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Living with familiar danger

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KAWIYA— A lot of people take their relatives to mental hospitals as a third option

People with mental challenges in the country are on a knife edge, literally, as, every more often, community members who do not appreciate mental health issues and just watch them roam around instead of taking them to mental health facilities, turn against them. As YOHANE SYMON writes, the situation has the potential to cost lives on both ends.

Every morning on week days, seven-year-old Nasir George, a Standard 2 learner at Makumba Primary School in Mangochi District, was the first to wake up and get ready for school.

His primary school teacher Mercy Makumba testifies that George was among the first learners to arrive at school every day.

When his mother told him not to go to school for other reasons, George could spend a good part of that day crying. Sometimes, he could disobey his mother and go to school.

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His passion for school gave her parents, who are primary School dropouts, hope that, one day, they would have a person in George to help them out in their old age.

But all this hope has, like morning dew, evaporated. What they have now are graphic images of their child lying in a pool of blood, with multiple wounds on his back and head.

The trauma is just too much for the parents such that George’s mother, 40-year-old Sakina James, has been failing to sleep since her child was allegedly killed by 22-year-old Limbani Sani, a psychiatric patient in the village, on June 23 2022.

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“My child was killed over a piece of sugarcane he had bought. I gave him money to buy a packet of sugar and, after buying it, he went to the lake to swim with siblings and friends. The man allegedly found them on the sand and wanted to confiscate the sugarcane from my son,” James said.

When the boy refused to hand over the sugarcane, Sani allegedly used a piece of wood, which he has been walking with, to hit the minor on the head and back several times until the boy became unconscious.

Before this incident, villagers say Sani had been hitting people with that piece of wood whenever he wished. No one thought of taking him to the hospital.

Currently, Sani is in police custody after people from Steven Village, Traditional Authority Chowe, in Mangochi District apprehended him and handed him over to law enforcers.

For all his life, Sani has been staying with his parents within Steven Village.

Despite having a history of mental illness, no effort was made to take him the hospital, which just reflects what happens to most mental patient in Malawi.

“I don’t know to handle this matter because my son will never be back again. Sometimes, I feel like avenging for his death but I have been holding back, knowing that revenge will not bring my son back from the grave. All what I want now is to allow justice to take its course so that my son can rest in peace,” said George’s father, 43-year-old Malunda Amidu.

Cases of mentally disturbed people being assaulted, or injuring innocent people within their localities, are not strange in Malawi, despite that the country has facilities that treat people with mental illness.

Recently, another mentally ill man was heavily assaulted by a mob in Mangochi after he picked a fight with callboys.

For a long time, the Mangochi man, commonly referred to as John, has been a well-known figure, quiet and calm.

He was staying on verandas of some shops within the township as he moved from place to place looking for his daily bread.

As the mob descended on him, kicking at him and slapping him as if they were killing a snake, onlookers cheered on. Some made fun of his desperate cries for help. 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 bothered to take him to the hospital so that his wounds could be treated.

Ironically, one of the callboys who was part of the mob got injured during the fight and people rushed him to the hospital for treatment.

For far too long, community members have become used to calling people like John mad.

But, then, on his own, John could not go to the hospital, possibly because his condition makes it difficult for him to feel pain and think properly.

In Malawi, the government and community members seem to take pride in failing people with mental illness. Despite mental issues being a health problem, the government has failed to give it the necessary attention the same way it gives other illnesses such as such as malaria, cancer, HIV and Aids, just to mention but a few.

Malawi is known for its chronic shortage of healthcare 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). The mental health sector is not spared on this shortage.

An analysis of Malawi’s budgets shows that 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 this public health budget is spent on mental health.

On top of that, a big part of the 1.5 percent of the public health budget allocation for mental health facilities is spent on a single hospital at Zomba Mental.

But of late, the government has been showing some signs of improving service delivery in the mental health sector by, among other things, devolving mental health services to local authorities through integration within the primary care system.

But what is not clear to date is which ministry, between the Ministry of Health and Ministry of Social Welfare, is responsible for taking care of mental patients that walk freely within the cities and townships.

About eight years ago, the government, through Department of Social Welfare and the Ministry of Health, embarked on an initiative premised on taking to the hospital all mentally ill patients that were found loitering in the streets, among other places. The initiative died a natural death.

Ministry of Gender and Social Welfare spokesperson Lucy Bandazi said it is the responsibility of the Health Ministry to support mentally ill people.

She said her ministry is more concerned with the plight of vulnerable children, such as orphans and street-connected children, because they consider mentally challenged people as the responsibility of the Ministry of Health

In an interview, Spokesperson for Zomba Mental Hospital Harry Kawiya decried locals’ lack of interest in mental health patients, leading to people’s failure to take such patients to the hospital.

Kawiya said the hospital has about 226 patients, a figure which, he said, is low compared to the number of patients that are roaming in the streets.

Kawiya challenged local people to start taking the plight of people with mental health seriously so that they can be allowed to be taken to health facility.

“A lot of people take their relatives to mental hospitals as a third option when they fail to get satisfactory results at traditional healers’ or spiritual healers’ houses. We have some people who are educated but don’t believe in taking their relations to the hospital. This way, we continue to put these people at risk,” he said.

He called on Malawians to embrace mindset change towards mental illness, arguing that mental illness is everywhere, including in countries where people do not believe in witchcraft.

On budgeting, Kawiya said, this financial year, Zomba Mental Hospital received K2.9 billion which will go towards drug purchases and Other Recurrent Transactions.

“But money, or any other resource, has never been enough considering that we have a lot of challenges to makes sure that people with mental illnesses are being assisted and given the same attention as other people,” he said.

Kawiya also called on the international partners to support implementation of some activities relating to mental health.

He observed that partners are more willing to support the Ministry of Health to tackle other illnesses— such as malaria, Aids and cancer— but develop cold feet when the issue of mental health is introduced.

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