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Mental Health in Cabo Verde

Mental Health in Cabo VerdeA stunning collection of islands off the coast of West Africa, Cabo Verde is the home of more than 600,000 people. After gaining independence from Portugal in 1975, Cabo Verde quickly built a successful democratic government. Despite economic progress, opportunities remain limited. Droughts have led many to emigrate. Among those who have stayed, many live without access to clean water, nutritious food or adequate housing, impacting mental health.

Mental Health Rate in Cabo Verde

Cabo Verde has made significant progress in all areas since gaining its freedom. The mental health of its people has been no exception. In 2017, there were no reported mental health professionals. Three years later, 11 total psychiatrists, 40 psychologists, 23 social workers, one mental health nurse and one occupational therapist were reported, demonstrating the country’s effort at combating mental health.

Suicide rates have also steadily declined, dropping from 17.46 per 100,000 people in 2013 to 15.23 in 2019. However, nearly 5% of people living in Cabo Verde still experience depression. To combat this, the Cabo Verde government has expanded mental health resources. In addition, it has launched initiatives such as educational conferences to reduce the stigma surrounding mental health.

Reducing Stigma

World Health Day is observed annually on April 7. In 2017, the World Health Organization (WHO) partnered with Cabo Verde’s Ministry of Health and Social Security (MSSS) to organize a conference focused on depression. The conference aimed to tackle the issue without stigma or bias. Under the theme “Depression: Let’s Talk,” the event occurred in the nation’s capital and welcomed everyone to participate. Before the conference, the WHO held press briefings to discuss topics such as stigma, strategies for raising awareness about depression, its impact on those affected and the available resources for support.

A series of events also took place across Cabo Verde on the same date. At the University of Cabo Verde, a roundtable discussion was held with several doctors from the WHO and MSSS, focusing on discrimination in mental health. At the Agostino Neto Hospital Central Hospital in Praia, a “Conversation morning,” was held. Pregnant and new mothers were invited to participate in an open discussion about postpartum depression. Led by the clinical director from the hospital alongside doctors from the WHO, patients were educated on signs of postpartum depression and how to navigate it.

Government Support

The day concluded with a forum on depression at the Government Palace. During the event, the forum’s chairman, Dr. Arlindo do Rosário, emphasized that the work of the WHO and MSSS “further highlight the government’s firm commitment to actually include mental health in our work.”

Recently, Dr. Angel Olider Rojas Vistorte hosted a conference on mental disorders and social media usage in Praia. The event, held in June 2024, was organized by the Jean Piaget University of Cape Verde, the Ibero-American University Foundation and the European University of the Atlantic, where Vistorte is affiliated. The conference aimed to create a safe space for discussing mental health and promoting healthy dialogue about mental health issues. In his lecture, Vistorte went beyond depression, addressing anxiety and eating disorders as potential consequences of excessive social media usage.

Conclusion

Cabo Verde has made notable progress in improving mental health care, reducing stigma and increasing access to mental health professionals. Despite challenges such as poverty and limited resources, the country has seen a decline in mental health disorders and suicide rates. Educational initiatives and open discussions have further supported awareness and progress. These positive strides reflect Cabo Verde’s commitment to better mental health for its people.

– Hannah Pacheco

Hannah is based in Boston, MA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Pixabay

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The Impact of Poverty on Mental Health

Impact of Poverty on Mental HealthPeople from lower-income countries are often overlooked as a target audience for mental health care. In impoverished countries, in particular, mental health care is crucial for breaking the cycle of potentially exacerbated mental illnesses that disproportionately affect underprivileged populations. According to the World Health Organization (WHO), 13% of people across the globe suffer from mental health disorders, varying in type and impact, with depression and anxiety being the most prevalent of them all. Poverty puts people at a higher risk for developing mental health disorders, and makes it difficult for those people to receive proper care. Only 33.33% of people suffering from depression around the world may have access to mental health care. The mental health care that is available is limited and poverty negatively affects it.     

The Impact of Poverty on Mental Health

According to research that Yihan Sun of the Department of Science at the University of British Columbia in Canada conducted, “mental illness … increasingly causes severe disability in both wealthy and underdeveloped countries,” and “poverty is one of the factors that affect mental health.” In short, the relationship between mental health and poverty is that of a snowball effect. 

Mental health as a result of poverty can make preexisting mental illness worse. More specifically, poverty can worsen symptoms of depression, anxiety and post-traumatic stress disorder (PTSD). Yihan Sun goes on to mention that depression can result from concerns about “erratic income and spending” related to poverty. For example, anxiety can increase due to people not being able to make bill payments on time. People may also experience PTSD when they live in locations that are “disaster-prone” to such things as “fire incidents, traffic fatalities, environmental hazards and gun-related violence.”

