In Africa, is Mental Health a Thing?
I grew up in a community where depression was thought to be for the rich. This mainly meant that it is not a disease, but maybe some feeling one gets when they don’t worry about “food and shelter” anymore. This was still my understanding until 2017 when I started having too much insomnia (it had increased in a short time), fearing people, missing my classes, or intentionally being late (I was in medical school) plus constant headaches. Through these almost 6 months of unhealthy symptoms, the cause was unclear and it didn’t appear to anyone that I was ill. However, when I started losing too much weight, losing appetite, and less interested in life, one of my pharmacist colleagues said to me “you look depressed”. I was quick to dismiss his observation because it drew what I felt like unnecessary attention and made me feel like a loser, but yet I took so much interest in the fact that it could be true. Briefly, after being drained and tired of hating myself, I decided to find out what was wrong with me.
“Of course I had depression!”
According to the WHO (2017), Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. In many African environments, including Rwanda, mental health is still observed as one to relate to people who have mental disorders like schizophrenia amongst many. Therefore, mental health, especially the one that shows mild and easy to neglect symptoms is has been given less attention, or if chronic, it is considered a curse. It is not a health priority yet mental health and disorders can be diagnosed and treated.
I for one had to see a psychologist without my parents’ consent because they’d think I’ve gone nuts. I can still remember the look of fear and concern evident on their faces when they found out that I have been going for counseling sessions.
With many things going on in life like the current pandemic or past experiences that impose stress on people, mental illnesses are inevitable. These include, but are not limited to; Schizophrenia, chronic depression, anxiety disorders, and excessive phobias, to name a few. Even though countries pay less attention to mental health than physical health, it is essential that we know that there are a lot of the physical diseases that are caused by mental ones. More importantly, as governments strive to strengthen their economies, the level of development depends on the health of the working force. Employers and managers who put in place workplace initiatives to promote mental health and to support employees who have mental disorders see gains not only in the health of their employees but also in their productivity at work (Mental Health, 2017)
African countries have experienced civil wars, electoral conflicts, and still under too much poverty which are bound to leave many psychologically and mentally disturbed. Many if not almost all of these post-conflict mental health issues go unattended hence causing more damage in the future. Though they are informed about the importance of mental health, there is still an unbelievable lack of will in acting to mental health. While there’s little allocated to healthcare as a whole (less than 15% of the national budgets) in many African countries, even less than 1% is allocated to mental health. Many have no psychiatrists and less than 100 psychologists and nurses to millions of people in the country(Gberie, 2017).
Rwanda that experienced the Genocide of the Tutsi in 1994, losing over a million Tutsi lives and left with traumatized families, has one psychiatric hospital. It took a while to treat some severely damaged survivors and the process of treating the post-genocide trauma is still ongoing. During the commemoration period, survivors relive their nightmare nursing wounds that did not heal at all, for they were not treated and it is in this period that cases of related murder are heard of. Mental health care is much needed to rebuild communities, restore people’s sanity, and help them develop their lives with all the support they need without being judged or stigmatized.
The past six months, coronavirus caught the world by surprise, unprepared, and everything from the virus to its news, rumors, conspiracy theories, fear attached to it spread like wildfire. This has humbled the greatest and the simplest countries and human beings. It also encouraged everyone to stop for a moment and reflect on what our lives balance on and/or what is more important and. This may not be the best time for many all over the world since many countries have taken decisions to protect citizens by declaring lockdowns. By this, jobs were suspended (except for essential workers like doctors and food vendors), activities are suspended, the economy is on hold and suffering, and people are required to stay home and limit unnecessary movements all in an effort of fighting against COVID-19.
The hardest part of this pandemic is the loss of loved ones. Doctors have lost their lives, and countries lose thousands of people per day. The rise in new infected cases and deaths has minimized attention to other issues in the community. By this, we don’t know how many are dying of hunger, other diseases, or other disasters like floods and wildfires that are happening in different countries across the globe. In Rwanda and all around the world, this could be a cause of an increase in mental health issues. Many have shown a mixture of being restless, fearful, and anxious due to worrying about their lives that are disturbed during the lockdown.
Mind your thoughts and emotions!
It has been proven that thoughts and emotions in relation to our mental health have an effect on health and hence affecting how we live and relate to others. Being emotionally healthy may not mean you are happy all the time. It simply means that you are aware of your emotions and can deal with them, whether they are positive or negative. Scientists don’t yet fully understand the biological mechanisms at work, but they know that negative feelings like stress, sadness, and worry can cause a spike in the body’s production of the hormone cortisol, which suppresses the immune system (Olga, 2019). To people that have understood the importance of seeking mental health care whenever they can’t control their emotions, prevent future health complications.
Many people are suffering in silence to the fear of being stigmatized or no access to the services they need. Many also are not aware that they are ill because they have normalized the symptoms they have. It is normal to be worried during the hard times, and most people can cope with it. But some experience persistent symptoms of mental health disorder, and prolonged stress can also lead to self-harm.” (Awale, 2020)
Nevertheless, there is hope for a better future if governments act upon prioritizing mental health too. They can start by allocating resources and creating mental health policies. This will encourage communities to know what mental health is and support the ill by not stigmatizing or using the cultural or religious methods that are usually brutal and violent to the ill. Health systems should reform and focus on increasing psychiatrists and psychologists in order to attend to all patients if possible.
More importantly, community awareness is an important aspect of achieving this. People should be taught to be proactive in seeking help whenever they don’t feel mentally well or have symptoms. Families should be encouraged to be mindful of their children’s mental health and not be quick to judge or jump to conclusions. Children are usually spared of a lot of thinking or worry since they’re not yet responsible for much, but they pick emotional energies like fear, anxiety, or feelings of depression from their parents. Therefore, we can only give them a great childhood and a future while being healthy ourselves by making mental health a thing!
It should be the thing to care for and prioritize in our lives and of our communities!
(Mental Health, 2017)
WHO | Regional Office for Africa. 2017. Mental Health. [online] Available at: <https://www.afro.who.int/health-topics/mental-health>/
Eaton, J., 2017. Mental Health In Africa: Innovation And Investment. [online] Mental Health Innovation Network. Available at: <https://www.mhinnovation.net/blog/2019/oct/10/mental-health-africa-innovation-and-investment>/
Gberie, L., 2017. Mental Illness: Invisible But Devastating | Africa Renewal. [online] Un.org. Available at: <https://www.un.org/africarenewal/magazine/december-2016-march-2017/mental-illness-invisible-devastating>/
Awale, S., 2020. Post-Pandemic Mental Health Epidemic | Inter Press Service. [online] Ipsnews.net. Available at: <http://www.ipsnews.net/2020/04/post-pandemic-mental-health-epidemic/>/
Mental health planning and service development (WHO)