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Treating Invisible Wounds

Treating Invisible Wounds

Mental Health and Psychosocial Support in the Central African Republic

The military-political crisis that broke out in 2012 has severely crippled the healthcare system in the Central African Republic (CAR).

This is especially true when it comes to mental health services.

Stigmatisation and misunderstandings about the causes of mental health issues and the effectiveness of treatment at the community-level also impede necessary care. 



According to the World Health Organisation, the prevalence of mental disorders increase significantly in the context of humanitarian crises - but in countries such as CAR, coping with an already weakened healthcare system, provision of mental health services is often overlooked. As such, where mental health and psychosocial support services (MHPSS) are needed the most, they are often hard to come by.

23-year-old Isaï was raised in the village of Yakada, 10 kilometres away from the city of Bria. Forced to leave his home due to conflict in Yakada, he and his mother now reside outside of the village with farming as their main source of income. 

Isaï first came to Bria Hospital in March 2018 on the back of a motorcycle. His mother had heard about the free health services that International Medical Corps provides in the Bria Hospital, encouraged her son to seek treatment and brought him to the hospital. Severely dehydrated, he had been unable to sleep or eat. A result of extreme agitation, the young man had been tied up for at least 10 days - his wounds were now deeply infected and he needed immediate care. 

The International Medical Corps psychiatrist diagnosed Isaï with psychosis and epilepsy but he also received vital care from an A&E nurse, who recognised signs of mental disorder, thanks to the MHPSS training she received from International Medical Corps. Having received treatment and medication, Isaï’s condition stabilised - and after only two days of treatment, he felt well enough to eat again.

Isaï was discharged from the hospital ten days later but returned to the hospital every two weeks for follow-up visits. He developed a good relationship with his psychiatrist, who encouraged him to keep taking his medication and return for follow-up visits. During the first two visits, Isaï’s mother accompanied him to the hospital but he would soon feel well enough to visit the hospital on his own. 

Today, Isaï eats and sleeps well. He takes care of himself and can work in the field again. Having relied on assistance to get around, he now manages to get from one place to another by himself. Grateful to International Medical Corps for assisting him but also thanks to the training that the nurse who treated him received, Isaï now hopes to get married in the future. He also wants to take care of his mother as she once took care of him.

Lacking the means to pay for treatment, Isaï was only able to access adequate mental health services because this assistance was provided free of charge. Thanks to the EU Trust Fund for the Central African Republic Bêkou, International Medical Corps continues to provide mental health services in the community, working alongside nurses and primary healthcare workers, who all carry out vital MHPSS services to those who need it the most. 

To learn more about our Mental Health Integration programming in CAR, please read a recent article written by our staff, “Integrating mental health into primary healthcare in the Central African Republic” in the special feature of Number 72 July 2018 Humanitarian Exchange Magazine. Additionally, a panel presentation highlighting this work was held by Overseas Development Institute and the recording can be found here: Improving mental health care in humanitarian crises.

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