Non-Communicable Diseases and Mental Health

Mental health can be considered a non-communicable disease (NCD), which is a disease that is not transmissible from one person to another and often includes chronic diseases and conditions like diabetes, heart and kidney disease. Mental health disorders have links to various non-communicable diseases. People suffering from diabetes and cardiovascular disease can be more at risk of developing anxiety or depression.

Unfortunately, non-communicable diseases are a significant cause of death for low to middle income countries. According to the World Health Organization (WHO), for the countries of Angola and the Central African Republic, non-communicable diseases are the broader cause of at least 20% of the deaths of their population in 2021. For the countries of Bangladesh and Cambodia, NCDs are the cause of more than 60% of the deaths of their populations in 2021. These countries are all classified as being low-to-middle income countries according to WHO.  

Current Global Poverty Status

Despite the devastating impact of poverty on mental health, particularly in developing countries, there is hope on the horizon. In the past 30 years, poverty has steadily and significantly declined in regions such as Latin America and the Caribbean, Eastern and Southern Africa, sub-Saharan Africa and Western and Central Africa, with poverty rates decreasing by at least 13% in each region—some by as much as 28%. 

East Asia and the Pacific have experienced the most dramatic improvement, with poverty rates plummeting from 65.2% in 1990 to just 0.6% in 2024. Although Latin American and Caribbean countries haven’t seen as much of a decline in poverty as the rest of the world, their poverty rate has still diminished significantly compared to the ’90s. 

The MINDS Act

Where there is hope, solutions to persistent problems are often within reach and this holds for those living in poverty in low- and middle-income countries. One such solution is the Mental Health in International Development and Humanitarian Settings (MINDS) Act, which offers a pathway to addressing these challenges.

The MINDS Act aims to enhance investment in mental health care from high-income countries, such as the U.S. and the U.K., to establish or support programs focused on breaking the cycle of poverty worldwide. By doing so, it seeks to address the reciprocal impact of poverty and mental health, helping to disrupt the harmful connection between the two.

Children would benefit significantly, as the rate of their anxiety and depression (due to living in poverty) would lessen. They would also be less susceptible to developing psychiatric disorders in their adulthood.

Solutions in Rwanda

Another solution could be in the form of programs like the ones implemented in Rwanda, after the sovereign state’s genocide of 1994. Findings determined that around 94% of the survivors witnessed traumatic events that would affect them decades later in the form of PTSD, depression and panic disorder. In response to the aftermath of the genocide, the state created a community-based psychotherapy that allows for “healing and peacebuilding for survivors.” Rwanda then proceeded to create the Gacaca Courts through the Government of National Unity, which would provide justice for survivors while emphasizing accountability for the perpetrators. The sovereign state eventually acquired enough stability to be able to provide it’s citizens with universal health coverage for mental health to each citizen for $2 a year.

Through the implementation of these programs, Rwanda has successfully and significantly lessened the state’s suicide rate from 8.84 in 2005 to 5.57 in 2018 as a result of community-based psychotherapy.  More than 1.2 million cases were tried in more than 12,000 courts after the creation of the new judicial system of the Gacaca Courts. Life expectancy within the country has since risen from 56 to 70 after the implementation of universal health care and the inclusion of mental health.

Conclusion 

Rwanda is proof that mental health care is incredibly important to the health of a community, especially during the aftermath of traumatic and tragic events. With the implementation of programs that changed and incorporated mental health care into Rwanda’s judicial system, universal health care system, and community, the country has, since the genocide of 1994, been able to look forward to its future with much better days ahead. It is possible to provide mental health care and restore hope, and solutions can emerge with humanity at the wheel.

– Sadie Treadwell

Sadie is based in Grovetown, GA, USA and focuses on Business and Good News for The Borgen Project.

Photo: Pexels

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The Connection Between Poverty and Mental Health

Poverty and Mental HealthThe United Nations (U.N.) Special Rapporteur on extreme poverty presented a new report at the 79th session of the U.N. General Assembly. This report details how the issues caused by mental health and poverty feed into one another, creating a vicious cycle.

It finds that those on lower incomes are three times more likely to suffer from depression, anxiety and other mental illnesses. Although the World Health Organization (WHO) has declared mental health a basic human right, 11% of the world’s population suffers from a mental illness.

Poverty Increases the Risk of Mental Health Conditions

Poverty creates psychological distress and, therefore, causes mental illness. Economic insecurity, job insecurity or poor-quality jobs, unemployment and underemployment (that is, being forced to work part-time due to lack of full-time employment) and less access to green spaces are all conditions of poverty that are proven to create stress. People experiencing poverty are additionally less likely to contact psychiatric services.

Social stigmas and self-stigmas (a negative perception of oneself that lowers self-esteem) also make it harder for people with mental illnesses to get a job and housing and to form supportive social networks. Stigmas likely play a part in the unwillingness of public policymakers to invest in tackling mental health issues. 

