Gede’s Substance Misuse Prevention in Communities and Schools

 The incidence of substance and drug misuse among young people continue to present huge concerns to the society, family and individual.  The number of young people in Nigeria with substance use disorders (SUDs) continue to rise and they are at increased risk for abuse or neglect, physical problems, poor behavioral or impulse control, poor emotional regulation, conduct or oppositional disorders, poorer academic performance, psychiatric problems such as depression or anxiety.

 Gede’s mental health programme seeks to prevent some of these issues among young people in communities and schools, through awareness campaigns to students, teachers and young people in Benue and Cross River states.

These activities started in November 2023 in the states, and aimed at reaching thousands of young people in schools and communities with high risk of substance misuse.

The expected outcome would be a significant behaviour change among young people on substance misuse through the knowledge and skills that will be provided by the campaigns in 2024.

The activities started in Ayiin community of Benue state and government secondary school, state housing estate, calabar, Cross River state and will reach over 30 schools and communities in coming months.

Gede Strengthened Mental Health Support for Children and Young People

In October and November 2023, Gede engaged in a series of events across 3 locations— Kebbi, Sokoto states and the FCT, within the ‘Open Minds’ Project. These events included: Community Mobilization,  Reflection Meetings  and Social Contacts. Community members and young people affected by mental illness and leprosy were actively involved in these activities, which resulted into building resilience to address stigma and discrimination.

In order to evaluate activities previously carried out— i) screening for anxiety and depression, ii) capacity building in mental health, and, iii) dedication to self help groups, reflection meetings with community members and caregivers were carried out. 

 The  social contact generally take up a more active role which  involves sharing stories of lived experiences of mental health problems as well as a fun-related  activity for children and young people (CYP). Some of the activities chosen by CYPs in Sokoto included a decoration by handprints on their community building to express ownership and unity. Similarly, in Kebbi, CYP choosed to draw items that made them happy on cardboard. 

 These activities helped to reduce stigma  and discrimination  associated with mental illness as well as promote  behaviour change . 

The ‘Open Minds’ Project is funded by Comic Relief, UK and  implemented by a consortium of organisations— Gede  Foundation, The Leprosy Mission Nigeria and  The Leprosy Mission England & Wales.

Gede Marked World Toilet Day 2023

Globally, there are 3.5 billion people still living without safe toilets. Over 419 million people still practise ‘open defecation’. In these situations, diseases spread, killing 1,000 children under-five every single day. This global crisis poses a threat to nature and everyone’s health, particularly women, girls, and other vulnerable groups.  

In Nigeria, 1 in 4 have access to a basic toilet. Over 122,000 Nigerians, including 87,000 children, die due to diarrhea yearly. 

The United Nations Children's Fund (UNICEF) says Nigeria will need to build no fewer than 3.9 million toilets annually to meet the ending open defecation practice by 2025 target.

It is due to this burden that Gede’s ‘Water, Sanitation and Hygiene Programme’ marked this year’s World Toilet Day, with a theme ‘Accelerating Change’. The event which is marked every November 19 focused on awareness raising on the need for households to promote hygiene practices—proper handwashing and construction of household toilets.

Over 450 students and teachers from Government Secondary School, Naka, Gwer West L.G.A Benue State, were reached with information, knowledge and skills on improving hygiene behaviour, construction and proper use of household toilets.

Participants expressed commitments in ensuring that the knowledge and skills received will be put to good use in order to eliminate open defecation across the communities.

GEDE COMMEMORATES WORLD MENTAL HEALTH DAY 2023

World Mental Health Day 2023 is an opportunity for people and communities to unite behind the theme ‘Mental Health is a Universal Human Right’ to improve knowledge, raise awareness and drive actions that promote and protect everyone’s mental health as a universal human right.

Every year, the event provides an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide.

Gede Foundation joined the global mental health community to lend its voice in 2 different activities within the period. 

Firstly, on the 10th October, 2023, the Foundation participated in a Ministerial Press Conference with the Federal Ministry of Health in Abuja. At the meeting, the Minister of Health and Social Welfare, Prof. Muhammad Pate stressed the importance of collaborative efforts involving the government, healthcare professionals, NGOs and communities to effectively address mental health issues in Nigeria. Stakeholders including WHO, NCDC Africa, CBM, TLMN, Clinton Foundation, NPHCDA, Mental Health Advocates, NGOs and people with psychological disabilities participated in the conference.

