Annual meetings | BasicNeeds Lao

For our first week with BasicNeeds’ team, we went on the field with the staff for the annual meeting with patients, families, village volunteers, local authorities and medical staff, taking place in each district’s temple. These meetings took place in Pakngum, Xayltany, Naxaithaong, Sikhottabong, Sangthong, Hadxaifong and Xaysetha provinces.

These annual meetings allow the staff:

- To give a presentation of the BN Model for Mental Health and Development
- To understand the difficulties faced by patients and their families, by medical staff, local authorities and volunteers
- To analyze the progress made, compared to previous years, according to patients and their families, medical staff…
- To share insights, experiences, patients’ needs and requirements …

Annual Meetings

Patients, volunteers and families were warned, a week earlier, by a speaker passing in the villages, that the BN’ meeting would take place in their district. At their arrival in the temple, participants are asked to register themselves (statistical tracking sheets are used to collect information, later used for research purposes)

Patient opening the meeting by singing.

At the beginning of the day, Anith, Khampone, Bouavanh and Siriphone present BN’s programme to the audience.

During the meeting, the assembly is split into five groups so that every single member is able to present himself. We noticed that it was a way for the staff that is was a way to win their trust and make them feel at ease. A regular problem faced by BNL’s officers is that people do not talk much because they are not used to expose their problems in public or because they don’t have much idea how they could tackle their issues.

Once they managed to overcome this embarrassment, BN staff gathers patients together as well as volunteers, local authorities and the medical staff to discuss three questions:

- What were the significant changes in the past few years?
- What were your contributions to the project?
- What are your suggestions to improve the programme ?

Like this epileptic depressive woman, many other patients are able to produce income, central in their long lasting recovery as it secures treatment and helps them to regain a pride in one’s self. Employment, made possible by BasicNeeds’ sustainable livelihoods module, helps them to rise from poverty. It facilitates their reintegration into their families as they are no longer an economic burden for them.

Patients are then invited to participate by reading their answers. Some patients said that, thanks to the treatment, they gained weight, they got a chance to participate to ceremonies such as weddings, they could work and hence help their families (selling bananas, working in the agriculture…). 80 % of patients helped by BN are able to generate income.
As for their contributions to the project, some patients mentioned they stopped drinking alcohol or taking other illegal substances.

A mother coming to the meeting with her youngest son (on the left) and her ill son (on the right).

The lives of families who care for a mentally ill person are often deeply impacted upon. They may have to give up work and use much of their finances in paying for treatment or travelling to hospitals. They may also suffer from similar discrimination as the mentally ill person they take care of.

During the meeting, families said that thanks to BN’ programme, they:

- Could have access to the medications for the person they cared for.
- Received training and hence were less worried / would get angry less easily / raised awareness of causes of mental disorders.
- Were given financial support to act within the sustainable livelihoods module.

Thanks to BN’s training, the medical staff can now undertake and deliver more effective mental health care. In 2007, The Mental Health Unit organized a 5-day Community Mental Health Training with BasicNeeds in Vientiane to provide knowledge about the recognition of mental illness’ symptoms.

If training widens the accessibility of mental health services, the medical staff however brought up some problems that still remain:

--> Hospitals are far away from remote rural areas and families can not afford transport to the capital city, the average income in Lao PDR being $1 per day.
--> Families do not have the skills to deliver mental health care and some patients take the wrong amount of pills. As a result, their symptoms reappear and they eventually stop taking treatment.
--> Some people who suffer from mental disorders in remote areas turn to traditional healers who are not able to deliver appropriate treatment.

Treatment costs 10 000 to 60 000 Kip/ month (1.3$ to 8$ per month). BNL provides hospitals with drugs which are sold for half price to patients. Poor patients receive free drugs. The money raised by selling drugs is used by hospitals to pay for treatment.

Due to a lack of funds, BN’ project will come to an end in the provinces out of Vientiane. Patients and families expressed their fear that once the project expires, the treatment would not longer be provided.

In Lao, families with mentally ill children often turn to monks, mental illness being often thought as caused by the possession of evil spirits. However, if monks manage to calm anxiety and depression, they are completely powerless to heal schizophrenia.

We were told that, due to community’s stigmatization, it was extremely difficult for families to accept that their child could be mentally ill. In small communities where everyone knows everyone, one can often hear about a patient : ‘Don’t touch this person, he is crazy’. Therefore, mental illness is often ignored. Through local authorities and volunteers, BN encourage those families to accept treatment and bring their child to the hospital.

During the meetings, we tried communicate with patients and their families even though the language barrier was hard to overcome.

Volunteers or community workers, trained by BasicNeeds, are a vital link between mentally ill people and the community, exploding myths and stigma. They identify mentally ill person, they help patients to pursue their treatment on the long run and they assure the link between patients and BN.

Baby Patient