrating, hallucinations, sexual problems, spontaneous abortions, etc. Counselling is offered to each patient and over a number of meetings, solutions are sought...until the patient is able to stand on his own.
Doctors without Frontiers (MSF) is a Non-Governmental Organisation (NGO) which specialises in providing immediate medical help in war-related catastrophic situations, and during epidemics. The organisation provides help in both physical and psychological urgencies, and brings purely humanitarian assistance to distressed people. In its early days, MSF offered the usual medical help, but in recent years has had to extend its humanitarian assistance so as to take on board psychological urgencies. In Congo RDC, MSF/Belgium has medical centres in Kinshasa, Goma, Basankusu and Kisangani (the only one of these centres to have a mental health programme as well).
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