Ayacucho is the capital of Huamanga Province in south central Peru. It sits high on the eastern slopes of the Peruvian Andes surrounded by mountainous farm land where people tend small plots of land or herd alpacas and sheep. The town famous for its colonial history and Holy Week Services also has a darker claim: it was the epicenter of brutal violence by Maoist Shining Path insurgents in the 1980s and ‘90s.
The years of violence took their toll on the country and an estimated 69,000 people died in the insurgency. Most were poor, Quechua-speaking peasant farmers in Ayacucho and nearby regions. The survivors were left to deal with the death or disappearance of loved ones, the destruction of homes and farms and the disintegration of families and communities.
Data gathered by the Truth and Reconciliation Commission of Peru showed high rates of mental illness in areas that had been affected by political violence. Problems included alcoholism, depression, post traumatic stress disorder, anxiety, schizophrenia and suicide. The region has high levels of domestic violence as well.
In 2003, in coordination with local religious and civic groups and with minimal equipment and a volunteer nursing staff, Sr. Anne opened a small psychiatric clinic. Soon there were volunteer psychiatrists and psychologists, as well as other medical students, interns and nurses helping out. The work has grown from visiting a few patients in their homes to serving over 2,000 patients with psychiatric evaluations, treatment and rehabilitation programs.
The Ayacucho Mental Health Clinic serves a population that lives in unremitting poverty. No one is turned away due to lack of funds. The goal is to provide treatment for the mentally ill including individual and group psychotherapy, drug therapy, medication management, home visitation (especially for high risk patients), ongoing family therapy, an alcohol and substance abuse program and a disabilities program for mentally challenged children and adolescents. The goal is for graduates of the program to reintegrate into the community, hold jobs and live with their families.
Funding and Sustainability
Achieving sustainability is an ongoing quest. Since the clinic serves people who are poor, it is difficult to envision the clinic becoming self-sufficient from patient reimbursement, although we continue to explore creative ways to meet this need.