Tag Archives: mental illness

Butabika National Referral Hospital, in Kampala, Uganda, is the country’s only mental health facility.

UCU nursing graduates seek to fill gap in Ugandan mental health care

Faculty of Public Health, Nursing and Midwifery, UCU School of Medicine, , , ,


 

By Douglas Olum

When Conrad Ochola suffered depression in 2017, he heard a voice in his head.

He walked before his elder sister with whom he lived and threw off some of his clothes. The abnormal action shocked not only the sister but also the rest of the family. They were not aware that Ochola, then a new graduate of Uganda Christian University (UCU), had battled his mental state for some time. He hadn’t slept for months, with strange voices constantly screaming in his head. One of the voices persuaded him to throw himself in a pit latrine. He survived because the hole leading into the pit was too small to swallow him.

Through those months, Ochola, suffering in part due to the loss of his mother, lived in fear of death, saw things in twos and dodged meals because every time he ate, he would feel pain as though he was eating his own body parts. He never told anybody.

Butabika National Referral Hospital, in Kampala, Uganda, is the country’s only mental health facility.
Butabika National Referral Hospital, in Kampala, Uganda, is the country’s only mental health facility.

It was when the 24-year-old stripped naked that the family came to realize that he indeed needed mental health care. They rushed him to Butabika National Referral Mental Hospital, where he was diagnosed with depression. After months of medication in this only such facility in Uganda, Ochola recovered.

Ochola, a marketing executive at a Uganda investment company called Xeno, is an example of how proper mental health assistance can make a positive difference.

Daniel Ojok, a high school graduate, wasn’t so fortunate. He crashed himself onto a speeding truck in December 2018 along the Gulu-Juba highway, days after dropping suicide hints that nobody got. The late Ojok is like millions of Ugandans who need mental healthcare but do not get it.

One mass example is in northern Uganda where thousands still suffer the traumatic consequences of the two-decade Lord’s Resistance Army (LRA) insurgency, hundreds have committed suicide and more still continue to do.

A recent World Health Organisation (WHO) report indicates that at least 1.7 million Ugandans (about 4.6% of the total population) suffer from depressive disorders and another 3% suffer from anxiety. Depressive disorder is a condition characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration. Two years ago, the WHO ranked Uganda among the top six African countries heavily affected by mental health issues.

The Uganda Protestant Medical Bureau (UPMB), a charitable and technical national umbrella organization, reports that 98% of people with mental health issues in the country do not have access to care.

The problem is attributed to lack of community-based psychiatric care facilities, poverty that incapacitates many families from taking their mentally ill members for medication and the misconception that mentally ill people are connected to witchcraft, the latter often subjecting victims to rituals that, unfortunately,cause further harm to their mental states.

Butabika Hospital currently has up to 900 patients – double its capacity. A Butabika nurse who spoke on condition of anonymity said most times the extra patients are admitted because they have no where else to go.

Often, those afflicted with mental health issues roam the streets. Men and women dressed in rags, with dirty, twisted hair and many times carrying sacks of rubbish, stroll along streets of urban places across the country or seated in isolated places, mumbling junks of sentences.

Training institutions such as the Uganda Christian University aim to lessen the Butabika overload and the number of victims on the streets.  The department of Nursing, for instance, is equipping student nurses with psychiatric nursing skills. Throughout their final semester of studies, students pursuing the Bachelor of Nursing Science, spend at least a day every week serving and learning at the Butabika Mental Hospital.

Mrs. Jemimah Mary Mutabazi, the head of the Department of Nursing at UCU, said as a department, they have been teaching mental health since the approval of their curriculum in 2006.

“It is part of curriculum because we want to equip our nurses with skills that enable them provide holistic care to their clients. Nurses work with people of different kinds including mentally ill patients and we want them to be able to handle all cases professionally,” Mutabazi said.

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For more of these stories and experiences by and about Uganda Christian University (UCU) programs, students and graduates, visit https://www.ugandapartners.org. If you would like to support UCU, contact Mark Bartels, Executive Director, UCU Partners, at m.t.bartels@ugandapartners.org or go to https://www.ugandapartners.org/donate/

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Counselors Irene Ojiambo and Joseph Musaalo at the UCU-Mukono campus (UCU Partners photo)

Erasing mental health stigma – one person at a time

Faculty of Public Health, Nursing and Midwifery, , ,


Counselors Irene Ojiambo and Joseph Musaalo at the UCU-Mukono campus (UCU Partners photo)
Counselors Irene Ojiambo and Joseph Musaalo at the UCU-Mukono campus (UCU Partners photo)

Note:  This is the first of a two-part series focusing on mental illness in Uganda.  Part I demonstrates how Uganda Christian University (UCU) deals with the problem.  Part II will provide an example of a program making a difference outside of the UCU campuses.

