Saturday 2017-12-16




By Samkelo Mahlalela | 2017-10-12

Vuka udwebe lishiya ubangene! Loosely translated, “Get up, get dressed and show up” is common lingo among the working class (particularly young women). The act itself, moves from the literal to the metaphor. On one end of the spectrum are young women who after the removal of their natural eye brows, draw eye brows of their own with the aid of an eye-liner or eye brow gel– which God forbid usually comes in all shapes and sizes, from the fine to the ridiculous.

Then there are those, who take things a step further to ensure that they turn heads. The “drawing” of the eye-brow is coupled with expensive ‘Brazilian’ hair-dos, expensive clothes, perfumes, cellphones – deemed necessary tools to “magnify themselves” - as popularised by South African socialite Somizi - and ultimately enable them to update their social media pages. Social media! has become an integral part of modern life, and can be very useful and informative, yet it also brings serious scrutiny on individuals. Modern life itself can be fulfilling, hectic to almost breathlessness, and is certainly filled with many pressures. Unfortunately, modern life isvery superficial.


The profiles of people who post on social media platforms, especially Facebook, Twitter and Instagram are created to inspire gold-coated lifestyles, bringing huge gaps between their real lives and their social media personas. Now we have a new breed of personalities, “Social media personalities”. With the goal to have the most ‘likes’, views and followers. Yes followers, Jesus had followers. In turn, many of the followers become envious, and gutted by the modern-day anxiety called fear of missing out (FOMO) syndrome, want to be like the idols they follow. With limited resources but still not wanting to miss out, they end up with huge debts accumulated from credit facilities necessary to compete with their role models on social media. In a way, this can increase mental health problems. The quest for mental health, the scales of balance do not show modern life as compatible with mental well-being for most people. It seems that instead of helping to improve our economic and social conditions, globalisation and technology is contributing to the increasing public pressure to seem rich, thereby rising health issues of our communities. The role of modern life in driving HIV infections is common knowledge.

It is the seemingly oblivious, slow brewing problem of mental ill-health. Although 10 October is the designated Mental Health Day, the country is commemorating Mental Health Day today in Siteki. Thus, there is no opportune time than the present, to create awareness on this slowly brewing public health problem, especially its potential to reverse the gains made in the HIV response. The 2014 WHO STEPS non-communicable diseases risk factors surveillance report on Swaziland, indicates that about 9.3 per cent of the respondents (1 in 10) of Swazis had seriously considered attempting suicide in the last twelve months preceding the survey. About 3.6 per cent had attempted suicide- of whom 59.8 per cent had done so in last 12 months. Of these, 27.6 per cent (one third) sought professional help. 11.3 per cent of the respondents had someone in their close family attempt suicide, while 7.6 per cent had someone in their close family die from suicide.About 37.3 per cent of respondents had reported using poisoning with pesticides and 29.6 per cent reported to use overdose of medication or drugs.

Putting these statistics into context (for context is king), one in 10 in the current estimated over one million population, means roughly 100 000 Swazi experience mental health challenges - a huge number indeed. Add to this, the fact that mental ill health is exceptionally misunderstood in the country. Affected individuals are usually in self-denial or at worst shunned and stigmatised with some referring to mentally challenged people as affected by vengeful spirits or possessed by demons. Consequently, many people who are affected do not willingly seek help or speak out. Even though many mental illnesses are treatable or controllable, when they go untreated, they have an adverse effect on the quality of life of the affected. They also have a spill-over effect on their families, friends, colleagues, perform at work and other spheres of their lives. At worst, they result in the loss of livelihood and lives when those with more aggressive conditions kill or hurt other people or take their own lives. For people living with HIV (PLHIV) the consequences are amplified and negatively impact the HIV response. Swaziland has an HIV prevalence of 27 per cent, and therefore there is a big chance that a large proportion of the people with mental health challenges may also be HIV positive. This means that our already overburdened health system will soon be facing this emerging problem. Firstly, the mental health consequences of living with HIV are often not recognised andPLHIV often struggle with the psychosocial impact of being diagnosed with HIV or the result of HIV-related stressors like stigma and discrimination or bereavement.

The most common mental health problems faced are feelings of emotional distress, social exclusion, depression and anxiety. Depression is associated with risky behavior, particularly alcohol and substance abuse, and non-adherence to medications. Adherence means taking medicine consistently and as prescribed by a health care provider at least 95 per cent of the time. Non-adherence can include missing one or multiple doses, not observing the correct time intervals between doses, or not observing dietary instructions. Resulting in poor health outcomes. While there are many reasons for poor treatment adherence, including the fear of stigma or rejection when people are seen taking their medications, adherence is critical and necessary to prevent the virus from reproducing and to bring it down to levels where it is suppressed. When the medications are not taken as prescribed, the virus replicates and the viral load increases, which can cause resistance to medication. Every dose that is missed gives the virus a chance to mutate (change itself), affecting the treatment regimen which usually demands alteration.

Apart from the health risk to the PLHIV not taking his or her medications properly, the health of others is affected when drug resistant strains are passed on to others. Not forgetting the government budget for medicines which will require more complex regimens. A lot of people do not understand the importance of mental health, yet a lot of people suffer from some sort of mental health disorder.We often hear that one in four people will experience some kind of mental health problem each year. Even more tragically, nine out of ten of those people will experience stigma and discrimination because of it. In the workplace, poor mental health is responsible for many lost working days and job loses each year. The theme for the 2017 commemoration is Mental Health in the workplace. Work is good for mental health but a negative working environment can lead to physical and mental health problems. Depression and anxiety have significant economic impact, harmful use of substances or alcohol, absenteeism and lost productivity.

There are many risk factors for mental health that may be present in the working environment. Most risks relate to interactions between type of work, the organisational and managerial environment, the skills and competencies of employees, and the support available for employees to carry out their work. A healthy workplace can be described as one where workers and managers actively contribute to the working environment by promoting and protecting the health, safety and well-being of all employees. A workplace that promotes mental health and supports people with mental disorders is more likely to increase productivity, reduce absenteeism, and benefit from associated economic gains. So, this mental health day, let us be vigilant of our colleagues who are stressed and create an environment that fosters peace and productivity. Mental Health begins with you.

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