First Person: Supporting mental health in Madagascar, one consultation at a time

Henriel Emashinavi works for who It is located in Ambobombe, where the Androi Regional Referral Hospital is based. She spoke about the care being provided to people suffering from mental health crises.

“Mental health conditions such as psychotic episodes, schizophrenia and depression are prevalent in Ambobombe town.

An increasing number of young people are suffering from mental health episodes. For young men, it may be related to cannabis use, and for young women aged 13 to 18, it may be related to relationship breakdowns and postpartum depression. I am.

For both men and women, one contributing cause is the constant fear of living under stressful conditions caused by the ongoing humanitarian crisis in southern Madagascar.

We have recently experienced droughts and cyclones in various parts of the South, further exacerbating the effects of climate change and deep underdevelopment. Because of this, many vulnerable people living in the South are struggling to survive. When crops fail, they have no safety net and often starve. Access to health care and other social protection services may also be problematic.

“Victim of Magic”

I met a woman named Elodie. She gave birth at age 20 and suffered from her postpartum psychosis after losing her child six months later.

When I met her, I noticed that her ankles were chained.

Her mother told me it was for her own safety because her daughter kept running away. There is a lot of stigma attached to people who suffer from mental health disorders. They are said to be “possessed” and victims of witchcraft.

Although mental health problems are treatable from a medical point of view, increasing ignorance and poverty are forcing people to resort to drastic measures such as tying up patients, which exacerbates the mental illness they suffer from. I am.

Elodie (right) and her mother (center) say her child responded well to the medication.

access to care

It is very difficult for patients to receive treatment. The nearest specialized hospital for mental health treatment is 600 kilometers away, so to meet the growing need for services, WHO introduced medical teams for routine outpatient care.

A total of 93 free consultations were conducted over one three-day period. Sixty-seven percent of those patients were women, including Elodie, who was seen by a neurologist. As a result of this consultation, she was prescribed medication and her mother said her mental health has improved. Elodie takes better care of herself. For example, she takes care of her personal hygiene.

WHO wants to see more services made available to people like Elodie, and while it’s clear there are limits to what visiting psychiatrists can do, they can help some patients on their way to recovery. I’m glad.

Elodie has the support of her mother and sister, but very sadly, the rest of the family rejects her, so she and her mother are kicked out of the house.

Her mother hopes that Elodie will make a full recovery soon so she can live a normal life again, earn money and contribute to the three-woman family. ”