Working Alone – Mental Pressure or Motivation?

By Ekaette Udoekong

Ekaette at the office

My name is Ekaette Udoekong. I am the ZonaI Representative for the South-South office Calabar. I work alone at the zonal office. I work from 8am to 5pm. My typical day begins with going through the previous day’s itinerary and incomplete tasks and setting a new to-do-list for 8 hours. I make early calls to confirm or reschedule meetings and appointments, set tasks, prioritise and take action. As the only staff at the zonal office, I am accountable for everything that happens there. Therefore, I read through the business plan of the organisation everyday and try to articulate where the zonal office is headed in the next months/year and how well I could develop both personally and professionally. 

While working alone may help me focus, it eliminates collaborative and creative problem
solving that comes from sharing ideas from brainstorming in a group. I do not experience office
politics and decision-making is fast reaching. Despite having to meet with peopledaily, it is tough working alone and it is somewhat difficult to overcome the isolating feelings of loneliness which sometimes is ignorantly stigmatised or aligned with weakness (similar to depression). Sometimes I even doubt my abilities. This wears down on my strengths subconsciously.  Some days at the office I wish to be bossed around, I wish to share my accomplishments, challenges, frustrations or even gossip with a colleague. However, I do this twice a month with my Line Manager but on Skype! 

I have managed to cope with this lonely feeling by cutting down calls and meeting with people either at their offices or at the zonal office. Working with colleagues from other NGOs/CSOs, sharing experiences at meetings because reaching out to others and getting my problems off my chest helps put me in the right frame of mind. Furthermore, talking things through provides ideas to help combat my feelings.  It is said that a problem shared is half solved! I also let my mind think wild and wide in the solitude of the noise-free office which leads to hours of unbroken concentration. With the Foundations’ focus on mental health, I plan my day to speak to at least one person and find out how he/she relates his/her situations with mental health and how its impacts productivity. It is one thing to understand and spot that you are lonely at the office but it is very crucial to face the challenge and be productive.  Someone once said and I quote “do not limit your challenges but challenge your limits” I have learnt to challenge the lonely office and motivate myself by long-thinking and trying new things daily.

Muazu Abba: Rekindling Hope

Muazu has four (4) siblings. As the oldest one, he took up the responsibility of caring for his younger siblings as well as his parents - not an easy feat especially if you are 22 years old. Muazu, from an early age learned how to do many odd jobs to make sure that his parents and siblings were well taken care of. At 22, he was a labourer. It was not ideal but it was what he could do to make sure there was food on the table and a roof over their heads. 

Muazu’s parents used to help out sometimes but when he turned 22, things got harder and their condition worsened. It was at this point that Samuel, a volunteer with Gede Foundation, approached him with a possible solution for his condition. Samuel told him that there was a project that was supporting Orphans and Vulnerable Children in various secondary schools in the Federal Capital Territory. Furthermore, the project was also supporting individuals in skills training and providing nutritional support for households. Samuel explained to Muazu that he could be one of the beneficiaries in the skills acquisition programme. 

At first, Muazu was very skeptical and did not understand why he needed to enrol for this project. The situation was difficult but he had always managed to make ends meet. He refused to join but after a while, Samuel convinced him and he registered for the course. He told Muazu that there were others that acquired skills in fields such as dress-making, computer lessons, hair dressing, running small enterprises, etc. Muazu talked to a few and decided it may not be a bad idea after all.

Muazu decided to go for a course in how to do laundry. As he started his course, he was surprised when he received rice, oil, milk, sugar and a lot more foodstuffs. This nutritional benefits assisted his family in a big way. He continued with his course until he graduated.

After graduation, he was offered a job in a hotel to do their laundry. When he saw what the hotel was offering, he thought it would be better to start something on his own. That is exactly what he did. His shop has a washing machine, iron, ironing board and other things needed for doing laundry.

Muazu Abba in his shop

Today, Muazu is married with 3 kids. In the short time he has had his shop, he has trained about 3 people who now have their own laundromats. He mentors them and encourages them to set up their own shops as a way to remain self sufficient.

BasicNeeds: Mental Health Camp Round 2

By Zunzika Thole-Okpo

After two successful Mental Health Camps, nothing much could faze us right? Wrong. Gede Foundation held its second round of MHCs on the 19th of September in Mararaba Gurku. Lucky for the team, the Chief opened up his palace once more. 

