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Displaced and distressed: people’s mental health in East Africa

Displaced and distressed: people’s mental health in East Africa

In the internally displaced person’s camp near Malakal town in Central Upper Nile State, South Sudan, Dhan Tap looks sadly at a photo on his mobile phone. The picture isn’t much to look at – a tattered white rope hanging from the grass-thatched roof of a typical South Sudanese home.

“This rope was used by a 13-year old boy who hung himself,” he says. “Many of our patients – whether adults or teenagers – feel there is no future for them. [This] boy felt his parents could no longer support him while in the displacement camp and he felt trapped, helpless.”

Escalating mental health needs

Dhan Tap, who himself fled from conflict in the area, works as a mental health counsellor in the camp in Malakal for Médecins Sans Frontières (MSF). Over the years, Tap has seen an increasing caseload of patients suffering mental health conditions, often linked to their experiences of past displacement and future uncertainty.

From January to October 2018, MSF’s Malakal mental health team supported roughly 30 new patients per month – one new case a day. Of those, half struggle with serious mental health conditions including attempted suicide, says Tap’s colleague, Dr Jairam Ramakrishnan.

With the exception of Dadaab Refugee Camp in Kenya, where predominantly Somali refugees have been gradually repatriated since late 2014, nearly all MSF mental health programmes in the East and Horn regions of Africa have seen a significant increase in the number of patients. This includes projects in Ethiopia, South Sudan, Sudan, Tanzania and Uganda.

When displaced, distress follows

The lines of patients seeking mental health consultations in Yumbe are always long; MSF conducts on average around 900 consultations per month. “But I suspect we are seeing only a fraction of those who need our [mental health] support,” Rambo says.

Rambo and his colleague Vastine Tayebwa, a clinical psychologist, believe there is one main factor that triggers the high number of mental health patients MSF teams are contending with in Yumbe: displacement.

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