Sharing experiences of improving mental health in Africa

Experts from mental health programmes in Kenya, Ghana and Nigeria gathered in London last week to share learning about the most effective ways to support people with mental health conditions in Africa.

Mental health conditions such as depression are a leading cause of disability worldwide, often leading to immense suffering and limiting a person’s ability to live independently, earn a living or participate in their community. 80% of people affected by mental illness live in low- or middle-income countries, where most have little or no access to treatment. Many live in extreme poverty, facing isolation, rejection and abuse. 

The five-day learning event was hosted by global mental health NGO BasicNeeds, which has been part of the CBM family since 2017. It brought together three organisations that have been working to help people with mental health problems in different parts of Africa - Caritas Nyeri from Kenya, Voice Ghana from Ghana and Gede Foundation from Nigeria – along with BasicNeeds and CBM staff.

Scaling up community-based mental health care

In 2014, BasicNeeds received a grant from Grand Challenges Canada to scale up community-based mental health care and support in Ghana, Nigeria and Kenya. The funding was used to support three local partner organisations to implement the proven “Basic Needs model”. This funding, along with support from BasicNeeds, enabled Caritas Nyeri, Voice Ghana and Gede Foundation – all of whom had a strong track record of running other health or disability programmes in their own communities - to set up mental health programmes for the first time.

Gede Foundation had many years’ experience of working with people with HIV/Aids in Nigeria before they started a mental health programme with support from BasicNeeds. Godwin Etim explains that attitudes towards mental health were a particular issue:

“It was an eye opener for us in Nigeria. Overcoming barriers - stigma and discrimination. It was the first programme in our province on mental health. Now people are openly coming forward.”

He valued the opportunity to learn from other organisations in different parts of Africa during the workshop in London:

“We have learned so much about interconnected projects. Great to hear the positive results of these projects - that they are working and promoting community response [to mental health].”

Helen Karimi of Caritas Kenya also valued the opportunity to review what had been achieved and learn from others:

“It was a fantastic week, that we were able to evaluate the work we have done with GCC, looking at the successes and achievements we make and challenges along the way and the lessons learnt.”

Holistic approach to mental health

BasicNeeds was founded in 2000 to improve the lives of people with mental health problems around the world. Like CBM, BasicNeeds take a holistic approach to mental health, helping people with mental illness and their families to live and work successfully in their communities by:

  •  improving access to treatment by training and equipping health professionals;
  • creating and supporting self-help groups and peer support initiatives that provide mutual support for people with mental illness and their carers and help them have a stronger voice in their communities;
  • helping people with mental health conditions earn a living, as part of their ongoing recovery;
  • educating communities about mental illness to reduce stigma and discrimination;
  • supporting people and communities to advocate for care, treatment, and rights within their own countries.

Images:
Top – Members of BasicNeeds UK, Kenya and Ghana come together with partners from Ghana, Kenya and Nigeria for a lessons learned workshop at the Commonwealth Foundation in London. 
Middle – Milka Waruguru from Kenya speaks to BBC Worldwide – the event provided the opportunity to cast a spotlight on mental health in Africa, with the visiting experts interviewed by BBC World Service and UK newspapers.
Bottom – A self-help group in Kenya, formed by BasicNeeds to offer support to people with mental illnesses.

Culled from CBM UK

GEDE FOUNDATION PARTICIPATED IN THE GLOBAL COMMUNITY MENTAL HEALTH PROGRAMME REVIEW IN LONDON

Starting from 14th January through to the 19th, the BasicNeeds Community Mental Health Model went through a review process after a 3-year multi-country programme implemented by partners in India, Kenya, Ghana and Nigeria. The review meeting took place within the Commonwealth Foundation complex at Marlborough House, Pall Mall, London. 

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The review process offered a unique opportunity for partners to reflect on the model, present country specific programmes in ways that promoted learning, and helped in developing roadmap for future interventions. Godwin Etim and Kizito Ebhohimen represented Gede Foundation at the event.

The meeting was funded by Grand Challenges Canada (GCC), organised and co-facilitated by a team from UK based staff of BasicNeeds and Christian Blind Mission (CBM). Different sessions provided practical approaches for the review of the model, which, initially, was to demonstrate effectiveness of social franchising in achieving scale up for mental health care and development in low and medium income countries. Participants also visited the Bethlehem Royal Hospital http://museumofthemind.org.uk/ that was founded in 1247 and was the first institution in the UK to specialise in the care of the mentally ill. The hospital continues to provide in-patient care as part of the South London and Maudsley National Health Scheme (NHS) Foundation Trust, and has been based in south London since 1930.

Going forward, participants developed a strategic framework reflecting experiences, results and lesson learned from previous programme within the boundaries of proven as well as improved indicators to ensure that interventions address the corresponding expected outcomes and impact through the Theory of Change.

