It is dawn in the vibrant city of Lagos. As the sun lazily pulls itself up in the horizon, a group of bright-eyed commuters stand huddled together with perked ears and ready feet. They are waiting for the “The Lord is my Shepherd” – a 14-seater black-striped yellow Toyota Hiace better known as Danfo, responsible for conveying the group of office cleaners, shop-openers and restaurant cooks.
A young woman stops a few metres away. She is dressed, however in a patchwork of different fabrics which come together to make no discernible meaning. Her dishevelled hair is tangled and matted with dirt. She cannot be more than 35, but years of insanity have etched lines deep into her face. One of the commuters shakes her head disapprovingly. Another shifts. “Them don use juju finish this fine geh”, he muses.
He couldn’t be further from the truth. This is no ordinary ‘madwoman’. 5 years ago, Peace as she was fondly called was peaceful, not only in demeanor but also in her associations. She had occupied a very different corner of Lagos as a lovable junior doctor, visiting patients and helping the sick on their way to recovery.
She had neither made any enemies among her peers, nor even during her training as a medical student. Certainly not from her village. She had been described with words such as ‘outstanding’, ‘impressive’ and ‘brilliant’. You couldn’t have met prouder parents at her graduation, who were esctatic that 7 years of handwork and expenses had finally paid off.
What then happened on that rainy afternoon in 1994, when Peace collapsed on duty in the middle of her patient round? The diagnosis was stress, followed by an unnamed mental disorder, then, 5 years alternating between the streets of Lagos and the psychiatric hospital in Lagos.
After reading Peace’s story, I am touched for several reasons. I am touched because Peace is a young lady, just like I am. In what way is she different from me? Could she have been “targeted” by some strange twist of fate? Was it something she did? Was it “something” “someone” did, “somewhere”? Yes, I’m talking juju.
I am also touched because not only is she your average ambitious young lady, she went above and beyond the demands of basic university education and became a doctor. By way of education, Peace has put more effort in and has achieved more than I and many others have. If as a doctor – a general practitioner for that matter, she couldn’t recognise the “signs”, then how about the rest of the general population like you and I? Peace’s demise seem to have began while she was under pressure from work. A situation which is not unique to anyone from any country, religion, race or intellect. Everyone gets stressed sometimes – what do we do in stressful situations?
Peace could have been anybody at all. Some of us might develop mental illnesses in the course of our lifetime, some of us might not. There are thousands of Nigerians like Peace who suffer from differing types of mental illness, but who are discouraged by society to be open about it, or even seek treatment. Labels such as “yabaleft” and “yabapsych”, even used in jest make a mockery of the difficulty that a lot of people go through in their day to day lives.
In spite of this, many have held on to the speculation that Nigerians on a whole are happy people, fuelled by a report years ago. Are we really happy, or are we experts at hiding our pain and discontent?
Not only do we only broach the subject when a high profile celebrities such makes us take notice, but many Nigerians tend to treat mental illness – which is actually a broad spectrum of conditions ranging from depression to schizophrenia – as a supernatural affliction. Few centres such as these can show a care plan on how they successfully achieve the goal of helping those affected reintegrate into society. In return, they are critically underfunded and have to rely on external funds, combined with a lean business approach to stay open.
As mental illness is so poorly understood by the general public and even medical professionals, churches and spiritualists are the the first port of call for most, where treatment options range from counselling to flogging. And this is considered regular practice.
While there might be a small number cases which have an under-worldly influence, this theory fails to explain the vast majority of cases like Peace’s which followed a highly demanding and stressful lifestyle, with very little periods of recreation.
Neither does it help that fewer than 1 psychiatrist per 1 million people, for each of the 200m people living in Nigeria. A recent study showed that at least 12.1% of the population have experienced some sort of mental illness in the past, and considering the difficult conditions people have to live under, actual figures could be much higher
1. “Demystification is a critical step in the steps to recovery from mental illness”, says Dr Iheanacho (MD). If you’re a friend/family of someone affected by this, the first step to helping your loved one back on to the road to recovery is to regard mental illness as the illness that it is, rather than an irreversible curse as it is made out to be.
2. If you’re facing mental health challenges, accept yourself and the fact that you have only fallen ill due to no fault of yours – and whether those around you understand it or not. You may not love yourself, you may not even like yourself but it helps to know fact from fiction.
3. Speak to someone close. Speak to your friends/family and let them know what you’re going through. Even if they can’t offer any immediate solutions, they can pray for you and check up on you too.
4. After accepting advice from friends and family asking you to “think positive”, contact a clinical specialist in mental health. Please DO NOT take any medication “prescribed” to you by a friend, or by any faceless “therapists” on online forums, as this might make you feel worse.
Here is a small list of therapists in Nigeria. If you know any not on the list, please e-mail firstname.lastname@example.org with subject title “Therapy list”, and we will include them on this list.
First, we need more clinicians in the area of mental health. At the time of writing this article, only one Nigerian institution offers a comprehensive guide for prospective students searching for degree courses in mental health in Nigeria. Compare this with three institutions offering the same course in neighbouring Ghana.
1. The government can improve the situation by investing in this area of education, and also making these courses more accessible to students, while guaranteeing them jobs on completion of the courses.
2. Prof. Oye Gureje – a renowned scholar in the field of mental health in Nigeria, suggests that spiritual healers and church counsellors should collaborate with, and refer their patients to clinical doctors. The aim is to spare patients from ineffective, torturous practices, and also facilitate some sort of treatment regime.
While the road is ambitious and fraught with obstacles, there is no way of predicting the outcome other than testing/waiting it out.