The treatment situation for mentally ill people in Zimbabwe is disastrous. There are 15 psychiatrists and 16 psychologists for a population of 14 million people. With the "Friendship Bench" project, SolidarMed brings a talk therapy developed in Zimbabwe to very rural areas in the southeast of the country.
Every sixth person in Zimbabwe is infected with HIV, almost every fourth patient suffers from "Kufungisisa". It is the Shona word for depression and means: "If you think too much". It can be paraphrased with worries that crawl into sleep at night and fear that robs you of all strength. Mental illness is a taboo. Suicide is a frequent cause of death in this country where political conflicts and poverty additionally promote mental illness.
Grandmothers as trustworthy behavioral therapists
Zimbabwean psychiatrist Dixon Chibanda developed the Friendship Bench project to address the acute lack of treatment options for people with mental health problems in Zimbabwe and also to reach people in village communities. Grandmothers quickly came to his mind. They are the backbone, heart and mind of many Zimbabwean families. "They are empathic, the best listeners, storytellers and comforters. They live in the villages where they are needed, and they have time," says Chibanda.
So Chibanda began training first grandmothers as lay therapists in psychosocial counseling. They learn to use established methods of talk therapy, the therapy is conducted in the Shona language and is adapted to local cultural concepts. The first step: "kuvhura pfungwa", opening the mind, the second "kusimudzira", standing up. The next step: "kusimbisa", becoming stronger. In this way, lay therapists help their patients step by step to recognize their problems and find solutions to deal with their worries.
Successful therapy concept
There are now more than 100 "Friendship Benches", distributed among 72 health centers in Harare, the neighboring city of Chitungwiza and in Gweru. The grandmothers have grown into a small army of more than 300 pastors in the fight against "Kufungisisa". Dixon Chibanda has scientifically validated the concept and published studies in international journals. These studies show that lay therapists in Zimbabwe are at least as successful as professional psychotherapists.
SolidarMed brings Friendship Benches to rural regions
Convinced by this approach, SolidarMed and Dixon Chibanda have developed a joint project for the rural districts of Zaka and Bikita in the province of Masvingo. These regions also lack therapy options for people with mental health problems. SolidarMed is therefore setting up a new therapy offer in Zaka district.
Already trained "trainers" have trained more than 100 grandmothers, but also other village health advisors in talk therapy. To date, "Friendship Bench" therapies now take place regularly at 20 health centers. This form of therapy is also offered in the local health centers. This also helps to counteract the stigmatization of mental illness. "Mental illness is treatable in the same way as other diseases," says Dixon Chibanda. "By integrating them into the health center, we make people more aware of this".
The "Friendship Bench" have long since been established not only in Zimbabwe, but also in Malawi and Zanzibar. This talking therapy developed in Zimbabwe is already being discussed among experts as a model of how people with mental illness can be effectively helped in very poor countries.