Staff Reporter
In an exclusive one-on-one interview with Kananelo Boloetse, Editor of Newsday, we delve into the impactful work of Dorcas Grigg-Saito, a Fulbright Specialist with a focus on Global Health. Having recently completed her assignment in Lesotho, Ms. Grigg-Saito collaborated closely with Jhpiego, an international public health NGO, on a series of initiatives aimed at addressing the critical mental health needs of Basotho. With extensive experience in global health, Ms. Grigg-Saito brings valuable insights into the challenges and successes of adapting the renowned Friendship Benches model from Zimbabwe to the local context in Lesotho. This conversation explores her experiences, the innovative projects she led, and the lasting impact of her work in improving mental health services in a nation facing significant mental health challenges.
Newsday: Can you describe your experience working in Lesotho as a U.S. Fulbright Specialist?
Dorcas Grigg-Saito: A significant part of my work involved laying the groundwork for implementing the Friendship Benches model from Zimbabwe. In Zimbabwe, this initiative trained grandparents, village health workers, and youth peers to become lay counselors, providing compassionate, informal mental health counseling. It was a privilege to collaborate with such talented and compassionate individuals as we worked to create safe spaces for mental health support across communities. Reflecting on my time in Lesotho, I am deeply impressed by the genuine commitment, exceptional competence, and warmth of the Basotho people, especially the health workers I interacted with at Jhpiego, the Ministry of Health, the U.S. Embassy, and various NGOs.
Newsday: Can you highlight some of the key projects you worked on with Jhpiego to improve mental health services in Lesotho?
Dorcas Grigg-Saito: One of the highlights of my work was collaborating closely with the Ministry of Health, securing the support and partnership of key officials, including the Director General for Health Services, the Director of Mental Health, and the Director of Clinical Services. Together, we developed plans to adapt the model to the local culture and raise awareness about mental health and suicide among Jhpiego staff and the wider community. Mental health is a pressing issue in Lesotho, with nearly one-fifth of the population affected by mental health conditions and the country facing the highest suicide rate in the world. The Friendship Bench model, with its proven efficacy and cost-effectiveness, offers a crucial solution to addressing these challenges and improving the quality of life for many Basotho.
Newsday: Were there any particular successes or breakthroughs that you experienced during your assignment?
Dorcas Grigg-Saito: One of the first breakthroughs occurred even before my arrival, when Jhpiego, an international public health NGO, identified the urgent need for additional mental health resources in Lesotho and recognised the effectiveness of the Friendship Bench model, which has been successfully implemented in over eight countries and cultures. This model’s problem-solving therapy has shown remarkable results, often improving the mental health of individuals with mild to moderate issues within just 4 to 6 sessions. For those with more severe conditions, we establish referral pathways to ensure they receive the higher levels of care they need.
A significant moment was witnessing the surprise—and then the commitment—of many people, even those within healthcare and NGOs, when they learned about Lesotho’s alarmingly high suicide rate. As they connected this statistic to the mental health struggles of their friends and family members, it was like a light bulb went off, sparking a dedication to raise awareness and take action on mental health and suicide prevention.
Securing the advice and support of the Ministry of Health was another critical milestone. Their insights, suggestions, and belief in the Friendship Bench model have been instrumental in planning its establishment in Lesotho.
Most recently, we received the exciting news that Jhpiego has secured one-year funding to pilot the program in two districts. Approximately 20 Lay Therapists and their coordinators will be trained in Problem Solving Therapy, and Friendship Benches will be set up in the districts of Mohale’s Hoek and Berea. Anyone will be able to use the services, on their own or with a referral from family or friends, a health facility, a school, or other community organisation. If the pilot is successful, we plan to scale the project to additional locations, expanding the reach and impact of this vital initiative.
Newsday: How does the mental health situation in Lesotho compare to other countries you have worked in or studied?
Dorcas Grigg-Saito: Throughout my career in healthcare, I have worked extensively with refugees and immigrants from various parts of the world, and I have observed many parallels with the mental health situation in Lesotho. In particular, there are significant challenges due to limited personal and societal resources, which exacerbate the serious impacts of depression, anxiety, and other mental health issues. These conditions not only affect people’s ability to manage their daily lives and care for their families but also hinder their overall health management.
A common thread across these contexts is a pervasive lack of hope, the stigma associated with seeking help for mental health or substance use issues, and the fear of discussing problems with others. My experiences underscore the critical importance of integrating mental health care with general medical care and educating people about the effectiveness of treatment. By addressing these challenges, we can help individuals lead healthier, more fulfilling lives.
Newsday: What lessons from your experience in Lesotho can be applied to other global health initiatives, particularly in resource-limited settings?
Dorcas Grigg-Saito: Mental health is a critical issue in every country, and its importance is increasingly being recognised globally. There is growing awareness of the profound impact mental health has on physical health and the effectiveness of medical treatments.
Given that over 77 percent of global suicides occurred in low- and middle-income countries in 2019, the strategies we have developed in Lesotho can serve as valuable models for other resource-limited settings. The cost-effectiveness of the Friendship Bench model, which trains lay counselors—whether they are grandparents, village health workers, or youth—is particularly relevant in these contexts. This approach demonstrates that effective mental health interventions are feasible and can be successfully implemented even in areas with limited resources.
Newsday: What advice would you give to other professionals looking to make a difference in global health through programs like the Fulbright Program?
Dorcas Grigg-Saito: My advice is to approach your work with an open mind and a willingness to learn from the people who live and work in the country—they are the true experts. Flexibility is key; be prepared to adapt your ideas and experiences to fit the local context and culture. It is crucial to understand that community members are the ones who know best how a program should be designed and implemented. Their insights and involvement are what ultimately drive success.
For more information about the Friendship Benches or to make a donation, please contact Oluwakemi Adeleke, Jhpiego Country Director, at Moriam.Adeleke@jhpiego.org.
