5
the effects of the violence in the 1970’s on the survivors, these reports are relevant to the
development of a District Psychiatric service. Following on an initial pilot study in 1995,
AMANI introduced a community-based programme in Mount Darwin District to address
these problems; both the ordinary psychological disorders, but also the disorders due to
torture and organised violence. This programme has been running since March 1995, and
this present report covers the time period from 1995 to 1998.
As a part of this community-based programme, the AMANI Trust has been running
training courses in primary mental health care for nurses, as well as other health workers,
since 1995. The basic training focuses on the basic knowledge and skills for detecting,
assessing and managing psychological disorders presenting to primary care and hospital
outpatient departments. The course also contains an input on the assessment and
management of survivors of organised violence and torture. Manuals support this basic
course10. About 150 nurses and health workers have been through this course in three
Districts.
The Basic Skills Programme 1995 – 1998
The major objective of the Basic Skills Programme was to create awareness in the health
team of the prevalence of CMD and to provide basic skills in the detection assessment
and management of these disorders. There was also input on disorders due to organised
violence and torture since these had been shown by epidemiological studies to a very
common sub-set within CMD.
The programme revolved around the following areas and was supported by a manual11:
•
•
•
•
•
•
•
Definition of the common psychological disorders
Classification of psychological disorders
Identification of the incidences of hidden psychiatric morbidity
Detection of psychological disorders including the use of SRQ- 8
Completion of the psycho-social histories of patients
Selection and referral of clients appropriately
Application of basic counselling skills and simple intervention methods
These were very successful courses, and strongly endorsed by both the trainees and the
management. The training led to a much greater awareness about both CMD and OVT
and to the formation of District Mental Health teams.
The Core Counsellors Programme 1997 – 1999
The next level of course was been offered to a smaller group, chosen from those who
attended the basic training. This was a 12-month course, with monthly teaching sessions
10
See AMANI. [1997](A), Survivors of Torture in Mount Darwin District, Mashonaland Central Province:
Overview of Report and Recommendations, LEGAL FORUM, 9, 49-60. see also AMANI.[1997](b)], Report on Psychological Disorders
in Clinics and Hospitals in Mount Darwin District, Mashonaland Central Province, HARARE: AMANI.
11
See Reeler,A.P. [1995], The Chiweshe Nurse-Counsellor Programme: Resource Manual (revised), HARARE:AMANI; Reeler,A.P.
(1995), Assessment of the Consequences of Torture and Organised Violence: A manual for field workers, HARARE:AMANI.
Training nurses in the assessment and management of psychological disorders: Report of AMANI Trust’s
programme in Mashonaland Central Province, Zimbabwe.