Appalling treatment of mentally ill people in Swaziland

A story published in last week’s Observer on Saturday about the appalling state of the National Psychiatric Centre was quite heartbreaking.  It appears people have just written off the patients at the hospital.

The story painted a bleak picture of patient-neglect as mentally ill people are living in very humiliating conditions where the hospital is flooding owing to poor drainage. It does not only rain but pours for these fellow members of our society, literally and figuratively. Not only do they have to live in less than ideal circumstances, they also have to contend with insensitive journalists who use derogatory terms to refer to mental illness. It now appears everybody is out to get them.

On January 22 2015, there was a headline in The Observer that referred to an alleged robber suspected to be mentally ill as a “nutcase”. More recently, on May 18, there was another story headlined “Stark raving lunaticson the loose in Siteki”. Now, that is a very insensitive way of referring to fellow citizens of the kingdom. The story published in May highlighted how there was an influx of mentally handicapped people in Siteki, with some of them accused of committing serious crimes. That is a huge concern that calls for prompt intervention and screaming headlines, but not those that are insulting to the mentally ill.

Following the offending headline, I spoke to Psychiatrist and Mental Health Specialist, Dr Violet Mwanjali, to get an understanding of the facts around mental illness. She defined mental illness as any illness that affects the mind, and there are many of them affecting thousands of people in the country. Schizophrenia, depression, bipolar,  autism, and eating, anxiety, obsessive-compulsive and post-traumatic stress disorders are examples.  

Dr Mwanjali called on the people of Swaziland to come together in managing mental illness so that it does not end up having adverse effects on society, such as crime, violence, broken families and suicides. It should never be forgotten that some mentally ill people are also caregivers, and failure to get treatment might result in them losing their jobs and failing to cater for their families, like paying school fees and buying food, for example.  Mental illness, very unfortunately, is one of the illnesses that suffer a lot of discrimination from the less informed. This discrimination, said Dr Mwanjali, is among the major impediments to treating mental illness.

It is worse when the discrimination is perpetuated by the media, because society usually takes what newspapers say as the gospel truth, and when headlines call mentally ill people “nutcases” and “stark raving lunatics”, some members of society will believe that it is acceptable to throw around such ugly names. 

 “Mentally ill people delay going to the hospital, even when they see the symptoms. Sometimes they are afraid to collect their medication because they are afraid that people will see them and laugh. They then end up with complications because they are afraid of the labels,” Dr Mwanjali said.

The state of affairs at the National Psychiatric Centre at the moment does not encourage anyone to go and seek treatment. Nobody wants to live in such a wretched fashion. Apart from drainage system malfunction, there is also overcrowding, which has seen some of the patients having to sleep on the wet floor as water seeps into their dormitories. Apart from the existing ailments they have, they might end up picking new ones as a result of the deplorable living conditions. If patients have to walk on human waste in an effort to take a bath, doesn’t it negate the whole idea of taking a bath in the first place?

Vision 2022 must certainly look like a castle in the air for patients at the Psychiatric Centre. In progressive countries a building like that would be condemned as it is not safe for human habitation, and those who ran discriminatory headlines would be censured.

We should never be seen to be taking advantage of those that cannot speak for themselves. We would never be that nasty to people with HIV, because they have the mental capacity to stand up and fight for themselves and a big stink, excuse the pun, would be raised by organisations that represent them. People with HIV and other ailments are also being hauled before the courts for committing crimes, but they are not profiled as is done with the mentally ill.

 Dr Mwanjali said the majority of mental illnesses, among them depression and suicide, could be totally treated if those affected consulted mental health professionals. Those illnesses that could not be treated could be managed, the same way ailments like diabetes and hypertension are. People with mental illness can lead normal, fulfilling lives if they get the correct help and take their medication as prescribed. They need moral support so that they do not feel that they have to deal with their condition all by themselves. Supporting them also involves accompanying them to the hospital as soon as signs of mental illness are noticed. Other family members also need to understand how the medication should be administered, just in case the patient is incapacitated to remember by himself.

What’s worrying now is that the conditions under which mentally ill people live might exacerbate feelings of desolation. I would feel despondent too if I had to be woken up at night to wipe away sewage water from the floor.

There is a saying that goes, “The greatest measure of society is in how it treats its vulnerable members.” What is happening at the Psychiatric Centre is shocking and deplorable. The patients there are real people, not shadows. They have aspirations to get better and get on with life like everybody else.  They are somebody’s mother, father, child, or aunt. They deserve to be treated with dignity. There are associations for the deaf, those with HIV, epilepsy and other conditions, but who stands for the mentally ill in Swaziland? Surely people can come together and forego a few luxuries to ensure that the ablution facilities at the Psychiatric Centre are fixed? The world is too rich to allow vulnerable citizens of the country to live like that. Hefty sums of money are being offered for the protection of the rhino, and we must believe there’s nothing for mentally ill human beings? It doesn’t make sense.  Let us be our brother’s keeper.

 Published in Sunday Observer

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Discussion on high suicide rate in Swaziland