[OPINION] Esidimeni: South Africa, have you lost your mind?
“I can’t wrap my mind around the fact that depression is an illness… In fact, it is such a non-issue that African languages never bothered to create a word for it,” wrote Kenyan humour writer Ted Malanda in The Standard newspaper. This comment fell under the headline titled: How Depression Has Never Been an African Disease – A common belief in Africa.
The death toll of the psychiatric patients who were in the care of the Gauteng Health Department has now risen to over 100, according to the Health Ombudsman. The abuse, maltreatment and castigation of mental health patients in Africa are an ongoing battle, but South Africa should be doing better even if the stigma affects our country too.
I myself took forever to tell people that I was on anti-depressants and mood stabilisers, and that I often saw both a psychologist and psychiatrist to help me be more functional. Even so, I was never going to be the subject of torture, or debilitating shame, and I was never going to become an outcast of the community just because I went ahead and sought treatment.
And this, for me, is what makes the Esidimeni tragedy so significantly terrible and a complete abuse of human rights.
Do you know what it took for those patients to go and get care? In a culture filled with all kinds of chastisement and punishment when it comes to mental disabilities, those who were brave enough to go and seek it out, in spite of this, died for it – at the hands of their caregivers.
In Africa, mental health diseases are often seen as supernatural infirmities that can be cured only through spiritual or traditional medicinal interventions. This kind of ‘treatment’ often manifests itself in several types of physical torture.
For example, in Nigeria families of the mentally ill send their relatives to ‘prayer camps’ - retreats where the sick person is often chained to trees and prayed for. Sometimes, the patients have the ‘demons’ beat out of them.
Many individuals are unemployable and poverty stricken so they tend to roam the streets of cities. It is for this reason that they are often placed in mental health facilities that serve as prisons rather than care institutions. Here sufferers again are restrained and caged in order to keep them away from the rest of society.
The stigma toward mental health does not stop in Africa though and isn’t as archaic a notion as we would like to believe.
In the West, the United States to be more specific, African Americans are less likely than their white counterparts to seek out psychiatric help, even though mental health challenges are so much more prevalent in their communities due to lower incomes, crime, racism and prejudice – which are key factors in contributing to stress, anxiety and depression, to name a few.
Just the other day I was watching African American comedian Issa Rae’s new show Insecure, when she (the lead) made the attitude toward psychotherapy perfectly clear. Her friend told her that she might see a psychotherapist and Issa’s response was: You’re going to pay for someone to be your friend? Basically insinuating that getting psychological help is a waste of time and money. This seems like a ridiculous reaction, but if you think about it – it is totally understandable.
Often, mental healthcare is a luxury accessible only to the middle class. This demographic is safe in their decision and because of the difference in culture and race, they often do not face the same cultural stigmatism – even though they may face societal ones.
According to the United Nations, South Africa is regarded as one of the more politically stable countries when compared to places like Sierra Leone and Ethiopia (let’s disregard the mess that occurred at Sona last week, shall we?) But even though our country has enjoyed economic growth comparatively, this has had no positive impact on the number of mental illness cases reported. In fact, because of high rates of crime and unemployment in our country, citizens of lower economic standing are even more susceptible to mental illness and need fair access to it the most.
The UN says South Africa boasts 22 psychiatric hospitals and 36 psychiatric wards in general hospitals, more than any other African country. But because of the attitude toward these patients, these facilities only provide access to about 14% of our 53 million odd population.
The World Health Organization says a big reason for the dismal treatment gap is because health professionals at these care facilities are themselves responsible for the stigmatisation of these patients and it's their attitude toward them that lead to people with mental disabilities choosing to suffer in silence instead.
For every 100 mentally ill patients, only 25 citizens might have access to care.
All things considered, the 100+ patients who lost their lives at Esidimeni did so in vain and suffered in silence anyway.
If our health sector has no capacity to process the meaning of this tragedy and the effects this terrible outcome is going to have on societies, they have quite literally lost their minds.
Haji Mohamed Dawjee is employed by Code For Africa at the head office in Cape Town as programme manager for impactAFRICA - the continent's largest fund for digital-driven data storytelling. She is a regular commentator on gender equality, sexuality, culture, race relations and feminism as well as ethics in the South African media environment.