MENDING MINDSETS MENTAL HEALTH – STAMPING OUT STIGMA PROJECT REPORT EXECUTED BY ROTARACT CLUB OF NKUMBA STEWARDS, BWEBAJJA AND KAJJANSI (D9214) ON 13TH – 16TH SEPTEMBER 2021 AT KAJJANSI MU LINE, KAJJANSI TOWN COUNCIL, WAKISO DISTRICT
1.0.
Executive summary
Ugandan mental health services have been characterized as inadequate, with little or no community care and the inadequate in-patient services that are unable to meet demand. The World Health Organization (2006) estimates that 90% of people with mental illness receive no treatment. The situation is attributed to the inadequate budget allocated to the mental health department and has been exacerbated by the exodus of the many skilled workers from Uganda to other countries in search for better pay, reducing on the Country’s highly skilled and motivated workforce. The outbreak of Covid-19 and its subsequential declaration as a pandemic in the year 2020 has demonstrated increased psychological distress and adverse impacts on mental health and psychological wellbeing of people characterized with drug and substance abuse, poverty, crime and violence among others. Unfortunately, the impact of COVID-19 on psychological wellbeing of people has not been studied adequately to offer any substantial solutions to the population. Considering the unprecedented way of life that the populace has been condemned to by the National lockdown, aggravated by the loss of source of income and death of relatives with no means to attend their funerals and many other after effects, there was need to make a timely intervention to rescue the mental health of the people. On that note, the Rotaractors from the Rotaract Club of Nkumba Stewards, Bwebajja and Kajjansi championed a mental health awareness project dubbed “Mending Mindsets
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Mental Health Project”. The Project was executed in Kajjansi Mu Line, Kajjansi Town Council, Wakiso District. The Project’s goal was to create awareness about the increasing cases of mental illnesses in the community, the symptoms of a mental illnesses and the plausible ways to tame mental disorders before they culminate in to complicated medial conditions and or suicide, later, curbing on the rampant stigma against mental illness victims. 2.0.
Introduction
In Uganda, mental, neurological and substance use disorders are a major public health burden. Depression, anxiety disorders, and elevated stress levels are the most common symptoms of mental illnesses that most times lead to suicide attempts. According to the World Health Organisation Report in 2017, Uganda is ranked among the top six countries in rates of depressive and anxiety disorders and this has been attributed to a number of factors including the escalating poverty levels, gender-based violence, drug abuse, diseases like diabetes and cancer. The invasion of the Corona Virus Disease in 2020, has exacerbated the dire situation after many people have lost loved ones, jobs and business capital running in to acute depression, often times resulting in to suicide. By definition, Mental Health is an active state of mind which enables a person to use their abilities in coordination with the common human tenets of society. Mental illness/ mental health disorder on the other side, refers to a wide range of mental health conditions/ disorders that affect your mood, thinking and behavior. Depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors are some of the many examples of mental illnesses, which over time cause frequent stress and affect one’s ability to function normally. To address the many looming disasters from mental disorders within the township of Kajjansi, the Rotaract bloc of Nkumba Stewards, Bwebajja and Kajjansi have packaged a set of activities in an awareness project dubbed “Mending Mindsets Mental health project”. Mending Mindsets Mental health project is an advocacy and awareness campaign by the Rotaract Club of Nkumba Stewards, Bwebajja and Kajjansi that is meant to mitigate the adverse effects of the mental disorders amongst the public, that are attributed to the
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unprecedented economic and social environment presented by the invasion of the Corona Virus Disease in 2020. The project name was carefully chosen to depict the responsibility the Club carries to ensure that the community is mentally healthy and physically strong. The campaign theme aligns towards mending the mindsets of the population towards living a happier life through understanding the symptoms and effects of mental illness and offering on-ground solutions towards a better mental health situation. The Project was executed over a week’s period, from 13th – 16th September 2021 in Kajjansi Mu Line, Kajjansi Town, Wakiso District. 3.0.
