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Stigma, marginalisation of people with mental disorders still rampant

21st August 2012
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Dr. Joseph Mbatia: Social problems compound mental disorders

Scores of desperate youth, moving aimlessly from street to street, are a common site in many towns and cities in Tanzania.

Clad mostly in torn apparel, the group, men and women, walk up and down streets fast, shoe-less, as if to meet an appointment somewhere.

Such people are sick, seriously sick. They suffer from mental disorders.

Shunned by most town dwellers, they are normally unaccompanied, virtually having no friends, or acquaintances.

For decades, most wananchi have been considering such people as outcasts, to be avoided by normal citizens as much as possible, in fear of being harmed.

The most a few families with the sick relatives can do is take such people to traditional healers for those who will appear less violent.

Most of those who have lived with the condition for too long, even if they may appear harmless, obtain their food from garbage or depending on hand outs availed to them by good Samaritans.

They sleep mostly on verandahs of their homes. Some build awkward squarters using cement empty bags or torn clothing - with nobody taking them for medication.

Apparently, Tanzania is one of the poorest countries in the world with an astonishing shortage in mental health care.

The country has 900-bed capacity for psychiatry patients. In some regions, there are only 20 beds for a population of 1.5 million people.

Mirembe Referral Hospital, a government health facility where people with mental disorders are taken care of in Dodoma, has capacity for 600 beds. Another almost similar mental health care unit - renowned Lutindi Hospital, in Korogwe District, owned by the Evangelical Lutheran Church of Tanzania [ELCT] – North Eastern Diocese (NED), has 100 beds.

Lutindi was founded by German missionaries in 1896. The hospital provides occupational therapy as part of treatment for its patients. Several non- governmental organizations (NGO) also offer comprehensive mental health care in form of treatment, case management and rehabilitation in partnership with local organizations and government. These are in Mtwara and Pugu.

But now, Tanzania, a country with a population of 40 million plus, with up to 80 per cent living in rural areas and 33 per cent of its people living under poverty line, will soon make a U-turn, in terms of provision of mental health care.

After a thorough research, Sebastian Kolowa University College (SEKUCO), a faith based institution, established in 2007,came up with a mission to provide high quality university level education, with emphasis on supporting people who are in the lowest spectrum of the social pyramid.

These include people with leprosy, the disabled, orphans, people with mental health problems and other vulnerable groups.

In this regard, SEKUCO has established a new programme- Bachelor of Science (BSc) in Mental Health and Rehabilitation ,due to take off during the 2012/2013 fiscal year.

SEKUCO’s Provost, Rev. Dr Anneth Munga, says the programmer’s curriculum will mainly focus on mental health and rehabilitation.

“The objective is to have well groomed clinicians who can support health services at regional and district levels,” said Rev. Dr. Munga in an exclusive recently.

“SEKUCO decided to come up with the new programme in recognition of prevailing shortage of wel- trained technicians in the field of mental health and rehabilitation,” added the academician.

The programme’s facilitator , Dr Joseph Mbatia ,the growing social problems, namely poverty, marital issues, family values, child abuse and drug addiction had driven the college into introduction of the relevant course in order to cope up with the obtaining situation.

Dr. Mbatia, one of the leading specialists in mental health in the country, mentioned other problems which afflict the society as stresses which tend to increase mental disorders.

Additionally, said Dr Mbatia, the programme is in line with the National Health Policy where every Tanzanian is expected to have access to accepted quality of mental health services.

The programme will also enable local communities in mastering skills of improving special functioning for people with serious mental illnesses.”

Presently, he said, the government is conducting training for psychiatric professionals but the number is too small to cater for the ever growing number of cases in districts, adding that there are only twenty psychiatrists in the country.

“It is prudent that the college has come up with the idea of introducing the new programme considering that many people are potentials of ending or attempting to end their lives be cause of acute frustrations and worrying situations,” said an academician at the college.

He added: “Victims of depression need love and support, to clear their past and help them take a step towards the future,” saying this would only be possible with a sufficiently trained number of professionals.

Quipped Julius Omari, a Tanga-based sociologist,” People have reached a point of despair because of tough economic situations.”

According to a report on mental health policy, authored by Dr. Joseph Mbatia, and Rachel Jenkins of the Institute of Psychiatry (Department of Health Services Research, London, there was a couple of improvements for the last 10 years

The authors say the success is mainly attributed to collaborative project undertaken by WHO/MOHSW, adding that there is now more awareness and knowledge about mental health illnesses in the community.

“At least there is improvement from nothing to something,” says the report, tabled in 2009.

“Stigma and marginalization of people with mental health disorders is, however still rampant.”

The report further unveiled the deploring state of the economy saying “Currently, most patients are so poor that giving free drugs without enough food can create breeding ground for side effects or discontinuation- hence relapse.”

“So far, supply of drugs in districts is erratic, while lobbying and advocacy for mental health in Tanzania is in its infancy.”

According to the report, England with a population of about 56 million people, has 2,164 registered psychiatrists with accountable psychologists.

The only institution providing professional training for psychiatrists in the country is Muhimbili Health and Allied Sciences (MUHAS) while occupational therapists are trained at Kilimanjaro Christian Medical Centre (KCMC).

A local pharmacist who opted for anonymity said mental health programmes in the country had been forgotten and neglected.

“There is need for the government to review the situation because prevalence of mental disorders and its associated conditions is now on the increase, due to lifestyle changes,” he said.

“The government should use news papers, radio and television (TV) to educate the citizens on early signs of mental health illnesses,” he concluded.

SOURCE: THE GUARDIAN
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