Just after we left the office, it started to rain; a bit disconcerting because we thought people may not show up for the MHC. When we got to the palace, it had stopped raining and fortunately, there were people already there, patiently waiting. There were the usual cases of seizure disorders, substance abuse disorders and mood disorders. There were also unusual cases. A young boy, not more than 14, developed a brain tumour just as he was about to go to senior secondary school. The boy’s father is aware that his son is mentally sound yet he still brought him to the camp. The reason for this was inspiring. The man, a pastor, needed his son to receive some counselling. The young boy faces a lot of discrimination, disdain and stigma because of how he is now. He used to go to school and did not need any help with anything physical. Last year, he underwent an operation to remove the tumour. The operation was successful. However, his motor skills have been impaired and he constantly needs help. As the father was speaking, the young boy was cowering and trying to cover his mouth. One could tell that he was uncomfortable. 14 is an impressionable age. While kids his age are out exploring and pretending to be adults, he sits in his chair and can only move with assistance. HIs father expressed gratitude at the counselling his son received. He thanked the foundation profusely and said he would welcome any further help that the Foundation would like to render. His father said he now has hope. For those that aren’t aware, ‘Gede' loosely translates to ‘hope’ in Fulani language.

Community Based Volunteer, Matthias, taking vitals. 

Chief's Palace, Mararaba.

As the pastor was speaking, we heard noises coming from the doctors room (a place that was set aside for the doctor to conduct consultations). The pastor excused himself and went to see what the problem was. Inside was a young man that the pastor prays for. The young man came with his parents and his brother all the way from Lafia, Nassarawa. The young man was screaming at the top of his lungs. He was shouting at someone/something we could neither see nor hear. This was someone I had had a conversation with earlier in the day. Here he was now, ranting and pointing to the sky and shouting at a person we could not see. As is expected (unfortunately), people gathered to stare, others stepped away as they were scared. This was a scene similar to the ones we see on TV where we see someone being put in a straitjacket. The truth is the young man was not violent, he was just shouting. Meanwhile, his brother was just swaying from side to side, softly mumbling. The brother is schizophrenic while he has substance abuse induced psychosis - schizophrenia like. For over 3 years he has had wandering tendencies, increased aggression, auditory and visual hallucinations. 

The scene described above seemed like something from a movie. One thing to understand is people are afraid of what they do not understand. We do not know what triggered the shouting. We did not know how to calm him down, but we have been conditioned to stare from afar and pass judgment. Through this project, this gap may become smaller and we can learn to be more tolerant of those battling with illnesses that are not physical. 

Living with Epilepsy: My Journey So Far

By Zunzika Thole-Okpo

Martina was a young and healthy girl at a boarding school outside of Abuja when it happened. She was showering and the next thing she remembers is waking up at the hospital, confused, multiple wounds, her mother crying while the dad consoled her. 

She asked her mother what was wrong. It was then that her mother told her that the school administration called to tell them that their daughter had fallen in the bathroom and was badly injured. They went further to tell her that one of her friends said she just fell and started shaking. Needless to say, Martina was terrified. The hospital said save from treating her wounds, the only other thing they could treat her for was malaria and typhoid and nothing else. Martina was treated but that did not change anything.

Armed with this information, the parents set out in search of answers and took their daughter home. The convulsions continued, they took her to church where she was prayed for but the ‘demons’ refused to let her go. She was a member of the choir and was asked to step down but she refused. One Sunday, as she was singing, she had another seizure. That did not deter her from singing though or participating in church activities. She went to help to prepare for an event at church. She was frying chicken when she had another attack and three of her right fingers were in the frying pan as well. She sustained burns but as soon as they healed, she was back to helping. One day, she was riding on a bike when she had another seizure which threw her off the bike and once more, she sustained visible injuries on her knees.

Undeterred, the parents continued to search for answers. In a bid to find more means of healing, her parents decided to search for answers traditionally. The first traditional healer they met gave her some concoctions but she still had violent seizures. After several months, the traditional healer confessed that the illness was too strong for him to cure. He claimed his ancestors told him the illness was beyond his power and so he let Martina go.

