Mental Health Treatment & Gender Equality in Uganda

Conflict, poverty and instances of social injustice can provide the context within which a person develops mental health issues. And yet, while studying to become a creative/psychomotor therapist, I learned very little about this.

I didn’t question it at the time, because mental health is a personal issue, right? My time in a counselling centre in Uganda last summer showed me that the answer to this question is, in fact, a clear no.

I volunteered as a psychomotor therapist in the Bishop Asili Counselling, Rehabilitation and Community Centre in Ngetta, northern Uganda. The local population living here suffered badly during the Lord’s Resistance Army insurgency.

More than a decade after the end of the war, I came to Uganda with a stack of books on trauma and post-traumatic stress, ready to do creative therapeutic interventions that might help women cope with their war-time experiences.

Very quickly, it became clear to me that the conditions these women lived in asked for something different. Something more.

Sister Florence, an Ugandan psychologist who founded and runs the counselling centre, reminded me that next to their history of war, “there are so many [other] sources of trauma, so many, so many, so many”.

Women in Ngetta face many challenges. The patriarchal context leaves women with few, to zero, rights.

They have no right to land or any kind of ownership, and the moment a woman marries, her new husband acquires rights over her sexuality and reproductive ability.

Ellen, one of the women I worked with in the counselling centre, described the patriarchal culture: “I was now in the hands of my husband and I was now under authority of my husband. I need to respect him and do everything he tells me.”

Her words reflect the complex power dynamics and hegemonic masculinity that undermine women’s social status and power. On top of this, many women struggle to feed their families every day, while often their husbands drink away the little money there is. Other women have lived through (often multiple) more recent traumatic events, such as emotional and physical abuse by a husband or brother.

It made me wonder how much help my therapeutic interventions focused on (individual) war-trauma could be.

Recognizing the unequal social position of women, I needed to have a clear feminist ideology underlying my therapy. This meant focusing on women’s social position and equality.

Our sessions were related to resilience, visibility and communication, grounding techniques, personal boundaries, and more. Work related to the strive for equality for women was essential. However, paying attention to – and ultimately challenging – violent and unjust structures is not often included in mental health interventions in the Global South.

The importance of women’s mental health for general health is widely recognized. Mental health in international contexts is slowly becoming more of an acknowledged topic within the field of international development. This is really good news, especially considering the fact that only a small minority of the 450 million people suffering from mental or behavioural disorders worldwide receive treatment.

In 2013, the World Health Organization published their Mental Health Action Plan: 2013-2020. It is an ambitious action plan that understands ‘the essential role of mental health in achieving health for all people’. Global Mental Health (GMH) is thus an emergent topic in which more and more people are currently working. However, with this renewed focus on mental health, many critiques have emerged, some of them accusing GMH of being a colonial practice.

GMH is accused of globally enforcing biomedical systems, which are characteristic of the Global North’s approach to health. The biomedical framework locates illness, including mental illness, within a person. Though psychological and social principles are sometimes taken into account, biological variables are the most central.

Issues of social injustice and structural violence (such as poverty, conflict, sexism, racism) are not taken into account, despite their significant impact on women’s mental health.

Very important work is being done in the field of GMH. Organizations like SOS Children’s Villages or Action for Child Trauma International are great examples of a rights-based approach to trauma.

We must be careful to avoid new forms of imperialism in which the Global North enforces its biomedical approach to health on all cultures. We should work towards locally-informed care which approaches mental health not as an individual issue, but as something to be addressed on personal, community, national and global levels.

Mental health should be seen as a social issue.

This would allow us to challenge discriminating structures, both globally and nationally, while also focusing on community and personal struggles.

In order to achieve mental health for all, there is an essential role for work towards an equal world, and this work is should be integrated in the field of Global Mental Health.

7 Women Breaking Stereotypes in Pakistan

Pakistan remains one of the most male-dominated societies in the world, and women still tend to be portrayed or stigmatised as subordinates. In the patriarchal culture of Pakistan, women are often limited to doing domestic work and forced to hide the talents and skills they possess.

Recently, however, more and more women have been breaking stigma and stereotypes by doing and achieving things traditionally seen as being ‘only for men’.

Here are 7 Pakistani women breaking stereotypes like they should be broken! 

Namira Salim

Namira Salim is the first Pakistani woman to reach the North and South Poles and, as a Founder Astronaut for Virgin Galactic, she’s the first future Space Tourist from South Asia to travel into space. Salim started her own initiative, SpaceTrust, which promotes Space as the New Frontier for Peace via novel peace theme initiatives to inspire change, encourage dialogue and enrich education.