Africa Institute of Mental and Brain Health

Based in Kenya, this organization provides affordable and accessible mental health services. Several of its current projects focus on tackling both mental illness and poverty. For example, the initiative’s HOPE project aims to improve the outcomes of those who are homeless and have severe mental health in Kenya, Ghana and Ethiopia.

Strong Minds

StrongMinds provides free, community-based therapy in low-income areas, with a primary focus on Africa, in its mission to radically expand mental health care for people with depression globally. It currently operates in four countries but has been in Uganda since 2013, providing therapy to women, children, refugees and incarcerated populations. About 16% of treated women report increased work attendance and 30% say their children are less absent from school.

WHO

Since 2014, the WHO has endorsed group interpersonal psychotherapy as a treatment for mental illness in vulnerable people in low-income regions. It has provided more than 160,000 women and children in Uganda and Zambia with group talk therapy. More than 80% of those treated were depression free after treatment and remained so for six months.

Final Remark

The report identifying the contributors to the cycle of poverty and mental health recommends more investment in mental health care. It also suggests the implementation of social protection schemes to support people in need. The charities carrying out this work are already seeing a massive difference. 

– Georgia de Gidlow

Georgia is based in Hertfordshire, UK and focuses on Global Health for The Borgen Project

Photo: Wikimedia Commons

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Mental Health in Benin: Challenges and Progress

Mental Health in Benin
Poverty and mental health are deeply intertwined in Benin, where nearly 38.5% of the population lives below the poverty line. Poverty exacerbates mental health issues, creating barriers to accessing necessary care. Mental health disorders such as anxiety and depression disproportionately affect individuals in low-income settings due to stress, lack of support, and stigma. These findings echo broader trends seen in other low- and middle-income countries, as outlined by the World Bank, which identifies the lack of infrastructure as a key impediment to effective mental health interventions.

Challenges in Mental Health Accessibility

Access to mental health services in Benin is limited, with the majority of specialized care facilities located in urban centers like Cotonou and Porto-Novo, leaving rural populations underserved. According to the World Health Organization (WHO), the country faces critical shortages in mental health professionals, with fewer than one psychiatrist per 100,000 people. Additionally, there are only a handful of psychiatric hospitals, and mental health care is often integrated into general hospitals, which lack the necessary resources and trained personnel. This imbalance between urban and rural health care access is further exacerbated by societal stigma, which discourages individuals from seeking treatment, and the absence of a comprehensive national mental health strategy.

Role of Poverty in Amplifying Mental Health Issues

From a human rights and social justice perspective, this cycle of poverty and poor mental health represents a critical ethical issue. According to the International Covenant of Economic, Social and Cultural Rights, “everyone has a right to the highest attainable standard of physical and mental health”. However, as Paul Farmer notes, the needs of the world’s poor are often overlooked, and the structural inequalities that perpetuate mental health disparities are frequently neglected by global health and foreign policy communities. Addressing these inequalities requires integrating human rights frameworks into public health strategies, emphasizing beneficence, autonomy, and resource equity to empower marginalized populations and break the cycle of poverty and mental illness.

Progress Through Community-Based Interventions

Efforts in Benin such as the “Saint Camille Solution” have made strides in addressing mental health challenges through community-based interventions. These include awareness campaigns, support groups and partnerships with international NGOs for resource mobilization. Such programs highlight the importance of addressing both societal stigma and resource allocation.

Moving Forward: Policy and Investment Needs

While some progress has been made, significant work remains to fully integrate mental health into Benin’s healthcare system. Strengthening the system requires a multifaceted approach, beginning with the training and deployment of specialized mental health professionals across the country, particularly in underserved areas. Existing professionals will need to receive continuous training, supervision, and evaluation to enhance their effectiveness. 

– Olivia Barker

Olivia is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Mental Health in Namibia 

Mental Health In Namibia
Extreme poverty looms over Namibia, negatively affecting its population of 2.6 million and keeping living standards low. These high levels of socioeconomic hardship often cause people to overlook the country’s mental health issues, although illnesses such as anxiety, depression, Post-Traumatic Stress Disorder (PTSD), trauma, bipolar disorders and psychosis affect 25.6% of its population and the number could double by 2025. Here is information about the correlation between poverty and mental health in Namibia.

Poverty and Mental Health in Namibia

Namibia has a poverty rate of 47% and 46% of its youth workforce is unemployed, according to ISS African Futures. These factors contribute to a lack of financial resources and constant pressure to earn more, leading to high stress and anxiety levels. The Namibian reported that “approximately 70% of Namibians suffer from stress and chronic health conditions.” Additionally, people with low incomes often have limited access to mental health services, further worsening their situations.

The country suffers from a traumatic history. From 1915 to 1990, apartheid South Africa occupied Namibia, during which many of the latter’s citizens were killed and displaced. The country only gained independence in 1990, after a long, drawn-out war, which caused 20,000 to 25,000 deaths.

HIV and Psychological Issues

Furthermore, Human Immunodeficiency Virus (HIV) is quite prevalent in Namibia. According to the World Bank, the virus infects 11% of adults aged 15 to 49 years in the country.