Her parents decided to take her to yet another traditional healer. He was well known and had ‘cured’ a number of ailments. His approach was even weirder. He asked Martina to take off her clothes. She asked him why. He said that the only way to cure her was by sleeping with her and transferring his ‘energy’ into her. Martina was torn. The traditional healer approached her as though to help her with her clothes and she screamed. The parents, thinking the traditional healer was doing his job, sat outside and did nothing until they saw their daughter running out of the shack half clothed. This episode ended their seeking for help with traditional healers but not before the traditional healer told them what caused the illness in the first place. He said someone from her past, a man, cursed her because she refused to sleep with him. Martina recalls no such incident.

Having epilepsy has stopped her from pursuing her education. She says being on medication helps a lot and she can go months without having seizures. Sometimes she gets tired and stops taking the medicine; that is when she has the seizures. The doctor she saw advised her to keep taking the medication and to start school if she wants. However, she stated that some people are afraid of her but she doesn’t blame them as people are often scared of what they do not understand. She is passionate about her situation and hopes people will eventually learn to accept and understand epilepsy.

Martina, the newly appointed secretary of the just formed Self Help Group busy taking notes of the meeting.

Martina’s determination could be seen in the way she immediately took up the responsibility of secretary at the Self Help Groups formation that took place in Mpape, on Wednesday, August 31st. She further promised to stick her medication strictly and thanked the Foundation, a BasicNeeds franchisee, for reaching out to the community.

Gede Delivered Stress Management Sessions to the National Review Tariff Committee in Kaduna

“As senior officers in the Ministries, we need to balance our tasks with these relaxation skills as this will help to promote sound mind and physical health which are relevant to productivity”- Dr Idris Shuaibu, Director, Legal Services, Nigerian Shippers’ Council.

A 3-day National Review Tariff Committee meeting was organised for 20 senior management level staff within the Federal Ministries and its Agencies in Kaduna from August 25-27 2016. The meeting, which was sponsored by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), aimed to produce a clear policy framework which will help to formulate ECOWAS’s Common External Tariff (CET) for member countries. Participants engaged in policy review sessions which touched on regional economic integration and trade. 

Gede was engaged in the meeting to deliver its ‘Managing Stress in the Workplace Programme’ to participants in order to help them develop personalized stress management techniques to cope with their work-related tasks. The workshop objectives were achieved through a combination of technical and stress management sessions. The implications of work-related stress to senior staff members such as in the Committee were highlighted using presentations, discussions and practical demonstration of workplace relaxation and stress relief techniques by Samuel Jinadu (Clinical Psychologist from Karu Behavioural Medicine Unit), Bassant Ram (a freelance Yoga Instructor) and Gede’s Godwin Etim. Issues covered during the innovative sessions included an overview of stress, causes and signs, identification of stressors, setting clear boundaries, stress and time management, strategies for relaxation and work-life balance, treatment pathways, dealing with stigmatization and practical yoga sessions.

At the end of the 3-day workshop, participants’ knowledge, attitude and practices related to managing stress in the workplace were significantly enhanced using the different approaches as they were also provided with basic hints in which these techniques could continue beyond the workshop. Participants were able to link stress and its significance to productivity as mentioned below-

‘Stress management techniques are vital, especially, forsecurity Agencies like the Custom Service whose duty is to regulate regionaltrade andalso inpossession offire arms along the Country’s borders which is obviously tasking’-Mr Ayalogu, Assistant Controller of Customs.

In order to discuss the programme and arrange a booking, you can contact Godwin Etim via 07030070934 if you want to experience Gede’s Stress Management Programme.

 

GEDE TEAM MEETS CRS-SMILE CSOs

Gede Foundation is delighted to inform our readers that the 6-month research contract that Gede signed with Catholic Relief Services (CRS) Nigeria/ Sustainable Mechanisms for Improved Livelihoods and Household Empowerment (SMILE) project in May 2016 has now moved to the community. 

The project is focused on delivering an approach to community based detection, treatment and referral services for vulnerable children with mental health and psychosocial problems and their caregivers. As our regular readers will know, there was a 3-day training on Data Validation conducted by Dr. Brandon Kohrt in July. Sequel to this, Gede’s team met with CRS-SMILE’s Civil Society Organisations (CSO) on August 2, 2016 to discuss an important milestone which is the move to the community.

The aims of the meeting were, (i) to present the project to the CSO representatives; (ii) to secure their support for the project in line with their commitment to the SMILE programme; and (iii) to discuss logistics for recruitment of respondents and preparations in the community.  