The event was capped with a reunion of the entire BasicNeeds family stretched to 1999, and characterised by resounding goodwill messages from past and current partners, staff and Board of Directors to Chris Underhill, Founder of BasicNeeds who has worked as a social entrepreneur in the field of disability and development for decades.

Partners and other stakeholders reiterated their commitments to contribute in addressing mental health and disability in regions that are most affected. The merger of BasicNeeds Uk with CBM UK presents the opportunity for more strategic focus for  programmes that address  both physical and mental disabilities.

The challenges of mental health issues

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Although the exact cause of most mental illnesses is not known, it is becoming clear through research that many of these conditions are caused by a combination of biological, psychological, and environmental factors. 

While stress sources don’t necessarily cause anxiety disorders, they can worsen symptoms. And while, as mentioned above, anxiety disorders are the most common mental illnesses affecting adults and children across the world today. 

Mental illness refers to a wide range of mental health conditions, disorders that affect your mood, thinking and behaviour. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviours. Many people have mental health concerns from time to time

Some mental illnesses have been linked to abnormal functioning of nerve cell circuits or pathways that connect particular brain regions. Nerve cells within these brain circuits communicate through chemicals called neurotransmitters. “Tweaking” these chemicals through medicines, psychotherapy or other medical procedures can help brain circuits run more efficiently. Defects in or injury to certain areas of the brain have also been linked to some mental conditions. 

Mental health-related issues have also been seen to run in families, suggesting that people who have a family member with a mental illness may be somewhat more likely to develop one themselves. Susceptibility is passed on in families through genes. 

Experts believe many mental illnesses are linked to abnormalities in many genes rather than just one or a few and that how these genes interact with the environment is unique for every person (even identical twins). 

That is why a person inherits a susceptibility to a mental illness and doesn’t necessarily develop the illness. Mental illness itself occurs from the interaction of multiple genes and other factors such as; stress, abuse, or a traumatic event which can influence, or trigger, an illness in a person who has an inherited susceptibility to it. 

Certain infections have been linked to brain damage and the development of mental illness or the worsening of its symptoms. Defects in or injury to certain areas of the brain have also been linked to some mental illnesses. 

Some evidence suggests that a disruption of early foetal brain development or trauma that occurs at the time of birth for example, loss of oxygen to the brain may be a factor in the development of certain conditions, such as autism spectrum disorder. 

Long-term substance abuse, in particular, has been linked to anxiety, depression, and paranoia. Other factors include; poor nutrition and exposure to toxins, such as lead, may play a role in the development of mental illnesses.

Mental health challenges and disorders have many different signs and symptoms and can look different in different people. They can impact how a person thinks, feels and behaves.

Some common symptoms of a mental health challenge or disorder are: changes in mood, changes in the way you perceive thing, obsessions, fears, feelings of anxiety

Mental health challenges and disorders can happen to anyone. They affect people of all ages, races and social classes. No one is immune.

The best way to prevent mental health challenges from getting worse is to recognize symptoms early and get professional help. Many mental health challenges and disorders can be treated successfully. When the signs are recognized early, that person can get started on the path to a full recovery.

The Managing Director, Gede Foundation, John Minto, at a training on behavioural change and research methodology on capacity building for healthcare agencies said, his organisation is ready to work with the Federal Government of Nigeria to integrate screening and treatment of mental ailment into the primary healthcare service.

Considering that some medical scholars have revealed that in a population of 160 million or thereabout, it is speculated that 64 million Nigerians suffer from one form of mental illness or the other deserving attention, Minto said the big thing is for his foundation to work with the government to integrate issues of mental care in primary health at the community level. He added that they were in a working relationship with the Federal Ministry of Health and the National Agency for the Control of AIDS (NACA) to make sure that mental health is in the HIV national strategic framework.  

Culled from The Daily Trust Newspaper

They Fled Boko Haram, Only to Be Raped by Nigeria’s Security Forces

Culled from The New York Times

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MAIDUGURI, Nigeria — The camp was supposed to be a refuge. Falmata’s life had been stolen by war ever since the sixth grade, when she was abducted from her home and raped repeatedly by Boko Haram’s fighters for the next three years.

She finally escaped last spring, slipping into the bush while her captors slept. Fourteen years old and alone, she made it to a camp for victims of the war, and had just settled in for the night when she heard footsteps outside her tent. A security officer’s voice instructed her to come out. Frightened, she obeyed.

He took her to his quarters, she said, and raped her.

Hours later, after she had returned to her tent, another officer arrived, she said. He raped her, too.

“The same day I was brought there, soldiers started coming to rape me,” Falmata said. “They did it one after another. I’m not even sure those two knew about each other.”