Samina Baig 

Samina Baig is the first Pakistani woman to climb Mount Everest and the Seven Summits. She was awarded the Pride of Performance by the government of Pakistan, and runs initiatives that encourage women to take part in outdoor activities. Last year, Baig was appointed as the National Goodwill Ambassador for Pakistan by the United Nations Development Programme (UNDP).

Ayesha Farooq

“Instead of looking up to role models, become one yourself”Ayesha Farooq. Farooq is the first female to become a fighter pilot in the Pakistani Air Force. She’s also made history as the first woman to be assigned to one of Pakistan’s front-line dogfighting squadrons. 

Sana Mir

Sana Mir is the former Captain of the Pakistan national women’s cricket team. She was first female Pakistani cricketer to rank number one in the International Cricket Council bowler rankings, and led Pakistan to two gold medals in Asian Games in 2010 and 2014. Mir has been vocal in recent years when speaking out against body-shaming in sports advertising.

Zenith Irfan

Zenith Irfan is the first female motorcyclist to ride across Pakistan and an all-round bad-ass. After her father’s early death, Irfan decided to fulfil his dream to tour the world on a motorbike. The journey was a huge step in a country where it can be taboo for women to venture out alone, nevermind on a motorbike, and CNN have called her “Pakistan’s boundary-breaking motorcycle girl”. 

Tahira Safdar

Justice Tahira Safdar is the first woman chief justice of any court in the history of Pakistan, currently serving as the Chief Justice of Balochistan High Court (Balochistan is Pakistan’s largest province). In a patriarchal society like Pakistan, where the subject of law and the profession of judiciary are preserved for men, Tahira Safdar has set one of the finest and most inspiring examples for women in Pakistan.

Uzma Nawaz

Did you just say that car repairing can only be done by men? Well, Uzma Nawaz, the first female car mechanic in Pakistan, is here to prove you wrong.

These are just some of the women in Pakistan who have broken through in a society that’s still very much dominated by men. I find each of these women incredibly inspiring, and hope that they can be a source of inspiration for other women out there too. What are you waiting for?!

Eradicating Violence in Rural Zimbabwe

When it comes to the fight against violence against women and girls, it’s quite safe to say that in my community we haven’t won yet. However, we are making progress, and this progress is due to the dedication of Village Health Workers (VHW).

Aside from offering health care, VHWs are instrumental in advocating for the abolishment of violence against women. I understand that women the world over face violence in so many forms, and that the problems women in my community are facing are mirrored in challenges women face globally.

It’s how we’re tackling gender-based violence in my community that makes us unique.

Royden-Nyabira in Mashonaland West province is located 50km from the capital city of Zimbabwe – Harare. We do not have a dedicated organization in my community working to end GBV, however, that has not incapacitated us from tackling the issue.

Village Health Workers are the ones who have taken up the advocacy as well the policing role in the fight to eliminate violence against women. VHWs act as the eyes and ears of the village and work with law enforcement agents and the Ministry of Health – which has resulted in a sizeable number of cases of GBV being reported.

There are still a lot of men who are resistant to change and continue resorting to violence as a means of solving family disputes. However, we do not tire because this is a fight which we must win. My community’s strategy has always been  simple and realistic – VHWs educate community members through conversation and discussion.

It’s perfect for us because there is room for everyone to interact and ask questions, while VHWs have the opportunity to answer and clarify things. There is a lot of information about GBV available online, but people in my community are very poor and cannot afford to buy data to access information on the internet.

By circulating information through word of mouth everyone has the opportunity to learn – even those who can’t read or write or access the internet – and so the possibility of leaving anyone behind is reduced.

Utilisation of what we have available is what makes us a unique community. Oral education has had a positive impact so far, and the community’s attitudes to GBV has changed – as evidenced by the reduction of GBV cases. Our Village Health Worker’s commitment to ending GBV has not been in vain.

On top of everything else, VHWs voluntarily conduct a door-to-door operation to engage with residents. This has helped victims of violence to come out of their silence and tell their stories in safety. The method itself has helped build trust between the health worker and the victim because without trust it’s difficult to convince victims to share their stories.

VHWs work on voluntary basis and are very committed. Their opinion on gender based violence is that it is an abuse of human rights and a health care emergency, which means that when reacting to reported cases of violence, they treat no case as an afterthought.