Present in the meeting were Dr. Cynthia Ticao, Mr. Godwin Etim, Ms. Jeremy Boglosa from Gede Foundation; Mr. Joseph Inyang (Senior Programme Manager for CRS-SMILE) and representatives from the following CSOs: Elohim Foundation, Catholic Action Committee Against Aids (CACA), Justice Development and Peace Commission, and Society for Community Development.  

Recognising The Impact of Poverty on Children’s Mental Health

Mma-kamba

When her father died, Mma-kamba was very depressed. She was so depressed that she left the house to co-habit with a young man. She was judged, shunned and ridiculed for making this ‘wrong’ choice of leaving home at that age and may have tagged her irresponsible for leaving her mother to shoulder the burden of taking care of the home and siblings. 

This is just one example of how mental health, however daunting, is ignored among other burdens such as clean water, sanitation, nutrition, shelter, security and basic human rights. Government and civil organisations concentrate more on the aforementioned issues and neglect mental health. Individuals, children included, who are psychologically or mentally challenged often suffer alone - ashamed, stigmatised by family, neighbourhood and the community at large. 

It is important to note that responses to stressors differ from person to person. Mma-kamba’s response to her family’s condition could be because she was looking for comfort and her search led to the young man she started to co-habit with. Having just lost an important figure in her life, this may have been her way of trying to fill that void. 

Psychological research has shown that living in poverty has a wide range of negative effects in physical, mental and well-being of children (https://www.jrf.org.uk/report/psychological-perspectives-poverty) and impact within the context of their homes, school and communities.  Poorer children are at a greater risk of several negative outcome such as abuse and neglect, socio-emotional problems, behavioural problems and even poor academic outcomes. The BIG question! What can be done to help children in this state aside from judging their response to depressive conditions?

All agencies have a responsibility to respond positively to the 2013 National Policy on Mental Health Services Delivery. Barriers that affect mental health promotions should be eliminated and instead, be given as much attention as physical health.

By Ekaette Udoekong

My Experience: Working With Survivors of Child Trafficking

By Saater Brenda Ikpaahindi

From a very young age, I knew I wanted to work with the less privileged of society. My childlike ideas at the time centred around building an orphanage or adopting several children and living happily ever after. While my other childlike fantasies and utopian dreams fell to pieces, my deep desire to work with vulnerable children never waned. 

About five years ago, I was privileged to work for a UK-based organisation that supports children trafficked from Africa. I remember the first time I was asked to sit in on an assessment with a newly referred child who just escaped from the shackles of her trafficker. I think I was more nervous than the young person who sat across the room from me. She looked normal enough and didn’t seem to have any visible scars of the circumstances and abuse she had been exposed to (far from my thoughts of victims of trafficking or abuse crying uncontrollably). But as she sat across the room from my colleague and me, she told us of the life she had lived, how she had been exploited, the challenges she had faced and the problems that had driven her to become a victim of trafficking.

For many survivors of human trafficking, the story is no different. The economic situation in their home countries leaves them susceptible to unscrupulous individuals who are ready to exploit their vulnerabilities. The promise of a better life in a big city or foreign land and a fictitious land flowing with milk and honey - the land where all dreams are made - serve as a huge pull for unsuspecting and ignorant victims. Traffickers promise young bendable minds an escape from their current situation and paint a vivid picture of success and prosperity. 

Unfortunately, this life, is often rife with nights without food, beatings, loss of family contact in their home countries, repeated rape, being passed around different men for the purpose of sex or relatives and family friends for the purpose of labour, denied education, free movement, and their voices silenced. Victims are sometimes imprisoned and criminalised for lack of proper identification or linked to criminal activities which affect their mental and psychological wellbeing.

After the assessment, as a newbie, I remember asking my colleague how she managed to do this on a daily basis.  How she managed to hear these stories and remain sane. I felt depressed and at the same time guilty. How many children had I passed by, who could be victims of trafficking? Why was I feeling worse than the person who had recounted her story when this was not about me? What could I do to help?  Was I ever going to get used to hearing these stories and can I really continue in this line of work? These questions boggled my mind for weeks.

But over the years, as I worked with these survivors of child trafficking, who despite being adults, sometimes behaved like children trapped in a time capsule and as they began to heal, open up, trust and confide in me, I knew in that moment that I was beginning to fulfil my childhood dreams.