Rape has been a defining horror of the war with Boko Haram, which has consumed northeastern Nigeria for eight years and spread beyond its borders. At least 7,000 women and girls have endured Boko Haram’s sexual violence, the United Nations estimates. Militants kidnap and rape young girls, teenagers and women, handing them out as so-called brides who are sometimes passed from fighter to fighter.

But Nigerian security forces have also raped victims of the war, preying on the people they are assigned to protect. Dozens of cases of rape, sexual violence and sexual exploitation were reported in seven camps in Borno State last year alone, carried out by guards, camp officials, security officers and members of civilian vigilante groups, the United Nations says.

People lined up for food rations being distributed under military watch in Mainok village in Borno State, Nigeria. Dozens of cases of rape, sexual violence and sexual exploitation carried out by guards, camp officials, security officers and members of civilian vigilante groups were reported in Borno State last year.CreditAshley Gilbertson for The New York Times

More than a year ago, the Nigerian government pledged to investigate the allegations of rape in camps for people displaced by the war, saying that “these very distressing reports will not be taken lightly.” But accounts of sexual assaults in the camps are still common, including from young girls who say they were raped by soldiers on many occasions.

“The soldiers would come and hold me so tight,” one 13-year-old girl said in an interview. She said she had been raped about 10 times this year at a camp in Maiduguri, the city at the center of the fight against Boko Haram, before running away for her own safety.

“They were old enough to be my parents,” she said of the soldiers who raped her.

The Nigerian military has cleared parts of the countryside to hunt for Boko Haram’s hide-outs, forcing hundreds of thousands of civilians to move into huge settlements throughout northeastern Nigeria. Many other civilians have made it to the camps on their own after fleeing Boko Haram’s deadly assaults.

Most of the camps are overflowing, with new arrivals every day. Food and water are often in short supply, residents say, and health workers are battling a cholera outbreak that has killed dozens.

At night, the camps are dimly lit. Aid workers come during the day, but typically not after sunset because of wartime curfews. Security forces tightly control who goes in and out of the camps, sometimes coercing women and girls to trade sex for food.

Government officials say they need 24-hour security to protect the residents, especially since some of the camps are regular targets of suicide bombers deployed by Boko Haram.

But in one camp, called Teachers Village, some residents said the security forces had worked out a system to select their victims. Young women were called to cook for them. After the women finished, security officers insisted that they clean up, telling them to go bathe in the officers’ quarters as the men watched.

Photo

 

“At first none of us knew they were doing this,” said Hadiza, 18, “but then the stories started to spread around camp that anyone cooking for them would be raped.” CreditAdam Ferguson for The New York Times

“At first none of us knew they were doing this, but then the stories started to spread around camp that anyone cooking for them would be raped,” said Hadiza, 18.

After living in the camp for several weeks, Hadiza said, she was picked to cook for the officers. She was terrified.

“Definitely my time has come,” she recalled thinking.

Later, she was asked to serve water to four security officers in their room as they dined. One by one they left, she said, until only one man remained. He dragged her into a separate room and raped her, she said.

Hadiza was injured, she said, but didn’t ask for medical care, fearing that the officers would seek revenge. She said she tried to keep a low profile for a couple of weeks, but officers spotted her and raped her again. She said she had been raped as many as 20 times in the camp.

“Once they identified you as a girl they wanted to have sex with, they would hardly leave you alone a single day,” Hadiza said.

By spring, word of the rapes at Teachers Village camp had spread so widely across Maiduguri that people began showing up at the gates to look for missing relatives. Distant relatives arrived for Hadiza and took her away.

Last year, President Muhammadu Buhari called for an investigation into sexual assaults at the camps after Human Rights Watch detailed the abuse in a report, ordering new measures to protect the vulnerable. Security officers have received more training, and at least 100 female officers have been deployed inside the camps. As a result, the number of complaints of sexual abuse has declined, according to some aid groups and the police.

The police have arrested several men for sexually abusing and exploiting women and girls, according to the United States Embassy. The arrests, made last December, include two police officers, a prison warden, two civilian militia members, a civil servant and three soldiers.

But an Army Special Board of Inquiry said in June that allegations against its soldiers at the camps were unfounded, while Jimoh Moshood, a police spokesman, said the investigations were continuing.

“Very little progress has been made by Nigerian authorities to implement President Buhari’s promise of justice for the survivors,” said Mausi Segun, the executive director of the Africa division of Human Rights Watch. “The delay reinforces displaced people’s sense of helplessness, and likely emboldens more perpetrators to prey on their vulnerability.”

In the war with Boko Haram, Nigerian security forces have been accused of many human rights abuses, including killing innocent civilians and detaining children for months to determine their loyalties.

