AJTS - African Journal of Traumatic Stress

A publication of African Psycare Research Organisation In Collaboration with Makerere University College of Health Science.

Published: 2020-04-27

LETTER TO THE EDITOR:

Provision Of Mental Health And Psychosocial Support Services (MHPSS) To Refugees As Persons Of Concern (POCS) In Urban Kampala City – A Case Story At Inter-Aid Uganda

AUTHORS: George Opong, Samuel Muiri Wangalwa, S Kugonza, Julian Ankunda, A Talimusinwa
*CORRESPONDENCE:

Dr. George Opong

Inter-Aid Uganda

Email info@interaidUganda.org

BACKGROUND

According to the United Nations High Commission For Refugees, UNHCR, at the end of 2018 an estimated 26.4 million persons of concern (POCs) lived in sub-Saharan Africa representing 35% of the global total of 74.8 million POCs. These POC are mainly refugees who have fled thir countries for a variety of reasons, mostly war and/or political persecution. By February 2020, UNHCR and the Office of the Prime Minister, Government of Uganda, (OPM/GOU) reported that the country was hosting 1,411,098 million POCs of which 79,958 lived in Kampala. A number of Non- Government Organizations (NGOs) have responded with different interventions but especially for refugees in the settlements. The refugee policy in part stipulates that urban refugees are required to be self-reliant which is not always the case. Generally in urban Kampala, like in many African cities,  there is a high expressed need for mental health care and psychosocial support. Unmet mental health and psychosocial needs aggravate the vulnerability of persons of concern as evidenced by the large numbers of POCs who walk into Inter Aid Uganda premises seeking for Mental Healthcare And Psychosocial Support Services, MHPSS (UNHCR , November 2019 Report).

Inter Aid Uganda (IAU) Program Description

Inter Aid Uganda (IAU) is a local national NGO supported by the Uganda Government and the UNHCR to care for refugees entering Uganda. It is under the care of the Office of the Prime Minister, Government of Uganda, (OPM/GOU). Inter-Aid Uganda significantly contributes to the improvement of the quality of lives of POCs and their households by increasing access to quality comprehensive mental health and psychosocial services (MHPSS) in urban Kampala. An average of 1,362 urban and referred cases from refugee settlements around the country are handled annually ( IAU Annual Report,  2019).  IAU has implemented MHPSS interventions in urban Kampala and coordinated refugee and asylum seeker referrals from settlements through well designed operations/services at their protection office, National referral hospitals, Medical hostel and during community outreaches. A number of Mental Health conditions and Psychosocial issues have been identified and subsequently handled. These have included Post- Traumatic Stress Disorders (PTSD), alcohol and substance abuse, depression, anxiety disorders, major stress disorders and other psychiatric disorders. These have been mostly addressed through daily mental health counseling services, peer support group meeting sessions, group therapy sessions, clinical reviews, community sensitization, provision of special medicines, nutrition and follow up in form of home and hospital visits.

Aims of the Inter-Aid Uganda Program

The main objective of the IAU MHPSS intervention has been to ensure that both urban and settlement referred POCs with mental health and psychosocial needs are able to access quality mental health care and psychosocial support through the “Circle of service provision model”. This is where Inter-Aid Uganda partners with the government health facilities, Kampala City Council Authority (KCCA) health facilities, National referral hospitals particularly Butabika and Mulago Hospitals, refugee settlements, other Non-Government Organizations and Ministry of Health to deliver a comprehensive psychosocial care and support package.

Lessons Learned

The MHPSS at IAU have strengthened access of mental health services to persons of concern in urban Kampala. Through psychological counselling, support and clinical consultation, 1,362 POCs have been reached in the year., 2019. Regular peer support group-sessions targeting 30 participants each are conducted. Each session brings together POCs with similar mental health challenges for mutual benefit and sharing. Patients referred from settlement for care have had successful treatment outcomes and been escorted back to their families in the settlements.

The care takers who play a critical role in the recovery continuum of the POCs with various mental illnesses have been provided with the necessary tools to support their roles. There has been an increased expressed demand for creation of mental health and psychosocial services by persons of concern. Of the 1,362 POCs reached with priority needs, some have reported movement away from critical vulnerable mental health and psychosocial conditions to better situations.

CONCLUSION

The Mental health and psychosocial services at Inter Aid Uganda have been successful in improving the quality of life of persons of concern in urban Kampala and to those referred from upcountry refugee settlements. This has been achieved by breaking the barriers to MHPSS access and continued efforts to demystify myths around mental health challenges in the communities of the POCs thus enabling the building of solid social support networks from which they have benefited.