Without mechanisms to monitor and trace the mental wellness of rural folk, in particular, locals fear a mental illness pandemic is brewing.
A little under a decade ago, health experts said one in every four Zimbabweans suffers from a mental disorder. This was attributed to the tough economic and social environment at the time.
Sandile Khumalo,* a villager from Dekezi, Insiza district worked as a mental health nurse for a decade at Ingutsheni Central Hospital in Bulawayo. Now in retirement, Khumalo is noticing a worrying trend in his village where several people are showing mental health illnesses.
“It has been more noticeable since the advent of COVID-19 lockdown especially among the youths. We are noticing a worrying trend in Dekezi and surrounding communities. Most youngsters are exhibiting signs of having mental illnesses. Depression and sporadic violent behaviours are common,” he says.
Tapping from his experience, Khumalo says it is common for villagers to claim that patients with mental illness have committed a crime against somebody and the illness is a form of retribution.
“Relatives reject some patients with mental illness. Those who are lucky (mental patients) are first taken to local traditional healers before they think of going to hospitals,” Khumalo adds.
Zenani Masuku, a director with the African Institute of Ending Bullying, Violence, Depression and Suicide (AFRIBS) says there has been a spike in severe mental disorders or illness because of delayed treatment. Unfortunately, according to Masuku, she is not aware of any study conducted in rural areas to come up with a detailed database of people affected.
“Certainly we have seen a high rise of young people with mental illnesses signs and the major causes are anxiety brought by the impact of COVID-19, depression, and uncertainties due to unemployment.”
Masuku says family background also contributes to mental disorders. “Some are victims of rape, other forms of physical abuse, children who have been bullied and young people who cannot get an education; all these issues trigger disorders in young people.”
Amid all these developments she adds “there are no facilities in rural areas that cater for mental patients to get the rehabilitation they need.”
“Patients in Matabeleland have to travel to Bulawayo to access assistance and in most cases, it is at Ingutsheni. There are not sufficient health workers in rural areas. Mental health is underfunded,” Masuku says.
There is a general feeling that the country’s healthcare system is at a point where mental health remains a matter of secondary importance and specialists warn of a ticking time bomb impacted by COVID-19.
“The emotional and mental toll of the virus (COVID-19) is not getting enough attention it deserves. Mental un-wellness is increasing in rural areas.”
Sandile Khumalo, Dekezi villager
“Anxiety is so high in rural areas. It has shaken our concepts of humanity. Substance abuse is increasing in villages.”
He also attributes some crimes to mental ailments.
“I can say most criminal activities especially at illegal mines in the district and other mining areas are influenced by mental cases. Circumstances of some murders or suicides are difficult to comprehend.” Several youth organisations have in the past expressed concern over rampant drug abuse especially BronCleer which is readily available on the streets.
Most of the illegal highly-intoxicating substances are believed to be smuggled from South Africa by cross-border transporters commonly known as omalayitsha.
Khumalo is of the view that periodic psycho-education sessions from the ward level with patients, relatives and the community to raise awareness about mental wellness must be conducted in rural areas.
A March 2020 World Health Organisation (WHO) Special Initiative for Mental Health Situational Assessment highlighted that on political support “the government of Zimbabwe has demonstrated modest support for mental health services through the development of the National Mental Health Strategy for Zimbabwe 2016 – 2020 and the limited allocation of funds for mental health.”
“Of the total health budget, 0.42% is allocated to mental health. Public spending on mental health is estimated at 0.13 USD per capita each year.” The report adds that the shortage of trained workers is a stumbling block.
“The country faces some complexities in treating people with mental illnesses. Legislation that supports mental health needs revising, as it has not been revised since 1999. There is a shortage of human resources for mental health in Zimbabwe, in part a result of the emigration of locally trained professionals due to economic instability.”
Khumalo says this is exacerbated by stigma and discrimination against patients with mental illness.
“What is more disturbing is the reaction by community members towards such people,” says Khumalo.
Source: The Citizen Bulletin