Kuvhura pfungwa: opening of the mind.
The process of formally asking humans questions about their behavior in order to glean their mental state has been done since the 1870s, when Wilhelm Wundt opened the first laboratory dedicated to psychology. The process of informally asking humans questions about themselves has been done for much longer—tens of thousands of years longer.
While the concept of therapy might still draw to mind clients stretching out on couches and doctors tapping a pen to their notepads, the picture of mind exploration looks very different in Harare, Zimbabwe. It looks a little more informal; maybe even a little more natural. Eschewing stuffy offices for park benches, and scrutinizing doctors for elderly women, the Grandmothers (as they are affectionately termed) of Zimbabwe are taking mental health—and its alarming lack of available resources—into their own hands.
The mental health help deficit
Mental health in the developing world (and only recently in the developed world, too) has finally gained the attention it deserves…at least from those on the outer edges looking inward. In 2016, the World Bank reported that the global economy was losing $1 trillion each year due to the lack of productivity that comes as a result of not addressing mental illness; but let’s splice that into more humanistic terms.
When individuals are suffering from anxiety or depression (which 10% of individuals in the world currently are), their listlessness, concerns with the future, and retreating behaviors often translate to lowered participation in society. This could mean that these individuals are foregoing educational opportunities; aren’t exercising their voting rights; and are missing out on employment growth.
Indeed, this outcome does have devastating effects on the economy; but at a more foundational level, it has devastating effects on the community, and perhaps most tragically, the individual, as well. During times of emergency—whether natural disaster or ongoing conflict—1 in 5 individuals suffer from anxiety or depression.
Not surprisingly, the countries most likely to experience ongoing conflicts are amongst the poorest in the world, due to social inequalities, an insolvent economy, and lacking governmental services; which roughly portends that unless we begin formulating grassroots solutions, the poorest countries will remain the poorest, and the mentally ill will get no reprieve.
The case of Zimbabwe
In Zimbabwe, 70 percent of the population lives in poverty and over 13 percent is HIV-positive, a setting of stress and desperation that is likely a contributing factor to the reality that a quarter of the population suffers from mental illness. Additionally, the country is still reverberating from the psychological distress caused by the Gukurahundi, a series of massacres throughout Zimbabwe that took place in the 1980s.
Despite the evident need for psychological first aid, fewer than 15 trained psychiatrists inhabit this country of more than 15 million people. Compound this with the stigma that extends itself so deeply into this culture that people showing signs of mental illness have been considered possessed and in-need of exorcism, and the necessity of innovative health care-circumvention becomes clear.
Calling all grandmothers
Based out of the country’s capital city, Harare, Dr. Chibanda was confronted with the devastation of a patient taking her own life, back in 2005. Though her treatment had been ongoing, this client eventually noted an inability to continue affording her travel to him, one of the sole mental health practitioners in the country at the time. It was this incident that forced Dr. Chibanda to recognize that the lack of access to psychological care was no longer acceptable. So he began recruiting grandmothers.
In Zimbabwe, like much of Africa, the tradition of respect for both matriarchs and the elderly is intrinsic to the culture. Already possessing respect and actively advising their younger brethren, the grandmothers of Zimbabwe were a logical choice.
It began with 14 women from the community, sitting on a park bench.
Uplifting and strengthening
English-speakers call it depression; in the Shona language, a similar concept, Kufungisisa translates to “thinking too much.” In Zimbabwe, the Harare Grandmothers have made it their mission to hear each and every one of those thoughts.
Using his clinical background, Dr. Chibanda located the intersection between the local culture and the overarching practice of cognitive behavioral therapy. Enter, the Shona Symptom Questionnaire. This tool, comprised of 14 questions such as “Have you been struggling to sleep?” and “Have you been worrying too much?” aids the grandmothers, armed with their empathy, patience, and honed-listening capabilities, to hear patients with a more critical ear and better assess their mental state. Packing a scientific method into something more human, this approach proves particularly useful in a setting where mental illness is too-often ridiculed and speaking about depression too-often rebuffed.
Ultimately, the goal of the Friendship Bench (as this system of compassionate caregiving came to be known) is to work with the individual on kusimudzira – uplifting – their spirit and kusimbisa – strengthening – their soul.
A solution worth replicating
Though the selflessness that these grandmothers demonstrate in creating a safe-space for individuals fighting depression and anxiety is far from quantifiable, anyone looking for some hard statistics will take the knowledge that this project has helped over 27,000 people as welcome news.
One of the original grandmothers, Joyce Ncube, commented, “Many died just because they had nobody to tell their problems to,” alluding to suicide in addition to depicting the high levels of domestic violence taking place in the country. “When people keep things inside, their problems start.” When people are able to let their worries out, however, immeasurable transformation is able to ensue.
This human-forward loophole of sorts has done more than make strides in closing the mental health care gap in Zimbabwe (though it’s certainly done quite a bit of that). It has evinced the power of what people can do for one another with a charitable heart and a little bit of time on their hands.
Take a dozen grandmothers and a few park benches, and show the world that $1 trillion begins with some compassionate conversation.
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Post originally written by Samantha Harper, GoAbroad Writer’s Academy Member