Project location
Mending Mindsets Mental Health project was executed in Kajjansi town in a trading centre nick named “Mu Line”. Kajjansi is located in Wakiso District, approximately 16 kilometres from Kampala, Uganda’s capital city, along Entebbe-Kampala highway. The township hosts over 10,000 people daily residing and or doing business within. Kajjansi Mu Line, the specific location of the project is a small slum with Kajjansi town characterized with many small drinking joints, small households and a considerably big population with an evident low standard of living. 4.0.
Implementing Organisations.
The project was executed by the Rotaract Club of Nkumba Stewards, Rotaract Club of Bwebajja and the Rotaract Club of Kajjansi. The Clubs through a deliberate partnership formed a bloc with a goal of executing heavily impactful community service projects through joint resource mobilizing. The Clubs are voluntary youth Organisations with an average membership of 40 professional youths each who have devoted their finances, skills and time towards bringing a smile to humanity through relevant community service projects around Nkumba, Entebbe, and in the island communities. The Clubs partner with their corresponding Rotary Clubs that comprise of professionals, community and business leaders in Uganda who voluntarily associate with a common goal of making this world a better place through impactful community service projects. Rotaract and Rotary Clubs are immensely engaged in humanitarian activities focusing on the 7 areas of focus of Rotary international.
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Over the years, Clubs have executed projects that have had positive impact on the lives of tens of thousands of people living within Uganda and internationally and have been acclaimed by the community and National leaders for creating an everlasting positive change in the lives of the people. The Clubs have been accredited for their bold interventions in one of the most vulnerable communities on Lake Victoria called Kimi Island, where they have held annual community service projects offering general and specialized medical services, menstrual hygiene management sensitization among young girls and women and aiding schools with scholastic materials among other donations. 5.0.
Project justification
Mental health is the pivot of human life. However, despite its importance, it is often the least prioritized amongst health conditions in Uganda. The Country has no national coverage of community mental healthcare and the available 28 out-patient facilities that provide followup care are thinly spread and often starved of funds for even essential medication with the majority of national mental health funding going to the national mental health referral hospital, Butabika Hospital in Kampala. Since the declaration of the COVID-19 outbreak a pandemic in the early months of 2020, the government instituted a number of preventive measures including National lockdowns that have overly destabilized the socio-economic status quo. This has presented extreme acute stress within the population that has induced trauma and destabilized the mental health of many individuals. Also, mandating social distancing has had dire consequences on the daily lives and mental health of many Ugandans, distorting their renown communal and social life characterized by hugging and shaking hands. Restrictions on traditional practices like honouring the dead, visiting family and friends, sharing, and merrymaking have escalated the already complicated grief and its long-term effects causing enormous anxiety and stress within the population many resorting to anti-anxiety medical drugs and substances for relief. The mental health disorders have been exacerbated by the loss of jobs especially in the informal sector that utterly survives on daily income and in sectors considered nonessential,
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like private schools. The gravity of terrible situation presented by the invasion of Covid-19 on the mental health of the population warrants a wide scope intervention in the area of mental health to sensitize the population on the many mental illnesses and the institute safe mechanisms to mitigate the resultant actions of acute mental disorders. 6.0.
Project activities 6.1.
General clean up: The project team and a group of volunteers engaged in a community clean-up of Kajjansi Mu line area. The team collected garbage that is recklessly dumped in the area with no proper management plan, and sensitized the dwellers about the health benefits of living in a clean environment. The community clean up marketed the image of Rotary to the community creating a perfect perception of the good willed individuals with a heart of humanity, an idea that widened the visibility of Rotary in the eyes of the public and created rapport with the community of Kajjansi Mu Line.
6.2.
