Tackling Somalia’s Unspoken Mental Health Crisis

MSF counselors gather women at a nutrition center inside Bay Regional Hospital, Baidoa. © Alberto Macin/MSF

Meet Alberto Macin, the spirited maestro of mental health initiatives with MSF for the better part of a decade. His globe-trotting missions span Mexico, El Salvador, and South Sudan, right through to Ukraine, the perilous routes from Libya to the Mediterranean, not to forget Mozambique, Kenya, and his latest haunt, Somalia.

Macin’s gig? Crafting mental health blueprints, embedding vital services into MSF’s action plans across the Somali region, guiding mental health and psycho-social bolstering, and keeping project teams sharp as a tack. 

“A lot of women bear the scars of sexual assaults, but it’s taboo to speak up.”

“We can’t manage my uncle anymore. He’s snapped — even broke the shackles we had.” 

“We’ve been uprooted countless times; our cupboard’s bare, only hunger keeps us company.”

“Planting’s a relic of the past — rain clouds? Forget it. Our journey is where the water leads.”

“I’m at my wits’ end about his care. They dropped ‘psychosis’ on us. The poor lad’s helpless, but I have mouths to feed.”

“Hope’s a ghost now…”

These heart-wrenching tales are a dime a dozen in our line of mental health consultations across the districts of Galkayo and Baidoa in Somalia, where MSF extends its lifeline. We’ve tangled with issues intertwined with violence, climate shifts, a drought of professional psychiatric aid, nagging diseases, and crippling poverty.

Battling the storms of conflict for eons, Somalia braces for humanitarian tempests with an undercurrent of mental strife. As wars, displacement, climate chaos, and stark poverty work their havoc, psychological despair knocks on countless doors. Sadly, the mental whirlwinds are often hushed, birthing a quieter plague of turmoil and trauma.

Mental obstacles in Somalia? They’re knotted with the socio-political threads of its fabric. Social biases and injustices meted out to women and children especially, spell trouble for mental health. Compounded by bouts of nature’s wrath and relentless strife, they stir up personal traumas, familial disconnect, insecurity, livelihoods turning to quicksand, and estranged social mores. In these lands, resources shrink to scraps, casting deeper shadows on the problem.

Humanitarian deeds, while often brimming with goodwill, might unwittingly bloat mental woes. Jamming people into camps, neglecting privacy, and toppling age-old community backbones stoke anxieties among the aggrieved masses.

The land is rife with psychosomatic ailments, blues, stresses, flights of psychosis, and the grip of substance slumps. Yet, the echoes of combat crash in with disorders like PTSD, bipolar antics, anxiety, and wild bouts of panic. Humanitarian help sometimes fans the flames of hopelessness — an agonizing sentiment when basics like grub, water, and healthcare dangle out of reach.

WHO pegs around 13% as wrestling mental maladies among war-torn folks, with mere ripples of usual suspects like depression, anxiety, PTSD, and more, while moderate bouts afflict 4%. Womenfolk, elders, bairns, and the differently-abled take a heftier hit in mental wellness stakes. The seriously afflicted are more vulnerable during crises, begging for both medical care and life essentials, yet face frustrating barriers in access. A grim vignette played out in Somalia.

In response to Somalia’s tales of woe, MSF partners with the health ministry to dish out indispensable mental care in Baidoa and Mudug. Mental health is no tag-along for us; it sails through all activities. We’ve set up shop supporting minds through counseling, psychosocial support, and intensive psychological solace in clinics. Yet, the hunger for mental health healing is vast.

Presently, the Ministry of Health (MoH) throws a life preserver to folks battling HIV, TB, and rogue TB strains, focusing on chronic paths to rouse consistent care and boost life quality. Local samaritans also lend mental health aid to survivors of terror — be it physical, psychological, societal, or economic violence. Still, MoH and allies’ yeoman’s efforts fall short. Far too many are left teetering without necessary drugs or therapeutic interventions to regain functionality and engage in day-to-day routines.

Between early January to September 2024, MSF’s mental gears ground through nearly 4,940 mental health check-ups in Somalia. Adding to that, we’ve also facilitated 7,644 group sessions to spread mental and psychological literacy, champion healthy coping mechanisms, school community anchors, healthcare troops, and even non-medical teams on the basics of psychological first aid and peer encouragement, serving a big-hearted helping of 38,476 souls.

An all-hands-on-deck strategy for mental health relief must spring forward, making clear how vital an integrated response is to Somalia’s mental monsters. Stitch clinical mental care into broader humanitarian endeavors, ensuring holistic access to food, protective shelters, and mental boosts through psychological first-aid, social discourse clubs, leisure ventures, and a clear path to secondary mental health relief. Wrangling specialists like psychiatric nurses, shrinks, and therapists must govern these realms, ensuring standards don’t slacken.

Communities in Somalia, bearing adversity with spunk, should be emboldened to be active players in mental aid schemes. Revving up local support and solidarity can plug gaps left by absent clinical experts. Igniting or breathing back life into community clans can spark a collective channel for troubleshooting and sharing emotional support for troubled souls. Such synergy not only restores a dash of the familiar but eases the emotional load inflicted by the affliction.

Psychological first-aid should star in the urgent response toolkit. Properly trained crew, spanning healthcare workers, educators, and volunteers, are the linchpin, doling out heartfelt aid and practical props to those drowning in distress. Despite being brushed off as modest, these acts deliver a world of relief in trauma’s early days.

Alberto Macin

Chief Crusader of Mental Health

Neglecting this urgent call could spell ongoing misery. It is time for humanitarian crusaders, local gatekeepers, and global kin to bump mental well-being to the frontlines, anchoring it steadfastly into the overarching emergency maneuvers. Through this, we cast a lifeline of hope and healing to innumerable Somalis stuck on the mental crossroad.

Somalia’s salvation doesn’t just rest on shoring up its wrecked edifices. It’s about mending heartaches and healing minds among its folks who have borne the brunt.

Edited by: Ali Musa

alimusa@axadletimes.com

Axadle international–Monitoring

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