Video by Farai Mugano. Pictures of Jekesai Njikizana
Sitting next to a patient with depression on a garden bench in Harare, Zimbabwe’s capital, Shery Ziwakayi, 70, speaks softly, offering accessible therapy with a warm, reassuring smile.
“You made the right decision to come to mbuya,” she tells her client, using the shona word for “grandmother” and offering her a handshake.
A Zimbabwean doctor has found a new way to provide desperately needed mental health therapy to his poorest compatriots by using lay health workers, colloquially known as “grandmothers”.
Psychiatry professor Dixon Chibanda’s concept is simple: a wooden park bench where people with common mental disorders sit and receive free therapy.
The Chibanda Friendship Bench proved popular and provided accessible and much needed therapy.
Decades of economic hardship and deepening poverty have taken a mental toll on many Zimbabweans, placing a huge burden on underfunded and understaffed psychiatric health services.
The Friendship Bench has helped fill a shortage of healthcare professionals in Zimbabwe – which has just 14 psychiatrists, 150 clinical psychologists and less than 500 psychiatric nurses serving a population of 16 million people.
“We need these alternative innovations to bridge the gap and my idea is to use grandmothers to provide therapy,” said Chibanda, wearing dreadlocks and round-rimmed glasses.
The pews are spaces “to share stories and through storytelling we can all be healed,” he said.
His therapy model is now being exported to the FIFA World Cup in Qatar, where 32 benches – each representing a team participating in the FIFA tournament – will be set up to shine a light on global mental health.
The World Cup project is in partnership with the World Health Organization (WHO), whose chief Tedros Adhanom Ghebreyesus hailed the initiative as “a simple yet powerful vehicle to promote mental health”.
It’s “a reminder of how just sitting down to talk can make a huge difference to mental health,” Tedros said recently.
Other countries have adopted the friendship bench model, including Jordan, Kenya, Malawi, Zanzibar and the United States, where 60,000 people in the Bronx and Harlem areas have accessed therapy. .
In Zimbabwe, about 70% of the population lives below the poverty line.
Chibanda’s idea for Friendship Benches came about after a patient he was treating at a government hospital took her own life.
“She didn’t have a $15 bus ticket to come to the hospital for treatment for depression,” he said.
“That was the initial trigger that immediately made me realize that there was a need to move mental health from hospitals to communities.”
Grandma Ziwakayi has been providing bench therapy for the past six years, seeing an average of three clients a day.
“Talking to us, many have recovered and are leading normal lives again,” said Ziwakayi, who has received training in basic counseling skills, mental health literacy and problem-solving therapy.
The grandmothers receive a stipend for their services and the operation is funded by Chibanda’s NGO, Banc de l’Amitié.
His patients come from all walks of life: young, old, stressed or drug addicts. Some are unemployed or in financial difficulty, others are victims of gender-based violence.
On a white sheet attached to a blue pocket chart, she asks customers if they are frightened by insignificant things; feel exhausted or want to kill themselves, among a host of other issues.
Choice Jiya, 43, said she owed her life to the service on the benches, having considered taking her own life when her husband lost his job shortly after giving birth to their twins in 2005.
“Before I went to the bench for therapy, I thought killing myself was a solution,” she said.
She now operates a small perfume and soap manufacturing business.
From just 14 grandmothers in Mbare – Zimbabwe’s oldest and poorest township – at the start in 2006, there are now nearly 1,000 benches and more than 1,500 grandmothers in different localities.
They have helped 160,000 people in the last two years alone.
The fallout from the Covid pandemic has led to an increase in mental health problems and the WHO estimates that more than 300 million people worldwide suffer from depression.
Its most recent report “paints a very bleak picture”, showing that six of the 10 countries with the highest suicide rates in the world are in Africa, Chibanda said.
For Harare health services director Prosper Chonzi, the benches are a “masterstroke”.
“The demand for mental health services is high due to the economic situation. It is one of the best interventions.
“It made a huge difference in terms of preventing suicides,” he said.
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