Community Engagement: PRIME Ethiopia share story of hope from a homeless patient
Early in November 2015, PRIME Ethiopia met with community members and the district administration in the Sodo district, where it is implementing the integration of mental health into primary health care. Known as the Community Advisory Board (CAB) meeting, these meeting take place every six months with the main objective of evaluating the performance of implementing the district mental health care plan since the previous CAB meeting, discussing the challenges encountered, and agreeing on the agenda for the following 6 months. These meetings are chaired by the deputy administrator of the district and last half a day. The meetings are highly interactive. The CAB members representing the cross-section of the community participate actively reflecting honestly on the contribution of PRIME to society, the responsibilities of the CAB in overcoming challenges and on the way forward.
The perspectives, guidance and reflections of the CAB members forms an essential ingredient of PRIME's implementation. In this last meeting, there was even more enthusiasm from the CAB members because of their experience of substantial improvements witnessed in patients that they thought were hopeless at the beginning of the PRIME project, as described in the story below.
Story of hope: a homeless woman finds home after 10 years
A woman was living on the roadside in the open space, be it rain or sunshine. Her living situation was horrendous beyond imagination. No one living in the neighbourhood knew who she was or where she was from. The treatment started when a civil servant living in her neighbourhood, earning an ordinary salary, decided to house her, care for her and help her with medication. The decision of this good samaritan was prompted by the availability of treatment in the district clinic for the first time, which inspired hope in her. But this also inspired one of the CAB members and other women in the neighbourhood to offer help. Within a few months of treatment, the woman got better and asked for her son, who was then traced. The CAB member, who was also involved in the care of this woman, the PRIME Principal Investigator (PI), Dr Abebaw Fekadu and Project Coordinator, Dr Girmay Medhin, were invited to the house where the patient was residing.
When we saw her, she was sitting and comfortable. Her mother and daughter-in-law were in the room with her. She looked well in her self. The excitement from one of the CAB members and other people was clear. We were truly gratified by this. But this is at least one of three homeless people who were treated successfully with help from the local community," said Dr Fekadu.
Dr Medhin added:
Now her own family members are supporting her. She is still weak but can talk properly and she knows herself very well, she can ask for what she needs and is functional. For instance, she is able to wear and manage her own clothing despite some ongoing symptoms. Witnessing this success story was a joyous moment for the PRIME team and motivating for all team members for their hard work. They hope that they will witness more success stories like these in the months ahead.”
Challenges of adherence and medication: CAB commits to resolve
One of the challenges reported by the PRIME team was adherence of patients to treatment due to economic reasons. The response from the CAB members was that this issue is already identified as a major problem and discussed in the district management. Appropriate supportive methods are designed and will be effected in the next few months. Another challenge reported by the PRIME team was sustainability of medication supply with significant negative effect to sustainability of the mental health service. The CAB members promised to work with the district management and will take full responsibility and commitment to make sure that there will be sustainable medication supply.
Getting this promise was considered an achievement by the PRIME team, although its practical implementation will only be evaluated in the next CAB meeting. Another positive development was the discussion that the PRIME team had with the district Ministry of Health, including the district administrator, deputy district administrator and the chair of the district political affairs. These three influential people were happy with the progress of the project and promised the PRIME team to do all they can to support the success of PRIME.
About the PRIME CAB in Ethiopia, Dr Fekadu added:
CAB meetings are always vibrant; members have excellent relationship with the PRIME team and with each other. There is always a sense of excitement, purpose and consensus.