Ethiopia: Creating Access to Community-based Mental Health Services for Refugees

With funding from the Bureau of Population, Refugees and Migration (BPRM), International Medical Corps is implementing a project to integrate treatment for WHO and national priority mental health and neurological conditions in Ethiopian Administration for Refugee and Returnee Affairs (ARRA) health clinics.  Through this project, International Medical Corps mental health specialists and refugee incentive workers are providing health consultations and treatment for vulnerable refugees in Bokolmayo, Melkadida & Kobe camps in the Dolo Ado complex in Ethiopia.  The organization is also building the capacity of ARRA staff through training. The beneficiary stories below illustrate International Medical Corps’ approach to providing comprehensive mental health programming that fills critical gaps in care.

Kalifa brought her three-year-old to an ARRA clinic because she had been having seizures for the past two years.  An International Medical Corps Mental Health Officer performed a comprehesive assessment and determined that the child had epilepsy, a neurological disorder characterized by seizures.  Based on a mental health situational analysis conducted in the camps by International Medical Corps to guide our programming, we found that epilepsy is heavily stigmatized in the Somali community. Another word used for epilepsy is “sheitan” (devil) and it is thought to be caused by possession by an evil spirit and to be contagious. People with epilepsy are often excluded from job opportunities and children with epilepsy may not be able to attend school due to fear and pressure from classmates. Our Mental Health Officer prescribed anti-epileptic medication and explained the diagnosis and treatment to Kalifa. After ten days, Kalifa happily reported that her child was free of seizures for the very first time.

Amina* was referred to our mental health team by the International Medical Corps Gender-Based Violence (GBV) team working in the camps. They noticed she would frequently lose track of her thoughts when answering questions and suspected she may be having psychological issues. Amina also has a daughter with an intellectual disability and her husband left her several years ago. Our Mental Health Officer carried out a joint home visit with a GBV team member. They discovered that Amina had injured and possibly broken her leg that day while collecting firewood which she sold for income for her family.  She seemed irritable and did not want to go to the ARRA clinic for fear that they would “inject her”. Our Mental Health Officer worked with ARRA health staff to visit the home with a Community Health Worker to address her concerns and arrange transportation to the ARRA health facility where she received urgently-needed medical care. The Mental Health Officer also followed up with her for an assessment and found that she suffers from flashbacks and nightmares after being subjected to bombing and having to flee her home in Somalia. Amina was also concerned about her daughter because she has a medical condition in addition to intellectual challenges. This is an example of how Somali refugees with mental health problems often have multiple and complex needs which International Medical Corps is able to address holistically. Amina’s leg is now healing and our team is developing a treatment plan with her and her daughter which addresses mental health needs while also facilitating links to other services and supports (e.g. medical, disability).

*Name and other identifying information changed to protect privacy.

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