By Patty Huston-Holm

For Irene Ojiambo, the desire to be a counselor came before she could speak the word. As a little girl, she saw people come into her house, crying and looking for her father, a priest. Instead, the distressed men and women got her mother who had them laughing on the way out. That, the young Irene knew, was the job she wanted.

For Joseph Musaalo, the call to counseling was progressive. The students he taught and the steady flow of needy children that his wife, Sarah, brought home found him increasingly wanting to do more. It was an 11-year-old female HIV/AIDS victim who showed up at his job with Compassion International who propelled him to action.

“We were shedding tears together,” Joseph recalled of that day and the pain that he and the girl both felt about the naming-calling she endured as well, for him, feelings of inadequacy to help. “I knew I didn’t want to feel that helpless again.”

So it was that Irene, who aspired to “make people laugh” and Joseph, who sought to stop the tears, became counselors.  Their offices slope down among the trees between the Uganda Christian University (UCU) medical building and the Noll classrooms on the Mukono/main campus. UCU has counselors at all five of its locations.

The first UCU counseling office opened in 2005 – eight years after the university was founded. A pastor was hired to do the job. In 2008, Joseph came on board, seeing UCU students and staff in a small room that was part of the Allan Galpin Medical Center.

“I immediately started making a case for locating the counselor services in a place that would provide more respect,” Joseph, now head of UCU counseling services, said. “There was – still is – a stigma about people seeking help for emotional problems. Some people say they are ‘mad’.”

Today, Irene, who came to UCU four years ago, and Joseph, at UCU more than a decade, offer counseling services in a building that was once a family home. They each see about five people a day or 50 total a week – usually by appointment and most often young females. They hold large meetings in a structure that used to house a resident’s car. A white tent for the twice-a-year para-counseling workshops is nearby.

“Counseling is about empowerment and not advice,” according to Joseph, known as “Uncle Joe” for his regular column in the university’s student newspaper, The Standard. “We listen, give coping solutions and empower people to make decisions, hopefully beyond a one-time crisis.”

Friends and family members give advice that may or may not be the best and could resolve a short-term problem related to bullying, abuse, diet, study habits, drugs and money. Counselors strive to enable individuals to not only resolve a single issue but to have to have the tools to avoid re-occurrence.

Mental health is less understood in developing countries like Uganda, according to Joseph.  Butabika Hospital, founded in 1955 in Uganda’s capital, Kampala, is the mental health national referral hospital for the entire country’s population of more than 40 million. One source notes that 98% of Ugandans with mental health issues have no place to receive services.

The UCU counselors are doing their best to fill that void for students and staff. The overriding issues of fear, anxiety, self esteem and depression are connected to such conditions as drug and alcohol use and abuse, HIV/AIDS and financial deficiency and pressure toward extra-marital and pre-marital sex and academic cheating.

The counselors, along with Richard Bwire, their administrative assistant, know the clients they see barely touch the surface of the campus need. In addition to the negative stigma with asking for help is the requirement that students and staff come to the counselors and not the other way around.

“They have to come to us,” Joseph said. “We know there are many out there who feel isolated with a problem, but they need to take the first step and ask for help.”

One way to help meet the need that is too large for counselors is staff and student training.  Since 2008, there have been 2,073 students and 396 faculty and staff receiving UCU para-counseling training to help themselves and others around them. Topics include self-awareness, and anger, stress and financial management as well as basic information about frequent mental and physical topics that a trained counselor addresses.  There are some conditions – such as Post Traumatic Stress Disorder common to those coming from war-torn areas – that only a certified counselor should handle.

“We are a Christian university and we are Christians, but we always follow the path of the client first; we unwrap the problem,” Irene said. “Some people we see have been hurt by people professing to be Christians.”

One client, one workshop at a time, Uganda’s trained counselors “must change the way of thinking that somehow mental illnesses are less serious than physical ones,” according to Joseph. “And we need to realize that we all have some level and some moments of mental incapacity, but when they become large, we need help.”

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To learn more about the UCU, go to http://ucu.ac.ug/. To support UCU, go to www.ugandapartners.org and click on the “donate” button. or contact UCU Partners Executive Director, Mark Bartels, at mtbartels@gmail.com.