An update on Tammy’s work in Zimbabwe

From left: Denford Gudyanga, Case Manager; Tendai Mayuni, Programmes Officer, M&E; Charity Shonai, Case Manager; Tammy Palmer and Mlambo Nefasi, Case Manager

In July we heard from Community Psychiatric Nurse Tammy Palmer, who was planning to travel to Zimbabwe to help spread the success of the Early Intervention in Psychosis (EIP) model of care. Here’s her first update.

I am now three months into my year-long career break, during which I’m supporting work to introduce the EIP model through the Zimbabwe National Association for Mental Health (ZIMNAMH), a non-governmental organisation that advocates for the rights of people with mental health problems.



In September I worked with ZIMNAMH’s national coordinator and clinical psychologist Ignicious Murambidzi and programmes officer Tendai Mayuni on developing the concept and how EIP can be delivered in Zimbabwe. Within the first few weeks we met with Dr Walter Mangezi, consultant psychiatrist at Parirenyatwa Hospital, who agreed to consult our EIP clients. He has also become a key figure in forming the EIP team.

We are piloting the programme at the University of Zimbabwe in Harare, plus the nearby rural Goromonzi district and urban area of Mufakose. We’ve met some key stakeholders including traditional healers, pastors, community chiefs and clinic nurses, gathering information about the prevalence and understanding of psychosis, the help sought and help offered.

As expected we found that some people, particularly in the rural areas but also within the university, understand psychosis to be a spiritual issue that should be treated by traditional methods which can include herbal medicine, spiritual medium, water and stones. We also heard stories of people being restrained and tied down due to violent or erratic behaviour. In addition we learned that people suffering from mental health issues who did not become violent often would not seek help, and neither would their families, so it would be managed within the home.

We also learned that substance abuse was an issue, particularly among young people.
As a result and to ensure our services are accessible to local people, we decided to partner with the Traditional Medicine Practitioners’ Council to host workshops and collaborate with traditional and faith healers. We have also formed a partnership with an NGO that offers support for people struggling with drug addiction called ‘CADASA’ which operates in Mufakose. We’ve also linked with ‘Africaid’, an NGO that offers support to young people suffering from HIV in Mufakose and Goromonzi.

The Ministry of Health has approved our programme and we’re now finalising the agreements. We have recruited our first case managers on a voluntary basis for six months initially. They will be with us for three days a week and include an occupational therapist, a social worker and a counsellor.

Our current priority is health promotion to both lay people and to stakeholders so that we can establish referral pathways and begin case management. We created brochures and posters which we handed out at World Mental Health day celebrations along with branded bottles, and we’ve given a presentation on Psychosis and Substance Misuse at Goromonzi High School. We have designed most of our health promotion materials and thanks go to Dr Eileen O’Regan from EIP Nottingham for doing a presentation on EIP in Zimbabwe and to Lundbeck Ltd for hosting it.

The EIP interest group is growing and we expect it to continue to grow. We’ve also applied for a research grant from Wellcome Trust and expanded our network of professionals to include Dr Chibanda (psychiatrist and PhD holder) under the Ministry of Health, Zimbabwe, as well as Derek Chambers from the University of Nottingham.

I hope to update you again toward the end of my year here.