At checkpoints to enter Maiduguri, soldiers and militia members have turned away large groups of displaced people fleeing Boko Haram, unless they can pay an “entrance fee,” aid workers say. People escaping with their herds are sometimes charged a fee for each animal. Those who can’t pay the bribes have been sent back into harm’s way.

Inside the camps, soldiers and members of civilian vigilante groups have been accused of forcing people to pay for the privilege of setting up tents or leaky shelters made of tarps and grass. Some displaced people told Amnesty International that they had to sell their belongings to survive, and when they ran out of things to sell, they had to have sex with soldiers and civilian militia members to get food.

Falmata, the 14-year-old kidnapped by Boko Haram, said her ordeal began when she was in primary school, enjoying her classwork and dancing to local Kanuri music.

Along the Niger-Nigeria border, just like other areas where militants are active, hundreds of thousands of people are facing food scarcity.

Militants stormed into her home and took her while she was caring for her sick mother. They forced her to marry a fighter, but that man died in battle a week later, so they gave her to another husband. She tried to resist, so they gave her a third. Barely a teenager by then, she became pregnant, she said, but the baby died days after he was born.

One night, Falmata woke up and realized the whole camp was asleep. Now was the time, she thought. She ran until she reached a village, finding an older woman with a lantern who pointed her to a road. Soldiers spotted her and took her to Dalori Camp, a sprawling site outside Maiduguri.

She thought she was being delivered to safety — but immediately faced the same kind of sexual abuse she had risked her life to flee. And this time it was being committed by the people who were there to protect her.

During her two months at the camp, she said, security officers, not always the same men, came for her repeatedly. Falmata described the men as “soldiers,” but it was unclear if they were members of the military, the police or another security force. She said they carried weapons.

“I felt it would continue forever,” she said of the abuse.

She knew she had to flee, again, so she asked for a pass to go to the market. She walked out of the camp the same way she had escaped Boko Haram: alone, with no money and no idea where she was going.

As a little girl, she remembered, she had visited her grandmother once in Maiduguri, but she had only a vague idea where. Falmata spotted a man she had seen around the camp who spoke her dialect, and begged for help.

“Look, I have a problem,” she told him. “These people are going to kill me. They come to me every night.”

The two drove around the city for hours, trying to track down Falmata’s grandmother, asking everyone. Eventually, they found her. She had thought Falmata was dead.

Falmata now lives with her grandmother, but is too ashamed to tell her what happened. Someday, she hopes to continue her education and become a lawyer. She wants to represent the powerless.

I Developed AIDS At The Age of 22 From Someone In The Music Industry

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I met him in a nightclub parking lot in Houston, Texas. I was 19 years old.

At the time, I was a sophomore at Sam Houston State, planning to pledge Alpha Kappa Alpha and ride out my college experience. But, I was also at that point in life where I longed to have Prince Charming sweep me off my feet so we could live happily ever after. Admittedly, I felt that without this element of my life, I was incomplete. I was a broken, lost, and scattered soul – not at all prepared for what I was about to endure.

He was a well-known Houston area music executive. He was charming and well-connected and from the moment we met, we were inseparable. He introduced me to my first job in the music world as a promotions assistant and I eventually climbed the ladder and became a manager. Being around musicians wasn’t new to me. My father was a successful writer and I grew up around artists like Mint Condition and Prince. But the hip hop world was an entirely new beast, and I was completely submerged in it.

Our life was filled with power, sex, drugs, and strip clubs.

I got anything I wanted – designer clothes and shoes and entry into the hottest parties. I was rubbing elbows with the biggest names in music and the lifestyle pulled me in. So, when the cheating, lies, disrespect, emotional and mental abuse started, I had no exit plan because I constantly pacified the severity of our unhealthy relationship. Our relationship came to an abrupt end when I found out through a mutual acquaintance that he had impregnated another woman. That was the last straw and I finally left him.

A few months later, I passed out in the shower.

When I woke up, the paramedics were doing their best to keep me conscious. After being released from the hospital that day, I went back home still not feeling like myself. I had chills so bad, I was shaking like a leaf. I had a fever of 105 and I felt as if my body was starting to leave earth, and I was powerless to stop it. I tried over-the-counter medicines to bring my fever down, but nothing worked.

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Eventually, I was rushed back to the hospital where I fell into a partial coma.

This time, I was in the hospital for almost a month when my mother’s long-time physician walked into my room and stood over my bed. “So, about your AIDS virus,” the doctor said.

I looked at her in a panic of confusion.

I was on a breathing machine so words were not an option at the time. I could only shake my head over and over – no, no, no. She said I had full-blown AIDS and only 2 t-cells remaining. Things were not looking good for me. At that point, a million questions ran through my head. How will my life move forward? Will she tell my mother? When the doctor left my room, I immediately went numb. Before I could process everything, two social workers came in and asked me to write down all of my sexual partners. They handed me some forms and I felt like I was signing my life away.