Studies have shown that HIV has a direct link to mental health; it causes damage to brain cells and leads to a variety of neurocognitive disorders. Living with HIV also causes acute psychological distress and depression, both for the patient and their loved ones. A 2024 study found that depression affects 24.6% of HIV patients and 17% suffer from anxiety.

Approximately 9.3% of Namibians die from HIV. The burden of carrying the disease and the discrimination against it also increases the risk of suicide. From April 2020 to March 2023, 1,542 Namibians committed suicide, 82% being men. 

Cultural Influences

Another factor that further complicates mental health in Namibia is the stigma and cultural beliefs toward mental health issues. Many Namibians consider mental illness to be a sign of weakness or low willpower. Because of this, people go undiagnosed and there is less availability of treatments. A 2020 study showed that the level of public prejudice against mental health was 41% on the Community Attitudes towards Mental Illness (CAMI) scale.

The country has only two major mental institutions: Windhoek Central Hospital, which dedicates only 220 beds to mental health care, and Intermediate Hospital Oshakati, which offers 60 beds but often deals with 200 patients at once.

Solace in Drugs and Alcohol

Citizens affected by poor mental health in Namibia often cope through substance abuse. However, this can further exacerbate their condition and can result in psychosis, bipolar disorders, and depression, along with a decline in physiological health as well.

 The United Nations Office on Drugs and Crime reported that: “in 2020, the Government of Namibia confiscated 843,892 kg of cannabis, 4,930 tablets of mandrax, 2,922 grams of crystal meth, and 1,072 grams of cocaine.” Also, in 2023, WHO stated that Namibia drinks “2.38 of pure alcohol per capita amongst people aged 15 or above.”

Alleviating These Issues

Despite all these challenges, there is still a ray of hope for Namibians. Countless organizations have stepped up to advocate for mental health awareness and solutions. Established in 1980, Lifeline/Childline focuses on supporting emotional wellness and child protection in Namibia. It now has wide-reaching services all across the country and has gained international recognition from organizations such as USAID and UNICEF.

Lifeline/Childline operates a free counselling helpline that is available 24/7, providing mental health support to individuals suffering from a wide range of issues such as anxiety, depression and trauma. The organization provides counselling via telephone, text message or in person, making them accessible to a large sum of the population. From April 2024 to June 2024, its toll-free helpline answered 10,101 calls.

The non-profit also runs awareness programs that aim to reduce the stigma regarding mental health in Namibia and the importance of seeking help through social media campaigns, educational workshops, community outreach programs and its radio show.

Even though Namibia seems to be struggling in the face of these challenges, it’s important to acknowledge the fact that non-profits such as Lifeline/Childline are making a palpable difference and are changing people’s lives for the better. With more progress from the country’s numerous non-profits and government, mental illness rates in Namibia will likely decline and its citizens will be able to have bright, optimistic futures.

– Mustafa Tareen

Mustafa is based in Lahore, Punjab, Pakistan and focuses on Global Heath and Celebs for The Borgen Project.

Photo: Flickr

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IDIL: Mental Health Access for Indigenous People in Oaxaca

IDIL: Mental Health Access for Indigenous People in Oaxaca The United Nations General Assembly (UNGA) has designated 2022 to 2032 as the International Decade of Indigenous Languages (IDIL). The United Nations Educational, Scientific and Cultural Organization (UNESCO) leads global efforts to support this initiative. In Mexico, the project La Enfermedad de la que Nadie Habla en el Pueblo (ENHP) aims to expand access to mental health information and services. It does so by providing resources in Indigenous languages and incorporating Indigenous perspectives.

The International Decade of Indigenous Languages

The UNGA established the International Decade of Indigenous Languages (IDIL 2022-2032) to fulfill the objectives of the United Nations Declaration on the Rights of Indigenous Peoples. Throughout this decade, initiatives focus on preserving, revitalizing and promoting Indigenous languages worldwide. The Australian Government reports that many of these languages have reached a critical level of endangerment.

UNESCO estimates that approximately 40% of languages spoken will no longer be in use a century from now. Indeed, many are likely to be Indigenous languages. During International Decades, global facilitators coordinate action and mobilizations to raise awareness on a particular topic. La Enfermedad de la que Nadie Habla en el Pueblo is one example of coordinated action for IDIL. 

“La Enfermedad de la que Nadie Habla en el Pueblo”

Indigenous youths developed the project La Enfermedad de la que Nadie Habla en el Pueblo (ENHP), which translates to The illness nobody talks about in the village, to make mental health information accessible in Indigenous languages. ENHP successfully provided information in 30 Indigenous languages, addressing a critical gap in health communication. In a UNESCO article, the director of the Network of Interpreters and Intercultural Promoters, Eduardo Ezequiel Martínez Gutiérrez, stated that at least 30% of Oaxaca’s population is not fluent in their doctor’s or government’s language, a key issue ENHP aims to solve. The project also trains interpreters to act as intermediaries in mental health spaces.

