THRIVE Gulu: Mental health support for survivors of conflict in Northern Uganda during COVID-19

Mick Hirsch is the President and Executive Director of THRIVE Gulu, a grassroots trauma recovery organisation providing mental health support to 1st, 2nd and 3rd-generation survivors of conflict in Northern Uganda. The organisation also works in the Palabek Settlement with refugees from South Sudan. In this post, Mick describes how the organisation is responding to mental health needs during the pandemic with community Lay Counsellors Gender-based Violence Monitors and radio call-in programmes. 

Key messages Innovations
Mixed messages, government restrictions and uncertainty generate feelings of anxiety, helplessness, grief and fear Radio programmes for community awareness-raising and psychoeducation
The situation exacerbates psychological trauma from past experiences during and after the war Tele-counselling, including a helpline available 24/7 where individuals can leave confidential messages
Moving from micro-level (individual and small group counselling) to a macro-level activities (radio programmes) has proven successful Previously trained Lay Counsellors and Gender-Based Violence Monitors helping to triage and refer cases                                       

The COVID-19 pandemic and country-wide lockdown has majorly affected the lives of people in Northern Uganda. They fear the virus itself and worry about accessing quality health care should they or their loved ones become ill. Moreover, they suffer under social restrictions that interfere with income-generating activities crucial for day-to-day survival. Community spaces that provide social and emotional support are now outlawed. This includes churches in a predominantly Christian society where many cannot afford a Bible. Information and misinformation spread faster than viral transmission. The unprecedented frequency of Presidential addresses increases anxiety as communities await new and unexpected restrictions.

There are few positive words to counter the fear and trembling. THRIVE Gulu’s mission during this time is to spread a positive message that restores hope and psychological wellbeing to society.  

Since we are no longer able to deliver our usual face-to-face counselling, we have had to find creative solutions. Not only do we have an obligation to maintain continuity of care for our current clients and communities, we must also respond to what we can only assume is an increased need for mental health services during a time of uncertainty and insecurity. Accordingly, we have responded in two particular ways:

1) Lay Counselors and Gender-Based Violence Monitors. For over five years, THRIVE has been training two lay counselors and two GBV monitors in every Empowerment Group we establish. In a time like this, the presence of over 100 community members trained in basic crisis intervention, intake reporting, and referrals provides a layer of support that far too few communities possess. They are our eyes on the ground, our first responders and the catalyst of our referral mechanism. They meet with patients and caregivers to encourage them to refill their medications while maintaining a two-meter distance and educating community members about the importance of physical distancing.

Lay Counsellors travel to communities on bicycles (before the pandemic)

2) Radio Call-In Programs. We have increased our radio call-in programs from once per quarter to once per week. We use this time to address the impact COVID-19 is having on mental health, including such topics as the signs and symptoms of stress, anxiety, depression, suicide, epilepsy, GBV, child protection and alcoholism. We currently receive about 20 calls during each show from people wishing to speak with one of our professional counsellors. We have a dedicated phone line for individuals to call at any time and leave confidential messages. Our radio shows reach thousands, spanning at least 10 districts in Northern Uganda. 

Radio call-in programme with Alal Single Dora, Country Director; Akera Alex, Program Officer, Counselor; and Oroma Christine, Senior Counseling Manager

Prior to the pandemic, one of our projects focused on supporting teenage parents. THRIVE initiated this project as an implementing partner of Save the Children, however, it was suspended due to lockdown. So we have taken to the airwaves, choosing a radio station popular with youth. We speak about issues that directly pertain to young people, such as the importance of making safe, healthy decisions around reproductive health and avoiding unwanted pregnancies. We also use this time to share information about COVID-19 and the importance of physical distancing and hygiene for infection prevention.

We have been surprised at how effective tele-counselling can be in the communities where we work. One of our counsellors shared: 

Previously, we did not think that providing counseling services over the telephone would have much impact. Now, we have learnt that distance should not be a barrier to support individuals, even if they come from remote communities.

Community volunteers have also been an incredibly powerful asset. We have noticed that community members are relying heavily on our Lay Counsellors and Gender-Based Violence Monitors during this time of crisis to report concerns about mental health or incidents of GBV. Their work has been crucial in reaching and supporting community members during the pandemic. Even with physical distancing restrictions, our motto holds true: “Together We THRIVE!” 

Follow THRIVE Gulu on Twitter, Facebook, YouTube and Instagram.

Key resources:

  • Mental Health and Psychosocial Considerations for Volunteers in COVID-19 (IFRC) [Link]
  • Mental Health & Psychosocial Support for Staff, Volunteers and Communities (IFRC) [Link]​
  • Quick Tips on COVID-19 and Migrant, Refugee and Internally Displaced Children (UNICEF) [Link]
  • How to include marginalized and vulnerable people (UN Women & Translators without Borders) [Link]
  • Gender implications in Development and Humanitarian Settings (Care) [Link]

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Region: 
Africa
Population: 
Maternal and neonatal health
Children and adolescents
Adults
Families and carers
Humanitarian and conflict health
Setting: 
Community
Approach: 
Task sharing
Technology
Prevention and promotion
Detection and diagnosis
Treatment, care and rehabilitation
Disorder: 
All disorders
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