A ZIMBABWEAN psychiatry professor, Dixon Chibanda, has come up with a novel way of providing desperately needed mental health therapy for his poorer compatriots: a park bench where people sit and receive free therapy with lay health workers, called mbuya (grandmothers).
His therapy model is now being exported to the football World Cup in Qatar, where 32 benches — each representing a team competing in the Fifa tournament — will be set up to cast the spotlight on global mental health.
Chibanda’s friendship bench has proved popular and offered much-needed, accessible therapy. Decades of deepening poverty have taken a mental toll on many Zimbabweans, imposing a burden on underfunded and understaffed psychiatric health services.
The friendship bench has helped bridge a shortage of professional healthcare workers in Zimbabwe — which has only 14 psychiatrists, 150 clinical psychologists and fewer than 500 psychiatric nurses serving a population of 16 million people.
“We need these alternative innovations to narrow the gap and my idea is to use grandmothers to provide therapy,” said Chibanda, adding that the benches were spaces “to share stories and through storytelling we can all be healed”.
World Cup/ WHO praise
The World Cup project is in partnership with the World Health Organisation (WHO), whose chief, Tedros Adhanom Ghebreyesus, has praised the initiative as “a simple yet powerful vehicle for promoting mental health”.
It is “a reminder of how a simple act of sitting down to talk can make a huge difference to mental health”, he said.
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Other countries to have adopted the friendship bench model include Jordan, Kenya, Malawi, Zanzibar and the United States, where 60 000 people in the Bronx and Harlem areas have accessed the therapy.
In Zimbabwe, about 70% of the population live below the poverty threshold.
Chibanda’s idea of friendship benches germinated after a patient he was treating at a government hospital took her life.
“She didn’t have $15 bus fare to come to the hospital to receive treatment for the depression,” he said.
“That was the initial trigger that instantly made me realise that there was a need to take mental health from the hospitals into the communities.”
‘A masterstroke’
Shery Ziwakayi has offered therapy from a garden bench in Zimbabwe’s capital, Harare, for the past six years, seeing an average of three clients a day.
“Through talking to us many have recovered and are leading normal lives again,” said Ziwakayi, who received training in basic counselling skills, mental health literacy and problem solving therapy.
The grandmothers are given a stipend for their services, and the operation is financed by Chibanda’s NGO, the Friendship Bench.
Her patients come from all walks of life — young, old, suffering from stress or dealing with drug addiction. Some are unemployed or in financial trouble, others are gender-based violence victims.
On a white sheet clipped to a blue handheld board, she asks clients if they are frightened by trivial things, feel run down, or have felt like taking their lives, among a host of other questions.
Choice Jiya, 43, said she owes her life to the service offered on the benches, having considered suicide when her husband lost his job shortly after she gave birth to their twins in 2005.
She now operates a small business making perfumes and soap.
From just 14 grandmothers in Mbare — Harare’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 assisted 160 000 people in the past two years alone.
The fallout from the COVID-19 pandemic has seen a spike in mental health problems and WHO estimates that more than 300 million people around the world suffer from depression.
Its most recent report “paints a very bleak picture”, showing six out of 10 countries with the highest suicide rates in the world are in Africa, said Chibanda.
For Harare’s Health Services director, Prosper Chonzi, the benches are a “masterstroke”.
“Demand for mental health services is high due to the economic situation. This is one of the best interventions. It has made a huge difference in terms of averting suicides,” he said.
