In 2003, Médecins Sans Frontières  – Holland (MSF) promoted an awareness raising campaign in Tajikistan, with the aim to increase commitment from the Ministry of Health, national and international organizations.  As part of the advocacy campaign, a photo exhibition titled “Will You Remember Me?” – words spoken by one of the patients at the end of the interview – was organized and opened to the public.

There are approximately 1,000 patients in the 16 functional psychiatric institutes, with an estimated 40,000 more who need help throughout the country.  Due to stigma from the community and the harsh economic situation, people do not seek help from the institutes, especially in the early stages of their illness, because they feel ashamed and it’s a common belief they are being punished by God.   Medical staff are few, under-qualified and underpaid, although they are essential in the support and effective care of the patients.

Essential drugs and medical supplies were provided to the institutes every 3 months, and staff were trained by MSF to diagnose and treat common illnesses.  Psychotropic drugs are needed but are not available as they are too expensive and a license is necessary to obtain them. Staple food is provided by the World Food Programme and MSF, with a supplementary feeding programme introduced by MSF for severely malnourished patients, who were given extra high protein food: milk, eggs and butter.

With no occupational therapy, patients sit with nothing to do all day.  Family visits have a very positive effect on patients, but the frequency of this depends on location and the time a patient has been in an institute. One institute, however, provided basic musical instruments and this had a very positive effect on the psychological well-being of the patients.