It is 8.50am on a wintry June morning at the Thoko Ngoma clinic in Alexandra.
Today is immunisation day, and the clinic is full of mothers clutching babies cocooned in blankets and tiny woollen beanies. But the mothers aren’t just here to get their babies immunised.
They’ve also come for the Baby Mat session: a pioneering mental-health initiative run by the Ububele Resource and Training Centre. The mat — a simple duvet on the floor — creates an intimate, human space in an otherwise busy clinic, where mothers can share their problems with trained counsellors and find solutions.
“The idea is to strengthen the attachment between mother and child. This is the fundamental building block for mental health later in life,” says Ububele psychologist Melanie Esterhuizen. Ububele (“compassion” or “kindness” in isiXhosa and isiZulu) was founded by Tony and Hillary Hamburger in 1999. Both are clinical psychologists with 30 years’ experience in clinical practice as well as in community work and training.
The centre provides services for mental-health users in the community of Alexandra and focuses on areas where it feels it can make the most impact — particularly in child psychology, focusing on children from birth to seven years old, and training adults to run groups.
Ububele is at the forefront of parent-infant psychology in South Africa — a relatively new field. “The bonding relationship between mother and child is one of the best predictors of later mental health,” says Getti Mercorio, Ububele’s chief executive. ‘A well-attached baby is more likely to develop into a well-adjusted adult.”
Ndhivu Kutame was staying in Alex when a friend who knew his passion for counselling told him about Ububele’s courses. Kutame first did a course in child observation and then trained in working with groups. “I have never heard of any other course like this,” says Kutame. “It is quite unique and very dynamic.”
He says he feels ‘very lucky” that he was able to take the course without paying, because he was unable to afford the cost. He found the course allowed him to interact with professionals and he soon came to know them as friends. “It’s multiracial; you are not judged on academic qualifications,” he says. “You are given space to share your ideas.”
Kutame is now a community worker in Polokwane, where he uses his training to work with orphans and vulnerable children. Ububele also runs a nursery school on its premises. With its five staff members and 45 children, the school is the organisation’s largest expense. “It provides a service to the community and keeps the work alive in the building,” says Katherine Frost, psychologist and head of the Ububele Umdlezani parent-infant project.
Group therapy is another way Ububele has found to make community psychology as effective as possible. “It’s the best bet,” says Mercorio, who believes that resources for mental health services will never meet the needs of the people. Each week Ububele staff members review the Baby Mat sessions.
Today the team is concerned about a three-year- old and her mother. The little girl had been bitten by rats and the mother was facing domestic violence. Later the child suffered terrible burns in an accident with a paraffin stove.
They discuss the situation and decide to offer the child a place at the organisation’s nursery school, where she can receive expert counselling. But raising funding for the various programmes often proves challenging for Ububele.
“How do you measure the results?” asks Tony Hamburger. “If I were an NGO I could collect blankets, I could count them and present a number. But how do you measure fulfilment or success?” The centre has received some support from the government, but works hard to secure donations from overseas, as well as from local companies and individuals.
The department of health and social development told the Mail & Guardian that the minister’s budget vote earlier this year gave special priority to health conditions such as HIV/Aids and TB that have high mortality rates. It “would be difficult to suggest that at this point mental health should be prioritised above the high mortality rate areas”, the department said.
Ububele does receive funding from the government for two of its focus areas: training childcare workers in group work with children using persona dolls (dolls used to communicate with children and to facilitate a comfortable environment to share their problems); and work discussion groups with leaders of community- based organisations.
Hamburger believes that mental health interventions at a young age tend to be simpler, more cost-effective and longer lasting. ‘The effects seem to be sustainable over time,” says Hamburger.
“In terms of mental health you are getting good value for your buck.” He thinks that child psychology and training make the best focus for Ububele: “It is the quickest place to intervene and you will see a return within 10 to 15 years.”