'Zimbabwe's radical cure for depression'

June 25, 2020 11:34 PM

How a bench and a team of grandmothers can tackle depression. A BBC 'lockdown longread' article by Rachel Nuwer about the Friendship Bench programme in Zimbabwe.
posted by misteraitch (17 comments total)

This is truly wonderful and I hope it spreads world wide. I think of my own grandmother (may she rest in peace) and how much even at a very advanced age she would have loved to have helped people like this. Also: We focus on people who are suffering from common mental disorders, such as anxiety and depression, known locally as kufungisisa; translated to 'thinking too much'. That is the best and most accurate term for anxiety and depression that I have ever heard- far far better then the words in English. (Or bastardized Greek and Latin).
posted by Homo neanderthalensis at 12:11 AM on June 26, 2020 [14 favorites]

I love everything about this. I especially love that what the doctor probably originally saw as a weakness - that the women were not trained in western medical concepts - ended up being a strength, because they were able to connect with people in a culturally rooted way.

I also liked this line: "his supervisors told him that there were no resources they could give him. All of the nurses were too busy with HIV-related issues and maternal and child health care, and all the rooms at the local clinic were full. They could, however, give him 14 grandmothers and provide access to the space outside."

It's amusing to think that you might go to your supervisors asking for resources for a program and they are like, "Hmm, money? nope, none available. doctors? nope, can't give you those. We don't have any marketing budget, or admin support, or materials, but lemme see... oh yeah, we can probably spare 14 grandmothers from our supply room."
posted by lollusc at 12:15 AM on June 26, 2020 [21 favorites]

Also this "Nor do the grandmothers seem to get burnt out despite counselling people on the brink of crisis day after day. “We’re exploring why this is, "? My bet (if it's true at all that they don't get burnt out, and maybe it's not true - there could be reasons why the doctor is not fully aware of the level of burnout) is that these grandmothers have basically spent their lives doing intense emotional labour for people around them, so adding a few extras to the list of people they have these responsibilities for is not actually making their lives substantially harder.
posted by lollusc at 12:19 AM on June 26, 2020 [19 favorites]

these grandmothers have basically spent their lives doing intense emotional labour for people around them, so adding a few extras to the list of people they have these responsibilities for is not actually making their lives substantially harder.

With a maybe a little side benefit of finally getting some actual acknowledgement and praise for the skills they developed from all that labor.
posted by gusottertrout at 12:22 AM on June 26, 2020 [30 favorites]

Grandmothers. Is there anything they can't do?
posted by Paul Slade at 12:56 AM on June 26, 2020 [6 favorites]

As someone who has never had a grandmother I would like to have something like this in my life very very much.
posted by Kitchen Witch at 2:05 AM on June 26, 2020 [6 favorites]

James Meek has an article in the current LRB discussing the WHO and Dr Tedros, its current head.

The article reviews Tedros success in Ethiopia in providing community based health care - and how that model has proved effective.
"community-centred and woman-centred, and as much about education as doling out pills. The first phase was one year’s health training for thirty thousand high-school graduates, most of them women ...
child mortality was cut by two thirds, maternal mortality by 71 per cent, HIV infections by 90 per cent and malaria deaths fell by 73 per cent. ...
[and elsewhere] politicians and public remain complicit in the fantasy that ‘healthcare’ equates to hospitals, doctors, drugs and machines, and ‘community’, meanwhile, has become a euphemism for ‘You’re on your own.’ "

Community centred and woman centred - and not even high school graduates!
posted by Barbara Spitzer at 2:17 AM on June 26, 2020 [12 favorites]

The philosophy of accompaniment.
posted by homerica at 5:13 AM on June 26, 2020 [4 favorites]

The article reviews Tedros success in Ethiopia in providing community based health care - and how that model has proved effective.

I'm failing to find a citation in my quick google search, so take this with a large pile of salt, but I think Jamaica was the first country to implement a large-scale community health worker program, back in the 1960s or maybe early 1970s. It (unsurprisingly) proved to be enormously effective and I believe the program is still in operation, and became the model for many other countries. There is also the more recent community health worker model implemented by Partners for Health in Haiti, also tremendously effective and frequently emulated.

All of this to say, the Zimbabwe program sounds like a good model that might work in many other places. (And, selfishly, as someone whose grandmothers have all passed away, the idea of some grandmother time on a bench sounds incredibly nice.)
posted by Dip Flash at 6:15 AM on June 26, 2020 [1 favorite]

Not everything he wrote aged so well, but I keep thinking of Kurt Vonnegut's Slapstick and the plan the president in the book had to solve America's ills by giving its citizens new middle names and with them new, additional families.

I think he would have liked giving people grandmothers.
posted by DirtyOldTown at 8:38 AM on June 26, 2020 [2 favorites]

I love this. I especially love the way it shows that yes, in fact, there is valuable life after youth! So much of youth culture in my part of the world seems predicated on the idea that after wrinkles appear, the best thing you can do for society is to vanish from it as completely as possible. It's great to see more hard evidence that people don't actually "age out" of usefulness to the world.
posted by invincible summer at 8:46 AM on June 26, 2020 [5 favorites]

This is so inspiring.
There's a very good community mental health program somewhere in the Nordeste state of Brazil, I've tried to find the information to post on the blue before, but it eludes me.
posted by mumimor at 10:17 AM on June 26, 2020

We could so use something like this here in the US. Mental health is such a pervasive issue that a program like this would be of immense benefit.
posted by Roger Pittman at 12:42 PM on June 26, 2020

On the burnout - these women are a self-selected population with enough experience to know what they can do and have ongoing control over their tasks or hours in a way that modern doctors simply don't have. It also seems like they aren't asked to deal with some of the more dangerous sections of patients? It's a fundamentally different and much more manageable paradigm than being a fulltime doctor in a modern health system.

The article mentions a pilot program in New York that seems to be doing well. I'm hoping we can see it translated across the US. I expect the demand for mental health services, or even just a friendly person to talk to, to spike dramatically.
posted by Ahniya at 12:49 PM on June 26, 2020 [2 favorites]

I think burnout is also affected by what your role is. If as in the current system in the US where your role is that you're the only thing standing between this person and a cliff and they're determined to launch themselves off that cliff and there's 100 other people also trying to get off the cliff and also the government is actively trying to send them off the cliff and also you're not making enough money to keep yourself off the cliff, we were not really set up to be able to deal with that.

If your role is just to know how to talk to people who have depression to help them not feel so lost & sad & scared, well that's something human beings are more than able to do as long as someone shows them how.
posted by bleep at 1:37 PM on June 26, 2020 [5 favorites]

This is a wonderful programme. In the U.S., a group called Sidewalk Talk has been trying to start something with a similar spirit.
posted by PhineasGage at 4:47 PM on June 26, 2020

As someone who has never had a grandmother I would like to have something like this in my life very very much.

I also never had a grandmother -- mine both died before my first birthday and I am not sure I ever met either one of them within those first few months of life. In college I sort of borrowed the grandmother of a classmate who had a locally-living grandmother (although he himself was a resident student from out of town), and it was wonderful.
posted by hippybear at 6:12 PM on June 26, 2020