Child and Adolescent Mental Health Uganda

by gilbert in Butabika

We did it
On 5th January 2016 we successfully raised £5,279 with 128 supporters in 0 days

 Hello! £ goes a long way out here; anything towards raising the experience of life for the children here would be appreciated massively.

by gilbert in Butabika

New stretch target

UPDATE : Beyond delighted that I have surpassed my initially small target of £1500. I wanted to start with a moderate amount because I have quite simply never raised money before, and like all ideas, this one has taken time to germinate; has taken some research and fieldwork to realise the potential of what I could meaningfully do with £5000.

I started to raise money after witnessing the myriad lack of basics on the ground for the children that the hard working staff simply were not able to provide on top of their roles; education, adequete therapeutic engagement and personal care planning but CRUCIALLY, resettling the overwhelming number of children who end up here either back to families who can safely care for them, who are educated around mental illness or epilepsy and in the abscence of that; facilities where they can be placed to live and grow and get education outside the four walls of the hospital. 

Although the scope for change within the ward in terms of what can usefully be done with the £ is endless,  my goal is that it needs to be sustainable after I am gone and help change the direction of child and adolescent mental health care if possible in some small way. I have now come to understand that running a pilot project over a period of 3-6 months, collaboratively with the Social Worker from Butabika and Social Work students from local Universities, with support and supervision from highly qualified staff from the UK LINK (NHS east london foundation trust), would be the best way to meaingfully make use of the money raised and address one of the main crises in child and adolescent mental health care. RESETTLEMENT AND FOLLOW UP.

Children are abandoned here on a weekly basis and our longest stay patient currently is over five years. Once children reach 18, they 'graduate' to the adult ward. The NGO's I am researching cater mainly to orphaned children but the reality is that there are few organisations who provide for behaviourally disturbed children, those with learning disability or entrenched mental illness. The ones that too are often vastly costly and overstretched. This project takes a huge amount of manpower in terms of researching what is out there and what viable routes there are to resettling children. 

Therefore if I reach my target the pilot, which will be properly monitored and evaluated, will see what steps can be taken, relationships built and awareness raised in terms of this issue. 

The majority of the money will go on this, and I aim to be as transparent as possible about costings once it is launched. I will update regularly and try and explain how we are evaluating a pilot in such early stages; I anticipate building relationships with NGO's and organisations prepared to work with us will be a large part of the equation. 

I am aiming to make an educational film about epilepsy for the Ministry of Health as it continues to be so minsundertsood here however I have now decided to apply for funding for that elsewhere.  A large number of the deaths result from people falling in fires when cooking outside, as treatment in not sought and seizures uncontrolled. It is vital we educate the community on epilepsy as a neurological disorder, too many young people are abused, suffering and dying as a result as having the illness.

The other ideas I had spoken of beore this update are outlined below, and as I mentioned before the scope is endless. But I have decided a focused project that allows some of these children without relatives or support of any kind a chance at a better life is where I want the majority of the money to go. I am including the list I made before, as whatever money I have left over may contribute to some of these ideas, and I will be explicit about which. 

I have already started a vegetable garden (photos coming) to enrich their diet. This was the list from before the idea for the pilot project came about: 

Employing specialistis within autism and learning disability, working with general nurses in running trainings to promote better physical health care within mental health hospitals (deaths are frequent and common here) 

Employing a weekly teacher for the children who are long-stay, trying to implement a curriculum for some of the children who literally, live out their childhood here. 

Employing some of the inspirational (but woefully underpaid) staff to work in community education and outreach projects, targeting spiritual leaders so that we can work collaboratively with them. Nurses get about 100 pounds a month here. Most work additional hours for nothing as the wards cant function without them. I frequently visit the wards and there are not enough qualified staff on the ground, the human resource is simply not there.

