Pro­jec­ts

Ivory Coast

In the sur­roun­dings of Bouaké, the second lar­gest city in Côte d’Ivoire, we sup­port the SAMENTACOM (https://samentacom-ci.org) pro­ject, in col­la­bo­ra­ti­on with the local uni­ver­si­ty and the Natio­nal Pro­gram for Psych­ia­try.  It is led by a dedi­ca­ted psych­ia­try pro­fes­sor, Prof. Koua, and aims to estab­lish a care net­work for peop­le with men­tal and epi­lep­tic ill­nes­ses and psy­cho­so­ci­al disa­bi­li­ties in the sur­roun­ding rural regi­ons.  Cen­tral to the con­cept is the out­pa­ti­ent psych­iatric work in coope­ra­ti­on with the exis­ting health sta­ti­ons, which are at the fore­front but are not yet equip­ped for the tre­at­ment of this pati­ent group. For this rea­son, nur­ses and other hel­pers are trai­ned in the rural health sta­ti­ons and trai­ned to dia­gno­se and tre­at the­se disea­ses.

Staff of the health posts, which media­te con­tact bet­ween the health cen­ters and the vil­la­ges (Agents de San­té), but have only litt­le trai­ning them­sel­ves, are to be trai­ned to visit peop­le with men­tal ill­nes­ses and epi­le­psy in the vil­la­ges, offer them tre­at­ment and con­ti­nue to accom­pa­ny them. In addi­ti­on, the infor­ma­ti­on and coun­sel­ling of rela­ti­ves and vil­la­ge com­mu­nities is important in order to enab­le a dif­fe­rent view of the­se disea­ses and to pro­mo­te the inte­gra­ti­on of the pati­ents into their fami­li­ar soci­al envi­ron­ment. Self-help groups are also initia­ted and sup­por­ted wit­hin the frame­work of this pro­ject. In this way, 1000 pati­ents are to recei­ve out­pa­ti­ent help by the end of 2019. 

The SAMENTACOM pro­ject is to be gra­dual­ly exten­ded to the ent­i­re Ivory Coast, which will cer­tain­ly take many years. Regu­lar con­tac­ts are the­re­fo­re main­tai­ned with the local and regio­nal health aut­ho­ri­ties and the natio­nal health minis­try, which will also be kept infor­med of the pro­gress of the pro­ject. On the one hand, we would like to show that psych­iatric help is also pos­si­ble with limi­ted resour­ces. On the other hand, we would like to try to draw the atten­ti­on of the Ivo­r­i­an sta­te to its respon­si­bi­li­ty for men­tal health and the obser­van­ce of human rights. 

In pre­pa­ra­ti­on for this pro­ject, MCF mem­bers were alrea­dy in Bouaké and the sur­roun­ding rural are­as in 2018, whe­re they saw the plight of the sick, iso­la­ted in the vil­la­ge com­mu­nities and often living out­si­de in so-cal­led Camps de Priè­re (CdP)-prayer camps. The pray­er camps are vil­la­ges with reli­gious offe­rings, which usual­ly accept ment­al­ly and epi­lep­ti­cal­ly ill peop­le for pay­ment, most­ly for long peri­ods of time, even against their will con­cer­ned at the request of their rela­ti­ves. Men­tal ill­nes­ses and epi­le­psy are here inter­pre­ted reli­gious­ly as obses­si­on by evil spi­rits, and so the tre­at­ment con­sists of pray­ers and some­ti­mes also of tor­tu­re to which the sick are sub­jec­ted in order to dri­ve the evil spi­rits out of them. To force the pati­ents not to run away or cau­se dama­ge they are often chai­ned to trees in the open air, in many cases for years. The path of the pati­ents usual­ly leads via hea­lers who prac­tice tra­di­tio­nal medi­ci­ne to the pray­er camps, which are most­ly evan­ge­li­cal­ly ori­en­ted, with tra­di­tio­nal reli­gious ele­ments play­ing a more or less important role. In view of the hel­pless­ness of many rela­ti­ves in dealing with men­tal ill­nes­ses, the accom­mo­da­ti­on of the sick in pray­er camps often seems to them to be the only pos­si­ble solu­ti­on. The Camps de Priè­re are the­re­fo­re of cen­tral impor­t­an­ce, and the deve­lop­ment of con­struc­tive coope­ra­ti­on with them is an oppor­tu­ni­ty for the deve­lop­ment of psych­iatric care in West Afri­ca. We are con­vin­ced that the supers­ti­ti­on and exclu­si­on of the ment­al­ly ill will dimi­nish as good help beco­mes visi­ble and tan­gi­ble.

A pilot stu­dy cove­r­ed a total of 71 Camps de Priè­re in the Bouaké area, 40 of which were stu­di­ed. This was docu­men­ted. In a fur­ther step, all Camps de Priè­re in Côte d’Ivoire will be recor­ded and selec­tively inves­ti­ga­ted.

The pro­ject is working with the natio­nal phar­maceu­ti­cal aut­ho­ri­ty to deve­lop the sup­ply of medi­ci­ne to the cen­ters.

In the mean­ti­me, we have visi­ted the pro­ject again (see tra­vel report). SAMENTACOM has been in ope­ra­ti­on for a year now, the staff is com­mit­ted and the first posi­ti­ve expe­ri­en­ces and results are avail­ab­le. For the cur­rent sta­te of affairs (April 2019) and fur­ther plans, plea­se also read the tra­vel report on this home­page.

Bur­ki­na Faso

All over West Afri­ca (and not only the­re) psy­cho­lo­gi­cal­ly ill peop­le are exclu­ded and locked away. This also is hap­pe­ning dai­ly in Bur­ki­na Faso. The pas­tor and musi­ci­an Tank­pa­ri Guitan­ga has wat­ched the mise­ry for a long time and then deci­ded to help him­s­elf. In May 2015, he foun­ded the aid orga­ni­za­ti­on Yen­faa­bi­ma e.V., and began his work in a small ren­ted house in the com­mu­ni­ty of Pié­la in the east of Bur­ki­na Faso. 

Initi­al­ly, 40 peop­le came for mon­th­ly psych­iatric con­sul­ta­ti­ons, but the cen­ters‘ offer is sprea­ding quick­ly and was broad­cas­ted on the radio.   The­re are several hund­red ment­al­ly ill peop­le who often find their way to Pié­la from afar every month and are trea­ted the­re. The nur­ses who trea­ted the ment­al­ly ill, who held the mon­th­ly con­sul­ta­ti­on hours las­ting several days, have so far tra­vel­led from the capi­tal Ouag­adou­gou and from Oua­hi­gu­ya, 360 kilo­me­ters away. With our finan­ci­al sup­port, one of the nur­ses — Timo­thée Tinda­no — was offe­red the oppor­tu­ni­ty to work direc­t­ly in Pie­la, so that he no lon­ger has to tra­vel hund­reds of kilo­me­ters. He has glad­ly accep­ted this offer and will use part of his work to con­tact the sur­roun­ding health cen­ters and train the local nur­ses and agents de San­té. He is also sup­po­sed to inform the local aut­ho­ri­ties about the situa­ti­on of ment­al­ly ill peop­le, visit Camps de Priè­re and moti­va­te them to coope­ra­te.