May 2025, IMHSUS News
During May 2025 IMHSUS was involved in the further development of the initiative at Mirembe National Mental Health Hospital in Tanzania to establish a more community-oriented approach to providing mental health services across Tanzania.
2-day training programmes were provided by Chris (IMHSUS Chair) and Mirembe colleagues to staff working at Morogoro and Babati District Hospitals to build up their knowledge and skills levels in identifying and meeting the needs of mentally ill people in their community.
The visit also coincided with International Mental Health Awareness Month, so Chris also assisted Mirembe staff in their national mental health awareness campaign “Afya ya Akili ni Afya” (mental health is health) and screening events in Iringa, and presented a short workshop to psychology students at Iringa University.
On 30 – 31 May Chris and Dr. Innocent Mwombeki (IMHSUS Board member) attended the first Tanzania Mental Health Summit in Kahama, where Innocent , Dr. Paul Lawala (Mirembe Executive Director) and Rachel Kombe (Mirembe Director of Nursing) gave a presentation about what is currently happening at Mirembe Hospital and their visions for the future. This was a good opportunity for networking with other statutory and NGO organisations, and donors, who are supporting people with mental health problems in Tanzania, particularly those who are working with the youth population.
June 2024, New Partner
IMHSUS has just signed a Memorandum of Understanding with the Gambia Ministry of Health (see Partners page) following discussions with the Manager of the National Mental Health Programme, Mam Jarra Marega. This is an important development for our NGO as it will enable us to work with the Ministry of Health to impact the provision of mental health and substance use care across the whole country. This agreement follows a number of weeks’ work on developing a grant application to help transform mental health service in The Gambia. Our agreed grant funding application to the European Commission will enable the establishment of 10 employment projects across The Gambia for people with mental health and substance use problems, which will also function as mental health information and advice centres, and providers of public mental health education programmes to schools and local communities. These projects will be funded for three years and after that, are expected to be self-supporting and sustainable. More news later!
April 2024, Mirembe Hospital visitors to London
The four members of Mirembe National Mental Health Hospital staff have now completed their 6-week visit to London. During their visit they spent time in various community-based mental health, substance use and forensic teams across the CNWL catchment area, observing team and clinical interactions, and finding out about operational and management structures. They have now drawn up a strategic action plan to discuss with colleagues at Mirembe and the Tanzanian Ministry of Health. CNWL and IMHSUS will be working with them to translate this into achievable objectives over the coming months.
At the end of their stay they gave a brilliant presentation to about 50 CNWL staff about cultural and belief influences on mental health in Tanzania, an overview of Mirembe, its history and future aspirations, and a presentation of Mirembe’s response to the Hanang landslide disaster in December 2023.
CNWL hopes to host more colleagues from Mirembe via the Commonwealth Professional Fellowship Scheme in 2025.
March 2024, Developing community-based mental health services in Tanzania
Following the three-month visit to Tanzania in early 2023, to help Mirembe National Mental Health Hospital develop community-based mental health and substance use services, four colleagues from Mirembe are visiting Central & North West London NHS Foundation Trust for six weeks in March and April 2024.
Their program, fully funded by the Commonwealth Professional Fellowship Scheme, includes various training events and week-long visits to several community-based mental health, substance use, and forensic services across London. This will enable them to observe some of the clinical interventions with patients and gain an understanding of the operational, management, and communication structures underpinning the teams. During this visit they will also be giving presentations about cultural and belief influences on mental health in an East African context, an overview of Mirembe Hospital and its aspirations for the future, and a presentation on the mental health trauma response by Mirembe staff to the major landslide in Hanang District in December 2023, which claimed the lives of more than 90 people. IMHSUS will hopefully follow up on this work on developing community-based mental health services in-situ later this year with support for training and operational development.
November 2023, Focus on Mental Health Conference, Moshi, Tanzania
On November 3 and 4, around 50 mental health experts from different institutions in East-Africa and around 20 mental health experts from the Netherlands gathered at the Bristol Cottages Conference Center in Moshi for the Focus on Mental Health Conference. IMHSUS trustees Dr. Mwombeki, Dr. Mbatia, and Dr. Van der Markt attended and contributed to the conference.
The main aim of the conference was for the different cultures to learn from each other regarding mental health treatment and systems.