Open space mental health campaign: In an organized open space campaign, the community dwellers were enlightened on the various types of mental health disorders, the symptoms and the effects of mental illness. Among the various types of mental health disorders, anxiety disorders, depression, and post-traumatic stress disorder were highlighted as the most common. The campaign also explained the causes of the mental health disorders and the various ways through which the disorders can be subdued.
6.3.
Focus groups: The Project team recruited community dwellers in to focus groups to ascertain how much knowledge and information they had on mental health. This was done through sharing of experiences and answering a set of questions that were already prepared on a questionnaire. The interview guide was prepared in Luganda, one the local dialects in Uganda and the most spoken across the Country, to guarantee accuracy of the responses.
6.4.
Documentary filming: The Project team realized that mental health is a neglected facet of the general human health and as such there was need to
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create and disperse information regarding mental health. On that note, the team invited volunteers from within the community to share their life experiences in line with mental health. A confidentiality agreement was signed by the volunteers and all their experiences were filmed in short clips. The short films are to be complied in to a documentary that shall be carefully shared with stakeholders to show the existence and the negative effects of mental health disorders in the communities we live in. 6.5.
Anxiety and Depression support groups: Support groups form a fundamental platform on which mental health disorders can be resolved through encouraging the victims to share their emotions without fear of judgment. With that in mind, the project team created a community support group that includes community leaders and professional counselors that shall offer psychosocial support to the depression and anxiety victims through evidence-based counseling and advise.
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Project impact
The Mending Mindsets mental health project has had tremendous impact in the community of Kajjansi. The project provides a timely reminder that mental health is essential and that those living with mental health issues are deserving of care, understanding, compassion, and pathways to hope, healing, recovery, and fulfillment. The Mending Mindsets mental health project created impact in a number of ways as explained below: 1. The Mending Mindsets project created awareness about the existence of the mental health disorders, the various symptoms of mental illnesses and demystified the myths surrounding mental illnesses. 2. Stigma associated with mental health disorders has been subdued to a significant extent after the project team explained that mental illness is not a curse but rather a normal mental condition that can be resolved with a set of psychotherapy activities. 3. The Project raised the importance of prioritizing mental health at all levels of service delivery by the Government by highlighting the number of mental health disorders in
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the community and the information gap that exists about mental health within the population. 4. The Project created community support infrastructure that will enable people with mental illnesses to share their emotions with professional counselors without the fear of judgement and later receive counsel and guidance on how to deal with their mental conditions. 5. The project highlighted the relationship between poverty and mental health. This relationship dictated that various grass root economic empowerment initiatives need to be instituted to mitigate the escalating poverty levels, subsequently curbing on the mental health disorders in the community. 6. The people of Kajjansi Mu Line and the surrounding areas understood the fundamental cores of Rotary and its good deeds around the World. Through the execution of the project, the image of Rotary in the eyes of the public took a positive trend and the misconceptions regarding the Rotary fraternity and its members were demystified. 8.0.
Project beneficiaries
The Project targeted a wide scope of the Kajjansi population especially those that are struggling to deal with the Covid-19 aftermath. The project direct beneficiaries included children that have been locked out of school for the last two years, business people especially those in the informal sector whose businesses have since been closed and are struggling to find an alternative source of income, private school teachers who have lost their primary source of income due to the closure of schools, among other vulnerable groups in the community of Kajjansi. The direct beneficiaries were close to 50 people with close to 100 indirect beneficiaries, giving a total of 150 beneficiaries.