A month and a half later, I was finally released from the hospital.

Immediately, my priority became advocacy. I never wanted another woman to feel how I felt the day I was given my diagnosis, but I didn’t know where to begin. Who was to blame? Was he to blame for being careless and abusive? Was I to blame because I chose not to ask his status? Either way, everything in my life was changing. I vowed to share my story with the world and inspire others about the importance of self love.

As my advocacy journey took off, I veered further away from my life in the music industry. A friend convinced me to confront my ex-boyfriend and share my truth. When I did, he was hardly receptive. Even as I walked away, he disrespectfully called out to me and said I should give him another chance because my ass got fatter. I was disgusted, but proud of myself for standing up to him, telling him what he’d done and showing him that he hadn’t broken me.

Now, I travel the country speaking to people of all ages about what it means to live with AIDS. I’m still baffled by the level of unawareness associated with the stigma of AIDS and HIV. Often, I get asked questions that remind me how far we have to go as a society to learn about this virus, which is the first step in eradication. I’ve been living with AIDS for 11 years and my virus is currently undetectable, which means that is is absolutely untransmittable.

People I encounter are often shocked that I’m still alive.

Did you take the same thing Magic Johnson took?

Are you rich? 

It’s still a little known fact that medicine has come a long way, and that staying on top of your medication and taking good care of your health can help people living with AIDS and HIV live long and happy lives without the threat of spreading the virus to their loved ones.

They are even more amazed to find out that I have a partner, and that we are planning a family together. It is possible, however, for those living with the virus to find love. It is possible to have a loving relationship with a supportive partner and also have the AIDS virus. I’m thankful to have a man in my life who, when faced with the reality of my situation, did not walk away. He came to the doctor with me, asked his questions, did his research, and stayed by my side.

Looking back on this journey, I don’t blame myself but I do take full responsibility for my part and for not loving myself enough to walk away from a man who was not worthy of me.

Not only do I dedicate my life to educating people on the facts behind the HIV/AIDS epidemic, but I also facilitate self love workshops. This is what it took for me to find this incredible understanding of my own power and of my unstoppable ability to push through.

We are never defined by the mistakes we have made, but by our ability to build ourselves up despite them.

December is National HIV/AIDS Awareness Month

Sultan Laments Trend of Drug Abuse Among Women, Youths

Sultan of Sokoto and President-General, NSCIA, Muhammad Sa’ad Abubakar III on Thursday lamented the growing trend of drug abuse among women and youths, challenging the Society of Gynaecology and Obstetrics of Nigeria (SOGON) to use its platform in reversing the trend.

Speaking at the formal opening of SOGON’s 51st Annual National Conference in Sokoto, Abubakar who was the chairman of the occasion expressed serious concern over the ugly trend that is fast affecting public morality.

However, the conference tagged: SOGON- Sokoto 2017 has as its theme: ” Maternal and Newborn Health in a Challenging Economy.”

The revered monarch further advocated for the ban production, sale and consumption of such drugs that were being abused.

According to him” the trend is quite disturbing. How can SOGON use its offices to check-mate it even cough syrups such that one cannot just go to any chemist to buy such drugs”, he stressed.

According to the ‎royal father” We are going to table the issue during our meeting of traditional rulers. It will form part of the discussions to be held”, he said.

Earlier, Professor Brian Adinna, National President of SOGON) said no nation can develop and perform better without ‎proper family planning and effective provision of health services for women and the newborn.

He noted that maternal health was a sensitive aspect in health services delivery of any society.

According to Adinma, the theme of the conference was well chosen in view of the contemporary experiences and economic down turn affecting the health sector in delivering services.

He said women were more vulnerable to numerous health complications as cervical cancer, VVF among other related ailments.

According to him” SOGON is out to effectively ensure the reduction of maternal mortality ‎to the barest minimum.”

He further stated that the society has taken the responsibility to invite specialised partners from across the world to complement and update it’s focus towards addressing maternal mortality and child health challenges.

Adinma however, commended Governor Tambuwal for his various health projects and support in the state.

” We are aware of your giant strides in the establishment of basic health institutions, the community health insurance initiative and structures.

Similarly, he eulogised the unprecedented efforts of Governor Ibrahim Geidam of Yobe state for his unequalled compassion for maternal and child health.

Highlights of the event were the ‎conferment of an honorary status membership on Governor Ibrahim Geidam of Yobe state and the unveiling of SOGON’s Journal by Governor Aminu Waziri Tambuwal with a donation of N10 million each by the government’s of the two states while commending the Yobe state government for the resilience and courage displayed in achieving so much within the health sector in the midts of Boko Haram insurgents persistent attacks on the state in the last 6 years.

