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Emergency psychiatric care in North Kivu in the Democratic Republic of the Congo
Marlene Goodfriend1, Rachel ter Horst2, Giovanni Pintaldi3, Anja Junker4, Helena Frielingsdorf5, Joelle Depeyrot6, Lea Matasci7, Claudio Moroni8, Abdou Musengetsi9, Leslie Shanks10
1 psychiatrist and mental health advisorat Médecins Sans Frontières, and is based in Amsterdam, the Netherlands
2 medical doctor and previous Humanitarian Affairs advisor with Médecins Sans Frontières, based in Baarn, the Netherlands
3 psychologist and mental health advisor at Médecins Sans Frontières, based in Amsterdam, the Netherlands
4 paediatrician at Kinderarzte Praxis, Berlin, Germany., Germany
5 psychiatric resident at Karollinska Hospital, Stockholm, Sweden., Sweden
6 clinical social worker, based in the United States
7 psychologist, based in Switzerland
8 psychologist and now project coordinator with Médecins Sans Frontières, based in Singapore
9 nurse and deputy medical coordinator with Médecins Sans Frontières, based in Goma, DRC
10 medical doctor and previous medical director of Médecins Sans Frontières–Holland, based in Toronto, Canada., Canada
Correspondence Address:
 Source of Support: None, Conflict of Interest: None
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People with psychiatric disorders in humanitarian emergencies are primarily neglected and lack appropriate treatment. This results in unnecessary suffering, stigmatisation, loss of dignity and increased mortality. This paper describes the experience of Mèdecins Sans Frontiéres in providing emergency psychiatric treatment as a component of a busy medical programme in Mweso, a conflict affected region of North Kivu, the Democratic Republic of the Congo. Interventions included treatment with psychotropic medications by non specialist physicians and counselling by lay counsellors. Most patients were treated for psychotic disorders with good results. Our experience shows that generalist medical doctors can be trained to diagnose and treat psychiatric disorders. Introduction of emergency psychiatric care in humanitarian emergencies is needed and feasible, despite multiple competing priorities. Key issues to consider are contingency planning for programme interruptions due to security issues, simplification of protocols and shared care with mental health counsellors.
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