Be-cause health matters 14

Niger

The example of Niger was explained by Ibrahim Maman KABIROU, working with COOPI, which is based in Diffa, a town in the far east of the country. They offer numerous activities in relation to mental health and psychosocial support: training; supply of medicines; coordination at regional level on mental health aspects; long-term supervision of health structures to monitor medical agents and community intermediaries who are already trained; and last but not least, awareness-raising work. It is by raising the awareness of key players in the community that mental health and psychosocial support programmes (MHPSS) can be normalised, thus changing mentalities and negative judgements on this subject. The speaker also noted that, following these awareness-raising initiatives, many referrals had been made, ensuring coverage of certain hard-to-reach areas and the effectiveness of the DIAPs (Dispositif Itinérant d'Appui Psychosocial), a kind of mobile team providing psychological support assessments.

Watch the video of Mr. Maman Kabirou Ibrahim (Niger)

Chad

The example of Chad was discussed by Lucien KIKWABAYA, a doctor with the International Rescue Council (IRC), replacing Moumouni BONKOUNGOU, who unfortunately died of Covid-19 a few days prior to the conference. Lucien KIKWABAYA presented the IRC’s mental health activities in Chad. Specifying that MHPSS only existed in refugee camps in Chad, IRC is very present there and focuses on clinical care and the training of community intermediaries and paramedics. Unlike COOPI in Niger, IRC in Chad works in collaboration with the United Nations High Commissioner for Refugees (UNHCR) on mhGAP training, which is a major institutional and political difference. On the other hand, the IRC in Chad seems to be less advanced where coordination is concerned: indeed, one of focal points for improvement is to work towards dividing the MHPSS Working Group into sub-groups in the provinces and camps to achieve greater efficiency. Here we see the importance of the aspects of cooperation, coordination and involvement in the different clusters.

Watch the presentation of Mr. Lucien Kikwabaya (Chad) and Mr. Moumouni Bonkoungou (Chad) here.

The discussion

Aissatou Sokona NIAKATE (Guinea) launched a discussion in which she spoke as a discussant. She underlined the common points between the two areas of intervention mentioned: the large size of the two countries, the very limited human and financial resources, the complete lack of a national mental health policy, etc. These pitfalls are, however, partly offset by the existing network between the communities and the health structures. Adequate support for people with mental health problems requires the sometimes identical, sometimes complementary needs of health workers and community intermediaries. In this case, Aissatou NIAKATE stated that training community workers in mental health (particularly on the mhGAP) was an excellent strategy. By integrating practices, the links between health structures, communities and patients become stronger. In this sense, psychologists’ and/or psychosocial workers’ support for facilities acts as a bridge between the medical and community spheres. The various psychotherapeutic activities or the supervision of community facilities by health workers are opportunities to create wider and more comprehensive coverage.