Child survivors of human trafficking inspire me. Most of them have been through untold hardships, suffering and exploitation which affects their daily functioning. Yet, they find the will to live, the strength to rise above their past, the tenacity to trust again and they dare to believe that their tomorrow will be better than their yesterday. 

I have had the opportunity of working with some of the bravest young people I have ever met, who once victims are survivors of some of the worst forms of abuse. Some have gone on to get degrees, get married, have children and some are now advocates for children trapped in similar situations by sharing their stories in the hope that they will help rescue other children from exploitation. These children have left an indelible mark in my heart and I’m persuaded that more needs to be done by individuals, Civil Society Organisations and state agents in putting an end to modern slavery, one of the worst forms of abuse and human rights violations of our time. 

Saater is a volunteer for one of the projects at the Foundation.

Does Academic Success Equal Job Success?

Higher education is an important goal for many and it’s evident by the large number of people working to acquire degrees in undergraduate and graduate studies. Some students put a huge amount of effort into their studies and graduate with exceptional academic grades. Others do not focus on their studies and put minimal amount of effort to pass their classes and earn a degree. In a perfect world, students who perform exceptionally well should not have a problem finding excellent jobs to be successful in their careers. However, the reality is both exceptional and ordinary students are faced with similar experiences in job opportunities and successes. This is the reality! The big question is what is the psychological impact on undergraduates and how does one explain correctly the realism that academic success does not necessarily translate to job success.

Today, I was at the academic division of the Cross River State University of Technology (CRUTECH) to receive collated results for 14 students on the UniCem – Gede Foundation Education Support Programme. As I studied the results I would say that on average it is ‘good’. It came to mind that I could get an opinion from one of the awardee on who has just graduated on this matter-

My name is Eso, Eso John a graduate of Banking and Finance. I had the privilege of the award of scholarship from Lafarge Africa Plc (UniCem) through my study time at the University. It’s a misconception that financial aid translates to academic successes. Academic success is influenced by motivations, parenting encouragement, studying techniques, ability to manage academic stress, ability to identify correctly one strength and weakness, ability to over procrastination to mention but a few. A student who has these and financial aid would make an excellent academic performance. It is true that jobs are limited now but any graduate who has no additional skill will not have job success with or without good academic successes. Additional skills such as adventure, entrepreneurial skill, ICT competence, ability to work with others and so on are important in job search, therefore, I would advocate for additional initiatives to the financial aid to make awardees have advantage over others after graduation.

By Ekaette Udoekong

AFTER ENLIGHTENMENT…THE LAUNDRY

By John Minto, Managing Director, Gede Foundation

This article appeared on Health Reporters and can also be read by following this link http://healthreporters.info/2016/08/19/after-enlightenmentthe-laundry-by-john-minto/

Although there are some serious questions to be asked about any international ‘targets’, there can be little doubt that the celebrations which greeted the inclusion of mental health into Sustainable Development Goals (SDGs) were justified and well earned. Mental health activists rightly celebrated the fact that, now, there is global recognition of at least two vital issues which are captured in the SDGs – 

3.4 – By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

3.5 – Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

Goals matter. Targets matter. International agreements matter. Why? Despite the fact that they are often politically motivated and can be based on ‘the loudest voice’ principle, they can capture issues which are of genuine concern and which need resources to address them. In the case of mental, neurological and substance use (MNS), a compelling case has been made that, as a starting point, conditions such as depression and alcohol abuse should be seen as problems ‘across the board’ (that is, they impact negatively on education, health and an ability to earn a living) and can no longer be ignored. On top of this, the global mental health community used ‘shock’ tactics to get their message across effectively – the fact that suicide is the biggest killer of teenage girls around the world garnered a great deal of media attention over the last couple of years in particular.

But, after enlightenment, the laundry as the saying goes. What happens now?

Voices have already been raised in terms of ways in which to address the ‘key issues’ (although even these are open to debate). Should political will and resources be immediately put into the training of a greater number of mental health experts? Should urban based mental hospitals be the focus of service delivery, acting as catalytic players in the drive towards health for all? Should community level mental health take precedence instead? What about stigma and discrimination? Should there be priority populations and conditions initially – such as post-traumatic stress disorder for internally displaced persons?

A recent article by Maya Semrau et al (“Strengthening mental health systems in low-and middle-income countries: the Emerald programme.” BMC Medicine (2015) 13:79) offers a convincing framework related to ways in which health systems can develop and support those needing quality healthcare.