August 2023, Impact Creators and IMHSUS Secured a Grant from Paula Foundation to Provide Sanitary Pads to a Girls’ School
Impact Creators, a Kenyan NGO, has partnered with International Mental Health and Substance Use Support (IMHSUS) to secure a grant from the Paula Foundation to provide sanitary pads to a girls’ school in the poorer regions of Nairobi.
Impact Creators is a non-profit organization dedicated to improving the mental health and well-being of adolescents, especially adolescent girls. They provide workshops at schools on personal growth, mental health, and menstrual hygiene.
The Paula Foundation has vouched to supply a batch of sanitary pads to a school that is deemed to be in greatest need. This will help to ensure that girls have access to the menstrual products they need to stay healthy and attend school during any time of the month.
“This grant is a significant boost for Impact Creators and IMHSUS, and will allow us to expand our reach and impact.” Said Afra van der Markt, one of the founders of IMHSUS “We are grateful for the support of the Paula Foundation and are excited to continue our work to improve the lives of young women across the region.”
The scarcity of access to sanitary pads is a major problem for girls in low- and middle-income countries. It can lead to girls missing school, experiencing health problems, and even dropping out of school.
This grant will help to address this problem and ensure that girls in Nairobi have the opportunity to get an education, regardless of their menstrual status.
March 2023, Tanzania visit
IMHSUS Chairperson, Chris Bumstead, is in Tanzania for a 3-month self-funded visit combining his work for the UK-based Central & North West London NHS Trust, where he works part-time as the International Healthcare Partnerships Coordinator, and the goals of IMHSUS.
The NHS Trust received a small grant to enable 2 volunteers to travel to Dodoma, Tanzania for a month to provide training to staff at Mirembe National Mental Health Hospital, as a first phase of a much bigger project (which has been discussed for many years) of helping them to develop a community-based mental health service. The volunteers succeeded in training 24 “Champions” as trainers who then delivered training to 13 of their colleagues at Mirembe Hospital and 22 staff at 2 district hospitals in the Dodoma Region (Kongwa and Kondoa). The focus of the 4-day training for the Champions, who are all professionally trained multi-disciplinary clinicians, was on the considerations required for providing an effective community-based service – good care planning, risk assessment and management, relapse prevention, engagement with patients, their carers and the community, and safety for staff working alone in the community.
The Champions then in turn trained their colleagues at Mirembe over four days to refresh their knowledge of mental health and substance use conditions and their medical treatment and psycho-social interventions, using a slightly adapted version of their own training (translated into Swahili), which they co-designed. This package was then delivered to the district hospitals with a further-abbreviated 2-day version. The response to the training from all trainees was very enthusiastic, with many trainees remarking how this approach is going to really benefit them in the way they provide care for their patients, resulting in better care for the patients and ultimately a more efficient and economic healthcare system. But they all want more training!
Many of the IMHSUS board members have either worked at Mirembe Hospital or have long-standing connections with the hospital, so it makes sense for this initiative to become part of IMHSUS’s work plan and for us to seek funding to expand on this initial phase. Chris is now working with the Champions to devise the infrastructure and practices that will underpin this new service, looking at team composition and organization, referral criteria, communication and documentation, budgets, and the ongoing training program for staff. While he is there he will also be conducting focus groups with staff and patients, so that their voices can be heard and contribute to the service development process. He will also run some workshops so that more staff are aware of how they can improve and coordinate the care their patients receive in the hospital and enable them to live a better-supported life in the community when they are discharged.
Mirembe Hospital is keen that this initiative is successful and is prepared to start the new service, even without additional funding, and to run a pilot project in the Dodoma region using existing staff resources, by thinking imaginatively about how they can manage their time. Their rationale for this is that by helping patients to stay in the community they will relapse less frequently and therefore not require frequent re-admissions to the hospital, which is often the case now. This will reduce the overcrowding at the hospital, have a positive impact on the hospital budget and how it can be used, and enable staff to provide a better quality of care for the patients who need to be admitted because they will have more time to spend with each of them. Ultimately in order to be sustainable the service will require additional funding, mainly if it is to be expanded to incorporate all the regions of Tanzania that continue to refer patients to Mirembe. This is going to be the focus of discussions with the Tanzania Ministry of Health Mental Health Department. IMHSUS will therefore be looking for funding opportunities that support this work and hopefully, with agreed and signed Memoranda of Understanding with both Mirembe Hospital and the Tanzania Ministry of Health we will have a better chance of success in our funding bids.
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