Nobody has ever officially diagnosed Marie with postnatal depression, although the community’s Chief Medical Officer, Djibril Niane, 42, remembers her case and nods at the disorder’s mention. “But we only have two health huts and one health post to service over 9,000 people within the region, and we have to treat many life-threatening diseases such as malaria and flu,” he says. “Our priority is getting mothers to deliver their children at health centres and with midwives present rather than at home. Young mothers are also prone to premature delivery and complications during the birth. We don’t have the facilities or training to worry about their mental health afterwards as well.”
Funding to the health posts is already stretched as far as it can go, Djibril adds. UNICEF are their major donors – responsible for financing many of the health posts’ much-needed vaccination and nutritional support programmes – but money is tight and it’s often a case of too little, too late.
“The real worry is that when the girls are too depressed to breastfeed their children, their families can’t afford to buy formula milk and the babies quickly become malnourished,” says local midwife Awa Diouf, 32. “Thankfully we do have emergency food supplies such as Plumpy’Nut paste that we can provide in those circumstances and we can help children before their situation becomes too severe. But without treatment, depression can be really dangerous for both mother and child. Culturally, I don’t know why we don’t take it more seriously here.”
When asked if she plans to try and raise awareness in the future, she looks uncomfortable. She’d like to, but it depends on money, she says eventually.
Over the border in Guinea, the situation is just as concerning. When Binta Doumbaya, 18, from Norassoba, found out she was pregnant two years ago, she was relieved – after all, it meant she would be able to stop having sex with her much older husband. “Everyone was very happy for me,” she remembers. “They shook my hand and called me ‘cocomanie’, which means ‘pregnant woman’, and treated me with respect. To have a child is the most important thing you can do when you’re a girl.”