Improve the access to mental health care in the Kigoma Region

Overview1. Fracarita International2. Brothers of Charity3. Structure of Fracarita Tanzania4. Mental Health Situation in Tanzania5. Fracarita Tanzania: Our projects in Kigoma6. Fracarita Tanzania: Problems7. Fracarita Tanzania: Solution - Outreach8. Fracarita Tanzania: Conclusion

1. Fracarita International- Not for profit organization of the Congregation of the Brothers of

Charity- Support its services in Latin America, Africa and Asia- Focus on mental health care, care for people with a disability and

education- Attention to capacity building, coaching, exchange of knowledge and

expertise, international fundraising and influencing policymakers- Works through regional offices, e.g. Fracarita Tanzania- Has a consultative status to the UN- Open to collaboration with other groups to achieve their objectives

2. Brothers of Charity- Founded 200 years ago in Ghent, Belgium- Started in 1911 with their first mission work in Congo- Now active in 32 countries worldwide - Focus on mental health care, care for people with a disability and

education- Pioneers in mental health care in the developing countries.- Evolved from a missionary organization to a worldwide multinational

and multicultural organization based on subsidiarity

Brothers of Charity – Tanzania

Trustees Board

Fracarita Tanzania Foundation – Country Coordinator (Kigoma)

Fracarita Tanzania Foundation – Assistant Country Coordinator (Dar Es Salaam)

Mental Health Education Youth Centers & Orphanage and Street Centers

Care for people with disabilities

1. Marumba Rehabilitation Center

2. Kasaka Psychiatric Centre

1. Kihinga High School2. Newman Institute of

Social Worker3. Ahadi Institute Kigoma

1. Maendeleo Youth Center

2. MWOCACHI Orphanage Center

3. Sanganigwa B Street Children Center

1. Bangwe Sheltered Home Centre – Kigoma

2. Rumonge Deaf Cooperative – Kigoma

3. Structure of Fracarita Tanzania

4. Mental Health situation in Tanzania:- 2,5 million people in Tanzania are suffering from mental illness- 20% of them have access to mental health services- 900 psychiatric beds in the country- 1 governmental mental health hospital in Dodoma with 600 beds- 1 mission mental health clinic of the Evangelical Lutheran church of Tanzania

with 100 beds (in Korogwe District)- In Dar Es Salaam: Muhimbili University Hospital with mental health care- Arusha Mental Health Trust (AMHT)- 0,04 psychiatrist/100.000 inhabitants vs. USA: 10,9 psychiatrist/100.000

inhabitants- 0,007 psychologist/100.000 inhabitants vs. USA: 33,9 psychologist/100.000

inhabitants

4. Mental Health situation in Tanzania:- There is a growing recognition that mental health is a crucial public health and

development issue in Africa.- There is an emerging evidence from low and middle-income countries that

mental ill-health is strongly associated with poverty and social deprivation- People with mental disability may be impoverished by increased health expenditure, loss of

employment, reduced productivity and exclusionary impact of stigma- People who live in poverty are often isolated, disempowered, helpless, hopeless which can

lead to chronic insecurity and social mistrust, affecting people’s mental well being.

- => Vicious circle of mental ill health and poverty- Eradicate extreme hunger and poverty is M.D.G 1 and now S.D.G. 1: End

Poverty in all its form everywhere

5. Fracarita Tanzania: Our projects in Kigoma- Maendeleo Youth Centre

- Smalls scale, but accessible initiative for vulnerable children and adolescents (street children, traumatized children…)

- Live together in a community- The patients are treated as a individual and encourage to develop a sense of

responsibility- Contributing to social aspect of life: education, development, culture and sports

5. Fracarita Tanzania: Our projects in Kigoma- Bangwe

- Sheltered home for elementary care for mentally disabled children- Through activities focus on their social rehabilitation- Integration into society by the presence of other children or even elderly people- Have a special class room of them nearby primary school

5. Fracarita Tanzania: Our projects in Kigoma- Kasaka Mental Health care

- Offers ambulatory mental health care- Target group is chronic and acute mental ill people- Capacity of 20 beds- Only initiative for acute intake in Kigoma Region

5. Fracarita Tanzania: Our projects in KigomaIndices 2012 2013 2014

Number of consultation 901 5092 4796

Number of hospitalization 32 168 155

STATISTICS OF CONSULTATION FOR KASAKA

FUNCTION NUMBER DIRECTOR 1 DOCTORS 2 Nurse officer 2 Nurses A3 3 Laboratorian 2 Driver 1 Cook 1 Cleaner 2 Watch man 2

Social work 1

psychologist 1

STAFF FOR KASAKA MENTAL HEALTH HOSPITAL

5. Fracarita Tanzania: Our projects in Kigoma- St. Dymphna psychiatric center Marumba

- Offers adapted therapy and medication- Target group: acute and chronic psychiatric patients- Possibility to participate in therapeutic agricultural activities- Sometimes treatments for people with epilepsy- Guidance for cannabis addicts and reintegration into society

5. Fracarita Tanzania: Our projects in Kigoma STATISTICS OF CONSULTATION FOR MARUMBA HEALTH CENTER

Function NUMBERPharmacy 2Clinical officer 1Nurse attendant 3Social worker 1Cook 1Technical 2Farmer 1Cleaner 1Agriculture 5Driver 1Director 1

STAFF FOR MARUMBA HEALTH CENTER

Indices 2010 2011 2012 2013 2014

Number of consultation 3055 3120 2955 2323 2491

Number of hospitalization 156 147 121 93 112

A FASCINATING STORY

Mrs. ILAMBONA

A patient present in the compound of St Dymphna in Marumba since 2006.