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Expenditure report
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ITEM PROJECT LAUNCH Photography and Videography Banner T-shirts Cake Refreshments Sub total DAY 1: CLEAN UP PA system hire Garbage truck hire Refreshments Sub Total DAY 2: AWARENESS PA system hire Refreshments Sub Total DAY 3: SENSITIZATION PA system hire Refreshments Sub Total OTHER EXPENSES Transport Appreciation tokens for participants Refreshments for day 4 Chairman Documentary Sub Total GRAND TOTAL
QUANTITY
UNIT COST (Ugx)
AMOUNT (Ugx)
lumpsum 1 20 1 lumpsum
200,000 120,000 25,000 70,000 110,000
200,000 120,000 500,000 70,000 110,000 1,000,000
lumpsum lumpsum 14
35,000 40,000 500
35,000 40,000 7,000 82,000
lumpsum lumpsum
10,000 20,000
10,000 20,000 30,000
lumpsum lumpsum
10,000 38,000
10,000 38,000 48,000
lumpsum 4
330,000 30,000
330,000 120,000
lumpsum lumpsum lumpsum
20,000 40,000 3,500,000
20,000 40,000 3,500,000 4,010,000 5,170,000
10.0. Implementation strategy The implementation of the project was spread across a period of one week, with each day’s activities focused on mental health awareness, prevention and mindset change. The project activities were chronologically lined to introduce the concept of mental health to the population, share experiences and forge joint solutions with the community dwellers. Below is the order of project execution:
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Day 1 (11th Sept 2021) - Launch: This marked the start of the 7-day implementation exercise of the Mending mindsets mental health project. The launch was graced by the Project partners and it involved laying down the strategies that shall guide the implementation of the project. Day 2 (13th Sept 2021) - Community clean up: This was the first activity of the actual project execution. The community clean up exercise was meant to raise a friendly signal to the community of Kajjansi Mu Line that will later create the necessary rapport required to register a successful mental health awareness project. The Clean-up exercise also awakened a sense of responsibility within the community to maintain a clean environment as a way of preventing the contraction and spread of hygiene related diseases like diarrhea and gastrointestinal infections. Day 3 (14th Sept 2021) - Focus group discussions: This exercise focused on extracting information from the community project beneficiaries about their mental health status especially amidst the turbulent economic environment presented by Covid-19. The discussions relayed valuable information to the project team that shall guide the next phase of the project execution. Also, the project team was able to gauge the volume of information the community had about mental health, which was underwhelmingly low. Day 4 (15th Sept 2021) - Dealing with Depression and Anxiety: Keeping in mind that depression and anxiety are the most common forms of mental health disorders, the project team set aside a day to make an overhaul discussion on the same. The discussions involved sensitizing the public about the various symptoms of depression and anxiety and the best mechanism to avert the dire effects such as suicide that can be presented by ill-handling of these conditions. Day 5 and 6 (16th – 17th Sept 2021) - Shooting a mental health documentary: To document the evidence that Society is struggling with a silent killer called depression and anxiety, a group of 4 volunteers from the beneficiaries recorded their life experiences describing how they have been dealing with acute stress and anxiety caused by a number of factors including poverty. The short films were shot for two days and shall be complied in to a documentary that shall be broadcast and shared with relevant stakeholders to manifest the importance of mental health. We believe that this shall form a firm ground against which the
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project team shall lobby for additional partnerships with other Organisations and Government. 11.0. Project plans Mending Mindsets Mental Health campaign ignited a sense of responsibility within the population to support those struggling with mental disorders and create a hospitable atmosphere that will allow them to share their inner feelings. On that note, the awareness campaign is to remain in force through the community support groups that will encourage victims to speak up about the way they feel with a guarantee of confidentiality. The Club plans on partnering with media houses and other stakeholders to make more strides in the right direction to avert the dire effects of mental health disorders within Uganda. Below are the project plans in the next 5 years: •
Advocacy towards placing of mental health on government agendas.
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Advocacy for a change in laws and government regulations to include the protection of the rights of persons with mental disorders.
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Promotion of mental health and the prevention of mental disorders through media and open space awareness campaigns.
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Protection and promotion of the rights and interests of persons with mental disorders and their families.
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Improvement in mental health services, treatment and care across the Country.