Also was the formal induction of 29 new members of SOGON at the well attended event witnessed by the Senate Leader, Senator Ahmed Lawan, Deputy Governor of Sokoto state, Alhaji Ahmed Aliyu, wife of Kebbi state Governor, Dr. Zainab Atiku Bagudu Shinkafi, Speaker, Deputy Speaker and Members of YOHA, Members HoRs, Emirs of Machina, Ngazargamu, ‎Jajere, Fika and Damaturu among other personalities that cut across all sectors including politicians especially from Yobe state.

Article Culled from The Nation Online

Journey to the North

By Binfa Kelvin Gono

Binfa Kelvin Gono

Binfa Kelvin Gono

"Congratulations guys, we are going to Maiduguri! So Binfa and Yusuf, I hope you are ready.” These were the words of Dr. Cynthia Ticao the Performance and Project Director at Gede Foundation. After months of hard work, careful planning and negotiations, it was finally time to depart for Maiduguri to help identify Mental Health and Psychosocial Support Needs of Internally Displaced Person’s (IDPs). We were very excited about this project because of its potential at meeting and bringing help to displaced persons in Nigeria. 

After intensive training by Dr. Bonnie Kaiser, the day came for our departure. I can remember how emotional we became as staff came down stairs to bid us farewell. Within hours we were at the airport and boarded the plane to Maiduguri. Just like proud soldiers on a rescue mission, but this time around on a mission to represent the integrity and humanitarian ethics of GEDE Foundation in Maiduguri. I promised myself that I was going to enjoy every bit of my journey and my work in Maiduguri. I watched from the skies as I wondered how Maiduguri will look. How are the displaced persons coping? Will our work be a success or failure?  As I pondered on this, the pilot interrupted my thoughts with an announcement. “Please kindly put on your seat belt as we approach Maiduguri and will be due for landing in 15 minutes.” At that point the excitement within me turned into dread; will we be safe? What if something bad happens? As the thoughts began to trouble me I quickly shifted my eyes to the windows and watched the beautiful landscape of Maiduguri. I watched with keen interest and amazement. Within a few minutes, we landed at Maiduguri International Airport. 

The airport was old with a lot of military presence. The weather was uncomfortably hot but the smiles of the people were charming and heart warming. As we left the airport and drove towards the heart of Maiduguri town, I started having a contrasted view about the Maiduguri we see on the news and the Maiduguri I was seeing on ground. The city had beautiful street lights like the ones found in Paris streets. The road sides were beautifully inter locked as if seeing naked sand was a crime. Business activities looked normal just like any other city I have been to in Northern Nigeria. I could not hold back my curiosity as I kept on asking the driver questions upon questions as they run through my mind.

The following day we had series of meetings and trainings with our partner organization (Catholic Relief Services - CRS). By the third day we were due to go on our first side visit to the communities. As we drove off the city, we started seeing visible signs of the insurgency. Armoured tanks by major junctions, beggars littered every where, people were generally looking shabby than usual while thatched huts were all scattered along the road as we journeyed. I enquired about the thatched huts and was told that those were shelters for the displaced persons. How can someone live in that? I protested as if it was their fault. They looked at me with such eyes that seemed to say “you never see anything” connoting you are yet to see worst. By the time we were at the third community my eyes had seen enough of the discomfort and sufferings. 

Oh poor and wretched people, with a rich mother like Nigeria you are living in rags and calling dried grasses home. Young men were seating idle under the shade of trees with nothing productive to do. Elders looked with such curiosity and I guess wondered what we might have brought to support their plight. Children were looking at us like some radiant stars from the skies. Other children queued up under the hot sun as they waited turns to fetch water. I almost broke into tears as a young boy grab my hands to say hi. I quickly knelt to ask him his name, “Mohammed” he said, with a big beautiful smile. I looked into his cute eyes and was about to ask him how he was doing when he asked, “uncle can I say ABCD”? “Why not?” I responded. “A, B, C, D, ……..Z”, he missed some of the letters but did not care as long as I was listening to him. Other children quickly came around to say hi and recite English alphabets. My heart melted with such joy at the motivation of the children to learn. There is hope at last, I confessed within me.

With the site visits over, the team was eager for their work. Our first day at the field was a distressing one. Here we were eye ball to eye ball, feet to feet and hands to hands talking to the IDPs. Their stories were emotionally overwhelming. They lost love ones, properties, animals etc. Men and women broke down with tears as they shared their experiences. One of the participants noted, “we have been assisted with food but nobody has come to ask us these questions you are asking us.” During psychological debriefing of the research team, it was evident that the experience was hard on us all. I remember one of the research assistants asking me a question, “Mr Binfa, how are we supposed to listen to these people and can’t do anything to help.” It was a feeling of helplessness at the magnitude of stress and distress the IDPs pass through every single day for over three years. 

