RE: “Mental health day to focus on first aid” (The New Times, October 10).
I do not think the Ministry of Health (MoH) is moving fast enough to address mental health in Rwanda. I have read through the mental health policy and the statistics included therein are appalling when compared with what is actually on the ground.
The statistics are 99% of survivors witnessed violence, 31% of women suffered rape, 57% witnessed killings by a machete, and 99% believed surviving the Genocide against the Tutsi was a miracle. This is a massive burden of post-traumatic stress disorder which needs treatment.
Obviously, there is a need for holistic approach to mental health, but if the same urgency was put to it as is the case with malaria, HIV and maternal deaths, we would see more concrete results.
The gaps speak for themselves:
1. Mental health facilities: There is only one national referral facility— Ndera Hospital—for mental patients. There is a need to strengthen this Catholic Church-supported hospital. The Government’s referral hospital, CHUK, needs a centre for mental health to support Ndera.
2. Mental health professionals: Rwanda has only 6 or so qualified psychiatrists who used to be based in Ndera Hospital but have now been taken to district hospitals.
The Ministry of Health needs to work with the Ministry of Education and College of Medicine and Health Sciences (former KHI) to avail more scholarships for specialists training abroad in the country.
University of Rwanda has fortunately produced psychologists but, as a matter of priority, MoH should ensure more training available to them while being deployed to hospitals. Meanwhile, MoH should scale up Partners in Health’s very good initiative in mental health in Rwanda. PIH has attempted to address the glaring gap by focusing on training psychiatrist nurses to carry out community outreach programmes and based in district hospitals.
MoH would scale up such initiatives to local health centres by ensuring a psychiatric nurse who can provide basic support as Rwanda builds up its mental health infrastructure.
King Faisal Hospital and Rwanda Military Hospital have no psychiatric doctors for consultation and MoH should work with the hospitals to address this issue. With trainings, comes the issue of adequate remuneration for such professionals to prevent the brain drain to Western countries and/or private sector.
3. End mental health stigma: Just as MoH has extensive campaigns on malaria and maternal deaths, the same approach is needed for ending the stigma around mental health. I would suggest using Umuganda as a very good tool for sensitising population on this issue.
4. Budget support: The above-mentioned interventions require budget support and it’s important that the Ministry of Finance to recognises the need to avail sufficient funds for the above.
5. Mental health medications: Currently, HIV medicines are given free or at a subsidised cost to patients. The same approach is highly required to ensure mental health patients have adequate treatment.
Mental health conditions are easily a time bomb in that, unlike other more obvious diseases, the illness can lurk in families and generations causing untold damages down the road to future generations. We all need to take this issue with utmost seriousness, especially as a country with a deep traumatic past.