Mental health matters in Machar

In many societies around the world, talking about mental health is still taboo. Health promoter Tasawwar gets the conversation started among members of a Pakistani fishing community. 

Health Promotion Supervisor Tasawwar Ali discusses the stigma of hepatitis C through the visual representation of a butterfly in Machar Colony, Pakistan.

Machar Colony, formerly known as “Machara” or “Fisherman’s Colony”, is a well-known settlement in Karachi, southeast Pakistan, situated between a port and mangrove swamps.

It boasts a multicultural neighbourhood with numerous Bengali, Burmese and Pashtoon populations, among others.

After the devastating 2010 floods in Pakistan, MSF starting providing primary health care the following year to improve access to emergency and maternity-based medical services in the area.

Our battle against stigmas related to mental health is still going strong

During early interactions with patients, a need for mental health services became a recurring concern.

To address this, MSF opened a mental health department to provide psychological support services with outreach activities focusing on mental health awareness.

Bridging the gap

In 2015, I joined MSF as a mental health counsellor.

During my first community group session, I observed that many people struggled to understand the subject due to cultural barriers created by marginalisation, taboos and a lack of education.

Many had questions regarding psychological problems, but there remained a distinct lack of knowledge on how to get the conversation on mental health going.

In the course of my work, I engaged community members by relating local examples of how people express their psychological problems in somatic - or physical - forms, the workings of cross-cultural psychology and the daily stressors that continue to create psychological disturbances.

Over time, people started getting involved, interacting and becoming increasingly motivated to express their feelings.

A patient’s journey comes full circle

A case in point is one of my patients with depression, who I worked with individually and during group sessions.

After eight sessions, he gradually recovered.

The impact of treatment motivated him to volunteer by playing a key role in encouraging people to seek help for their mental health.

Community acceptance

Mental health promotion had been a significant starting point through which the community learned about and became increasingly supportive of the mental health concerns of their loved ones.

In our work, we actively tried to reduce stigma and discrimination by engaging the local community.

According to our monthly reports, there had been a significant increase in patients over time.

This indicator marked a growing acceptance among individuals in their perceptions and understanding of psychological support.

Tackling Hepatitis C

I now work with MSF as a health promotion supervisor.

Now that the project focuses on hepatitis C, the mental health department has transformed into the patient support department.


The MSF clinic in Machar Colony, Pakistan.
The MSF clinic in Machar Colony, Pakistan.

I feel proud to be a part of MSF’s health promotion team in Machar.

Every year, our health promotion team organises a World Mental Health Day event in the community, where students, teachers, parents, elderly community members and patients participate by expressing their views on mental health awareness.

Our battle against stigmas related to mental health is still going strong. And, through our health promotion activities, I am lucky to have been given the opportunity to change the lives of hundreds of survivors.     


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