Nursing In Ghana

FAKE MOURNERS: THE NEGLECT OF MENTAL PATIENTS

Fake Mourners: The Neglect Of Mental Patients

“Is my dream shattered? Has my future fallen apart? What am I doing here? Why me? This life is not worth living, I will die from this wicked world, I will kill myself…”

The thought kept boiling in his mind as he leaned sullen against the wall in a little corner of the ward. Mudaka has not come to terms with the fact that the more he thinks about whatever misfortune which led to his current home, the more his condition worsens.

A warm touch on his shoulder from behind brought Mudaka to reality. The action of the intruder separated Mudaka from his thought influx but Mudaka has no insight to appreciate the things around him and the fact that he is in the confines of a psychiatric ward receiving treatment for his sickness.

“Sir Mudaka”, the nurse called out his name affectionately as he touched his shoulder. He likes it when his name is prefixed with “Sir”.

“It is time to take your medication”, the nurse said and tapped his back almost immediately. He gave him a gentle caress in search to ignite his nerve to elevate his mood but Mudaka wouldn’t budge. The nurse intensified his therapeutic communication skills by continuous persuading and coaxing Mudaka who finally gave in and took his medication.

Mudaka is 2 weeks old on the ward and nothing seem to have changed in him. He is still the same as the day he was brought to the ward. Mudaka’s gloomy face defines sadness and hopelessness. A face portraying a man who has completely lost interest in all things around him. He has no volition to bath, eat food, carry out his daily routines and he is always mute.

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Sir Mudaka would not take any initiative by himself if he is not therapeutically stimulated, and this, to the nurses is common in severe depressive patients as in Mudaka’s case. The nurses understand this and will always do their best to see Mudaka take his bath, changed into new clothes and look nice. They would ensure his medications are administered as well as his food. They would engage him in all therapies necessary to ensure his recovery.

The people who brought him to the hospital told the nurses that they have no hope in his recovery as they narrated how the family had shopped prayer camps all over the country to no avail. But the nurses are confident that Sir Mudaka will one day smile to people and see the beautiful side of the world.

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The informants further claimed they are good Samaritans at a prayer camp who decided to bring him to the hospital because he has been abandoned at the prayer camp by his parents.

They asked if the hospital could keep the patient for a year while they go back to the prayer camp to trace the patient’s family. Despite the assurance given them by the health professionals of the patient’s good prognosis, they showed little interest in cooperation.

Sir Mudaka’s condition improved remarkably within a month and he was able tell the nurses a lot about his personal life and family. But the nurses noticed that the patient mood changes anytime he is asked about what he wants to become in future. He would always become mute whenever that chapter is opened before him. His disinterest and discomfort in talking about that topic sent a signal to the nurses that there might be some painful memory the patient is avoiding.

The Clinical Psychologist was invited. The patient revealed that he wanted to become an entrepreneur and lawyer but his dream was truncated when his uncle seized and sold all the properties his father bequeathed him, including houses and farmlands. This led to his school dropout as he could no longer pay his fees. He told the nurses his family members after getting their share of the booty from his uncle all turned against him, the only son of his parents, both deceased.

Sir Mudaka has not had any visit from his family members since he was admitted. The house address and contacts of the informants were all incorrect. The phone numbers in the folder are out of reach and the said prayer camp where the patient is said to have been brought from is non-existent.

Efforts by the hospital to trace the family proved futile. The patient is however able to remember one of the people who brought him to the hospital as his cousin and said he could go home after discharge.

After 3 months on the ward, Sir Mudaka was fully fit to go home. The Psychiatric Social Welfare department took charge to ensure his reintegration into his family. Sadly, Mudaka’s arrival at home was met with fierce resistance from his aunt. The aunty gave thousand and one reasons why she could not accept Mudaka her house. His uncle has relocated to the cities and other relatives are not also willing to stay with him.

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It took the intervention of the village chief and other opinion leaders to talk to the aunty to accept Mudaka.

Mudaka was brought back to the hospital by his community members in a relapsed state barely a week after going home. His condition has worsened. He is more suicidal this time than before. He appeared to have not taken a bathe during the one week stay at home. His eyes are sunken with wrinkled skin. Information gathered later by the hospital revealed that he was locked up in a room by his aunt.

Mudaka has been on the ward close to a year after his second admission and has not had any visit from his family. He is not ready to go home for fear of being lock up in a room and his family on the other hand are not ready to take him either. The mere mention of him going home is enough to trigger a relapse on the ward even before he steps foot on the exit door. He sees no reason why he should stay with his family who have so much hatred towards him.

He virtually became the property of the hospital since his family and relative have abandoned him. On his 7th year on the ward he fell seriously sick and had to be referred to a teaching hospital for further management.

Unfortunately he couldn’t survive after 6 months of battling with the physical condition. The chief of his village was informed of his death and within 48 hours the hospital was besieged with scores of family members led by the patient’s uncle.

The patient was never visited by any of his family member during his years of hospitalisation but he has dozens when he died. The family denied him love and support at the time he needed it.

They came with flashy and expensive cars to bury their beloved one. They bought expensive casket. The spectacle of the funeral convoy speaks of a family of rich background. They clad in funeral attire shedding false tears. The facial expressions that accompanied their lamentation were visibly incongruent. Tears of pretence and false dirges they sang, throwing their hands in the air with ululation, as if they have lost a breadwinner and cursing the force behind his death.

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They are fake mourners who love the dead more than the living and this is worst in the case of mental illness as the problem is compounded with stigma, lack of education on mental illness and cultural belief. Society belief persons afflicted by mental illness can no more be useful in society after treatment and thus find it difficult to accept them back home after treatment.

Some patients have been on the wards for over 30 years because they either cannot locate their hometowns or their families have abandoned them. Those found on the streets and were admitted as vagrants would have their families trooping when the patient is dead but they were nowhere to be found when the patient needed them. This poses a big challenge to mental healthcare providers and facilities at large.

There is the need to intensify mental health education to the public to demystify the myth surrounding mental illness. The government needs to set priorities in mental health by resourcing the psychiatric facilities.

Community health nursing needs to be strengthened and adequately resourced to be able to deliver on their mandate. They need communication gadgets and means of transports like cars, motors and bicycles to able reach out to the remote communities to deliver mental health education.

Religious leaders can play a key role in this crusade. They can use the churches and the mosques as a medium to propagate mental health education to their congregants.

Mental healthcare providers, both in the communities and the hospital settings need motivation to intensify the education despite the deplorable condition they work in.

The future of mental healthcare in Ghana looks bright if government sets its priority on mental health right, but until then, we can only rely on hope.

The writer, Malcolm Ali is a mental health advocate and nurse activist.

He works at Ankaful Psychiatric Hospital in the Central region.

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Malcolm Chibaro Ali.

Malcolm Chibaro Ali.

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