Good news and new challenges in Uganda

In most African countries there is no such thing as a welfare state. Families try hard to give their children a good education, with the hope that they will get well paid jobs and take over the support of the younger children – particularly the payment of school fees. 

Jane is the only girl in her family, the eldest of eight – seven brothers! She did well at secondary school, and with the hopes of her parents invested in her, she achieved a degree in accounting at Makerere, Uganda’s top university.

Jane got a job at a high performing accountancy firm. She was able to pay the school fees for her brothers, and to take good care of her parents. She thought she could now aim higher, and set out to gain a postgraduate diploma.

At this point when Jane’s life appeared to be going very well, she experienced some stress and her mood began to go down. She lost concentration and both her work and her studies suffered.

Then came a dramatic change in mood, which went up to way above normal, too active and overtalkative. When she became irritable and argumentative, that did it: she was immediately fired from her job.

“When someone has physical pain, they can go to the hospital and tell the doctor that I have pain here, but my challenge is that I had pain but it was not physical. I lacked the person to talk to, it was killing me silently” she says.

Bipolar disorder is a serious mental illness common all over the world. You can control the moods to some extent with medication, but talking about the illness and learning how to manage it is one of the crucial treatments. The mental health team at Mukono Hospital, supported by Jamie’s Fund, are great at offering time to talk as well as giving out the right pills.

Jane’s family didn’t seek treatment at first because they didn’t even know that what was happening with her was a mental problem that could be treated. They just looked on and when she was out of control, they locked her inside the house.

 “We saw it as an embarrassment in our family and we didn’t ever want the community to know about it” her mother says.

“It was only when a family friend told us about the initiation of mental health services that we went to Mukono Church of Uganda Hospital.”

Jane and her mother

As Jane eagerly agreed to treatment, so mum readily agreed to become an ambassador for mental health in her community, happily celebrating her daughter’s new life. 

After just two months there was a clear improvement and Jane was happy and well. She was continuing to attend the hospital for her regular treatment sessions, but as with most patients who live some distance from the hospital, it’s likely that the lockdown conditions will have prevented her getting her treatment at times. 

All of the teams supported by Jamie’s Fund face huge challenges in supporting their patients and enabling them to continue with their treatment. Not so many people in rural areas have access to phones – for on-line psychotherapy! – and they normally receive their medication from the team in the clinics at the hospital or village health centre. The results of the virus and especially the very strict lockdown, may be far reaching and far more damaging than anyone will be able to measure. 

Please remember people with mental illness and epilepsy in Uganda, and the teams who care for them with so much love and devotion. 

Lamet Jawotho and Mo Wilkinson

Bringing knowledge and understanding, restoring hope

Lubaga Hospital

There is no doubt that Covid19 has been, and continues to be, a challenge to our friends in Uganda.  It was therefore with “double joy” that we have received news of an mhGAP training workshop that has just been successfully completed at Lubaga Hospital[1], on the western side of the capital, Kampala, and the second oldest hospital in Uganda.

Twenty-four hospital staff took part in the five day workshop between the 12th and 16th October, 2020.  The course was facilitated by senior psychologist Joshua Ssebunnya, a longstanding friend of Jamie’s Fund, and his colleagues. Using a variety of teaching techniques, they worked with doctors and nurses from across the hospital to enable them to diagnose and respond appropriately to a wide range of mental health conditions.

Feed back from discussion groups

This was achieved through a mixture of teaching, group discussion and practical role-playing exercises.  Participants and hospital management rated the course a great success and noted that the participants, who were not mental health specialists, were “already feeling the importance of mental health …”  The report sent to Jamie’s Fund also noted that that the sessions were lively and that, in consequence, none of the participants dozed off!

In his closing remarks, the Hospital Executive Director thanked Jamie’s Fund for its support and expressed the hope that Lubaga Hospital will now set up a mental health unit within the hospital.  Already a WhatsApp Group has been set up to support those who were trained in this workshop and a Clinical Officer has been tasked to work with the Deputy Principal Nursing Officer to continue the roll-out of mental health care across the hospital.

Participants with their certificates.

The team at Jamie’s Fund are delighted with the success of this workshop and we are pleased to have been able to provide the funding.  The cost of each workshop varies depending on different factors (including whether or not it is residential) but the rough cost is around £4000 for the five days.  We believe this is money well spent, as the training of twenty or more clinical staff across a hospital can have a huge and disproportionate impact on the lives of many people.

Mental illness often presents in other departments such as A&E and maternity or as an apparently unrelated presentation at out-patients clinic. Without such training the diagnosis may be missed.  By training staff from these different clinical areas to recognise mental illness the lives of individuals can be improved and they can begin to hope again.  Investment in mhGAP training is thus a relatively low cost way of bringing care and relief to as many people as possible.

If you would like to make a difference to the lives of people with mental illness in Uganda by supporting the work of Jamie’s Fund please click here.

Hugh Burgess

[1] Uganda Martyrs Hospital, Lubaga is a private, not-for-profit hospital that was started in 1899  by Catholic missionaries. It  currently has 237 in-patient beds as well as a range of out-patient clinics. The hospital seeks to provide “quality, accessible and affordable healthcare services” across a wide range of specialties.