WACIT Bangladesh: When there is genuine community engagement, there are no health taboos

The first good sign was hearing about the large number of community volunteers at this network of rural health centres and satellite clinics. The second and real test was hearing from the mothers on their perceived benefits through education and prevention, and how they would advise future mothers.

When I saw evidence of including not insensitive topics such as family planning and particularly gender-based violence, I was not surprised. If trust between the community and services is built over a number of years, with community leads and volunteers acting as bridges, there are no taboos to avoid. Mental health should come easy next!

The three young children in the waiting area also passed the secure attachment test – none of them would come to me!

WACIT Bangladesh: Community engagement and innovation in rural health clinic

Only 12km from the border, one would never expect this systematic network of maternal and child health centres and satellite clinics provided by Shimantik NGO. Mothers waiting in the clinic did not have to travel more than one km. The highlight was hearing their own advice for new mothers – no surprise that this centre alone has 54 community volunteers!

The staff innovation, tools and strategies reflected that engagement: healthy nutrition packs, the smiley banner for every village family home under antenatal care, and the Mother Banks to encourage families to save for the new baby. Ready for the next mental health stride!

WACIT Bangladesh: Young people redefining mental health 

There were a few pleasant surprises during the school mental health awareness workshops with young people and teachers:

When I asked what words had been used to invite pupils and parents, the inspiring headmistress shrug her shoulders: “mental health of course, they are fine with it”.

Indeed they were! Young people defined it as ‘state of mind’ that can help them achieve and cope better; reflected on what helped them recognise signs and, crucially; how they turned their mental state round when under strain.

Using exams as an example was a good start, but relating to help them focus on their cricket skills and make more runs seemed even better!

WACIT Bangladesh: Second day of thinking to the future 

The test was whether health care professionals could relate child mental health to their role, rather than try to change it. 

Their recommendations for improvements in practice speak volumes: “building relations with children, apply knowledge, give families more time, and increase team work with families’ involvement”.

So did their service recommendations: “more child-friendly environments, counselling corner for children, train fieldworkers for outreach follow-ups to increase access, and extend monthly mothers’ meeting to incorporate parenting work”.

Special thanks to a brilliant headmistress and co-facilitator! Everybody seemed to smile at the end – hmmm, quite everybody… 

WACIT Bangladesh: The next psychosocial layer for these excellent healthcare teams

The objective was – and still is – clear: It has taken many years for these primary, child and maternal health care teams to develop under the impressive expansion of the Shimantik NGO. Considering the training credentials of its sister organisation Research, Training and Management – which hosted the workshop – the next step was obvious:

How can we equip the excellent and large group of healthcare professionals with psychosocial skills and thinking appropriate to the role; then considers a mental health service model at the next stage?

It was only a humble start, but very promising at that. Cases were viewed in a slightly different context, observations were sharpened, and parallels were drawn, with some theoretical linking. It was most appropriate to finish the first day with a song, which seemed to scare the monsoon off…

WACIT Bangladesh: A visionary NGO for disadvantaged groups

The Shimantik health care and school projects defy belief in their systematic extent to target disadvantaged groups through community health centres, outreach, a state of the art hospital being built, and an education centre. Inspiring vision and leadership from the founder!

The passion works in linking services with the community (e.g. stadium next to the complex) and the next generation, although the 22% bring below the poverty level is a challenge.

WACIT Uganda: How cultural integration starts early for refugee children 

For children born in the settlement, acculturation came easily. The older ones adapted quickly, both within their separate but proximate communities and especially at school. It was refreshing to see them mix as it was the most natural thing in the world.

Adults need more work, as they bring more entrenched experiences and tensions, even between national groups. They also need support and alternative economic means to encourage them to send children to school.

Overall, this was a prime example of tolerance, with children leading the way.