Mental health clinics in violence-prone South Sudan are rare and endangered

The specialized clinic in Mundri, in South Sudan’s Western Equatoria state, is a rare and endangered facility in a country desperate for more mental health services.

The clinic is in one of eight locations that aimed to bring mental health services for the first time to over 20,000 people in South Sudan.

But its future is unclear, now that the program's funding from Italian and Greek sources is about to end.

Launched in late 2022, it proved a lifeline for patients in a country where mental health services are almost non-existent in the government-run health system.

Vobia Kawaja, a 34-year-old widow and mother of five, benefited from the services.

“I wanted to run away, to abandon these children. I even thought of ending my life. But since I attended the training, it has changed me,” she told the Associated Press.

Across South Sudan, there has been massive displacement of people in the civil war that began in 2013 when government troops loyal to President Salva Kiir fought those loyal to Vice President Riek Machar.

The eruption of fighting was a major setback for the world's newest country, which became a major refugee-producing nation just over two years after independence from Sudan.

Although a peace deal was reached in 2018, the resumption of hostilities since January led the UN to warn of a possible “relapse into large-scale conflict.”

The violence persists even today, with Machar under house arrest and government forces continuing with a campaign to weaken his ability to wage war.

And poverty — over 90% of the people live on less than $2.15 per day, according to the World Bank – is rampant in many areas, adding to the mental health pressures many people face, according to experts.

In a country heavily dependent on charity to keep the health sector running, access to mental health services lags far behind.

The country has the fourth-highest suicide rate in Africa and is ranked thirteenth globally, World Health Organization figures show.

In South Sudan, suicide affects mostly the internally displaced, fueled by confinement and pressures related to poverty, idleness, armed conflict, and gender-based violence, according to the International Organization for Migration.

Last month, authorities in Juba raised an alarm after 12 cases of suicide were reported in just a week in the South Sudan capital.

There were no more details on those cases.

Dr. Atong Ayuel Longar, one of South Sudan’s very few psychiatrists and the leader of the mental health department at the health ministry, said consistent services are essential to those struggling.

"Due to the nature of the mental health diseases, it’s a kind of disease that runs with chronicity. So, people will get the recovery and they will be fine. But, if we don’t maintain and sustain that service they’re receiving, we’re going to end up having them relapsing again,” she said.

In Mundri, the AP visited several mental health facilities in June and spoke to many patients, including women who have recently lost relatives in South Sudan's conflict.

In 2015, the Mundri area was ravaged by fighting between opposition forces and government troops, leading to widespread displacement, looting and sexual violence.

Ten years later, many have not recovered from this episode and fear similar fighting could resume there.