Therapy at the bench

Psychiatrist Dixon Chibanda trains teams of grandmothers to provide open-air counselling sessions in Zimbabwe.
Chris Woolston is a freelance writer in Billings, Montana.

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Dixon Chabanda sits on a Friendship Bench with a group of matriarchs outside a primary healthcare clinic in Mbara, Zimbabwe

Dixon Chibanda is a psychiatrist at the University of Zimbabwe and director of the African Mental Health Research Initiative. Credit: Rainer Kwiotek

The grandmothers of Zimbabwe are inspirational custodians of local culture and wisdom, with much to give. Here, I’m sitting with a group of matriarchs in Mbare, a township in Harare. All are trained therapists who welcome people in the community to the Friendship Bench, a nationwide mental-health project that I created as a psychiatrist in 2006.

The grandmothers provide evidence-based therapy while sitting on a ‘friendship bench’ such as the one shown here — which, like most of them, is next to a primary health-care clinic. A 2016 randomized controlled trial found that people they had helped were significantly better after six months than were those who had received standard care (D. Chibanda et al. J. Am. Med. Assoc. 316, 2618–2626; 2016).

I treasure my time with the grandmothers. We sit on the bench and talk about our families, recent births and deaths and the troubles in the community. Here, some of them are telling me about the growing problem of substance abuse — from cannabis and ‘home brew’ (strong home-made alcohol) to codeine-containing cough syrup and cocaine.

When someone comes to the Friendship Bench, the grandmothers ask them to share their stories. Those meetings are now happening online because of the COVID-19 pandemic, but the stories haven’t changed: people are struggling with HIV; they’re facing domestic violence; their children are abusing drugs. A grandmother will listen to the story and encourage the person to pick a single problem to focus on. Then it’s like they’ve seen the light. They brainstorm with the grandmother on their next steps.

The grandmothers help people to feel rooted in the community, and are amazingly empathetic. They’ve often faced many of the same issues, and offer smart and achievable solutions. Nationally, we have 700 grandmothers, aged from their 60s to their 80s, on the Friendship Bench. Most stay until they move to the greener pasture called Heaven. They give all they can until the end.

Nature 582, 452 (2020)

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