By Orla Ryan
BBC, South-western Uganda
Juliet Nakayembe takes great pleasure in the many plants which now adorn her house
in south-western Uganda.
Months earlier, her garden had been overgrown.
She struggled not only to grow food, but also to find a reason to live.
When Nanyange's husband died, his relatives forced her out of the house
Then, she did not know what was wrong, she did not know the word for
depression. She just knew she could not sleep and could not find the energy
Inside her house now, voices are rising.
A woman is crying as she talks about how she wants to abandon her children
and leave Gayaza village.
The land is too old to till, she says. The women
sitting on straw mats are vociferous and practical in their advice.
Women meet weekly in Juliet's house in Gayaza in Rakai district. In
psychological jargon, this is an interpersonal psychotherapy group.
In practice, it resembles community support and friendship, the kind of network
which has been destroyed by the HIV/Aids pandemic.
The success of these groups in combating depression and boosting
productivity means that they will be rolled out to the other Ugandan
districts of Luwero and Mpigi later this year.
Relief organisation World Vision had long found a poor take-up of development programmes in the Masaka/Rakai area, one of the areas of Uganda
hardest hit by HIV/Aids.
Research carried out with John Hopkins University in America found that 20% of the people World Vision worked with in these areas showed the
symptoms of depression.
Until the survey, no word for depression had existed in the local language, Luganda.
The process threw up a word, Okwekyawa. The word is only needed now, because the
traditional networks of support have been broken by the HIV/Aids pandemic.
World Vision group facilitator Christine Nanyondo said: "Before, there were
relatives, they could give you suggestions. Relatives have died, even the
neighbour you run into, he is depressed... It has broken all the social
Two years ago, Columbia University experts began training group facilitators
The first groups met once a week for a few hours in the presence of a
Fred Wasajja used to think that only cowards talked about their feelings
At the end of 16 weeks, only 6.5% of people in the psychotherapy
groups still showed symptoms of major depression, compared with 86% previously.
Productivity in the area has also improved, Grace Onyango, World Vision's
psychosocial specialist said.
She sees a clear link between depression and
"Without behaviour change and attitudes, as much as NGOs will
give out help, they are creating dependency systems. We want them to start
working for themselves," she said. "It [depression] is a great hindrance to
Those who took part in the groups say it gave them hope on what had
previously looked like a grim future.
Nanyange Paskazia lost both her husband and her parents to the disease. When
her husband died, his relatives forced her out of the house.
She spent her days crying, failing to find the energy to grow food for her
three daughters to eat.
She thought she might be ill but was afraid to be tested. "What if they tell
me I am HIV positive? Won't I kill myself?" she told me through a
Through the 11 members of her group, she found "hope and courage."
Now she sleeps regularly and has started working again. She is happy, she says, and wants a future where she is healthy and can look
after her children.
In Ngono village, Namujuzi Gaida Kabogaza struggles to find money to keep
her nine children in school.
She lost seven of her brothers and sisters to HIV/Aids. After their deaths,
she found herself fighting with her husband, who drank and complained of her
Before she joined the group, she feared people would gossip if she
talked about her problems. Slowly, she regained her energy to work.
Cowards talk about their feelings, or so Fred Wasajja thought before he
joined the group in his village.
He has lost his eight brothers to HIV/Aids
and is looking after eight of his nieces and nephews.
The burden is great, he says, and he and his wife struggle to meet it. At times, he has thought of suicide and he also fears he has the disease.
He has not been tested yet, and is thinking of taking the test in Kampala, a three-hour trip
"Would it not be better to know?" I ask.
"Yes and no," he says.
When he does find out the truth, he now knows there will be people in his
village he can turn to for support.