THE World Mental Health Day (WMHD), marked on 10 October every year, provides an opportunity to draw attention to Africa’s large and growing burden of mental health conditions, with children and adolescents worst impacted.
Zanzibar health workers, recovering patients, government officers, development partners and other stakeholders also joined together to mark the day, an opportunity patients and health workers used to express their ordeals.
Critical shortage of skilled workers/staff, equipment and medicines dominated the message from services providers, including nurses and doctors at the Zanzibar’s main psychiatric Hospital, Kidongo-chekundu area in the Urban district, Unguja Island.
“In-fact the current situation is challenging. We have been having no essential medicines for our patients for the past two months,” health staffs lamented, adding that the essential medicines they require are antidepressants and tranquilizer.
Antidepressant are medications used to treat major depressive disorder, some anxiety disorders, some chronic pain conditions and to help manage some addictions, while tranquilizer refers to a drug which is designed for the treatment of anxiety, fear, tension, agitation and disturbances of the mind, specifically to reduce states of anxiety and tension.
Dr Suleiman Abdu Ali, Coordinator at the psychiatric hospital emphasized that they urgently need support for medicines and equipment such as a car and supply of fuel for outreach programs mainly in rural areas.
“Lack of medicines normally puts our (staffs-doctors and nurses) and patients at risk particularly when some of them (patients turn wild). A nurse recently escaped being attacked by a group of mental health patients she was treating,” he narrated with a call for attention to the hospital.
He also reminded the government about the need to improve/construct a road to the hospital after development partners supported the funding of the construction of new building at the hospital, “We now have enough space, accommodating patients who get food and sleep comfortably, but unreliable supply of medicines remains a problem.”
How they marked the 2022 WMHD
According to Mr Ali, the hospital in collaboration with the Zanzibar Association for People with Development Disabilities (ZAPDD) organized school visits to at least six secondary schools in South Unguja South region for educating students about how they can avoid the avoidable mental health problems mainly stress and depression.
“We reached about 721 students, including 435 females, and also ten teachers benefited from the public awareness program on mental health to commemorate the day,” Mr Ali explained, adding that they also had media (radio and TV) programs aimed to raise the awareness.
Cleaning of the Psychiatric Hospital was also another activity followed by demonstration last Monday, when the guest of honour also inspected some of the activities such as hand and crafts products and farming done by people recovering from mental health.
He said people with mental health can be treated in such a way that they get back to normal and take part in social and economic development, “We have many who continue with studies, artists and farmers. We should not think they are useless; they only need support,” he said.
The coordinator says Zanzibar has an estimated 7000 to 8000 patients and that care starts from the lowest administrative level (Shehia) where there are ‘community health officers’ in Unguja South and North trained to provide initial help (mainly psychological) to mental health patients before referring them to hospital.
“Mental health care service is provided in most facilities, including the Primary Health Care Units (PHCUs) in Unguja and Pemba. We urge people to report to the health centres once they have a mental health patient,” he emphasized.
What the government says
In response to challenges facing the psychiatric hospital, the executive Director of the Mnazi Mmoja referral Hospital Dr Muhyddin Abdi Mahmoud said “The government has taken into consideration the urgent need for medicines and equipment.”
The guest of honour, Dr Saada Mkuya Salum- on behalf of the first lady mama Maryam, commended health workers for working hard in treating patients, as she asked members of the community to discourage stigma, hiding children and discriminating people with mental health problems.
“Our ongoing health reforms include psychiatric facilities. The government is committed to see the health sector is fully reformed- including infrastructure, training of staff/skilled labour, equipment and availability medicines,” she said.
She appealed to members of the public not to believe that curses, witchcraft and superstition are behind mental health problems, instead they should seek treatment from hospitals. It is reported that some mental health patients are hidden and discriminated because of the perception of being curse and superstition.
Ms Riziki Mohamed Juma from ZAPDD said “We need collective responsibility and team work to care for mental health patients. But the government should ensure sustainable supply of medicines.”
She says “Myths and misconceptions surrounding mental health act as a barrier to treatment, and patients and their families fail to seek for care and support that they require for fear of being stigmatized.”
“Combating stigma and discrimination is not the sole responsibility of the government, but requires a multi-sectoral approach, involving all groups including media,” Ms Juma said as Ms Asha Abdulla who is recovering from mental health says “We thank the government and development partners for supporting us, I hope I will get married after full recovery.’
WHO response
The Message of World Health Organization (WHO) Regional Director for Africa, Dr Matshidiso Moeti, says this year’s theme, “Make Mental Health and Wellbeing for All a Global Priority”, serves as a reminder that after nearly three years, the social isolation, fear of disease and death, and strained socio-economic circumstances associated with the COVID-19 pandemic have contributed to an estimated 25 percent global rise in depression and anxiety.
Across the African continent, he says more than 116 million people were already estimated to be living with mental health conditions. Suicide rates remain particularly concerning, as are the exponential rates of alcohol use and abuse among adolescents as young as 13 years of age.
“We need to urgently strengthen regulatory systems to close the gaps that allow such young people to easily access alcohol, contributing to heavy episodic drinking rates as high as 80 percent among teens from 15 to 19. The situation poses a serious threat to their education, while setting the stage for a lifetime of alcohol abuse and the associated risks of noncommunicable and other related diseases,” he says in the message.
Inadequate financing for mental health continues to be the biggest limitation, negatively impacting efforts to expand Africa’s mental health workforce. As things stand, there are fewer than two mental health workers for every 100 000 people, the majority of whom are psychiatric nurses and mental health nursing aids, he points out.
