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The Stigma of Mental Illness


Saturday afternoon I was at Harare Hospital Psychiatric Unit. I went there with Susan, a doctor friend of mine from Australia, who was visiting and she wanted to meet Dr Dixon Chibanda, a Harare psychiatrist.

The phone number we had for Dr Chibanda was not working. So we thought it would be better to go and find his details at Harare Psychiatric Hospital.

The sister-in-charge was nice. She said we could wait in the reception room while she tried to call Dr Chibanda.

A tall handsome guy in his late 30’s came to greet us, carrying a big container of water. He politely introduced himself and sat comfortably next to Susan. She moved away a little but he shifted closer to her, so their knees could touch.

He then named a number of Zimbabwe prophets and wanted Susan to tell him which one was the best. Susan said she did not know anyone. While Susan and the man with the jug of water engaged in a disjointed conversation, I decided to wonder around the garden of the Psychiatric Unit.

“Is the President of Kenya Jomo Kenyatta?” one guy asked me. I said that he was not the one anymore. Then he said, “What about Ghana? It is Nkrumah? You know Nkrumah?”

I said I did know Nkrumah personally but he certainly was at one time the President of Ghana. The man smiled and shook my hand. He kept on holding it. For a few seconds, I got a bit worried. What if he suddenly stopped smiling and became violent?

Mentally-ill people can be unpredictable. We should not have come here at all. But here we were, moving around and talking to mentally-ill patients as if we had a right to enter such a space meant for those who are quite clearly disturbed. The man let go of my hand. I was relieved. I wanted to go away from him quickly. But he grabbed my hand again.

“Have you got a phone?” he asked. I said I did. “Call my cousin in Borrowdale. She is the daughter of my mother’s sister. Tell her I need slippers and also something warm. I am very cold here,” he said.

I took the number. Then he let go of my hand and in impeccable English, he said. “Thank you madam. I am much obliged to your kindness. And I am very sorry to have taken some of your precious time. I watched him walk away. He was probably in his mid 40’s. I wondered what could have caused his mental illness.

He may have had a very good job and a family. Soon as he left me I was approached by a boy, who was possibly 17 or 18-years-old. The boy was busy dancing to music in his head and desperately wanting some attention.

Then an elderly lady in the blue-and-green hospital uniform stood in front of me. She kept staring and smiling. Then she said something about her mother’s cows and why they should be sent back. I said indeed, the cows should go back. She said, “Handiti wazviona? Dzakarohwa nemheni dzaive nhatu. Mhenyu hadzina kuzoenda. (Now you see? Three cows were destroyed by lightning. The rest did not go. I agreed with her on everything to do with the cows).”

The woman reminded me of Marukwe, the mentally-ill woman who used to live in our village. Each time we behaved badly, my grandmother Mbuya VaMandirowesa would scold us by calling us Marukwe.

Marukwe was not the only mad person around our village. There was Mamvura, who talked to himself all the time. Mamvura was a scary big man with wild uncombed hair and big bare feet. He always used a string from the bark of a tree as a belt for his pair of trousers.

Mr Muzorori of Muzorori & Sons Stores supplied Mamvura with old clothes and warm clothing in winter.

Mamvura used to sit on the verandah of Muzorori & Sons Store. Sometimes you would see him walking up and down the road and coming back to the verandah to sit and beg for a drink or whatever anyone was eating.

Mamvura died at the beginning of the liberation war. Some people said he was shot dead by Rhodesian soldiers because he disobeyed the curfew. Maybe that was true.

Today, we have one mentally-ill person near our village called Israel. He is my cousin, son of my aunt, Tete Mai Israel, who lives a few kilometres across the river. Israel used to work in Bulawayo as a carpenter. He was married with two children. One day he started hearing voices telling him that someone wanted to bewitch his food at work.

Each time it started raining, Israel would run back to his house and hide in the wardrobe, saying rain belonged to the devil.

He would stay singing religious songs until it stopped raining. Because his behaviour had started to be so disruptive and unpredictable, Israel lost his job. Then his wife left him.

Israel came home to his parents. They took him to a n’anga or traditional healer where he was given various medicines to drink and to rub on his body.

But there was no change. At one time, when my mother was still alive, he arrived at our homestead. Since he is the son of my aunt, he could exercise flirting or romantic banter with my mother, because she was the wife of his uncle, mukadzi wa sekuru.

He greeted me politely. When he saw my mother, his face was full of joy. She called out to him saying, “Ah, my husband, you have come. You must not desert the wife of your uncle for so long. He greeted her and said he was hungry.” She said she would not feed him until he bathed.

My mother gave Israel soap, a towel and warm water in a bucket. She showed him the bathroom and he asked if she could bath him and scrub his back. She said no, she was too busy and besides, he was very dirty. He should come back another day when she has time and she would bath him nicely and gently then oil his ugly cracked feet.

My mother gave Israel my brother’s old school uniform, including a very nice jacket from Kutama College that used to belong to Sydney. Israel ate all his sadza and dried meat in peanut sauce. He did not speak to anyone as he ate. When he was full, he stood up and without saying thank you or good bye, he disappeared. That was just the way he was and still is.

Two or perhaps three times a year, Israel walks into our homestead. He will eat and then leave. Everyone knows Israel is a madman or benzi. But he is not at all violent. He moves around and asks for food from people. We are used to seeing him in that mental state.

My cousin Israel is probably in a better condition than most mentally-ill people in Zimbabwe. The causes of mental illness are many. In the village, Mbuya VaMandirowesa used to tell us that mental illness was caused by bad spirits or ngozi.

Although I now know better than what Mbuya told me, I often wonder whether ngozi is a contributing factor to madness.

In town, you often see people who are quite unwell, vanopenga. But surely this is not all due to ngozi. This is often caused by economic hardships and the stress of modern day living.

According to statistics by the World Health Organisation (WHO), Zimbabwe has about 1,3 million out of 14 million people, who are mentally ill and needing support.

There are only 14 psychiatrists to care for these 1,3 million mental patients. Madness or psychosis can cause a person to commit violent offences like murder, rape or assault. In Zimbabwe, some young unemployed people get depressed and suffer from anxiety. In order to escape from their problems, they take excessive alcohol and drugs, leading them to a state of mental illness.

On Saturday afternoon, we did not find Dr Chibanda at Harare Psychiatric Hospital.

But we left our phone numbers with the sister-in-charge.

As we left the reception, a woman in hospital clothes appeared from somewhere shouting: “You are the prophets from Kenya. I knew it!” Then she started following us.

One of the staff members grabbed her by the arm, telling her that she was not going anywhere.

They started arguing. Some mentally ill people suffer in silence without any support from drugs at all.

The general public needs to be educated about mental illness so we do not subject the person, who is unwell to stigma and discrimination.

Calling a mentally-ill person names like Marukwe or benzi, does little to promote their health and well-being.

Some of us who grew up thinking madness is caused by evil spirits have a tendency to blame mentally-ill people or even laugh at them.

And yet, mental illness is a disease, like any other.

Dr Sekai Nzenza is a writer and cultural critic.

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