This door-to-door process is time-consuming but it is effective, as evidenced by the community’s growing understanding of what GBV is and the implications it has on the well-being of victims and the community as a whole. In my community, we believe everyone has a role to play in ending gender-based violence. If we can’t do it for the present then surely we have to do it for our future generations.

I believe that if people are willing and committed to the fight to end violence against women, we can and will be successful. We can and will reach Goal 5.2 of the Sustainable Development Goals so that by 2030, there will be elimination of all forms of violence against all women and girls in public and private spheres, including trafficking and sexual and other types of exploitation.

This is a very ambitious target, but it’s achievable if everyone joins in.

Time to Disarm the Patriarchy

We live in a time where the threat of nuclear war is a normal household conversation. Many live in a nation led by a man who cannot control his urge to press ‘tweet’ on every unhinged thought he dreams up each morning. And yet, he alone has the authority – the sole authority – to push the launch button on a preemptive nuclear attack, should the mood strike him.

The risks that nuclear weapons currently pose to global peace are monumental.

We also live in a time where the seemingly unmovable and intractable weight of our patriarchal society is suddenly being forced to reckon with women’s voices and stories and experiences – both the ugliness that we’ve endured and the talent and wisdom we’ve been barred from contributing.

We know for a fact that if peace is the goal, women absolutely must be part of the process to achieve sustainable and lasting results. Women are key to national and global security. When women are meaningfully involved in peace processes, it is more likely that peace lasts.

Empowered women create communities that are more just, prosperous, and safe. We know that having women involved at every level of decision-making is strategic—and yet, when it comes to nuclear weapons, women are rarely included at the table where political and security decisions are made. In a cruel twist, we regularly disincentivize women from actively participating in the careers, conversations, and halls of power where this work happens.

Credit: Women’s Action for New Directions

That’s where our project comes in. Women’s Action for New Directions (WAND) recently launched a campaign specifically designed to educate young women about how they can advocate for international diplomacy over militarism.

It’s more important than ever to make sure the public – and women specifically – know how they can get involved to keep our democracy and safety intact. The Disarm the Patriarchy campaign is designed to engage young women in efforts to reduce the role of nuclear weapons in U.S. foreign policy as activists, policy-makers, diplomats, legislators, and scientists.

It has never been more important to educate ourselves and demand change. We are building a new generation of peace and disarmament activists and amplifying diverse women’s voices in the disarmament sphere.

Our Disarm the Patriarchy Handbook gives women the tools they need to be advocates for policy change and hold their elected officials accountable for creating a safer world for all of us.

Nancy Parrish is the Executive Director of Women’s Action for New Directions (WAND), which educates and empowers women to advocate for security and peace with justice. We believe that women are central to shifting the militarized, patriarchal culture that pervades our society and leads to endless war and violence. We know that when women are engaged in the political process and given the right tools, they can be true agents of change.

Girls are Facing a Mental Health Crisis

According to the World Health Organization (WHO), around 80,000 people die by suicide every year. This means that one person dies by suicide every 40 seconds.

Suicide is “the second leading cause of death among 15 to 29 year olds globally,” and is not limited to developed countries: “78% of suicides occurred in low- and middle-income countries in 2015.Depression is “the leading cause of disability worldwide, and is a major contributor to the overall global burden of disease.

What these shocking numbers reveal is that while there are many serious global health issues that demand attention, mental health must not be left behind, and this is especially true when considering the current state of girls’ mental health.

In The State of the World Population 2016, UNFPA portrayed a worrying picture of girls’ mental health, stating that suicide is the “second leading cause of death for adolescent girls between ages 10 and 19.” In the United States, according to the Centers for Disease Control and Prevention, suicide rates among teenage girls reached a 40-year high in 2015.

In the United Kingdom, data on child and adolescent mental health from the National Health Service has revealed significant differences between genders. For example, “more than two-thirds of antidepressants prescribed to teenagers are for girls,” 90% of children admitted to hospital due to eating disorders are girls, and hospitalizations due to self-harm involving girls “have quadrupled since 2005.

The reasons for this global trend of worsening mental health conditions among girls are complex. A common cause given for such a dire situation is the negative effects of social media, especially in relation to body image issues. Though research has documented a link between social media and girls’ body image issues, this does not tell the whole story of why girls’ mental health is in crisis.

There are also serious issues of sexual harassment and abuse, domestic violence, and poverty faced by girls worldwide which have significant impacts on mental health. Research has found, for example, an increase of children living in poverty in the UK, and poverty has been found to be a risk factor for worsening mental health.

