This article was originally published in Vanuatu Daily Post, Life and Style magazine.
Taem bae yu gat bebi, hemi shud be wan gudfala taem. Be samtaem fasin hemi no olsem. Hemi normal sapos yu stap harem no gud smol, se fram body blong yu mo laef blong yu hemi diffren taem bae yu kasem bel mo gat bebi. Sapos yu harem no gud kasem long taem mo harem no gud big wan, yu go luk Mind Care Unit lo Vila Central Hospital.
Although mental health initiatives began in 2009, it wasn’t until 2014 that Vanuatu established a Mind Care unit with a specialized team. Dr. Jimmy Obed leads the way in providing services and raising awareness about mental health despite a lack of funding, resources and staff. On top of these hurdles, he also has to be culturally sensitive to Vanuatu’s Melanesian values with his approach. Many people in Vanuatu don’t consider mental illness to be real as physical illness and believe it’s a ‘sick blong ol white man.’
Since it’s establishment, Dr. Obed has seen only three cases of postnatal depression. Statistics from Beyond Blue show that 1 in 7 women have some level of postnatal depression and considering that 300 babies are born in Vila Central Hospital every month, Dr. Obed believes there are probably more cases but people are simply unaware of what postnatal depression is.
Although having low and high moments are normal after birth, postnatal depression extends beyond moments of feeling overwhelmed, sad or anxious. ‘Postnatal blues and postnatal depression are different,’ says Dr. Obed. ‘The blues last a little while but postnatal depression is when the depression becomes severe and lasts up to a year and beyond.’ He says that women who suffering from postnatal depression display odd behavior. ‘Signs include neglecting the baby, refusing to feed the baby and than the typical symptoms associated with depression are also present. They are usually referred to us through friends or the maternity ward.’
Ol narafala fasin blong postnatal depression hemi olsem:
- Yu no wantem stap wetem bebe
- Yu kros lo bebe mo man blong yu
- Yu harem no gud big wan. Yu stap cry mo wantem killem bodi long yu
- Samtaem bae yu fraet se fram yu stap ting ting no gud fasin lo smol bebe
- Yu no wantem kai kai afta bae yu less lo lukim out ol responsibility lo yu. Olsem fasin we yu harem se yu no wantem cook or makem job lo yu. Ol esi samting we yu stap makem bifo, yu stap harem no gud now ya.
- Yu no wantem luk ol fren mo famili blong yu
- Ting ting blong yu hemi olboat mo yu no save ting ting stret
- Yu stap worri tumas blo evri smol samting
- Yu harem se bodi blong yu hemi sik no gud
A post in the popular online Facebook forum Yumi Tok Tok Stret demonstrates the lack of awareness surrounding postnatal depression. Earlier this year, comments responding to the post about a teacher who didn’t want to feed her baby and then abandoned the two-month-old child suggested that she was a bad mother, assumed she must have substance abuse problems and that her teaching position should be revoked. Others encouraged her husband to beat her.
‘The stigma of postnatal depression is also amplified by our culture. People think women are supposed to look after the kids and if they are suffering, they get blamed for it,’ says Dr. Obed. ‘In Vanuatu, when you talk about depression, people don’t see it as an illness. They think of it as a ‘sick blong ol white man’. Vanuatu is supposed to be a happy place. Sometimes the Mind Care unit is the last place people with mental illness go to. First they’ll see a cleaver or go to church and pray, or go out and drink too much kava, then once they’ve exhausted all those avenues, they come to us.’
Often people don’t even bother to manage their depression and suffer silently. In the outer islands, people would have an even more limited awareness regarding depression. Although there are focal nurses, they also deal with other general nursing duties. Dr. Obed admits that they need more funding and awareness programs. At Vila Central Hospital, postnatal depression is not spoken about in the antenatal programs nor have midwives received training specific to the issue.
The Mind Care unit offers counseling and if necessary, medication, to women who are suffering from postnatal depression. Unfortunately it’s not available at the hospital pharmacy, where it would be free or subsidized. For new mothers with little income, it’s quite expensive to obtain the medication from pharmacies in town. Furthermore the medication is taken over a period of time, increasing the costs, and it can take up to six weeks to have effect. A request has been sent to the Ministry of Health to include this medication at the hospital.
For family members and friends who believe that someone is suffering from postnatal depression, Dr. Obed stresses that’s it’s important to provide a supportive environment and to not blame or treat the new mother badly. ‘First olgeta hemi must undastandem wanem sikness ya. They can’t help the fact that they are depressed. If the mother isn’t feeling well, the family should step in to help take care of the baby, for the safety and wellbeing of both the mother and baby. When the mum feels better, she will step back in. It’s important that support is given in the initial stages because it can spiral.’
Sapos yu or wan famili or fren blong yu hemi gat postnatal depression, plis go luk Mind Care unit lo Vila Central Hospital.