According to Socialab, 65% of Indigenous people in Oaxaca, who speak up to 177 linguistic variants, cannot engage with content in Spanish. In response, the ENHP produced short videos with interpreters from various Indigenous communities. These videos discuss the symptoms of anxiety and depression and offer coping strategies. The project’s translation and interpretation efforts exemplify the goals of the International Decade of Indigenous Languages by improving access to mental health care for Indigenous peoples in a culturally relevant context.

Implementation of ENHP

The UNESCO program Impulso Joven, “Because Youth Matter,” awarded $10,000 in startup capital to 20 youth projects across 11 Caribbean and Latin American countries, including ENHP. Impulso Joven also provided practical workshops, training sessions and mentorship. The ENHP project unfolded in four stages. Initially, each interpreter completed a course on emotional disorders and mental health. In the second stage, interpreters adapted the course content to be culturally and linguistically relevant for Indigenous territories. Following this, the third stage involved the creation of audio and video materials. Finally, in the fourth stage, the team distributed these materials to Indigenous communities to help reduce the stigma around mental health.

Importance of Reconceptualization

ENHP’s efforts to reinterpret mental health information plays a crucial role in making mental health resources accessible to more Indigenous Peoples. This approach aligns with the goals of the International Decade of Indigenous Languages. The goals focus on actions supporting the United Nations Declaration on the Rights of Indigenous Peoples. The American Psychiatric Association (APA) has studied the barriers Indigenous Peoples in the United States (U.S.), Canada, the Pacific Islands and Australia face in accessing mental health services. These barriers include mistrust of mainstream services, social stigma associated with seeking help, insufficient awareness to recognize signs of poor mental health and the challenges of accessing mental health services in remote areas.

APA emphasizes that barriers to accessing mental health services for Indigenous populations should be viewed within the broader context of systemic, structural and societal challenges. Sandra García Reyes, an educator with ENHP, told UNESCO that mental health and self-care are integral to community care. ENHP has reinterpreted mental health information from a Western perspective to a holistic and relational approach. Furthermore, they take into account the intergenerational impacts of forced assimilation, relocation and discrimination.

Impacts of the IDIL

IDIL provides a framework for collaboration among diverse stakeholders, promoting coherence, continuity and cross-cultural dialogue in actions taken worldwide. IDIL is a global call to develop policies and make strategic investments to protect and revitalize Indigenous languages and support their speakers. According to UNESCO, IDIL involves 4,213 communities from 60 countries and 1,772 organizations. Across these communities, 202 languages are spoken and 2,635 events have been organized to recognize IDIL. Projects like La Enfermedad de la que Nadie Habla en el Pueblo exemplify how youth-led initiatives can enhance the lives of Indigenous communities by incorporating intersectional, community and cultural perspectives while safeguarding their languages.

– Tanisha Groeneveld

Tanisha is based in Leeds, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Initiatives Supporting Mental Health in Zimbabwe

Mental Health in ZimbabweAs of 2024, Zimbabwe’s population stands at approximately 16 million, highlighting an urgent need to support mental health initiatives as more people require access to care. Currently, 54% of Zimbabweans lack access to health care and the suicide rate is 14 per 100,000 people. With less than 20 psychiatrists available for the citizens of Zimbabwe, the mental health care gap is stark.

However, with support from developed countries and effective government programs, Zimbabwe is making significant strides in addressing its mental health challenges. Key initiatives include the World Health Organization’s Special Initiative for Mental Health and the Zimbabwe Life Project. These efforts aim to improve mental health systems, foster successful global partnerships and offer individuals and nations the chance to contribute.

The WHO’s Special Initiative for Mental Health

In 2020, more than 100 stakeholders, including nonprofits and politicians, backed the strategy outlined by WHO’s Special Initiative for Mental Health. These programs provide training to equip mental health professionals and caregivers with the skills needed to offer effective mental health support. Between 2021 and 2022, the WHO’s Special Initiative for Mental Health increased investments in mental health.

Furthermore, it expanded the capacity of general health staff in primary health care centers to identify and assist Zimbabweans experiencing mental disorders. The initiative emphasizes the importance of human rights for those struggling with mental health, including access to information and the right to privacy. This approach fosters a more inclusive and supportive environment.

The Zimbabwe Life Project

The Zimbabwe Life Project (ZLP), established in 2018, is a nonprofit organization that promotes mental health, well-being and resilience in Zimbabwe. The organization seeks to develop a skills exchange program involving mental health professionals in Zimbabwe. This initiative will facilitate participatory exchanges of knowledge, skills and experiences.

A primary objective is to share specialized mental health expertise and foster positive partnerships between mental health professionals in the U.K. and Zimbabwe. Furthermore, ZLP initiatives focus on continuous, comprehensive mental health care in Zimbabwe. In 2019, the organization donated medical equipment worth more than $20,000 to the nation.

