Handicap International experience in Afghanistan - CBM

Mental Distress is a Concern for Persons with Disability and Needs to be Addressed UrgentlyTherefore, the curriculum of doctors and other health workers should include knowledge about mental health.This is a major challenge for the Directorate of Mental Health in the MoPH. Health facilities staff needs tobe equipped to address mental health issues. This problem is even more crucial when it comes to womenwith disability who show higher signs of anxiety and depression than men with disability. Gender sensitiveinitiatives (female health and social workers, specific health curriculum or specific section in all health services)need to be systematically incorporated into any programmes being designed. Lastly, it would be effective toaddress mental health in a concerted way through existing methods such as community and religious leadersand community health workers. Intervention should also make the family the focus for effective support 27 .Engaging religious and community leaders would need to be part of any strategy to provide health servicesto this population.Certain steps can be taken in order to overcome barriers to access of public health services such as reducingdistance to health facilities and cost:• Accessibility to health services refers to physical accessibility, but not only to that. Access needs tobe viewed in a wider sense starting with affordability, transportation facilitation as well as providingfacilities for the person who accompanies the person with disability.• Available generic drugs at the lowest possible price is also a challenge; if a good diagnostic is establishedbut people cannot afford the cure, then the health situation of the population will not be improved.• Setting up a referral system for disability and mental distress: this could be done alongside the trainingof various staff on disability. Bridges need to be built between the technicians and social workers whowork closely with persons with disability on one hand, and the health professionals on the other. Thiswould be a first step towards taking into account mental disability as well as psychological distress,which seem widespread in the country.Gender sensitiveinitiatives(female healthand socialworkers, specifichealth curriculumor specificsection in allhealth services)need to besystematicallyincorporated intoany programmesbeing designed27GHOSH N., MOHIT A., and MURTHY R S., “Mental health promotion in post-conflict countries”, The Journal of the Royal Society forthe Promotion of Health, November 1, 2004; 124(6): 268 - 270.The Health Picture31