Kufungisisa is an African word but it describes millions of people in every country in the world. The literal translation is “thinking too much” but, in local parlance, it means depression.
Growing up in Zimbabwe, Dr. Dixon Chibanda never gave Kufungisisa a thought. His childhood was ordinarily happy until he was 12 and a traumatic event threatened his outlook. His parents broke the news to Dixon and his two sisters that they were going to get divorced.
“I took it badly,” Dixon recalls. “I still remember praying in the night that my parents would not divorce, telling God that I would go to school, not complain and clean the house if he would make sure that my parents didn’t divorce, and when they did I felt as though God had abandoned me. I stopped praying for a long time. I thought God didn’t do what he was supposed to do.”
It was Dixon’s first close encounter with Kufungisisa and the beginning of what would become his future passion, although he didn’t realize it then.
“The family upheaval did shape my career, but not consciously. That was the first milestone in my childhood that contributed to my focusing on mental health.”
The next step came at age 15 when Dixon was the only child of color in an all boys high school.
Dixon remembers running away from school, back to the arms of his father where he and his sisters were Iiving.
“My dad said, you have to figure out a way of standing it, but I was crying so badly he decided to talk to the head master. My father complained and that made things worse for me.”
A year later, Dixon transferred to a more diverse high school where he started to recover from the psychological trauma he had suffered. And he began to think about his future, deciding that he wanted to be a doctor. He chose medical school in Czechoslovakia.
“When I got there it was déjà vu all over again with the whole racism thing. It was terrible. You are constantly reminded you are black, a foreigner, you’re not wanted.”
Nonetheless, Dixon made friends and met a musician who became a mentor, taking Dixon under his wing and making a huge difference in how Dixon coped and survived.
Dixon thought he would become a pediatrician or dermatologist but his experience during his residency in psychiatry opened a new door.
“I saw people moving around like zombies, like the movie ‘One Flew over the Cuckoo’s Nest.’ Doctors were using Electro-convulsive therapy for depression, also as a punishment. I distinctly remember watching people being electrocuted--that’s what it looked like. And I didn’t see positive results.”
Eventually Dixon came to the conclusion that you could get a lot done by simply talking to people without giving them medication. In his homeland of Zimbabwe, 1 in 4 people suffers from depression and anxiety and there are only 10 psychiatrists serving a population of 13 million.
Fast forward to 2005. As the only full-fledged psychiatrist working in the public health sector in Mbare, Zimbabwe, Dixon says he knew his duty was to take mental health to the community, but he didn’t know how. Then, another traumatic episode forced him into action. One of his patients, a 26-year-old woman named Erica, needed help but didn’t have the $15 dollar bus fare to get to him. She committed suicide in her family’s garden.
“No bus fare was the sparking point. I got into this state of soul searching trying to discover my role as a psychiatrist in Africa.
“After talking to colleagues, family and friends, I found out that one of the most reliable resources we have in Africa are grandmothers. They are the custodians of culture and wisdom in every community and they don’t leave their communities in search of greener pastures.”
Dixon had discovered an untapped asset to help improve the health of the community. Now he needed a place for them to do their work. The solution was surprisingly simple.
In 2006 The Friendship Bench began to take shape, funded by Dixon’s own money. 14 Grandmothers signed on to man the Friendship Benches. When a troubled patient visits a health clinic for help, they are evaluated and may be referred to The Friendship Bench.
These are ordinary benches situated outside the clinics where the local people are comfortable sitting and talking to an empathetic Grandmother about problems such as domestic violence and HIV.
“We’ve removed elements that you would get in traditional settings like hospitals and white coats,” says Dixon. “And you have these Grannies who are so casual and use ordinary language.”
The Grannies are trained to provide six sessions of individual problem-solving therapy to each patient and refer those at risk of suicide to their immediate supervisors. The first session lasts an hour or more, during which time the grandmother listens, establishes a rapport with the client and takes notes that are reviewed regularly by the professional team.
From the first group of 14 Grandmothers, today there are hundreds working in more than 70 communities, providing psychological support and intervention for more than 30,000 people in Zimbabwe over the past year, with plans to expand into Rwanda, Liberia, Malawi and Tanzania.
“There are more than 600 million people over 65 in the world,” says Dixon. “Imagine if we could create a global network of grandmothers in every major city in the world.”
Yes, imagine that, and then help make it happen!
Dr. Chibanda is an associate professor at the University of Zimbabwe Clinical Research Centre and the Director of the African Mental Health Research Initiative. He graduated from medical school in 1993. He also holds Master’s degrees in psychiatry and epidemiology and public health from the University of Zimbabwe and a PhD in psychiatry from the University of Cape Town.