Goodwill messages and commitments from government and implementing partners centred on the basic human rights for people with mental health conditions including the right to be protected from mental health risks, the right to available, accessible, acceptable, and good quality care, and the right to liberty, independence and inclusion in the community.

Secondly, Gede Foundation organised an awareness campaign on mental health in Government Secondary School, Agasha in Benue State. The event reached over 350 people including students and teachers, with information on stress, drug and substance abuse, depression, adolescent mental health, prevention and access to mental health services. Participants gained knowledge on mental health, mental illnesses, signs and symptoms and referral pathways for treatment and care for those in need.

With an increasing number of persons with mental health conditions globally and in Nigeria, it is expected that these events will help to promote and sustain respect to human rights, inclusiveness and access to quality mental health care.

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Sanitation and Hygiene in Daudu Community

Water, Sanitation and Hygiene activities continued with community mobilization and sensitization in Benue state on the 21st August,2023.

The aim was to sustain good hygiene behaviors among community members in 10 communities starting with Daudu in Guma L.G.A.

The overall objective is to strengthen communities with knowledge and skills in order to achieve 'open defecation free' status. Prior to this, boreholes and ventilated improved latrines were provided to these communities in public places. However,households are encouraged to build toilets to complement the WASH facilities provided by the project in order to eliminate open defecation. WASH committees have been established and relevant foundations laid that promoted community- based hygiene improvement behaviors. The project which started in 2019, has recorded improvement in wellbeing and

reduction in incidences of waterborne diseases. This phase is to sustain the innovation and ensure optimal behavior change.

Goodwill messages were received from community gatekeepers including, Chiefs, religious leaders and the state Ministry of Water Resources and Rural Development. In collaboration with relevant state Agencies and Ministries,the overall targets will be achieved overtime. This activity is led by trained WASH committee members and supervised by Gede Foundation.

Sensitisation: Mental Health and Substance Abuse

Earlier this week, Gede Foundation conducted a sensitisation on Mental Health and Substance Abuse at Lobethas Unity College, Daudu, Guma L.G.A., Benue State. The objective was to create awareness on Mental Health and Substance abuse among young people in order to promote and improve their social, emotional and psychological well-being. Over one hundred and twenty (120) students including teachers were in attendance. The Foundation’s resource person, Mr John Udoh took the students through various Mental Health conditions, characteristics, problems and ways or measures to improving and preventing them. The Vice Principal (Admin.) Mr Edward Iorkuter, thanked Gede Foundation for bringing this noble activity to the school, adding that it is timely, considering the hardship experienced in the society currently, which could affect student's behaviour.

The Dean of Studies, Mr Fabian Shargh, commended Gede Foundation for the initiative, adding that it will reduce bullying in schools as students have come to learn about trauma and it's effects among young people.

The Head boy, Chiatior Yiman George expressed gratitude to Gede Foundation for enlightening the entire students on Mental Health and Substance abuse and promised that the knowledge gained from the activity will be put to use to improve their general well-being.

This activity is scheduled to take place in 10 Secondary Schools in the State.

CBM Global, UK visited Gede

Gede implemented Mental Health Anti-stigma Project in partnership with Time to Change Global (TTCG), a 2-year Project that ended in 2020. The project was first of its kind in Nigeria where a combination of physical and online social contact events were designed to address mental health stigma across different target populations. In addition to the social contact events, there was a campaign called, “It Could Be You, Please Be More Kind,” and a toolkit was designed based off of the experience of people with lived experience of mental health problems.

The impacts of the Project spanned beyond the Project life cycle and its successes are yielding supports in other mental health interventions across the states. It is based on this that Christian Blind Mission (CBM), UK visited Gede to explore the relevance of the approach used and to debrief on ways to improve in subsequent designs. 

Interviews with Project staff and trained Champions (people with lived experience) were carried out and documented for future project design. The project reached over 3 million people through virtual and physical social contact events with Champions.

The Project was funded by MINDS UK and TTCG.

Gede received Project Partner from The Leprosy Mission, England and Wales

In 2019, Gede partnered with The Leprosy Mission, Nigeria (TLMN) and The Leprosy Mission England and Wales (TLMNEW) to implement a 3-year OPEN MINDS Project in Nigeria. 

