How Vanuatu’s healthcare professionals are transforming the country’s approach to mental health

7 August, 2018

Isabella Olive

Isabella Olive, IsraAID Humanitarian Fellow in Vanuatu, on a day spent visiting patients with Port Vila’s mental health officer. On Tuesdays, the staff of the Port Vila Central Hospital Mind Care Clinic go the extra mile for their patients. The clinic is home to the practice of Dr. Jimmy Obed, Vanuatu’s one and only psychiatrist. Dr. Jimmy is assisted by Lawrence Hinge, a mental health officer.

IsraAID works closely with the Mind Care Clinic and in association with the Vanuatu Ministry of Health to help to build national Mental Health and Psychosocial Support (MHPSS) infrastructure. IsraAID’s training workshops target community leaders to empower communities and build local leadership. This means training teachers, coaches, police officers, nurses, and religious leaders with the hope that, after being trained, they too will be able to facilitate trainings in their communities.

IsraAID is also working to build a national roster of trained participants so that volunteers will be more easily mobilized in times of need. Lawrence, the Port Vila mental health officer, has been trained by IsraAID, in addition to his professional certification. He is also a facilitator of IsraAID’s MHPSS training.

Tuesday the 17th of July began by checking off a small whiteboard inside the clinic. Lawrence and Jimmy noted which patients had come in on Monday to receive their medications and which had not. In order to reach these patients, the hospital charters a van to make the journey into the more remote villages throughout the island of Efate. Dr. Jimmy was unable to join us on the clinical visits to the villages, so Lawrence was the acting health professional for the rounds. We were joined in the van by a physical therapist and a nurse who were visiting patients as well.

We left the paved roads of Port Vila for the dusty dirt pathways into the remote villages. As we approached the address of the first patient, Lawrence removed his uniform shirt revealing a casual t-shirt underneath. He quickly went outside and spoke to a few people standing nearby, recording on his hand what I later found out was a phone number. Lawrence explained that the patient had gone away to a neighboring island and the people outside had given him a number to attempt to reach them.

It took two more attempts until we finally reached one of the patients. Lawrence greeted him with a friendly handshake and there was a clear rapport between them. Lawrence explained that the patient used to run away when he saw the van coming, but now he understands the need to continue care. The patient had expressed that since he missed a dosage of his medication, he had begun to feel the early warning signs of a schizophrenic episode. Afterwards, Lawrence explained that they train their patients to recognize these signs and triggers. When the clinic had more manpower, they used to hold family conferences to better educate the patients’ families.

Lawrence echoed IsraAID’s approach to MHPSS, saying that one of the most effective tools for mental health officers is having community leaders trained so that they can assist and refer patients to the clinic. As part of IsraAID’s workshops, the participants are split and any health professionals in the group are led in a separate workshop called MHGap. MHGap is led by Dr. Jimmy and teaches health professionals how to diagnose mental illnesses. Lawrence believes firmly that Vanuatu needs more clinics and mental health professionals throughout the provinces with the skills that MHGap provides.

As we reached another patient, I saw Lawrence remove his uniform shirt again. I asked him why he kept doing this. His reply was humbling and revealing: “So that I am on the same level as them. So no one thinks I am above them.” He approaches them as a peer. There is no stethoscope or lab coat to elevate him to a status which may intimidate patients.

As we trekked down to visit the last of the patients, their levels of receptiveness to care varied. The one constant was the effort by Lawrence to greet them as a friend. I asked Lawrence about his professional goals. He told me he hopes to one day run a group home for people with mental illnesses who have been abandoned by their families and community.

While MHPSS infrastructure is desperately needed in Vanuatu, IsraAID’s impact shines through. IsraAID not only provides workshops, but these workshops are designed to ensure sustainability. The fact that Lawrence has begun to share his experience with others and to facilitate training sessions is a testament to this empowering approach. Today, IsraAID-trained community leaders and health professionals, like Lawrence, are building the mental health infrastructure that Vanuatu needs.

The IsraAID Humanitarian Fellowship is an annual program offering 14 students from colleges across the United States a two month internship in one of IsraAID’s humanitarian aid and development programs around the world. The fellowship is supported by the Schusterman Foundation and the Koret Foundation.

Isabella Olive studies Government & Politics, with a minor in International Development & Conflict Management, at the University of Maryland and is an IsraAID Humanitarian Fellow in Vanuatu. She is from Pittsburgh, Pennsylvania.

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