For the 7weeks we spent with the IDPs, we heard horrible stories, emotionally overwhelming stories, stories that can make a person sick for several weeks. How they are coping with these experiences is a miracle (hopefully the outcome of the research will help us better understand this).  However, mentally some of them are breaking down, attributing everything to God and showing signs of helplessness. For how long will they keep holding on, only time can tell! But one thing is certain, they need help and they need the help now. 

Sleepless Nights

Written by Zunzika Okpo

Some time last week, I read an article from the New York Times about how Boko Haram conscripted young girls. How they used these girls to recruit other girls and in turn, used the girls for reproductive and religious purposes. Needless to say, it was a heart wrenching read. I could barely bring myself to imagine what the girls went through and how strong they were. Imagine having a bomb strapped to your waist and instead of blowing it up, you seek for help. It is a scary thing for anyone, especially ones so young to go through. 

The article brought back some memories from the field. I have heard scores of stories. Most of them border on not being able to sleep, hearts pounding at the slightest noise and the ever present fear and dread. Of course there are even stranger stories. Even as most of the people in the IDP camps cannot sleep, there is one man who cannot sleep at night, only at night. His village was attacked at night. His whole family was asleep when they heard screams and people running. The man got up to check and saw the insurgents. Some of them were holding young girls, aged between 10 and 14. He ran to his children’s room and told them to hide under the bed and in the corner so they would not be seen. They did as they were told. The insurgents started pounding on the door. They were brandishing knives and some were sporadically firing their guns. Out of fear, the man opened the door for them. He had guns, knives and cutlasses in his face. He saw as the young girls that were with the insurgents went from room to room. He prayed they would not find his children. His wife was in their room with their youngest - barely a year old. As luck would have it, someone called from the outside and the insurgents left. They had scattered everything in his house but did not take anything or anyone - except for the man. When they took him, they inflicted all kinds of pain on him. They threatened to kill him, his whole family too. They told him they knew about his children and would go back to the village to find them and his wife. 

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They did not immediately say what they wanted from him. They did not explain why they beat him and threatened to hack him to bits; they just kept at it. He was tired, he was hungry and he was thirsty. He lost count of days. He recalls that they would stop beating him for a while and just as he was about to give in to sleep or pass out from exhaustion, they would be back. Day and night lost meaning. They then asked him to join them in service. He wondered what would happen if he refused. As he could barely talk, he only nodded. “He won’t be much use,” one of the men said in Hausa. This man was tasked with disposing off the body. 

He was careless thrown in a bush and left to die. He explained how he did not know where he was and how he just stayed there waiting to die. After what seemed like forever, some people came about. They seemed harmless. They poked him and he groaned. Everything was chaotic but they managed to get him to a hospital where they tended to him. He is OK now. The family reunited. The children are safe. Yet the father cannot sleep at night. He stays up every night looking outside. When day breaks, he goes to sleep. As long as the sun is out, he gets some sleep. 

'I like having a diagnosis but everyone can experience poor mental health'

In my 23 years I have been diagnosed with two mental health illnesses.

The first was OCD when I was 14, an anxiety disorder that can cause the individual to experience intrusive thoughts and a need to carry out rituals as a result.

 Before my diagnoses, I felt isolated and ashamed of who I was

The second was depression, following a break up and living 200 miles away from home at university in the South West of the UK.

Feeling alone without a diagnosis

Before my diagnoses, I felt isolated and ashamed of who I was. I felt like I must have been the only person on the planet who was experiencing what I was going through.

And even then, I knew something wasn’t right but I couldn’t put my finger on what that was. A diagnosis showed me that what was happening to me had a name, it was recognised as something that could be treated.

In turn, this made me more open to treatment including medication. I saw it in the same way as I saw a physical illness: it needed treating to go away or to keep it at bay at least. This insight has been invaluable.

The positives of having a diagnosis

Having a diagnosis has equipped me with the tools to explain myself to other people.

I would say I have always been more anxious, more alert and on edge than others I know. For such a big period of my life I had no idea why that was which made me angry that I wasn’t the same as other people.

Now I know that I have a medical reason for my behaviour and it’s a reason I can use to help other people understand.

If I am having a particularly bad day, I can tell people that it’s because of my OCD.

There are webpages dedicated to the anxiety disorder that people can read and I feel as though it describes who I am perfectly. When I find it difficult to explain myself, I now have the back up of all that information out there that I never knew existed before.