Conclusion

Supporting mental health initiatives in Zimbabwe is crucial as the country faces significant challenges in meeting the mental health needs of its population. A combination of limited resources and a shortage of trained professionals has made access to care difficult for many. However, focused efforts are underway to improve mental health systems, foster global collaboration and provide essential knowledge and resources to those in need.

International organizations like the WHO have supported Zimbabwe’s mental health sector. Indeed, programs like the WHO’s Special Initiative for Mental Health and the ZLP have made strides in increasing awareness, training health care providers and integrating mental health care with primary health services. These initiatives aim to treat mental illness and promote long-term resilience and well-being across communities.

– Alysha Miller

Alysha is based in Toronto, ON, Canada and focuses on Global Health for The Borgen Project.

Photo: Flickr

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How Elderly Poverty in Madagascar Impacts Mental Health

Elderly Poverty in MadagascarMadagascar, located off the southeastern coast of Africa in the Indian Ocean, is the fifth-largest island in the world. With a population of more than 30.8 million people, Madagascar is renowned for its rich biodiversity and unique ecosystems, including the infamous lemurs and lush rainforests. Despite its natural wealth, Madagascar faces significant challenges in poverty alleviation, consistently ranking among the world’s poorest countries. Its citizens navigate poverty through various means, including subsistence agriculture, fishing and small-scale entrepreneurship, while also relying on community support networks and resilience in the face of adversity. However, the mental and emotional toll elderly poverty in Madagascar causes heavily disturbs the culture, beauty and essence of its climate and people.

Poverty and Mental Health in Madagascar

When examining the ramifications of poverty on mental and emotional well-being, it is crucial to note its pervasive role among senior citizens. According to “Face of Poverty in Madagascar,” a poverty, gender and inequality assessment that the World Bank created, “Only 2.4 percent of the population in 2010 was 65 and older, and elderly poor represented only 2 percent of the poor population.” According to ScienceDirect, “Antananarivo-Renivohitra, the capital district of Madagascar, had an estimated population of 1,275,207 in 2018 (RGPH-3, 2018), of which only 5.5% were over 60 years old.”

While the population and poverty in Madagascar predominantly have a youthful demographic, this does not mean that poverty affecting the island is not detrimental to the psychological well-being of older Malagasies. Poverty leads to food insecurity, lack of safe housing, limited employment opportunities, reduced social mobility and education disparities. The World Bank reports, “The highest prevalence of illiteracy in 2010 was among the elderly population of 64+ years old (50 percent).” Without academic instruction, obtaining secure employment becomes increasingly difficult, forcing Madagascar’s elders to pursue jobs that require less intellectual prowess and more physical stamina, a skill that diminishes with old age.

The Impact of COVID-19 on Madagascar

SARS-CoV-2 (COVID-19) arrived in Madagascar with airborne passengers traveling from Europe in March 2020. While the country took preventative measures to limit the spread of the virus, illness struck Madagascar’s population predictably targeting those of older age. According to original research conducted by BMJ Global Health, due to COVID-19, life expectancy in Madagascar has dropped by 0.8 years for men and 1.0 year for women, primarily due to increased risks of death among individuals over the age of 60. The National Library of Medicine explains, “The probability of testing positive increases with age with the highest adjusted odds ratio of 2.2 [95% CI: 1.9‐2.5] for individuals aged 49 years and older.”

Not only did the virus risk and claim the lives of Malagasy elders, but dealing with its harshness and the majority of its symptoms, “(The most common symptoms of illness onset among confirmed cases were cough (27.2%), fever (18.7%), weakness (14.7%), runny nose (13.3%), and headache (13.1%))” prevented elders from returning to their jobs and continuing to support themselves and their families. The elderly population in Madagascar, already vulnerable to nutritional issues, faced heightened anxiety due to COVID-19, as concerns about their health, life expectancy, and ability to make a living increased.

Food and Health of the Elderly in Madagascar

A 2023 study by GSC Biological and Pharmaceutical Sciences examined the food and health practices of people aged 60 and over in the urban commune of Antsirabe I and the rural commune of Andranomanelatra in the Vakinankaratra Region. The study found that while the elderly were concerned about their health, hygiene practices—such as treating drinking water and washing hands before meals—were inadequate. The evaluation of nutritional status revealed that 37.5% of elderly individuals in rural areas were underweight (BMI < 18.5), compared to 17.9% in urban areas. Factors associated with poor nutritional status included education level, housing comfort, monthly income, food expenditure, dietary diversity and average energy intake.

The MDGs

While the intersection of poverty and psychological distress presents a formidable challenge for Madagascar, addressing this issue necessitates not only measures to alleviate poverty but also immediate, sustainable solutions to safeguard emotional and mental health. The Millennium Development Goals (MDGs), as outlined in the UN’s Millennium Declaration, represent a global commitment to eradicating extreme poverty, particularly in resource-limited countries like Madagascar.