Not only are girls suffering from the most common mental disorders of depression and anxiety, but research has also found an increase in post-traumatic stress disorder in this demographic. And while links between suicide and a history of mental illness have been established, the WHO has highlighted the critical issue of high suicide rates among “vulnerable groups who experience discrimination,” such as LGBT and indigenous peoples, refugees, and migrants – and girls are included in all of these categories.

To address this crisis, organizations such as Girls Inc. are raising awareness of the importance of mental health for girls. Similarly, the International Bipolar Foundation has created a Mental Health Awareness Patch in partnership with girl scouting organizations that can be earned by Girl Scouts in all ranks to provide them with an opportunity to learn about mental health, how it’s portrayed in the media, and how to be involved in anti-stigma campaigns.

And if social media can be harmful to girls’ mental health, it can also be a source of help. For example, the Sad Girls Club is an online community for girls – particularly of color – dealing with mental health challenges. It was founded by Elyse Fox, who experienced depression herself, and officially launched in February 2017. The club goes beyond an online community, however, as it also holds real-life meetings.

The fact that mental health has been added to the UN Sustainable Development Goals under goal 3 is a good example of mental health being placed at the heart of the global agenda. The mental health of girls around the world today is without a doubt a complex and multi-faced issue. It requires an approach that takes into consideration the intersection of issues that have brewed this crisis, such as the role of social media in girls’ lives, poverty, and violence.

If we truly believe that ‘the future is female,’ then our girls’ mental health must be made a priority.

A Healthy Twist on International Women’s Day

It has been quite a year for women in the world. We have raised the #MeToo movement from a hashtag to a force. We have marched, yet again, for rights that are often agreed upon but still seldom given. We have won seats in government, testified in court, spoken out in interviews. We’ve started organizations, and built families. We have persisted.

SOGH members attend the Women’s March in Stockholm. Credit: Giorgia Dalla Libera Marchiori, Sweden

Despite all of these ‘women’s wins’, there are still glaring disparities in literally all categories from economic gaps, to social treatment, to health. There are global programs, data sets, indexes, and statistics to prove and draw awareness to those discrepancies. Recently, the UN released a report declaring that the Sustainable Development Goals (SDGs) gender indicator still leaves “significant gaps to women’s empowerment”, specifically in health areas.

If the big international and governmental organizations struggle to deliver promises for equality, what can we as individuals do?

It can be difficult to know where to begin or which steps to take to create a solution for inequality. The answer is simple: just start somewhere. There is so much each of us can do! At the Swedish Organization for Global Health (SOGH), we start with health. We join together as individuals with different backgrounds and expertise, and commit to standing together, working in solidarity, and fighting for health equality.

If you’re somewhere other than Sweden (Hej, from Stockholm!), we’ve crafted three ways for you to celebrate International Women’s (Health) Day:

First, understand.

Women face different threats than men do, and still must fight for basic rights and protection to their own bodies. The top threats to women’s health globally include: reproductive health problems, maternal health issues, HIV, sexually transmitted infections, violence (intimate partner, sexual, or gender-based), non-communicable diseases (addictions, accidents, obesity), being young, and ageing. Globally, the health of girls and women often become secondary priorities. Women in the United States make 80% of all health care decisions for their families, and tend to prioritize their own health last. Some women are purposefully kept from care, while others may not be able to obtain the procedures they need. Understanding the threats and the issues women face is the foundation to a healthy future.

Second, practice.

When was the last time you went for a check-up? A breast exam? Have you talked to the girls in your life about self-care, safe-sex, health relationships? What have you been doing to ensure that you and your circle are practicing a healthy lifestyle? From food, to decisions, to difficult conversations, we cannot help to create health in others if we don’t first seek it ourselves. Practice what you preach, click around the Girls’ Globe health posts, make an appointment, quit a habit, have a difficult conversation, and check-in with your loved ones to elevate health in and around you.

Third, unite.

On International Women’s Day, we reflect on the status of health for women. Our work must address the uniqueness of women’s health based on circumstance and environment. Some threats to women are universal no matter the context or place. However, issues like gender equality, access to care, and quality services vary intensely based on income or geography. This added layer means that as activists, we not only have to understand or practice, we have to act. Our action can be in towns nearby, in organizations reaching far away, or in classrooms where future leaders are preparing themselves. Wherever we are and whatever we do, we must unite together for all women.

For more information on International Women’s Day, follow hashtags #IWD2018 or #TimeIsNow, and read about the 2018 UN theme: Rural and Urban Activists, Changing Women’s Lives.