HOW MENTALLY HEALTHY ARE WE NIGERIANS?

The purpose of this essay is to decry bad attitudes of the Nigerians have toward mental illness and to promote awareness of diseases of the mind and available cures. The essay raises more questions than it  answers. Could bad governance at all levels coupled with massive unprecedented corruption that seems to offer Nigerians little hope of making it till tomorrow all stemming from mental illness? Could the feelings of helplessness and hopelessness that Nigerian children and adults experience on a daily basis leading to low levels of self-esteem and drug use all be traceable to mental illness?

Could massive prostitution be related to attempts to deal with mental illnesses? Violence connected with cult, boko haran, witchcraft, kidnapping, MEND, and MASSOB all combines to render the average Nigerian susceptible to mental health issues. Could armed robberies and kidnappings be related to attempts to deal with mental illnesses? When this writer was Lecturer & Education Officer with the Institute of Management and Technology (IMT), he was friendly with a colleague who had a “dangerous Child.”

The dangerous child was autistic and severely mentally retarded. Parents of this child did not understand what they were dealing with so their only option was to hide their child with special needs in the innermost part of the house away from everyone’s views.  Each time the child came out to the parlor where this writer sat with the parents, she was hurriedly chased back to the room that served as her permanent top-secret-security prison. 

This writer sat motionless, stationary, immobile, stock-still, apprehensive, worried, and fearful of this dangerous child. The visit was always uneasy. It was like “I-can’t-wait-to -get -out of- here” or  “I-can’t-touch-the food-and-drink-of-these–people-or-else-I-catch-this-disease.” Looking back, this writer is embarrassed since he had the Master of Science at that time and must have heard of or known someone who had taken advanced graduate courses in abnormal psychology and mental retardation.

 This essay underscores, accentuates, or calls attention to the fact that Nigerians  of today have many mentally ill subgroups in the population of 170,000,000 persons. Nigerians are not very much unaware of the causes and effects of mental diseases. We Nigerians don’t take the time or have the patience or capacity to deal with our mentally ill family members. At the end of this essay are recommendations included to assist in combating the scourge of mental illnesses in Nigeria.

Akula Owu Onyeara is a popular Nigerian Highlife music of the 70’s. The song is about the psychotic nature of mental illness and its pervasive effects on the sufferer and larger society. The sufferer is described as Onye Ara or the insane who lacks commonsense and the ability to discern between what is right and what is wrong, between what is to be done and what to avoid.

Translation of the lyrics goes like this:   Crazy man, please don’t fight with broken bottles. You are crazy. He is crazy. In the cold season, he bathes with cold water. In the hot season, he bathes with hot water. What do you call such a behavior? He is crazy. He’s mentally sick. If you give him a piece of cloth, he throws it away and goes unclad. What do you call such behavior? It is insanity. It is mental illness. If you keep him at home, he sneaks unclad to the open market. What do you call such behavior? He’s crazy. Crazy man, please don’t fight with broken bottles.

 

Nigerians have reasons to lament the increasing number of their neighbors with psychiatric problems. Robin Hammond observes: Where there is war, famine, displacement, it is the most vulnerable that suffer the greatest. Abandoned by governments, forgotten by the aid community, neglected and abused by entire societies,  Africans with mental illness in regions in crisis are resigned to the dark corners of churches, chained to rusted hospital beds, locked away to live behind the bars of filthy prisons. Read more: http://www.robinhammond.co.uk/condemned-mental-health-in-african-countries-in-crisis/

The Africa Today describes the number mentally ill Africans as being “frightening.” (Africatoday80gmail.com, November 29, 2011). Figures coming from Nigeria indicate that in a particular geographic area of Nigeria, the mentally ill patients increased from 28,000 in 2009 to 42,000 in 2010.  If the statistics accurately reflect the situation, then it is safe to say that Nigeria has an enormous number of mentally ill persons, perhaps in the millions. Could these statistics  be responsible for the high incidence of violent crimes, kidnappings, murders, corrupt politicians, and thefts in the country?  Shamefully, Nigeria has only 130 psychiatrists, 4 neuropsychiatric nurses, and 8 neuropsychiatric hospitals that attend to 180 million people.

The ratio of psychiatrists to patients stands at 1 per 1million (that is, 0.01 per 100,000) as against the following: 31.1 per 100,000 (Massachusetts); 16.5 per 100,000 (USA); 12.3 per 100,000 (Augusta); 12.14 per 100,000 (Arizona); 9.3 per 100,000 (Atlanta); and 4.6 per 100,000 (Idaho). That means that Atlanta alone has close to 1,000 times as many psychiatrists as the entire nation of Nigeria.

Even the small potato State of Idaho beats Nigeria 461 to 0 in the number of psychiatrists.  This is a shame on my country. It is shame on the Nigerian medical professionals residing in the Western countries. What an embarrassment on Atlanta’s or New York’s Nigerian communities for sitting dormant while our people are losing their minds.

It is urgent that the Federal Government endeavor to lure surplus psychiatric professionals home from the Western countries that include America, Britain, Canada, and France. Of the 506 African psychiatrists in the United Kingdom, 214 (40%) are Nigerians. Why can’t someone lure these mental health practitioners home to our country?

It is reported that Lagos State government has placed the number of its mentally ill patients at 2 million or 14.1% of the population. There are no figures for Anambra, Imo, Abia, or Ebonyi  but we would suspect that the number of psychiatric patients in the former Biafra would far surpass, double, triple or even quadruple that of Lagos State.

