Akekelwa Catherine Chitonka’s Story

RefuCare Initiative, Zambia

I am Akekelwa Catherine Chitonka, Co-Founder and Team Lead of RefuCare Zambia, a youth-led organization advancing mental health equity for marginalized adolescent girls and young women. My journey into mental health advocacy began with profound loss at 19, I lost my closest friend to suicide. She was brilliant and kind, yet beneath the surface, she was drowning. There were no school counselors, no crisis support systems, no one trained to see the signs I now recognize everywhere. Her death was not inevitable it was the predictable outcome of systematic failure.

That grief propelled me into social work at the University of Zambia and then to Lifeline/Childline Zambia, where I managed national child protection programs. But everywhere I looked, I saw the same pattern: individual interventions treating symptoms while the systems producing mental health crises remained unchanged.

In 2023, I co-founded RefuCare Zambia because I was tired of working around broken systems - I wanted to build alternatives.

Today, RefuCare serves over 500 adolescent girls and young women whom Zambia's health system has completely abandoned: girls with albinism facing violence and educational exclusion, child marriage survivors denied reintegration support, refugee women in remote settlements, and rural adolescents with zero access to mental health care. 

Through our RISE, RREN, AWARE, ASSAN, and LEAD programmes, we provide trauma-informed counseling, establish peer support networks, train young women as mental health leaders, and advocate for policy change. We developed the INSPIRE Mental Health Toolkit now used in 50+ schools because communities cannot wait for governments to build infrastructure. We create it ourselves.

My work is grounded in the belief that mental health is inseparable from justice. You cannot heal trauma while violence continues. You cannot treat depression while people remain powerless. 

Mental health advocacy must address root causes gender-based violence, child marriage, poverty, discrimination or we are merely managing symptoms. And critically, the most affected must lead. People with lived experience are not beneficiaries or consultants - they are experts with solutions. RefuCare exists because the girls we serve designed it, lead it, and sustain it.

Please share your reflections on what you've learned and you would like to share with our global community.

Mental health equity requires transferring power, not just providing services. The global mental health sector talks endlessly about "centering lived experience" and "community engagement," but these are often euphemisms for extracting stories while professionals retain all decision-making power. 

At RefuCare, young women with lived experience of suicide ideation, child marriage, and trauma are not advisors they are the mental health workforce. They design programs, facilitate peer support, train communities, and lead advocacy. This is not consultation; it is leadership. Until we transfer actual power to those most affected, we are perpetuating the same hierarchies that created mental health inequity in the first place.

Community-based, peer-led models are not second-best they are the future. The mental health sector remains obsessed with scaling professional psychiatric services, as if the solution to global mental health inequity is more psychiatrists. But most of the world will never access a psychiatrist. Zambia has 1 psychiatrist per 1.5 million people. Rather than lamenting this "shortage," we must recognize that peer support, community-based care, and digital innovations are not stopgap measures—they are sustainable, culturally relevant, and often more effective than clinic-based care. 

RefuCare's peer supporters reach girls in refugee settlements and rural schools where no professional will ever go. This is not a compromise; it is justice.

Protect your own mental health or you will not last. I learned this the hard way. Leading mental health work while carrying secondary trauma, burnout, and grief is unsustainable. For two years, I believed rest was weakness, that boundaries were selfishness, that my pain was irrelevant compared to the suffering I witnessed daily. I was wrong. Burnout does not make you a better advocate it removes you from the fight entirely. Seek therapy. Find peer support. Set boundaries. Rest is not luxury; it is resistance against systems that expect marginalized people to sacrifice ourselves endlessly.

Hope is a discipline, not an emotion. Some days, the systems feel immovable. The violence feels endless. The funding never comes. Girls still die. On those days, I remember Grace a child marriage survivor who attempted suicide twice, received support through RefuCare, trained as a peer supporter, and then saved another 15-year-old girl's life. 

I remember that every girl we support has the potential to support 20 more. Hope is not naive optimism it is the stubborn, strategic refusal to accept that things cannot change. That discipline sustains me when nothing else does.

What has been your favourite moment as a member of GMHAN?

My favorite moment was at the 3rd International Conference on Public Health in Africa (CPHIA) in Lusaka, Zambia in 2023. I was invited to speak on a panel about decriminalizing suicide ideation a topic deeply personal to my work with suicidal adolescents through RefuCare. Sitting beside me was a GMHAN advocate from South Africa whose work I had admired from afar but never met in person.

As she spoke about GMHAN's continental advocacy campaigns, the network's efforts to challenge mental health stigma across Africa, and the collective power of grassroots advocates united across borders, something clicked for me. Until that moment, I had felt like a lone voice shouting into the void in Zambia fighting stigma, advocating for adolescent mental health, training peer supporters with little recognition or support. But listening to her describe GMHAN's work, I realized I was not alone. I was part of a movement.

After the panel, we talked for an hour. She invited me to join GMHAN's action groups. That conversation changed everything. Suddenly, I had access to a global community of advocates who understood the isolation, the funding struggles, the resistance to peer-led models, the exhaustion of doing this work in contexts where mental health is dismissed. I had allies.

What excites me most now is waking up every day knowing I am part of a tremendous, growing community of advocates initiating change across every dimension of mental health women's mental health, youth suicide prevention, lived experience leadership, policy reform, stigma reduction. 

When I face a challenge at RefuCare, I can reach out to GMHAN members in Kenya, Uganda, Ghana, India, Philippines who have faced the same barriers and can share strategies. When we achieve a victory like a school adopting mental health protocols I can celebrate with people who truly understand what that victory means.

GMHAN transformed me from an isolated advocate in Zambia to a member of a global movement. That solidarity is everything. It sustains me on the hardest days and amplifies our impact on the best days. We are stronger together than we could ever be alone.

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