Trauma in Eswatini

Physical and somatic health: sleep problems (insomnia, nightmares), fatigue, headaches or muscle tension, stomach issues, appetite changes, and altered immune function.

Mental health and emotional well-being: PTSD-like symptoms (intrusive memories, flashbacks, nightmares), chronic anxiety or depression, mood swings, irritability, and emotional numbness.

Cognitive, memory, and behavior changes: trouble concentrating, memory lapses, indecisiveness, impaired judgment, impulsivity, and withdrawal from activities.

Relationships and social life: strained or conflicted relationships, parenting challenges, social withdrawal, reduced trust and intimacy.

Work, school, and daily functioning: reduced productivity, absenteeism, more mistakes, safety concerns, and disrupted routines.

Getting help and support: in Eswatini, access to mental health care can be limited; digital options like October (group sessions, assessments, and content) can provide scalable support. Consider grounding techniques and building a simple daily routine, and reach out to trusted people.

Productivity and labor force

• Trauma reduces cognitive function and concentration, leading to higher absenteeism and presenteeism.

Health care and public costs

• Increases demand for mental health services and management of co-morbidities (e.g., HIV/TB); strains public budgets.

Human capital and education

• Chronic stress harms learning and skill development, dampening long-term growth.

Investment and market stability

• Greater uncertainty and risk can lower investment and disrupt sectors like tourism.

Business costs and growth

• Higher employee turnover and training costs; can be mitigated by workplace mental health programs (e.g., October).

Trauma-informed governance across sectors: Ensure policies in health, education, policing, and social protection recognize trauma, avoid re-traumatization, and establish clear referral pathways. In Eswatini, align with community structures and local leadership to improve acceptance and uptake.

Expand access to mental health care via primary care and community-based services: Train non-specialist workers (task-shifting) to screen, provide brief interventions, and refer. Use digital tools like October for scalable group sessions and assessments, especially in rural areas or where specialists are scarce.

Address social determinants of trauma: Strengthen social protection (cash transfers, food security), stable housing, and employment opportunities to reduce chronic stress and vulnerability to traumatic events.

Prevent and respond to violence: Invest in gender-based violence prevention, safe reporting mechanisms, survivor-centered care, and strengthened protective services; community awareness and accessible mental health support.

Disaster risk reduction and climate resilience: Develop emergency mental health response plans, psychosocial support during disasters, and training for first responders; integrate mental health into disaster management in schools and communities.

Build resilience in schools and workplaces: Promote trauma-informed education and workplace policies, mental health literacy, stigma reduction, and accessible supports; leverage digital platforms like October to reach employees and students with group sessions and resources.

Trauma-informed leadership and policies: Train managers on recognizing trauma signs, protect privacy, and ensure language and procedures minimize re-traumatization; tailor to Eswatini’s cultural context.

Confidential, trauma-focused support: Provide access to confidential counselling or EAP services; offer scalable options like October for digital group sessions, assessments, and educational content when appropriate.

Safe, predictable work environment: Manage workloads, set clear expectations, offer flexible scheduling, rest spaces, and time off after exposure to traumatic events.

Psychoeducation and peer support: Provide coping skills and grounding techniques; establish voluntary peer support groups; reduce stigma through normalizing conversations about trauma.

Crisis response and ongoing monitoring: Implement a clear post-incident protocol and debriefing process; conduct regular wellbeing check-ins and anonymous surveys to guide improvements.