Meet Jessica: A story about strengthening the well-being of persons with mental health challenges in South Sudan

Mental illnesses are rampant and are often neglected. Yet, mental healthcare is an essential component of healthcare. All health facilities at all levels must integrate mental health into routine care. Persons with disabilities, including those with mental illnesses, are equally important in society and can contribute to community growth and development once treated.

In South Sudan and many other African countries, mental illness, and health challenges, in general, are often stigmatized. People with mental health challenges are often believed to be cursed by the gods, witchcraft, and demon possession. Stigma and discrimination, traditional beliefs, lack of information, and lack of access to medical treatment are barriers to seeking medical assistance and full recovery for people suffering from mental health problems [1]. As a result, many people with mental illness feel shameful, unloved, and neglected.

Mental illnesses are rampant and are often neglected. Yet, mental healthcare is an essential component of healthcare. All health facilities at all levels must integrate mental health into routine care. 

Persons with disabilities, including those with mental illnesses, are equally important in society and can contribute to community growth and development once treated.

The establishment of a mental health unit in Western Equatoria strengthened the well-being of people suffering from mental health problems. One such person was Jessica, a 13-year-old girl who lives in Yambio town.

Jessica’s parents separated when she was five years old. She was left to live with her father. A few years after her parent’s separation, her father remarried. While Jessica was passionate about education, she couldn’t continue due to social and mental health challenges that she experienced.  The grief due to the loss of her mother made her challenges worse. She was always absent from school and could not cope with her studies. She said, ‘‘I was fearful, timid, and not motivated in front of my peers. To make it worse, I felt like no one cared.  I dropped out of school because that was my only choice. For years, I struggled with my mental illness with no medical help. I wandered in the streets of Yambio, knocking on people’s homes until I later found my way to my aunt’s house.’’

In the community, many people lacked knowledge of mental health. Therefore, people with mental health challenges were left to suffer and wonder in the streets. They are also stigmatized because most people in their community believe that mental illnesses may be caused by witchcraft or curses.  Additionally, the hospital did not have a mental health department or health care workers to handle mental illness, and there were no medicines for people with mental problems.

Gender Equality and Social Inclusion

World Vision prioritizes the Gender Equality and Social Inclusion (GESI) Approach that promotes equal and inclusive access, decision-making, participation, systems, and well-being of the most vulnerable; transforms systems, social norms, and relations to enable the most vulnerable to participate in and benefit equally from development interventions, builds individual and collective agency, resilience, and action and promotes the empowerment and well-being of vulnerable children, their families and communities.

The goal is to achieve sustained, transformational change at the individual, household, community, and societal levels so that all persons can enjoy fullness of life.

The Prioritizing GESI in Health Interventions Project in Western Equatoria sought to reach vulnerable groups such as Jessica and other persons with disabilities. The objectives were to integrate GESI into routine health care, build the capacity of healthcare providers, ensure equal access to and use of health services, and improve the health-seeking behavior of the poor, vulnerable, and marginalized populations so they can obtain health services based on their rights. To that effect, a mental health department at Yambio State Hospital was established.  The health workers were trained, and medical supplies and equipment were provided to equip and strengthen the health system to provide mental health services. The project implements mental health awareness campaigns through radio, community dialogue sessions, open-air mass campaigns, and during routine outreach activities in the community, and health discussions at the health facilities to educate community members that mental health problems can be treated at the hospital. To ensure more people are reached, faith leaders were sensitized and later used as advocates to mobilize the members of their congregations to access mental health services and ensure that the mentally challenged patients are not stigmatized but rather supported to access healthcare. The campaigns also challenged the stereotypes and negative perceptions that witchcraft, evil spirits, or curses cause mental illness. During the awareness campaigns in the community, Jessica was identified and referred to Yambio State Hospital for treatment.

GESI Impact

Mental illnesses are rampant but often neglected[2]. Establishing special units for patients with mental health problems and equipping health workers on how to treat them are critical. Since the GESI project’s inception in 2016, the mental health department at Yambio Hospital improved the lives of hundreds of patients with mental illness and other mental health challenges.

Jessica now lives with her aunt Lucia who took her to the hospital. Jessica was admitted and treated at the mental health unit. She said, ‘‘I heard people who receive help if they have issues bothering them. I was unwell physically and mentally when I came to the hospital.” While at the hospital, Jessica received medication and psycho-social support from the mental health department. As a result, her health significantly improved, and she is now happy. Jessica cannot do a lot of things that she could not do before due to her mental illness. For example, she can now do all household chores, such as cooking and washing. She also can go to school.  She is now able to live a normal life. She feels she is part of society and her life is back. Her aunt is also happy because Jessica can now participate in many social activities.

Mental health is often neglected yet is an essential component of healthcare. All health facilities at all levels must integrate mental health into routine care. Persons with disabilities, including those with mental illnesses, are equally important in society and can contribute to community growth and development once treated.

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The Prioritizing GESI in Health Interventions initiative is funded by the Health Pooled Fund, a consolidated fund from the British Government’s Foreign, Commonwealth and Development Office, the Government of Canada, the Swedish International Development, the United States Agency for International Development, the European Union, and the Global Alliance for Vaccines and Immunization. The development of this success story was part of the GESI Transform Project funded by World Vision U.S.

[1]  Aidan Goldsmith and Cockcroft-McKay. 2019. “Mental health in South Sudan: a case for community-based support.” Disasters 43(3):534-554.

[2] South Sudan HRP 2023

Story by: Scovia Charles, World Vision South Sudan Communications Coordinator; Stephen Leonard Epiu, World Vision South Sudan Health, Nutrition, and Water, Sanitation and Hygiene Technical Manager; Leticia Nkonya, PhD., World Vision United States GESI Senior Technical Advisor; and Vicky Poni Mikaya, World Vision South Sudan GESI Coordinator