A great deal of the problems faced here are from people seeking treatments from traditional healers who see mentall illness as a form of spiritual possession or witchraft, and there is tension between seeking medical help and local remedies, possibly because in some ways we are financial competitors to those healers who see these children as their cases to manage. I have heard countless stories of children dying or becoming seriously unwell and attacked in the community simply because their families come to the hospital as a last resort, too late, after countless local rememdies fail. 

I want to organise a trip. Most of the children wander around the same four walls, day in, day out. And have done for years. To think what a trip somewhere, perhaps for a weekend somewhere in nature, might be able to do for them would be quite incredible. And implementing weekly trips from the ward for those well enough if I raise enough. I would have to employ staff to accompany me, organise transport food and lodgings etc. 

This project has enormous potential and I am totally invested in it. I am being paid a small amount to work here helping to teach a diploma in child mental health, so this is about raising the standards of the ward in Butabika and child mental health care in Uganda in a sustainable way. As the service has only been around for such little time, it needs a great deal of support. 

Thanks you so much everyone, I will keep you regularly updated on how things progress and every bit helps here enormously. 

 Hello hello.

I've had to get over some deeply held and quite ridiculous British embarrassment about trying to raise money for charity, despite having a lot of admiration for others that do it regularly!

But I'm here now, and things are obviously so much easier to absorb in the stark day to day than in the abstract. I'm working on the relatively new (5 years old) Child and Adolescent Mental Health Ward here at Butabika, Uganda's largest psychiatric hospital. It is the largest and one of the only inpatient wards for children with mental illness in the whole country. Before the ward begun, children were treated alongside adults. These children are also not only there because they may have a mental illness, the ward becomes a literal dumping ground for children who have been abused, abandoned, bereaved, stigmatised and significantly traumatised. Often they have nowhere else to go, and they have families that are untraceable. We have to estimate their ages a lot of the time because we simply don't have the information when police sometimes bring them in.

I'm here to help teach a diploma in child psyhciatry to health workers from all over the country. Epilepsy is still misunderstood here and many children still die as a result of seeking treatment too late. There is also a reliance on medication here, you often see children lying in bed or outside all day, overly sedated. 

Uganda has the world's youngest population, over 52% are under 15 years old. Life outcomes for children in mental health everywhere can be signifcantly poorer than the rest, but here it is a different story alltogether. The staff and hospital do all they can in  an incredibly demanding, under staffed and under resourced hospital. They have a tremendous and dedicated workforce, and this fundraising is not intended to raise funds for the equipment covered by the hospital, but to be able to in some small way, improve the experience for those young people who end up here. Some have been here for over three years. 

There is a simple list of things I've come up with, with advice that i want to try and implement alongside the other work i'm doing. I want to:


Hire a local who can utilise loads of the land to dig a vegetable garden, the kids learn skills, they grow seasonal produce, they eat better

Buy a load of blank name tags and permanent markers, so that those who stay for a long time have their own uniform, cup, plate etc, to raise the sense of dignity a wee bit

Buy a load of new toys and sports equipment - a basketball hoop that works, a pump, a net you can string up in the massive garden and sports equipment. Most of the children are not as active as they could be all day

A laminator, to preserve the kids pictures and the safety cards and medication charts we are making

A few big boards to hang pictures on and brighten the ward environment

A whiteboard, so we can organise the nursing shifts each day and everyone has a focal point to look at for what needs doing for the day 

New folders/pens

Educational books catering for all ages as so many miss school here

More equipment for the sensory room for the children with complex disabilities who might not be able to talk

Some additional medical equipment (cheap and sustainable) such as tempadots, disposable aprons, hand sanitsers in the bucketload, more gloves

The video I added is a BBC film made at the Hospital. It is not specifically about children but gives a good insight into the state of mental health here, and I did some follow up filming with the contributors for World Mental Health Day. 

Everything I raise will go towards trying to make the expereince of life on the ward as useful and nurturing as possible for these children. That's it really. Paypal frustratingly not a go to in Uganda so sorry bout that. xxxx


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