The core of Semrau’s work is an understanding that there is little to be gained from considering isolated elements within any response to a particular health burden. Instead, it is more productive to view a health system as “the sum total of all the organisations, institutions, and resources whose primary purpose is to improve health”. As Semrau also notes, “a well-functioning health system should deliver services of adequate quality to all people, whenever and wherever they need them and should protect the right to health for everyone, including people with mental, neurological and substance use disorders, whether through professional services or non-professional care services such as family or self-care”.

These are important insights for the development of mental health systems in any low and middle income country (LMIC) as they suggest an overall framework in which change can occur. At the time of writing, this framework is being, to some extent, tested in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda through the EMERALD (Emerging mental health systems in LMICs) programme which has already started to report back on some positive developments.

Part of the appeal of the EMERALD project is that it looks at the following key system issues –

1.Health System Inputs

Semrau argues that adequate resources for mental health, fair financing and improved economic outcomes for mental health and sustainable financing for mental health are all essential elements within the inputs needed for an effective mental health system. Pivotally, EMERALD is working on cost estimates and the impact of scaling up interventions for mental illness in particular. Underlying this approach is an important question which is perhaps too infrequently asked – what is the cost of not addressing mental illness in any given society? Are the costs of not treating MNS far larger (especially in the long run) than investing in treatment?

2.Health System Processes

As Semrau notes, “another key objective for EMERALD is the evaluation of the context, process, experience and health system implications of mental health service implementation”. Currently, although it is acknowledged to have strengths and weaknesses, many LMICs are using the WHO mhGAP Intervention Guide which offers guidelines (which can be used by lay health workers) related to diagnosis and treatment of MNS disorders. This is linked to an assessment of the strategies (in LMICs) related to the development and implementation of mental health plans at all levels of healthcare service delivery. The key is to provide evidence regarding ‘what works’ in terms of integrated mental health services using existing health platforms. There is, as we all know, no point in reinventing the wheel and seeing how the mhGAP can be fully implemented within the context of existing structures and platforms is an important element within systems development.

3.Health System Outputs

It is perhaps natural that many mental health commentators and ‘supporters’ want to see output quickly – mainly through more treatment pathways. However, even if possible, this tends to defocus an important issue surrounding the development and monitoring of key indicators for mental health service delivery and overall system performance. This is not to say that what cannot be measured should not be done, but the absence of hard evidence related to outcomes will be a serious barrier to advocating for mental health resources with any Government or donor. This, in itself, raises questions regarding monitoring and evaluation (and the use of modern technology where appropriate) which is often deeply challenging for LMICs whose main focus is often, not unreasonably, on front loaded service delivery.

To complicate an already challenging subject, Semrau also notes the importance of developing partnerships “with service users” which “are essential for the development of evidence-based care in government guidance across the globe. They may protect those who receive involuntary treatment abuses, or those who are marginalised due to their low socio economic status or social stigma attached to MNS disorders, through their greater involvement in the implementation of mental health system processes”. Semrau notes the importance of the work between healthcare professionals, service users/carers and government agencies in relation to the successful implementation of HIV healthcare and poses a question related to lessons learned re mental health.

The key to building a sustainable mental health system in Nigeria will focus on addressingissues related to health system inputs, processes and outputs. Naturally, the challenges will be found in the detail but with mental health now an SDG, there is clearly an opportunity for all interested parties and stakeholders to work together to build on best practice and to develop something unique to the context of Nigeria.

Few people now seriously doubt the importance and impact of MNS. In itself, this is a major victory for the global mental health community. However, after enlightenment…the laundry.

The Gede Foundation works to bring underserved and stigmatised health burdens ‘out of the shadows’ through high quality research, catalytic partnerships and advocacy which result in long term change at the community level. The Foundation is currently working with partners to establish the prevalence of depression, substance abuse and suicidality among people living with HIV-AIDS while, at the same time, exploring ways in which mental health protocols can be integrated into existing health platforms. The Foundation was recently awarded a BasicNeeds UK franchise (see http://www.basicneeds.org/gede-foundation-joins-as-basicneeds-first-franchisee-in-nigeria) to develop community based mental health programmes which address both mental illness (and epilepsy) and livelihood support for those suffering from mental illness and their carers. The Foundation is also currently working with partners to culturally validate tools for VC programmes throughout Nigeria. In the interests of transparency, Gede is not linked to the EMERALD project in any way