Day one - London
I leave London Heathrow in Emirates new Airbus
A380. Those who know me will know exactly how delighted I was be to
go on this for the first day. And it didn’t disappoint. This is the
only way to fly – even down the back.
Day two - Kampala
Arrive in Entebbe airport and I'm carted off
to Kampala which is about an hour’s journey. The hotel is huge and
Kampala seems like a nice town to me. Warm
weather. Gentle hills. I just can’t see many people around. Unlike
other places I go to it is amazing to be able to go outside without
security briefing and a security guard. It is a really safe place
apart from petty crime - although there has been some East African
terrorism here in the past year.
Then I meet Erin from the partner and donor
organisation to the project - World Vision. World Vision is a
huge worldwide, non-governmental organisation. They are one of the
few who work in mental health. I hadn’t realised how enormous they
are and even in Uganda they are a huge operation. They are children
focussed and Christian, but are
clear about never evangelising and are open to
beneficiaries of all backgrounds.Erin is in her twenties and leaves
me speechless with her mastery of the NGO world, policies and
ability to synthesise varied and complex concepts in a concise way
that even I can understand. They are a very impressive
A pleasant supper in the almost dark dining
room that evening.
Day three - Kampala
I meet with the formidable and delightful Dr.
Sheila. She works in the Ministry of Health and is lead for
mental health in Uganda.
I had met Sheila once before in Italy at a
conference on mhGAP. Sheila is a Public Health Physician and
has a background in mental health work. She has a remarkable
drive and vision on mental health in Uganda. In Africa it is
so important to have key people with a commitment to mental health.
This whole project would have no beginning middle and end without
the backing of Sheila. I know that she can make the project
My job was to gather background information on mental
health and health systems in Uganda. It was a struggle to keep up
with Sheila’s pace as she is so passionate on the subject and knows
it from the ground up.
In the end, I felt that I knew more about
the health service in Uganda than the health service in the
UK. There is a very well structured tiered layer of health clinics
running down from national and regional centres. The health
centres feed into a volunteer village level - the
Village Health Team. There are two national psychiatry centres
close to the capital Kampala.
Sheila, I believe, is actually the most
important part of the project as she has been with mhGAP from its
launch in WHO. She really drives the mental health agenda in
Uganda. Uganda is lucky to have such a dynamic force.
Day four - Kiboga district in the
west of Uganda
Today's task was interviewing health
workers on their services. Armed with my notebook and my WHO
copy of mhGAP manual, I headed to a rural area in the west of
Uganda. This was a three hour drive from Kampala along mud
roads past villages with no water or electricity. The poverty was
We met a health worker who was clearly
committed to her work but struggled to understand concepts of
mental illness. When I asked about schizophrenia she talked about
referring to an ear specialist for hearing problems. Yet when I
left the little corrugated roof building, I soon saw a homeless man
who was clearly psychotic and homeless.
The next practice was in a much better
building and supported by Irish Aid. Here there were two skilled
health workers. Yet here they said they didn’t see any mental
illness. Just before I started to speak to them I saw a young
Ugandan lady with four children. She looked depressed and sad.
They told me she attended frequently with physical health problems.
They had never asked her about depression. However, when I talked
to them about it and showed them the manual I could see that them
make the connection. I know they will ask her about this next
time and maybe think a bit more about mental health. I hope in the
future all these areas will have access to mental health
information. In the meantime people are referred on for further
advice through the layers of health services.
At this stage I felt this was real volunteer
work - going to clinics, seeing front line workers and getting
my hands dirty.
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