“Establishment of the first MHPSS technical working group in Djibouti “The challenge now is to keep the spark going”

Djibouti is a small country surrounded by Ethiopia, Somalia, Eritrea. With Yemen at a few kilometres across the Red Sea, the region is long-suffering from conflict and social turmoil. The flow of migrants and refugees have overwhelmed the already fragile health and social systems. This threatens to further increase in the short term. The minimal mental health and psychosocial services struggle to attend to the needs of its own and foreign populations exposed to a long path of stress, violence and trauma.

Often, we talk about the treatment gap in global mental health, the difference between the number of people who need care and those who receive it, estimated as more than 80% in low- and middle-income countries, and certainly even higher in Djibouti when considering all populations together. But, a very important advocacy message, another gap less often addressed but intrinsically related, is the coordination gap between policymakers and service providers, donors and implementing agencies, central management and local community actors. Building the mechanisms for better cooperation is the first step in sharing and tackling the burden of insufficient or inadequate mental health services and psychosocial support.

Having worked on both sides of the spectrum and aware of the crucial role of these coordination mechanisms, I was very interested in this deployment to help with a long-due need of building a community among the principal stakeholders and the scare but usually very active players in the field; from national authorities, United Nations agencies and academic institutes to NGOs, local grassroots and community associations, all committed and willing to move the MHPSS agenda forward.


Caritas daycare centre for unaccompanied children, Djibouti city

Inspired by the dominant landscape of the modern port, the base of the local economy, and the less developed fishing villages and impoverished neighbourhoods on both sides of the bay, I like to picture my role in Djibouti as a facilitator of bridges to mind those gaps. By bringing people together and developing a professional and personal network, a technical working group provides the platform to discuss important areas of intervention, identify existing and needed resources, and plan for strategic lines of action.

Hosted by the WHO Country Office and after just 3 weeks moving around, it is very motivating to discover how keen everybody is to participate and welcome the idea of the technical working group. The challenge now is to keep the spark going and engage all members, in the long run, translating their interests into concrete plans and collaborations. By reducing the coordination gap, we aim to prepare the country for the challenges of being part of a volatile context, ultimately reducing the treatment gap for present and future populations in need of primary and specialised mental health services.