OVER the past few days, Zimbabwe was gripped with horrendous tales of how one Thubelithe Khoshow (26), a businessman based in Kwekwe went on a rampage, murdering six people and injuring five others on October, 9 2021. A police report revealed that when Thubelithe became mentally disturbed and acted violently, he was taken to a church’s shrine by her aunt for prayers.
By Patricia Mashiri
Unfortunately for his family, they found it noble to take Thubelithe to a shrine instead of a mental health facility or health institution for that matter. Which brings us to the question of whether Zimbabweans or Africans in general are aware of the referral pathways to follow in the event of violent mental health case. What could be the reasons behind people preferring spiritual healing rather that medical and scientific solutions to mental health? Are we too spiritual or maybe it is something to do with our mental health delivery system?
Unfortunately in Zimbabwe, mental health is not treated as an emergency from family level up to government level. At family and community level, society tends to ignore the tell-tell signs of mental instability and in most cases, if one indicates that they may be depressed, they are called cry-babies or attention seekers. Government on the other hand lacks prioritization of mental health as evidenced by the massive human resources shortage around mental health. According to official data, Zimbabwe has not more than 14 psychiatrists, with many of them being based in Harare and Bulawayo.
The other major reason is that Zimbabwe’s public health system is currently underfunded. In the year 2000, the government of Zimbabwe was able to resource 62.3 percent of the national health budget, this dropped dramatically to 38.3 percent by 2014 and funding levels continue to decline. Most health care providers are not trained to diagnose mental illness, leaving many people struggling in silence with difficult conditions. Zimbabwe also has only six public institutions with psychiatric beds and these are Harare Hospital Psychatric unit, Parirenyatwa Hospital Annexe, Ingutsheni Hospital, Mpilo Hospital Psychatric unit, Ngomahururu Hospital, Mutare Hospital Sakubva Unit and the facilities available are not suitable for kids or the elderly.
The World Health Organisation (WHO), recently indicated that the prevailing COVID-19 pandemic had brought numerous mental health challenges and called on governments to allocate financial resources towards mental health.
Speaking to HealthTimes, Dr Kudakwashe Mchena, a leading psychologist said Zimbabwe should learn from the Kwekwe scenario that mental health is an emergency and if not treated or given the attention it deserves, the consequences could be dire and catastrophic.
What happened in Kwekwe were basically things that affects sensory systems. There is need for people around to understand that these are just hallucinations linked to mental health illness. This person was psychotic, he was hearing voices at the time and unfortunately. hearing voices in our culture is associated with evil spirits, that’s why they wanted to cleanse the evil spirits but unfortunately that’s not the cure for mental health.
“Mental health is actually a disease that can be treated from a medical perspective. We need to educate society on the importance of taking the right decisions especially for a person who exhibits such extreme mental health symptoms. This could have been avoided if he was taken to hospital,” Dr Muchena said.
He added that Zimbabwe needs to pay close attention to mental health and should also ramp up mental awareness programs in communities across the country so as to equip people with the right information and knowledge around mental health.
“Our Health facilities are not in a very good state and that also impacts our mental health institutions across the country. There has been very little investment in terms of mental health facilities across the country and for a number of years now, there has not been an expansion in terms of the capacities of these mental health institutions.
“If we look at the number of mental health issues across the country, we see that they are rising but that rise is not being matched by investments in mental health. The thrust for us has been trying to instill health seeking behaviors so that we avoid situations that require hospitalization for mentally ill patients. The push is to have a more community-based approach to mental health,” Dr Muchena said.
Meanwhile, Tafadzwa Meki, the founder for Someone Always Listen Toyou (S.A.L.T Africa), said mental health referral paths were there but very few people know about them.
“This is why we find that we run all over the place because first of all we can’t identify this is a mental health illness, we look for other things which we can’t entire blame at people if they do not know what they are dealing with. There are cross cultural things to be looked at besides religion.
“The existing government mental health facilities look overwhelmed so people look for alternative systems which are their belief system and religion. It’s because of stigma people do not want to be labelled so they do it privately, you might not even know that its mental illness the man in question the mental health experts might say it was bipolar, dissociative disorder or hallucinations but to somebody who doesn’t know, they simply say ‘mamhepo’ (evil spirits) because that’s their understanding of what’s happening. The public also do not know where to go with mentally ill people,” said Meki.
She added that it all comes back to the policy and the work that needs to be done on the ground that the public needs to be equipped with enough mental health awareness.
“We need to start taking mental health seriously and start budgeting for its activities. It needs government and policy makers to sit down and go back on how HIV was made known into the communities which is what we need to do now. What is mental health. How does it come in now, how does it affect us.”
