23 November 2017
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The agony of raising a mentally ill child

Written by  Nancy Chavi
Mpeketula: I have no money to pay for the treatment and transportation costs for my son - Pic by Nancy Chavi Mpeketula: I have no money to pay for the treatment and transportation costs for my son - Pic by Nancy Chavi

Blantyre, October 10, 2017: Watson Mpeketula, 55, from Chilomoni Township in Blantyre testifies about the agony and trauma of raising a mentally ill child. 

“My 18 year old son [name withheld] started showing signs of mental illness in 2015.

“He would constantly disappear from home for days and when he later returned, my wife (Nancy) and I would discover that he was involved in mischievous activities like damaging people's property,” narrates Mpeketula.

Mpeketula bemoans the distress he endured when his son went to his electronics repair shop and destroyed all the appliances that were inside.

“All the items belonged to other people and they were only in my shop for me to repair them.

“As if the physical damages going on around us are not enough, we also have to endure negative comments uttered at our family by the community that we are failing to control our son; and, even worse, that we have bewitched him,” Mpeketula says.

Taking her turn, Nancy, 48, further reveals the suffering her mentally ill son has brought within their home.

“He often breaks our furniture and he once demolished part of the wall of our house which we had to re-build,” she reminisces. 

Nancy wonders what triggered the metal illness saying some people believe that he was possibly bewitched or he is taking drugs.

“However, when I confronted him about the drugs, he denied taking them,” Nancy says.

The Mpeketulas rely on the electronics repair business to sustain their family of seven.

However, doing business has not been easy since it requires them to work away from home, a situation which leaves their son vulnerable since he requires close supervision.

The family says it has taken the child to different places such as traditional healers and churches for assistance but his situation would only stabilize for a while before deteriorating again.

At some point, he was taken to Queen Elizabeth Central Hospital in Blantyre where he was sedated with Valium injections which are said to have caused him to sleep for long hours.

But upon waking up, he would walk with his hands clenched in fists and his head tilted forward.

Ministry of Health spokesperson Adrian Chikumbe says, currently, mental health care services are being offered across the country.

“All central hospitals in Malawi, including Zomba Mental Hospital, have psychiatric doctors and all district hospitals around the nation have psychiatric nurses.

Moreover, not all mentally ill clients require medical treatment; some just need home counselling. But when there are extreme cases, they are referred to the right hospitals,” he says.

On October 10, Malawi will joins the rest of the world in commemorating World Mental Health Day and this year’s theme is focusing on mental health in work places.

Chikumbe says the day is commemorated under different themes every year and this year’s comes after noting that there are many suicide cases caused by depression in workplaces around the world. 

Malawi also has a Mental Health Policy and a National Mental Health Programme that were formulated in 2002 and 1999, respectively, to help address mental problems.

Government expenditure on mental health is pegged at 1.0 per cent of the total health budget. 

However, the World Health Organisation (WHO) Mental Health Atlas (2011) paints a gloomy picture as regards trained medical personnel to assist mentally ill patients in the country.

According to WHO, Malawi has 0.01 psychiatrists, 0.22 psychiatric nurses, 0.22 psychologists, 0.01 social workers and 0.04 occupational therapists per 100, 000 people.  

Again, most of the general healthcare workers are not competent and confident in dealing with mental patients.

The WHO says in Malawi, neuropsychiatric disorders are estimated to contribute to 4.3 per cent of the global burden of disease.

Saint John of God Hospitaller Services is a Mental Hospital situated in Lilongwe with another branch in Mzuzu.

It consists of an outpatient’s department clinic and psychiatric hospital which offers services such as counselling, drug and alcohol rehabilitation, and community outreach.

The mental hospital’s clinician, Japhet Mwaba, acknowledges the agony that guardians and caregivers of mentally disturbed patients face.

“We meet a lot of caregivers of persons with mental disorders. In a month, I meet approximately 50 caregivers who are in desperate need of help for their clients as well as themselves,” Mwaba says.

The clinician explains that mental health cases vary depending on causatives.

He says, in some instances, the problem is caused by traumatic events directly linked to the person or the community where the individual lives or psychological factors such as worries over loss of a loved one.

“Physical conditions which affect the brain like diseases such as meningitis, HIV/AIDS or even accidents affecting the head can also cause mental disorder.

“Sometimes, even stress from an individual’s body change can be a cause of mental disorder,” explains Mwaba, adding that even alcohol and substance abuse leads to mental illness.

Mental health nurse at Saint John of God Hospitaller Services Justice Khosa further reflects on the challenges that caregivers face when raising a mentally ill person.  

“Stigma is the biggest challenge that is faced; both the patients and their caregivers are stigmatized.

Some are even excluded from development programmes in their communities,” he says.   
He adds that, in some instances, some caregivers become frustrated to the point of just locking up the

patients in a room or letting them wander off in the community.

To this effect, Khosa advises caregivers to be patient when faced with such situations and seek counselling.

“As management, we involve guardians and encourage them to give feedback on how their clients are doing in their homes.

“Most of them will come back and explain how the illness of their clients is impacting them psychologically, socially and even economically,” the nurse says.

Indeed, the problem of mental illness cannot be taken lightly in the country. Evidence of the magnitude of the problem is also witnessed across the country with some mentally disturbed people wandering in the streets and scavenging for food.

“I have heard of Saint John of God Hospitaller Services in Lilongwe that it offers good services but I have no money to pay for the treatment and transportation costs. I hear it is a private hospital,” Mpeketula says.

The Mpeketula family is just one of the many families that are going through such traumatic experiences and require a health system that offers mental health services that can easily be accessed by all Malawians.