Nigeria: Sitting on a mental health epidemic

It’s almost unimaginable that the pandemic has only been with us for a year. Time has stood still for the past 365 days since a previously unknown form of pneumonia was discovered in China’s Wuhan District forcing the world to a lockdown, the type of which has not been known since the Spanish flu. One […]

It’s almost unimaginable that the pandemic has only been with us for a year. Time has stood still for the past 365 days since a previously unknown form of pneumonia was discovered in China’s Wuhan District forcing the world to a lockdown, the type of which has not been known since the Spanish flu. One year later, the world is grappling with a mutant virus and its undesired after effect – increased mental health crisis.

Unlike in the developed world, mental health is not something Africans talk about. That is not because we are immune; it’s more because mental health is what we wish on the loathed enemy. Many an African would drop their top garments and slug it out with anyone calling them ‘mad’, the derogatory portmanteau term we most associate with mental illness.

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Early this year, American researchers discovered that mental health has increased among its citizens. In one report on the impact of the pandemic on Americans, 4 in 10 American adults have suffered from anxiety and depressive disorder as a result of the pandemic. Canadian findings have seen an increase in mental health disorders leading to substance abuse, suicidal thoughts and low self-esteem among its citizens.

In Africa where mental health is the stuff wished on perceived enemies, the figures are not there. The reasons are simple; A 2018 report in the Lancet Global Health affirms that only 14 people out of every 100,000 have made visits to mental health experts. There are only 1 to 4 mental health experts per 100,000 people. This is  shameful.

This is why a Daily Trust report from a visit by Professor Isah Marte, Chief of Staff to Governor Zulum of Borno State, to Nigeria’s Health Minister, Osagie Ehanire, should be a worrisome reminder that Nigeria is currently ignoring a mental health epidemic. Marte did not come to Abuja to complain about mental health. On the contrary, he brought what should be a disturbing report of the state of health in beleaguered Borno, the epicenter of Boko Haram, the often forgotten but now the longest insurgency in the history of Nigeria and its sub-region. In Borno, there are only 200 doctors, 1000 nurses, and seven pharmacists for six million people. While the insurgency itself has claimed an estimated 35,000 people, it has displaced two million. Eleven hospitals have been burnt down, seven have been vandalised and 185 primary health care centres have been affected.

Maiduguri, the Borno State capital, and the headquarters of the famed Kanem Bornu Empire, now has three million inhabitants from a pre-insurgency population of one million. Marte was dispatched to Abuja to seek federal assistance. Ehanire, as usual, made flippant promises. Tonight, if someone in Borno needs medical assistance, they might have to rely on promises!

Borno’s case is peculiar, but only just so. Other Northern states are no better. In Kogi, most rural dwellers still trek long distances to access health centres – usually a commercial one. I have cited the Kogi example because it is not officially at war other than the abnormal exposure to the same vagaries of the insecurity that plagues the entire country.

If primary health care is this far from the people in a country that budgets three percent on health, you could imagine the value it places on mental health. And this time around, one is not talking of the eternal traditionally backward Northern Nigeria but the entire country. Reports of people jumping over major bridges are rampant in a country where it is illegal to attempt suicide. Other psychopathic kinds of behaviour take up a substantial chunk of daily press reviews in Nigeria.

Our country is one in which data, even for mainstream matters, are completely lacking. As shameful as it is, it is not shocking that Nigeria gathers no data on mental health availability except that it has less than a dozen federally controlled mental health hospitals most rendering skeletal services due to lack of funds or qualified personnel or both.

One thing that is clear is that the Boko Haram insurgency has affected the psyche of most of its surviving victims. If Borno alone has two million displaced persons, one could only imagine how many there are across the rest of the North where Boko Haram and internecine strife are only a part of the many security challenges Nigerians have to face.

Displaced camps are doted basically in every open space hosting traumatised men, women and children, some of them unaware that they are suffering from insurgency-related post-traumatic stress disorder and other related illnesses. While the political class sees an avenue to increase their sleaze picks making resettling deals, a lot of these victims are a walking ticking time bomb.

The most disturbing problems facing the future of Nigeria is that some of the younger generation have been traumatised so many times that they have begun to see and live with the reality of trauma as if that is what life itself is all about. Even for relatively safe parts of Nigeria, the level of human rights abuse by government and its agencies exposes citizens to unmitigated effective disorders. Our psychologically puritanical North has recently made waves with the coverage of its codeine epidemic.

While zealots in government crave the headlines that come with the seizure and public crushing of beer and other alcoholic beverages by states that share taxes on those products, they ignore the epidemic of psychotropic substances ravaging the larger population – mainly its disillusioned youths. These are the youths whose thirst for living or success could no longer be quenched with religious texts promising better hereafter as a reward for terrestrial penury.

Ehanire’s response to Prof Marte’s shopping list is an example in classical insouciance, a lesson in why this epidemic would explode in our face someday soon. It also explains the lack of focus or direction by Africa’s most populous nation facing severe mental health challenges. Hear Ehanire: “We know where it hurts and I must say that our hearts go out to Borno. We do worry about what is going on there and how we can help; how we can put our heads together and see how we can alleviate the suffering of the people.”

That is the nation’s Health Minister sounding like Borno is a distant nation seeking big brother Nigeria’s help. He says Abuja feels the distant pain of Borno citizens and would send help when it has dealt with challenges within. If the gold of primary health care rusts this way, it is obvious that termites have consumed the wood of our mental health project.

Yet, wherever we are today, we all know someone who knows someone who has been affected by mental health even if we would not mention it at our social gatherings. If we must survive our current challenges and rebuild the nation, we would need a mentally balanced population. Is that even a priority for us?