Feeling ‘different’

Having a label has always felt important to me; I’ve always seen the benefit of having a diagnosis and a label that explains why I am the way I am but recently I have started to question: is this always a positive thing?

If I was to look at having a diagnosis from the flip side, it has only confirmed my suspicions that I am not a “normal” human being. Although having the label of “OCD” and “depression” has allowed me to normalise things for myself in terms of my experiences, I also feel that a diagnosis has made me feel an irregular, alien part of society. My behaviour isn’t what is classed as “normal” and so needs a name branded to it.

Linked to this point, I feel as though diagnoses can sometimes add to that taboo of there being two categories of people in life: the mentally well and the mentally unwell. People like me who have a diagnosis are lumped into the latter. But I would argue that these groups don’t exist. Sure, there are people with and without diagnoses but that doesn’t mean that you are either one or the other.

Everyone can experience poor mental health

Everyone is on a continuum.

It’s possible that everyone can experience poor mental health at some point in their lives

Some days we might wake up and feel terrible and can’t put our finger on why or we might experience a life event that in turn causes poor mental health. It’s possible that everyone can experience poor mental health at some point in their lives. It’s exactly the same as not always being physically well.

The idea that these two groups exists also feeds into the idea that those with a diagnosis are ill and need to get better. When we have been diagnosed, the very thing we want to achieve is “recovery.” But I would argue that my OCD will never go away and its makes up such a big part of who I am. Why do I need to constantly fight against that and strive to be what society deems as “normal”? Sure, I probably am a more anxious individual than the next person but don’t we need this mix of people in the world?

Maybe sometimes a diagnosis can just be reflecting a different way of thinking and being, not something toxic that needs to be tackled and eradicated.

I have always been taught that my way of thinking isn’t normal and that it needs changing which has only lead to me hating this part of myself

I now feel proud to admit this and scream it from the rooftops: my OCD IS part of me; it makes me who I am. I have always been taught that my way of thinking isn’t normal and that it needs changing which has only lead to me hating this part of myself.

But I don’t want to hate that anymore.

Instead, I believe that I can live alongside my OCD, listen to it, try to understand it, accept it and embrace it as part of my identity. My brain works differently to yours which means that I experience and to respond to stress in my own unique, individualised way.

And you know what? I’m perfectly ok with that. How boring would life be if we were all exactly the same?!

Article from Mental Health Today

Five Years Later...

By Zunzika Okpo

In the past week, Gede held more Mental Health Camps in the IDP camps. Our regular readers will know how our camps usually go but this time was a little different.

We encountered problems as soon as we got to the chief’s palace in one of the camps. It is not usually locked but on this day, it was. Users were already gathered outside the chief’s palace waiting for us. Our Psychiatrist for the day looked around and said, “well, we are here, we might as well do something.” So we gathered benches, plastic chairs and set to work. We set up our stations under various trees. We had work to do. 

We would usually see the same type of people with similar challenges. They cannot sleep, they are terrified, they keep having nightmares, they are worried about family left back in the North-East, etc. One woman, however, stood out. She was old, very old and did not have anywhere to sit. She was also very quiet. When she walked over to do her vitals, I could tell she was very frail and she also walked with a cane. When she went over to the doctor’s bench, her daughter in-law narrated her story. She had just very recently escaped from Boko Haram’s captivity. She had been held for over 5 years. The insurgents came to her village one day, burned everything, killed people and took the women and children. 

Whilst in their captivity, the old lady was put to work. She recalls making kunu (pap - a local Hausa drink) and taking it to the farmers working in the field. She was stopped by the insurgents who demanded to know what she was carrying. She informed them that she was simply taking the farmers something to drink. They seized the drink from her and took sips. It did not go down well as they claimed it was sour and she was trying to poison them. For this offence, the 79 year old woman was given 80 lashes. She continued living with the insurgents until one night during the Ramadan period it rained heavily. She claimed that when there were thunderstorms or rain, the insurgents stayed indoors. Therefore, she, and three others took off in the middle of the night, in heavy downpour and started their descent (they were held on a mountain). During the climb down, the old lady fell and twisted her ankle. To this day, she walks with a cain. Luckily for the four escapees, they made it to where the army was and identified themselves. They were then put in a camp where someone that knew her son was. The person got in contact with the son and told him his mother was still alive. After 5 years, the family assumed the worst - that she had perished at the hands of the insurgents. After all, she was 77 when they took her. 

The last thing she said was, “they don’t take any possessions, they don't want anything. They will burn and destroy everything in their path. They just want your life.”

The trauma that the IDPs have been exposed to is incomprehensible to someone that has not been through it. You would have to live through it to even begin to understand how they are all walking and laughing. It is a testament to people’s resilience. Hopefully through this and similar psycho-social interventions, healing and rehabilitation can begin.

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