Clearly, John and company have no rights
John roams freely in the townships of Mangochi. His load, seemingly heavy, does not weigh him down as he moves from one place to another. Periodically, he makes some stops to pick up and load more litter into his overloaded bag.
Whether alone or in the company of an individual who engages him conversation, John produces a smile on his face, which is partly disfigured by burnt wounds.
Seemingly, John does not feel any pain, at least judging from how he carries on with his life. But John meets problems in his life, just like any other human being.
For a long time, he has been a well-known figure in Mangochi Township. He made himself a home on the veranda of one of the shops within the township. After spending the day moving around, he could return to his usual place to erect a mosquito net before retiring for the night.
Although he is always calm and nonviolent, John was recently severely beaten by a mob after he picked a quarrel with one of the call boys. Unlike in other fights, John had nobody to rescue him from the mob.
As the mob descended on him, onlookers cheered them on, as if they were killing a snake. Some made fun of him. He was beaten and stabbed several times before being left for dead.
After the fight, John crawled back to his base with blood oozing from his body. Nobody cared about what would become of him. Ironically, one of the people in the mob got injured during the fight and people rushed him to the hospital for treatment.
John had nobody to take him to the hospital. Why? Because he has a mental illness.
The society calls people such as John mad. Perhaps people that are not important in society. On his own, John could not go to the hospital, possibly because his condition makes it difficult to feel pain and think properly.
Even when a well-wisher was taking him to the hospital some hours after the fight, he resisted, such that it had to take the intervention of several people to take him to the hospital.
After that, nobody cared to know how he responded to treatment. He disappeared.
John is an example of how mentally challenged people live in the country. Unlike other illnesses, mental health patients do not know that they are sick. In most cases, they even resist being taken to health facilities to get medication.
Most, if not all, live a “happy” life. A life without complaints. They always have food in abundance from the remains people throw away in bins.
Because they do not complain of the illness, or display pain from their condition, the world seems to ignore the challenges mentally disturbed people face on a daily basis.
Just like John of Mangochi, most of them sleep in places not suitable for sleeping. Their food customarily is unhygienic. Sadly, even their relatives do not appreciate the importance of taking them for medication.
Ishmael Osman of Mtalimanja Village, Traditional authority Mponda in Mangochi has a girl with mental illness.
To Osman, mental illness has no cure because it is mostly believed that it is caused by witches.
“We have tried to consult traditional healers to help us solve the girl’s health problem but it does not work. At the moment, we have just left everything in the hands of God,” Osman said.
However, Osman concedes that he has ever heard of a hospital for mental patients, but he is not sure as to whether her daughter qualifies or can be accepted into the hospital, saying this is why he has been taking her to traditional healers only.
“As a family, we have run out of ideas on how to help her. It is painful, but we have become used to the fact that we cannot not do anything with her condition,” he says.
In Malawi, mental health remains an Achilles heel for both government and relatives of mental patients. Despite being a health problem, the government has failed to give it the necessary attention as it reserves such attention for ailments such as malaria, cancer, HIV and Aids, among others.
Malawi is known for its chronic shortage of health workers, with an average of 0.02 doctors and 0.60 nurses treating an equivalent of 1, 000 people, according to the World Health Organisation (WHO).
Additionally, the country has, for a long time, been failing to meet the Abuja Declaration which recommends that countries should allocate at least 12 percent of the national budget to the health sector.
In Malawi, the 2017/18 national budget for health is slightly above eight percent, falling short by 4 percentage points.
Since 2008, the country’s total health expenditure has been hovering around 6.6 percent of Gross Domestic Product. However, only 1.5 percent of the public health budget is spent on mental health.
Additionally, Malawi has very limited specialist mental healthcare service providers. On top of that, a big part of the 1.5 percent of public health budget allocation for mental health is only spent on a single hospital at Zomba Mental.
But, of late, the government has been showing some signs of moving in the right direction, indicating that it is committed to the decentralisation of mental health services by integrating them within the primary healthcare system.
But what is not clear, to date, is the issue of responsibility. It is unclear who, between the Ministry of Health and that of Social Welfare, is responsible for taking care of mental patients that walk freely within the cities and townships.
About six years ago, the government, through the Department of Social Welfare and the Ministry of Health, embarked on an initiative of taking to hospital all mental patients that were found loitering on the streets, among other places. The initiative, however, was not sustainable.
When contacted, Ministry of Gender and Social Welfare spokesperson, Lucy Bandazi, pushed the issue to the Health Ministry.
She says her ministry is more concerned with the plight of vulnerable children such as orphans and street kids, and that they consider mentally challenged people as being under the responsibility of the Ministry of Health.
Malawi Health Equity Network (MHEN) Executive Director, George Jobe, urged Malawians to start treating mental patients with love.
“The government’s idea of forcing all mental patients to hospital was welcome. We do not know how it stopped. However, Malawians should start treating the disease seriously. We have a whole central hospital that treats mental illnesses. So, this is a sign that the government is trying,” Jobe said.
He urges Malawians to stop treating mental problem as something which is caused by superstition as is the belief in most rural areas.
Jobe says currently government has shown some willingness to care and support mental patients by increasing funding to the relevant sectors. But he said it is now the responsibility of Malawians to start taking mental patients to hospital.
Ministry of health spokesperson Adrian Chikumbe however feels government has done its part in protecting the rights of people with mental illness.
But he bemoans lack of support towards mental health as the one of the many things which, in part is making it hard for Malawi to promote mental health as a public health problem.
“To begin with, let me say government is doing a lot at the moment. We have allocated a whole doctorate to look into issues of mental health. Apart from that, every district has a medical person who looks after psychiatric patients. This is a positive development,” he said.
Minister of Health, Atupele Muluzi, has been telling all and sundry that the “government is committed to promoting good health among Malawians”, citing the partnership with development partners.
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