She was not talking for weeks and after treatment she could say her name and origin. We concluded that she was coming from the Burundian refugee camp.

For 9 years now we have never seen any family members, but thanks to our treatment she’s always keep laughing and smiling.

Mrs. Ilambona is a daughter of the center. Can we say that she has seen the sun shinning in her life!

6. Fracarita Tanzania: Problems- Since 1998 the Brothers of Charity developed Mental health care in Kigoma Region and

developed 5 strategies in organizing mental health care programs:- Changing the general mentality with regard to psychiatric illness and psychiatric patients (breaking the

chains, removal of stigma,…)- Integrating the care of psychiatric patients in the general health care programs (e.g. advocacy at

governmental level)- Developing adapted therapy, cure and care for different types of mental diseases and on several levels - Training of local workers in mental health care ( e.g. Founding schools for psychiatric nurses, training and

exchange programs)- Strong international structure and organization, focused on quality, continuity and solidarity.

- More and more people consult us even from Tabora, Arusha and Dar Es Salaam

But there are still problems or challenges:- a lot of people lack of proper treatment due to a lack of access to mental health

services- A lot of people aren’t well informed about mental health diseases- There is need for proper data to get a global view about mental health in Tanzania

7. Fracarita Tanzania: Solution - Outreach- Creation of a Outreach project with our Kigoma institutions and our

psychiatric care center from Bujumbura (experience with ‘equipes mobiles’)

- 3 clear objectives:1. Better acces to Mental Health Treatment for the people in Kigoma Region2. Awareness raising on Mental Health issues in Kigoma3. Data collection to improve the knowledge about the Mental Health Status in

Kigoma

7. Fracarita Tanzania: Solution - Outreach- More acces to Mental Health Treatment for the people in Kigoma

Region- Adaptation of our existing infrastructure- Creation of ‘equipes mobiles’ to visit new patients and provide a full continuum of

people with a mental disability- Train more mental health workers so more patients can be visited and treated- Conduct outreach activities to adress the needs of the population that experience

mental health disparities.

7. Fracarita Tanzania: Solution - Outreach- Awareness raising on Mental Health issues in Kigoma

- To foster more widespread the understanding about mental disorders, so that we help to reduce the misperception and negative attitude towards mental illness (witchcraft, punishment of God…)

- To create an awareness raising campaign: ‘disability is not an inability. So the vulnerable people will be more recognized and appreciated in the society.

- Fracarita Tanzania wishes to dedicate itself to the challenge of improving the living conditions of the most vulnerable people. It is the mission of Fracarita to increase the quality of life of vulnerable people, and wish to focus on two core values:* The personal rehabilitation as unique human being* The social reintegration in society as active member of community

7. Fracarita Tanzania: Solution - Outreach- Collection of data in order to improve the knowledge about the

Mental Health Status in Kigoma

- To collect data (patients, registrations, treatments,…) to learn more about the Mental Health Status in Kigoma. This can pass through the National Health office in Tanzania

- To increase awareness about the opportunities to benefit from the participation in mental health research

- To create an awareness raising campaign: ‘disability is not an inability. So the vulnerable people will be more recognized and appreciated in the society

8. Fracarita Tanzania: Conclusion- The Lancet in 2007: ‘No Health without Mental Health’

- “About 14% of the global burden of disease has been attributed and other common mental disorders, alcohol-use and psychoses.

- Mental health affects progress towards the achievement of several Millennium Development Goals, such as promotion of gender equality and empowerment of women, reduction of child mortality, improvement of maternal health, and reversal of the spread of HIV/AIDS.

- Mental health awareness needs to be integrated into all aspects of health and social policy, health-system planning, and delivery of primary and secondary general health care.”

8. Fracarita Tanzania: Conclusion- World bank: “The zero hour” for mental health

- Since May 2015, this international organization wants to pay more attention to Mental Health.

- A blog was published and they conclude in the article- “As we move forward with this task, we will be guided by the belief that

the agonies of mental health problems that distort people’s lives, family bonds and communities, and that impose a heavy economic and social burden, can be dealt with effectively if there is political commitment, broad social engagement, and international support to make mental health an integral part of health and societal well-being across the globe”.

8. Fracarita Tanzania: Conclusion- To improve the quality of care and services toward our patients to

make mental health an integral part of health and societal well-being across the globe and more specific in Tanzania we need your support

- You will receive our appreciation but also it will be of unremitting reward for most neglected of the Tanzanian population in general and most particularly in the Kigoma Region

Fracarita Tanzania: ContactBro. Gilbert K. Kilassa, fc.Country CoordinatorFracarita Tanzania Foundation

P.O.Box 612Kigoma Tanzania Mob +255 767 227 024 +255 655 227 024sd.development.gilbert@boc-tz.org www.fracarita-international.org