The Project was an integrated approach to empowering and building the resilience of children and young people to overcome mental health problems caused by two severely stigmatizing skin neglected tropical diseases—Leprosy and Lymphatic Filariasis. This approach strengthened community-based care and support for people affected by these skin NTDs and mental health problems in the Federal Capital Territory, Kebbi and Sokoto states.

The Project mainly benefited children and young people, and parents and caregivers, affected by comorbid mental health problems and leprosy and lymphatic filariasis.

The team examined the progress made in the project and its achievement as it relates to the planned goals and objectives. It was certain that primary beneficiaries were reached with planned interventions and systems have been strengthened for sustainability.

Secondary beneficiaries were the Health Policy Planners, Healthcare Workers, Teachers, Religious Leaders and Community Peer Educators.

In collaboration with the state government structures, the Project will continue to address the negative effects of stigma and discrimination associated with stigmatised diseases and increase access to services delivery at the community level. The project is funded by Comic Relief, UK.

The NoCTRAiN Project: Addressing Mental Health Needs in Crisis-Ridden Communities in Plateau State

By Patience Adejo and Saidat Azeez Saleh (Lead Writers)

Culled from Nigeria Health Watch

Mental health problems often stem from various challenges, including social issues related to loneliness or depression, environmental factors caused by stress, social exclusion, or exposure to violence, as well as psychological factors. In Plateau State, located in North Central Nigeria, an area renowned for its vibrant culture and thriving communities, a series of conflicts between farmers and herders have resulted in affected communities in certain parts of the state grappling with trauma, loss and displacement. Now, they face the daunting task of rebuilding their lives in unfamiliar surroundings. As a result, mental health concerns have arisen as a pressing issue, with survivors navigating the emotional and psychological impact of the conflict.

This reality has affected the lives of individuals living in the areas impacted by the crisis. In these turbulent areas, the profound impact of lives lost, property destroyed, and shattered homes have been made worse by the burden of mental health needs among internally displaced persons (IDPs) and communities. This sobering reality is illuminated by research conducted in Borno State following the Boko Haram insurgency.

The NoCTRAiN Project

Conflict and the displacement of people can have a significant impact on the mental health of communities, and several organisations, like Neem Foundation, the International Organization for Migration (IOM) and the United Nations Population Fund (UNFPA), have been providing mental health and psychosocial support services in IDP camps and in affected communities.

The North Central Transitional Aid in Nigeria (NoCTRAiN) project is one of these organisations, with the goal of providing assistance and support to individuals and communities in Nigeria’s North Central region who have been affected by crisis and violence. The provision of mental health services is a critical component of the NoCTRAiN Project.

Gede Foundation, a not-for-profit mental health organisation, implemented the NoCTRAiN Project in several Primary Health Centers (PHCs) across five local government areas (LGAs) in Plateau State: Riyom, Barkin Ladi, Bassa, Bokkos and Mangu LGA. The project, which started in 2019, was funded by the Christian Blind Mission (CBM).

The major goal of the project was to provide support, including mental health services, to those affected by crises who live in internally displaced camps and host communities. This was achieved by training local healthcare providers and community workers to deliver mental health services.

According to Mr Godwin Etim, Managing Director, Gede Foundation, “We successfully trained 85 healthcare workers, including doctors, nurses, and Community Health Extension Workers (CHEWs), in Plateau state. These healthcare professionals are now equipped with the knowledge and skills to provide evidence-based care using WHO’s mhGAP intervention guides.” Using this evidence-based tool, non-mental health professionals were trained to respond effectively to mental health concerns in their communities. This approach provided health workers with the knowledge and skill to identify mental health concerns, provide basic counselling, and refer individuals to specialised care when necessary.

Discussing the measures implemented to ensure that individuals in need of mental health support were reached and their needs met, Mr Etim said, “When we identify a community with displaced people, we begin active sensitisation on mental health, and we encourage them to seek help at the designated health facilities if they encounter any mental health challenges. At the facility, we made available medications for conditions such as anxiety, depression, and more. These medications are supplied to facilities where clients can access them at subsidised rates.”