One of the key focuses of Madagascar’s efforts to meet these goals is the conservation of its natural resource base and promoting sustainable development, as emphasized in the Madagascar Action Plan. This approach acknowledges that poverty reduction is not just about economic growth but also about protecting the environment, which many rural elderly Malagasy depend on for their livelihoods. As the government has pointed out, “Madagascar cannot do it alone and should not do it alone,” underscoring the need for international collaboration to address both poverty and environmental degradation in tandem. The global partnership called for in the eighth MDG reflects the notion that overcoming poverty will require support from multiple sectors and countries, aiming for sustainable development that benefits current and future generations.

The Madagascar Action Plan

The government of Madagascar has taken strides in linking health improvements with economic growth, as outlined in the Madagascar Action Plan. The commitment to improving access to health care, especially in rural areas where elders reside and elderly poverty in Madagascar is prevalent, plays a crucial role in enhancing productivity and reducing the pressure on natural resources. With the president’s “Madagascar Naturally” vision, the country emphasizes biodiversity conservation, protect the environment and reduce poverty. Through such initiatives, Madagascar is working to ensure that its population can both thrive economically and sustain its natural resources. As highlighted, “Developing countries’ debt problems” and the need for “sustainable access to safe drinking water” are critical components that will drive Madagascar’s progress toward achieving the MDGs and alleviating poverty.

Through techniques like observing the country’s natural resource base, the effect of demographic trends on development, and the importance of health as a prerequisite for development, it fosters adaptive coping strategies and enhances mental well-being. Implementing MDGs offers promise in improving the lives of Malagasians, potentially breaking the cycle of poverty and mental health challenges, providing those of older age peace and fulfillment when dealing with mental turmoil alongside impoverishment.

– Ryley Anthony

Ryley is based in Grand Prairie, TX, USA and focuses on Good News for The Borgen Project.

Photo: Pixnio

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How Inequality and Mental Health Fuel Global Poverty

Inequality and Mental HealthInequality is not just an economic challenge; it’s deeply psychological, influencing how individuals perceive themselves, others and society. Disparities in living conditions and opportunities profoundly affect mental well-being, leading to cycles of marginalization that erode trust, weaken social cohesion and harm mental health. This acceptance of inequality can become entrenched in societal norms, making it harder to challenge. However, understanding these psychological dimensions also reveals avenues for political and social change, as shifting perceptions can fuel efforts to reduce these disparities.

Understanding Global Inequality

Global inequality is marked by the uneven distribution of resources, opportunities and power, leading to significant differences in living standards. This issue is not only global but also deeply rooted within nations where social stratification creates rigid hierarchies based on power, status and wealth. For instance, the bottom 50% of the global population controls just 2% of the world’s wealth, while the top 10% commands 76%. Although global inequality between countries has slightly decreased, internal disparities within nations have widened, revealing an alarming trend of growing inequality even as some global measures improve.

Psychological Dimensions of Inequality

  1. Perceptions and Their Impact: How people perceive inequality is crucial in understanding behavior and societal cohesion. Perceptions, shaped by relative or absolute measures, influence how individuals view their place in society and their potential for upward mobility. Misjudgments in these perceptions can obscure or exaggerate the true extent of inequality, affecting personal choices and reinforcing societal dynamics that perpetuate the status quo.
  2. Mental Health Consequences: tyle=”font-weight: 400;”>>The psychological toll of inequality is profound, particularly when it comes to mental health. Dr. Greig Inglis from the University of the West of Scotland, who has extensively researched poverty stigma and its mental health effects, explains, “The most commonly discussed form of poverty stigma is discrimination, where people living in poverty are treated unfairly because of their financial situation. However, there are other forms of stigma, such as the anxiety about how others might treat them in the future due to their financial difficulties.” Inglis further notes that “the evidence is clear that poverty stigma is detrimental to mental health, often leading to low self-esteem, depression and other signs of mental ill-health.”

This stigma often traps individuals in a cycle where mental illness and poverty exacerbate each other, particularly in low- and middle-income countries (LMICs). Mental health struggles can lead to exclusion from economic opportunities, further deepening poverty. Moreover, poor mental health is closely linked to other health problems, reducing productivity and economic stability. Addressing mental health in these populations is essential for breaking the cycle of poverty and inequality.

Mechanisms Perpetuating Poverty

  1. The Role of Perception and Self-Interest: People’s perceptions of inequality are shaped by their environment and personal interests, with social and media cues playing a significant role. These perceptions can lead to biased views that reinforce existing inequalities, as individuals support policies that align with their interests, often benefiting the wealthy at the expense of the poor.
  2. Income Disparities and Social Stratification: Income inequality is a major driver of poverty, creating entrenched cycles that are difficult to break. Social stratification further solidifies these disparities, limiting social mobility and trapping those born into poverty. Overcoming these barriers requires systemic change that addresses the root causes of inequality rather than just its symptoms.