Why? Because the people in the former Eastern Nigerian were heavily desecrated by the killings the Igbos witnessed in the North; debased by sufferings they endured when they ran home with bodies of dead relatives; and further despoiled by malnutrition and kwashiorkor.

 Although the horrors of Biafra are real, yet there is no indication that the children in those areas (now adults) have ever been treated for post-traumatic syndrome. That some Nigerians, who have been through the tragedies are still suffering the devastating effects of the Civil War 50 years after Biafra, has not been investigated.

When we salute Igbos for overcoming the horrors of Biafra with no psychiatric evaluations, treatments or rehabilitation  offered by the Federal Government, we should be mindful that effects of untreated post-traumatic syndrome might be lingering and still influencing today’s Igbo people.

Experts blame the deterioration of mental health in Nigerian on “institution-based care practice” (involving hospitals, doctors, nurses and drugs), perhaps Nigerians would benefit more from the “community-based care practice “ of management of mental illness  (which involves health-care professionals, the patient, family, and entire community). There is nothing to be embarrassed of in mental illness.

Nigerians consider mental illness a source of shame and embarrassment; people hide their mentally ill relatives in the villages when they should be seeking help for them. Therefore, ignorance of the causes and treatments of the disease helps to render the situation more hopeless in the case of Nigeria. Other possible causes of mental illness among Nigerians can be a number of factors.

There are real stressful socioeconomic conditions of the country akin to running from one part of the bush to another during the Biafran War in order to dodge bombings, and avoid being killed by Nigerian soldiers.

Bad governance at all levels coupled with massive unprecedented corruption, seem to offer Nigerians little hope of making it till tomorrow. There are feelings of helplessness and hopelessness that Nigerian children and adults experience on a daily basis leading to low levels of self-esteem and drug use.

Could massive prostitution be related to attempts to deal with mental illnesses? Violence connected with cult, boko haran, witchcraft, kidnapping, MEND, and MASSOB all combines to render the average Nigerian susceptible to mental health issues. Could armed robberies and kidnappings be related to attempts to deal with mental illnesses?

Abject poverty or pennilessness ( $1 a-day wage)  pushes adults to engage in 419 and youth to robberies and extortions. Anxiety created by constant insecurity and apprehension can lead to depression or neurotic behavior. There are numerous cases where young college students suffer mental breakdowns that are popularly referred to as “brain fag.”

There is a superstition among Africans regarding mental illness in Africa. While Westerners believe mental illness is genetically inherited or caused by some chemical imbalances in the body, specifically, the African believes mental illness is caused by specific enemies or the ancestors, so you go after the enemy and kill him/her, and appease the ancestor through bloody sacrifices. One mentally ill Yoruba man was recently reported to have eaten the intestines of a woman on his witchdoctor’s advice ostensibly as a cure for his malady.

As you look around the Nigerian communities in Atlanta, Lagos, and Abuja you’ll see people trying hard to cope with mental difficulties the best they could, at exorbitant costs.  Some Nigerians drink large quantities of alcoholic beverages every day. These are alcoholics who go to their jobs with hangovers each day and manage to perform their duties and hold families together because society expects them to do so.

 Nigeria is the clearinghouse for various types of illicit drugs coming from Asia on their way to the United States, and the number of Nigerian young drug users is skyrocketing. There are thousands of “shanty” bars everywhere in Nigeria and people frequent these at odd hours of day and night to drink their sorrows away

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There are hundreds of brothels along roadways and private houses of prostitution in residential areas of Nigeria where people go to ease the pain of bewilderment. As a  man,  you go to “ashawo” (prostitute)  and complain about your mental problems and she tells you, “Oga, make you pay your money and  make you no worry, oh.”

Domestic violence is commonplace with men maiming or inflicting serious life-threatening injuries on wives (with fire, firearms, or machete) due to frustration;  loss of job. Divorces and separations are frequent and unreported and often blamed on emotional problems, as a man may kick one wife out and bring in another younger one in the attempt to resolve the issue associated to mental illness.

 People spend countless hours plotting  to amass wealth which they put to no good use other than to see money grow huge in account books and diminish anxiety created by poverty.  While constant pursuit of money seems to give one a sense of mastery over personal failures in some areas, incessant pursuit of wealth creates frustration and mental pains in other areas. Outdoor restaurants and beer parlors provide relief from worrying over personal and national problems: everyone aspires to the beer distributorship license.

It is gratifying to note that mental illnesses are treatable, and there are effective therapeutic interventions available, but the patient and family must seek help at the hands of modern professionals, not quackery. Why must we hide diseases of the mind when we openly treat malaria or headache? Ignorance is no longer bliss. Life is hard as it is, and every effort must be made to live it as comfortable as possible because “the mind is a terrible thing to waste”.

RECOMMENDATIONS:

1. Nigerian Government should build more psychiatric hospitals, equip its medical schools to train more psychiatrists, psychologists, psychiatric nurses and psychiatric social workers to deal with problems.
2. The Federal Government ought to have the Mental Illness Awareness Month on the calendar in which seminars are held throughout the country.
3. Efforts should be made to reduce the fear people have about mental illness by increasing the involvement of communities and family members of mentally ill persons in the diagnoses and treatment of the disease.

James C. Agazie (JD, EdD, MS, MA, BA) completed his primary and secondary schools in Nigeria before emigrating to the United States for advanced degrees in mathematics, education and law. His teaching and counseling experiences have taken him to primary schools in Nigeria, Enugu IMT, several secondary schools and undergraduate and graduate universities in the United States. Dr..Agazie lives in and writes from Georgia, USA.  Please visit his blog jamesagazies.blogspot.com for some of his other essays.