Owiny Dollo (right) sharing a light moment with an exhibitor of Shea Butter products in Patongo during the belated mental health day commemoration.
By Arnest Tumwesige
Agago: Ripe-ber, a Luo word meaning “unity is good,” is the name of a community-based group founded in 2019 by mental health caregivers in Kubwor Parish, Kalongo Town Council, Agago District.
True to its name, the group was established to promote solidarity and tackle persistent drug stock-outs affecting patients with mental health conditions.
Their mission is clear: to ensure consistent access to life saving anti-epileptic and anti-psychotic medications such as carbamazepine, phenobarbital, and chlorpromazine drugs that are often out of stock in public health facilities.
Although the National Medical Stores (NMS) is mandated to supply medicines to public and selected not-for-profit health facilities every quarter, many facilities in rural areas frequently face shortages, disrupting treatment and recovery for patients.
To fill this gap, the 20 member Ripe-ber group made up of caregivers and individuals directly affected by mental health challenges started a community drug bank. Members contribute funds or sell produce from a communal garden to purchase medication in bulk from pharmacies in Gulu City. These are then stored at Kalongo Hospital for convenient access.
“We contribute 2,000 shillings every two months, or sell vegetables from our group farm,” said Hitler Okello, the group’s chairperson. “This year, we planted half an acre of eggplants, and our cassava from last year is ready for harvest. That’s how we sometimes raise money for medicines.”
Limited Funding Behind Drug Shortages
Bruno Atyang, Principal Psychiatric Clinical Officer and head of the mental health department at Gulu Regional Referral Hospital, confirmed that drug delivery delays are common, especially amid a rising number of patients.
The facility, which has a 46-bed capacity (20 beds each for male and female patients), and six for children receives 20 to 40 new mental health cases every week. Most new cases, Atyang said, are linked to substance abuse, particularly among unemployed and educated youth.
The hospital currently monitors between 600 and 900 mental health patients across the Acholi sub-region. To reduce the burden on the facility, the team is shifting its focus to prevention through community outreach, sensitization campaigns, and substance abuse education.
Modest National Investment
For the 2024/2025 financial year, the Ugandan government planned to spend only 16,100 shillings per person on medical supplies. With a population of over 45 million, this translates to a national health supply budget of about 725.1 billion shillings, according to the Initiative for Social and Economic Rights (ISER).
The limited funding has led to the emergence of 71 self-help mental health support groups in Agago District, each consisting of 20 members. These groups, supported by Basic Needs Uganda (BNU), contribute funds and share knowledge on managing mental illness within their communities.
Mental Health in the Workplace
The 2024 World Mental Health Day theme, “It is time to prioritize mental health in the workplace,” resonated deeply with Simon Odoch, a civil servant in Agago’s production department. He cited wage disparities between arts and science professionals and the burden of multiple loans as key stressors for public employees.
Odoch also blamed political interference in recruitment processes, which he said undermines performance. “Some technocrats are recruited through political channels and later underperform, putting pressure on supervisors due to poor service delivery,” he noted.
At Akwee Primary School, which serves 2,135 pupils in Patongo Town Council, BNU has trained two teachers in basic mental health care. The school’s head teacher, Beatrice Nyeko, said the training had both professional and personal impact.
“My husband has epilepsy. Thanks to the skills I gained, I’m better equipped to support him with compassion and care,” Nyeko said.
Addressing the Moral Roots of Mental Illness
Uganda’s Chief Justice Alphonse Owiny Dollo believes that addressing mental health in northern Uganda must go beyond medicine and tackle deep-rooted social and moral issues especially among the youth.
“We endured 20 years of armed conflict and deprivation. Our social fabric was torn apart,” said Owiny Dollo. “It’s impossible to go through such life experiences and remain mentally okay unless you’re a demi-god.”
He added that the lack of post-war rehabilitation efforts since peace returned in 2006 has left young people to inherit trauma as a way of life. “When elders like me speak out, the youth think we’re telling fairy tales,” he added.
Gap in Community-Based Services
Despite growing demand, only 1% of the Ministry of Health’s budget is allocated to mental health, with most of it supporting institutional care. This leaves community-based services severely under-resourced.
Florence Adong, Program Manager at BNU, said the shortage of psychiatric professionals is particularly stark in Agago, a district of over 200,000 residents. “Government provides the drugs, but usage is hindered by frequent stock-outs, especially as community awareness increases demand,” she explained.
Leadership Challenges at Village Level
Local Council (LC) leaders are tasked with maintaining community security, but in some areas, they are falling short. Agago’s Resident District Commissioner, James Nabinson Kidega, accused some LC chairpersons of neglecting their responsibilities due to alcoholism.
He pointed to a recent operation in Patongo Town Council that uncovered marijuana fields concealed among sorghum crops.
Despite these setbacks, Kidega praised Chief Justice Owiny Dollo and Ambassador Dr. Olara Otunnu for spearheading efforts to revive traditional Acholi values an initiative he believes could play a key role in restoring mental well-being in the region.