Miriam’s story

Mr. Machak Tenti, a community mobiliser in Bokkos LGA, who was trained by the Foundation, told the story of Mariam, a resilient 30-year-old survivor of one of the farmer-herder clashes. Mariam witnessed the brutal murder of her entire family and was herself subjected to the trauma of sexual assault. Despite the fact that she could have sought refuge and support at an IDP camp, she chose to remain in her home, where the horrific events occurred, relieving the trauma. However, after learning of her situation, Gede Foundation stepped in and provided the necessary mental health support. With significant improvement in her mental well-being, Mariam has begun reconnecting with her peers in the community. She is one of the 2,037 people who have benefited from the mental health support provided by the NoCTRAiN project.

Mariam, like many other beneficiaries, is a member of a self-help group led by community volunteers. It provides a forum that enables beneficiaries to discuss and share their experiences. “Sharing these experiences helps to encourage and support one another. It also allows us to reach out to those who may be unaware of the available services, ensuring that individuals with similar conditions are informed about accessing medications”, said Tenti. He went on to say that for people with disabilities who are unable to access care, dedicated volunteers regularly check up on them to offer support and ensure they receive the necessary care.

However, the conflict in the region created a volatile and unstable environment, making it difficult to reach the communities at times. This, according to Mr Etim, was a significant challenge they encountered while implementing the project. “Task shifting is also a significant issue due to the absence of permanent professional health personnel at the PHC, necessitating reliance on community volunteers. This presents challenges when integrating the mental health project into an already overwhelmed system with limited staff capacity,” he added.

Ensuring sustainability

To address the long-term nature of mental health care, the NoCTRAiN project established a drug-revolving fund (DRF) system in which medicine purchases at healthcare facilities were collected and transferred to the Gede Foundation. These funds were then used to replenish the drug supply at the facilities, ensuring consistent availability of medications. This approach effectively ensured that future patients would continue to benefit from the intervention without interruptions. When the project concluded in May 2023, management of the DRF was transferred to the primary healthcare centres, empowering them to continue the programme.

While initiatives like the NoCTRAiN project are bridging a critical gap, they are often short-term. Integrating mental health services into primary health care will strengthen Nigeria’s mental health care system, ensuring improved access, early intervention, and better outcomes for people with mental health concerns in the country. The recent passage of the Mental Health Bill provides an ideal opportunity to put this into action, especially as it has a strong community-based focus and aims to ‘ensure a better quality of life through access to integrated, well planned, effectively organised and efficiently delivered mental healthcare services in Nigeria’.

Culled from Nigeria Health Watch

Project Close-out Meeting with NoCTRAiN Stakeholders

The North Central Transitional Aid in Nigeria (NoCTRAiN) Project that started in 2019 in Benue, Nasarawa and Plateau states ended in May 2023. The project close-out event held in Jos, Plateau state on the 23rd May, 2023. The project aimed to strengthen the resilience of conflict-affected host communities and internally displaced persons with attention towards disability inclusion, by implementing inclusive Health, WASH and Income Generating Activities in the 3 states.

The Project operated through a consortium of 4 partners namely; Center for Gospel Health and Development (CeGHaD), Evangelical Church of West Africa Hospital (ECWA), Universal Reformed Christian Church (NKST) and Gede Foundation. Partners led in their areas of specialty covering Vesicovaginal fistula, Eye Health, Mental Health, WASH and Livelihoods.

The Project reached 98,620 direct beneficiaries (56% women, 44% men, 15% people with disabilities) with the respective interventions in the 3 states, in order to strengthen their resilience through improved health and WASH services as well as livelihood measures. 

This was achieved by strengthening the health system through training of health workers, capacity building in health facilities, screening and treatment of vulnerable people, training community members on the maintenance and rehabilitation of WASH systems, and training vulnerable farmers on VSLA approach for income diversification. In addition to the trainings, the Project provided i) medication and treatment services, ii) boreholes, latrines and hand washing stations, and, iii) improved seedlings and agricultural items. 

A significant transformational milestones are reached across the 53 target communities where the Project was implemented. The state Governments through relevant Agencies have made commitments to sustain the Project beyond its life cycle. 

Gede Foundation focused on Mental Health, WASH and Livelihood across the 3 states. The Project was funded by Christian Blind Mission (CBM), Germany and Coordinated by CBM Nigeria.