Burundi's Climate Displaced Struggle with Mental Health Challenges

Bujumbura - When she felt water on her body in the middle of the night, Irène panicked. In March 2022, the rising waters of Lake Tanganyika invaded the houses along the riverbank in Bujumbura’s southern districts within hours following heavy rainfall. On this night, Irène lost all her meagre possessions and her house.

More than 239,000 people in Burundi were affected by climate change induced disasters between October 22 and April 2023. Many lost their land and homes. For some, rebuilding over the traumatic event has not been easy.

In 2021 at COP26, the International Organization for Migration (IOM), the World Health Organization (WHO) and Lancet Migration jointly called on world leaders to take concrete action to mitigate the consequences of climate change on migration and people’s health, urging them to acknowledge that climate change, health and human mobility are closely connected.

The urgent need to include access to mental health services in national climate change response policies remains and is likely to be even more pressing in view of the increasing number of climate induced disasters.  

Burundi is among 20 countries most vulnerable to climate change. Storms, torrential rains, landslides and flooding regularly hit the country, causing almost 90 percent of internal displacements. Still, the country is affected by droughts, soil degradation and erosion. These events have serious impact on the psychological wellbeing of those affected.

In the small coastal village of Gitaza, Rumonge province, Habonimana lost everything in 2021, when water from Lake Tanganyika, swollen by torrential rains and strong winds, entered her home and swept away everything.  

"When I saw my house, I felt deep pain, because I couldn't save anything."

Widowed, she has the sole responsibility of finding a new home for herself and her children.

She spent the next few years in a near-by house she rented for 15,000 Burundian Francs (approx. 5USD) a month.

“I struggled to find enough to feed my children and pay the rent. I remember crying a lot, especially when I couldn't pay the rent and the landlord kicked me out of the house.”

Habonimana's financial constraints have greatly affected her mental health. Feeling an increasing disconnect between herself and her community, forced to sleep outside, sometimes not eating for several days. Life became unbearable. 

After more than a year in this situation, Habonimana was referred to IOM by local authorities which provided her with semi-durable shelter assistance in a non-flood-prone area in the village.

“I felt peace in my heart when I came to live in this house. I said goodbye to all the mistreatment I'd suffered at the hands of the owners of the houses I'd been forced to rent. I regained my dignity.”

Although the construction of shelters has enabled flood affected persons like Habonimana to regain dignified housing, her mental well-being remains deeply affected by the events. Accordingly, assistance to populations affected by disasters must be accompanied by psychosocial care to overcome trauma and ensure sustainable reintegration.

Weak government structures in Burundi for psychosocial assistance in the face of climatic shocks poses barriers to adequate care for victims. The violence of the events creates a disparity between the large number of persons in need of psychological assistance and the few psychologists available. Recruited straight from university, many are inexperienced and don’t benefit from proper supervision.

When the waters from Lake Tanganyika invaded Irène’s home in March 2022, she escaped with her baby to a nearby house where twenty others were already sheltering. A month later, as the waters began to recede, she returned home. There was nothing left. Her meagre possessions had been washed away. This traumatic event was the latest in a long series of challenges that scarred her life.

Irène's life had been fraught with difficulties long before Lake Tanganyika flooded her house. Originally from Muramvya, she moved to Bujumbura in 2019 to work. She slept on site in a shed without a lock on the door. For a month, a male coworker visited her at night to abuse her. Soon, she became pregnant. The fatigue and nausea were so severe that she was forced to stop working.

After giving birth, she returned to her family in Muramvya. As the birth of a child out of wedlock is a very heavy burden to bear in Burundian culture, and despite having explained the circumstances of her pregnancy, Irène was rejected by her parents. Feeling increasingly alone, she moved back to Bujumbura, where she cultivated a small piece of land and managed to accumulate a few possessions.

After the floods took everything from her, she experienced one of her hardest years: "I didn't want to talk to anyone. Even when I passed a friend, I didn't want to talk to him. I'd ruminate. If someone spoke to me, I could react brutally, give a violent response."

IOM’s Mental Health and Psychosocial Support (MHPSS) teams have been working with populations in the affected neighborhoods, helping them to regain a sense of well-being that enables them to reintegrate into their communities.

IOM was able to identify Irene and other flood-affected persons who had become completely isolated. Gathered in group therapy, they shared their difficulties. By communicating with others who were also facing serious difficulties, Irène began to open up about her psychological challenges.

Via support groups like the one Irene became a member of, IOM supported 240 people between 2021 and 2022 throughout the provinces of Bujumbura Mairie, Bujumbura Rural, Rumonge and Makamba. The support groups formed meet every Wednesday for mutual counseling.

Today, Irène is positive about her future. She is once again able to communicate with members of her community and cultivates a small garden opposite her home.

While the response to the effects of climate change is integrated into Burundi’s National Development Plan, and into the country’s Vision 2040-2060, a reference to appropriate mental health and psychosocial support in the face of climate-induced disaster events is lacking. To move towards comprehensive support to affected populations, IOM has supported the Ministry of Public Health in developing a mental health kit to equip 15 health centers in Bujumbura and Rumonge. IOM has also trained 200 community health workers in four provinces on mental health, familiarizing them with the symptoms, causes and treatment of trauma and mental illness.

Post COP 28, where the world met to discuss how to achieve the objectives of the Paris Agreement, it is important to remember that crises linked to climate change also have serious repercussions on people's mental health. For people who have lost everything, psychosocial well-being is the first step to rebuilding their lives.