12.0. Partners •
JB Caring Hearts International: Is a charity non-profit organization based in founded in Uganda. The organization has been helping to improve the lives of children especially orphans and communities in Uganda and Malawi through education, outreaches, health and sanitation as well as skills development. The Organisation has had many community interventions in the area of Kajjansi and has been accredited for changing many lives in Kajjansi town council through offering life changing skills. The Organisation introduced the project team to the community leaders and was key in mobilization of the project beneficiaries.
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•
Wholistic Community Agency: This is an organization that was founded to help people in all communities live in a diversified community with access to social and economic values through training and promoting financial literacy while providing quality education to the less privileged. The agency offered the free requisite expertise in waste management and trained the community dwellers on the proper way of managing waste and the associated benefits.
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Impact Missions Uganda: A tour and travel company that offers travel packages to various holiday destinations catering to all needs and demands of various market segments. The Company offered logistic services and transportation of the Project team and service providers for the 7-day period of the project at no cost.
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Bamwine Counselling Services: This is a therapy startup that offers psycho-social support to patients seeking for mental wellbeing. It comprises a diverse group of trained experts handling different mental illnesses. The Organisation presented a team of professional counselors who delivered counselling services to the project beneficiaries at no cost.
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Rotaract Club of Bwebajja: The Club funded the project activities with Ugx 250,000 (Two Hundred Fifty Thousand Shillings) and also presented volunteers who were part of the project at execution.
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Rotaract Club of Kajjansi: The Club bankrolled the project with Ugx 200,000 (Two Hundred Thousand Shillings) and also presented volunteers at the project execution day.
13.0. Participation (Volunteer hours) S#
Organisation
No. of volunteers 18
1 Rotaract Club of Nkumba Stewards
11
2 Rotaract Club of Bwebajja
12
3 Rotaract Club of Kajjansi
5
4 JB Caring Hearts International
2
5 Whollistic Community Agency
2
6 Impact Missions Uganda
2
7 Bamwine Counselling Services
3
TOTAL
44
14.0. Challenges The execution of this project did not pass without any challenges. Below are the notable challenges encountered during execution •
Limited funding: The project team lacked the adequate funding to mobilize and work with a big number of beneficiaries with in Kajjansi town council and the neighbouring communities.
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Covid-19: The project execution was affected by the covid 19 guidelines that do not permit large gatherings. This meant that the project team had to institute cautious measures that included down scaling on the mobilization which consequently affected the number of the prospective beneficiaries.
15.0. Monitoring and evaluation The project team instated an active community support team comprised of community leaders, volunteers and professional counselors that shall look out for the depression and anxiety victims and listen to their story without judgement. The community support team shall have task of ensuring that they present a welcoming and friendly atmosphere that would easily appease the victims to approach, share, and be guided on the next course of action. The team shall follow up the victims through home visits and courtesy calls to ensure that they are recuperating normally and to also offer a shoulder to lean on in the hard times.
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The success of this project shall hinge entirely on the reduced number of mental illnesses going forward reported with in the community of Kajjansi Mu Line attributed to depression, anxiety and stress related to covid-19 and its effects, positive attitude towards covid-19 keeping in mind that it is not a death sentence. 16.0. Conclusion While the government has taken a minimal role in defining or mitigating the mental health crisis, there is need for several public education and awareness campaigns, and social movements run by grassroots organizations to address the mental health crisis. Specifically, these efforts shall reframe the perspective on mental health, notably by diminishing negative stereotypes and stigmas. On that note, the Rotaract Club of Nkumba Stewards, Bwebajja and Kajjansi invites all partners and stakeholders to craft creative ways of advocating for healthy minds in their various communities. 17.0. Appreciation Gratitude is extended to all the generous and big-hearted Rotarians, Rotaractors and wellwishers that financially supported the Mending Mindset mental health project. All participants that committed time and skills towards the execution of the Project at the launch held at Kajjansi Mu Line, humanity owes you. Utmost appreciation also goes to all individuals that applauded this idea, forwarded suggestions to make it a better project and offered moral support to the project team throughout the project.
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