Global Efforts to Tackle Inequality

The Business Commission to Tackle Inequality (BCTI) and the International Monetary Fund (IMF) have launched significant initiatives to address global inequality. BCTI’s 10-point action agenda focuses on embedding social performance and accountability into business practices. At the same time, the IMF has expanded its efforts to include fiscal redistribution, social spending and inclusive growth.

In response to COVID-19, the IMF doubled access to emergency financing, approving $116 billion for 85 countries, provided debt relief grants through the Catastrophe Containment and Relief Trust (CCRT) and collaborated on the Debt Service Suspension Initiative (DSSI) for low-income countries. Additionally, the IMF allocated $650 billion in Special Drawing Rights (SDRs) to bolster global economic stability during the crisis. These initiatives highlight the importance of addressing both the economic and psychological dimensions of inequality as part of a comprehensive strategy to reduce global poverty.

Conclusion

Addressing mental health and emotional barriers that sustain inequality can create more just and equitable societies. While economic growth is necessary, it alone may be insufficient; changing perceptions and breaking down psychological barriers are vital for fostering sustainable development and global social equity.

– Sandeep Kaur

Sandeep is based in Manchester, UK and focuses on Good News for The Borgen Project.

Photo: Pexels

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Improving the State of Mental Health in Suriname

Mental Health in SurinameSuriname, ranked second by the Pan American Health Organization (PAHO) for its high suicide mortality rate (exceeding 10 deaths per 100,000 people), has only recently begun to address its mental health challenges. It wasn’t until 2015 that the first epidemiological research effort on depression and anxiety in the country’s population was conducted. This delay highlights the lack of attention previously given to mental health in Suriname. However, in recent years, there has been more focus on this issue and solutions are beginning to take shape.

The Mental Health of Indigenous Peoples

The Suriname Herald highlights the correlation between the effects of changing climatic conditions and the decreasing mental health of Indigenous populations is often overlooked. The article shares an interview with an Indigenous Surinamese woman who explains how varying weather conditions have affected the practice of traditional knowledge that was passed down through generations. As weather patterns change, drought causes some agricultural land to become infertile. In contrast, flooding causes harvests to fail in others. The stress and loss of centuries-old ancestral traditions that are tied to the well-being of the land is taking a toll on the mental health of Indigenous people.

In response, a joint effort between a Dutch and Surinamese University and the psychiatric center in Suriname launched the Suriname Indigenous Mental Health Study (SIMH) in 2023. The study aims to bridge the gap in understanding the mental well-being situation among the Indigenous population. With the knowledge gathered from the study, a framework can be built for mental health treatment that implements traditional Indigenous health care systems.

Youth and Women

The COVID-19 pandemic revealed the concerning state of mental well-being among children and youth. In 2023, the United Nations Children’s Fund (UNICEF) reported that 36.2% of youth in Suriname aged 16 to 25 years old have struggled with suicidal thoughts. Additionally, UNICEF found that about 75% of the youth experienced symptoms of stress or depression in 2022.

BMC Public Health’s 2022 study suggests that female respondents in the districts of Nickerie and Paramaribo were at a higher risk of developing depression and anxiety disorders. Researchers found possible cases of depression in 11.5% of male participants. This is in comparison to 19.4% of females from the population of Paramaribo. The cause of the difference between genders in the results is not yet determined. Possible factors contributing to poor mental health for women include limited economic opportunities, a lack of (financial) autonomy, domestic violence and limited family support.

Supporting Mental Health Services

UNICEF recently launched a one-year pilot program to improve mental health in Suriname, beginning in October 2023. The program focuses on the rural district of Nickerie in the Northwest and spans from October 2023 until October 2024. The issue is approached on three fronts:

  • Decreasing the stigma of mental health
  • Strengthening mental health services
  • Equipping parents with information regarding the psychosocial upbringing

The program aims to reach 25,000 people in Nickerie through a media campaign. Additionally, it aims to engage 500 children and 500 parents in an initiative to teach mental health skills. UNICEF shared the program’s accomplishments through March 2024:

  • Social media content and television broadcasts have been developed to raise awareness about mental well-being.
  • Progress has been made in setting up a helpline for mental health-related issues and self-harm prevention.
  • A program to teach children mental health skills is in development. It is expected to launch in the summer of 2024.
  • The first in a series of sessions to educate parents on mental well-being and how to support their children’s mental health was launched in May 2024.

Conclusion

Socioeconomic and climate-related issues impact mental health in Suriname. Studies have shown that women, youth and Indigenous people are disproportionately affected. The good news is that when the numbers are clear, solutions can start to take shape. UNICEF’s educational approach to positive mental health and the SIMH study that collaborates with Indigenous communities will positively impact mental health in Suriname for future generations.

– Tanisha Groeneveld

Tanisha is based in Leeds, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr