Human Rights Archive Zimbabwe

4 psychological disorders will also have concurrent physical disorders, albeit mostly minor illnesses. Furthermore, it should not be overlooked that physical illness can often precipitate psychological disorder or dysfunction. This last factor is more important when disorders due to organised violence are considered, since this group is likely to suffer from physical disability due to the violence experienced4. The contribution of organised violence and torture to overall psychological morbidity have not been well-researched in Zimbabwe, but there have been a series of studies carried out in Mashonaland Central Province and Mount Darwin District over the past 2 decades. The first studies were carried out in 1987 by researchers from the University of Zimbabwe5. The first of these studies, conducted at Karanda Mission Hospital, indicated a point prevalence rate of 38.7%, with the majority of the conditions being shown to be anxiety or depression6. The second study, carried out at Bindura Provincial Hospital, indicated a point prevalence of 16%, with a similar profile being shown for disorders 7. These studies also indicated that nurses detected few disorders, with more than 90% of the psychological disorders being misdiagnosed as physical illnesses. Hall and Williams had no easy explanation for the difference in the rates found between these two settings, attributing them to differences in referral patterns. The most recent studies, carried out by the AMANI Trust, indicate that psychological disorders due to organised violence and torture are approximately 1 adult in 10, over the age of 30, in the clinical setting in Mashonaland Central Province8. A detailed clinical study of more than 300 survivors shows a picture of mixed psychological and physical disability9. AMANI��s Training Programme Since 1995, the AMANI Trust has been in a collaborative relationship with the District Health Team of Mount Darwin District. Although the primary focus has been on developing assistance to survivors of torture and organised violence, the aim has also been to strengthen the District’s psychiatric service. To this end, a series of small studies have been conducted, and, although these have been mainly concerned with examining 4 See AMANI. [1997], Survivors of Torture and Organised Violence from the 1970s War of Liberation, HARARE: AMANI TRUST. See Hall & Williams. [1987](a) Hidden psychiatric morbidity Part I: study of prevalence in an outpatient population at Bindura Provincial Hospital. CENT.AFR.J.MED. 33, 239-245; see also Hall & Williams. [1987](b) Hidden psychiatric morbidity Part II: 5 Training health care workers in detection: A pre- and post-study at Karanda Mission Hospital. CENT.AFR.J.MED. 33, 255-258 6 See Hall & Williams. [1987](a) Hidden psychiatric morbidity Part I: study of prevalence in an outpatient population at Bindura Provincial Hospital. CENT.AFR.J.MED. 33, 239-245 7 See Hall & Williams. [1987](B), Hidden psychiatric morbidity Part II: Training health care workers in detection: A pre- and post-study at Karanda Mission Hospital. CENT.AFR.J.MED. 33, 255-258 8 See Reeler et al. [2000], The prevalence and nature of disorders due to torture in Mashonaland Central Province, Zimbabwe, TORTURE (submitted for publication). 9 See AMANI. [1997], Survivors of Torture and Organised Violence from the 1970s War of Liberation, HARARE: AMANI TRUST. Training nurses in the assessment and management of psychological disorders: Report of AMANI Trust’s programme in Mashonaland Central Province, Zimbabwe.