Mental health and mental disorders can be found anywhere. In Africa, however, the mental health stigma is preventing people to get proper help. Instead, they are branded as cursed madmen, unable to heal or get the help they need, dragging themselves and their families down for good.
It is a rainy day in Nakaseke, a small township in Central Uganda. Now and then, unforgivable torrents of rain leave the people on the streets scampering for shelter. One of the many people on those streets is a middle-aged man who seems not bothered the least by the rain. He is dark, frail, sickly, and walks with an unenthusiastic slouch, a sign that he may not have had a proper meal for days.
Heavy drops of rain pound on his bare torso mercilessly. His long and shaggy hair is soaked to capacity. Water runs down his unbathed body leaving behind a layer of slime. The dirty piece of cloth around his waist that hardly conceals anything is falling off with every step he takes. He wades barefoot through the dirty run-off water that is already mixed with sewage from a nearby burst sewer. And he will continue walking in the rain oblivious to the health risks he is exposed to. From their shelters, everyone is looking at him, feigning concern. None will dare touch him though, he is the ‘madman’ of Nakaseke.
There is an African proverb that says ‘every marketplace has its madman’. Sure enough and literally, if you walk through any marketplace, whether in the village or the city, it is not rare to see a person presenting symptoms of mental health disorders. If you inquire, you’ll find that such people do have families who know of their condition. But sadly, nothing much is done to help them. Instead, they are left to tend for themselves. That is how some end up roaming the streets. One common thing is that they’re all misunderstood and have been given one common label: mad.
Despite mental health manifesting in many ways, society remains mostly ignorant. In fact, policymakers never prioritize mental health while formulating health policies. So do governments while allocating health budgets. The result has been a silent but deep-running pandemic in mental health care.
Mental Health: A Curse of the Family
In many communities, the topic of mental health is discussed in hushed tones. It is not uncommon that a victim is seen as cursed or possessed by demons. For instance, Sibutso, a resident of Soweto in South Africa recalls in pain how his father woke up one morning and stripped naked. His family was alarmed and rushed him to a psychiatric clinic. It was discovered he was suffering from depression and was immediately put on therapy. Upon returning home, they realized their friends and neighbors were avoiding them like the plague.
Word had quickly spread that his family had been bewitched. Any association with them meant you would catch the curse. And just like that, Sibutso started seeing the people he had known and worked with quickly turn into the other direction whenever they saw him approaching. His story is not isolated. It can not only be replicated in other African countries and reaches as far as India.
Mental Disorders are Manageable
The World Health Organization estimates that 10% of the total disease burden in Africa is due to mental disorders. Globally, 14% of diseases are attributed to mental health. While the developed world has advanced in managing such conditions, the same cannot be said of the developing world. More so the Sub Saharan Africa where there are 0.02 psychiatrists for every 100,000 patients. The situation is not made any easier by the attitude held towards mental health.
What people don’t know is that mental disorders, just like any other health condition, can be managed and the patient can continue to live a normal life. To properly manage them, it is essential to understand its type and cause as each case may present itself differently. First, mental disorders may be caused by biological or environmental and physical factors. Biological factors include:
- Genetics. Conditions can be passed down through genes
- Pre-natal damage. Caused by mother’s activities such as alcoholism during pregnancy
- Infection of the brain by disease-causing organisms
- Chemical imbalance in the brain. It causes conditions such as depression
- There are also environmental factors such as:
- Injury or trauma to the brain
- Substance abuse
- Life events such as physical or sexual abuse
- Social relationships
Understanding these causative factors helps in proper diagnosis and administration of therapeutic measures.
Mental Health: Common Types of Mental Disorders
Additionally, there are mental disorders of several types. Identifying each type is helpful in managing it as well as helping a family understand their fellow family member and how to take care of him/her. The most common types are:
- Bipolar disorder. This one mostly affects the mood. The patient experiences episodes of feeling high and other times feeling low
- Anxiety disorder. Patient feels worried or strong fear in a way that affects their life
- Clinical depression. Characterized by intense loss of interest in normal day-to-day activities
- Dementia. Characterized by impairment of some brain functions
- There are many other conditions such as autism and schizophrenia. Some cannot be cured, but they are all very manageable if treated correctly.
In Africa, the fact that society is ignorant of medical help means that most patients never make it to a psychiatric hospital. Moreover, there are very few psychiatrists. Most countries have no mental health institutions whatsoever, and patients are either attended by general practitioners in local health facilities or abandoned and forgotten at home by their families.
That is against a backdrop of an already strained health care system with inadequate infrastructure. For instance, a shocking report on Mathari Hospital, Kenya’s only mental referral hospital, revealed of a female nurse assigned to 146 male mental patients of whom 53 were dangerous criminals.
With the option of medical intervention gone, most families are left to turn to religious leaders or witchdoctors who perform rituals on them. It is debatable whether they succeed or not.
While mental stigma in Africa may not cease overnight, the facts remain that mental disorders are manageable and in some cases avoidable. Now is the time that Africans must have a paradigm shift in mental health.
Stop the stigma and, with love and understanding, embrace all affected.
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