Part 2. Mental Health and Partnerships
By Alexa Zeitz
Photographs by Elizabeth Wagemann
The topic of mental health had been largely off the agenda at the UN Summit, the Humanitarian Centre conference recognized the importance of addressing this most neglected chronic disease. Carol Brayne, Director of the Cambridge Institute of Public Health, explained that mental health goes unaddressed because of a big lack of data, low numbers of health workers and, most importantly, stigma and discrimination. Brayne argued forcefully that conceptions of mental health, including measurements and treatments, are very Western, and may often not be appropriate to developing country contexts. Dr. Andrew Mohanraj, who joined the conference via video-link from Indonesia, illustrated the importance of country-appropriate interventions with his experience establishing a mental health system in Aceh, Indonesia after the tsunami. Emergencies can be an opportunity and the influx of funds following emergencies must be used not only to deliver short-term relief and support but also to strengthen health systems for mental health. Mike Davies OBE, Head of Programme Development for CBM-UK, confirmed the need for appropriate mental health interventions in the case study of CBM’s successful community-based rehabilitation programmes.
Without data, global health interventions are often ineffective. The difficulty, yet importance of collecting this data on NCDs in developing countries was made evident in a session in which researchers presented their work on health systems. Ahmed Aboulghate, PhD candidate at the Cambridge Institute of Public Health, is hoping that his research on quality indicators in the Egyptian health care system will allow for better quality control of health care. Dr. Amos Deogratius Mwaka, joining the conference via video-link from Uganda, is examining cultural barriers preventing early diagnosis and treatment of cervical cancer in Northern Uganda. Professor Nick Wareham, who presented his research on diabetes and the work of a Cambridge seminar that trains students from developing countries in epidemiological research, argued that holistic public health research needed to be supported.
The implementation of different global health interventions is increasingly occurring under the heading of ‘partnership’. Is this just a fad or a more sustainable means of delivering development assistance for health? Dr. Jenny Amery OBE, Chief Professional Officer for Health and Education at DFID, gave evidence of successful partnerships with developing countries researching and evaluating programmes as they are applied, revealing that health interventions rarely follow a neat trajectory from controlled experiment to monitored programme. Maya Morris, Head of Global Community Support at AstraZeneca, offered another example of a successful partnership: the AstraZeneca Young Health Program, in which AstraZeneca, Plan and the Johns Hopkins School of Public Health have partnered to investigate adolescent health. Both Dr. Amery and Ms. Morris argued that partnerships, while struggling with inevitable asymmetries of power, were successful means of building sustainable programmes.
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