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Every market place has its own mad men! A common phrase but hardly do we think of the gravity it carries. Mental illness is a dual burden to the community and individual, because of its complexity and the stigma surrounding it. Many people would not like to be associated with a relative who has mental disorder. It cuts ones chances of marriage, work and socialization.

A feature story was once shown on Kenyan television of a frail woman (now looking like a baby) tied to a bed and locked in a dark room for years in one of the sprawling slums in the city.

Villagers within the slum had for a long time held suspicion of a woman who would discretely open the side door very early in the morning and late in the evening. She never let anyone into that room .This had been going on for more than 2-5 yrs with bizarre noises emanated from that room. Some had speculated she was a witch. Mental illness in many African communities is viewed a bad eye’s misfortune, either brought by parents or clan. It called for attention from the village healer or seer who would perform rituals to spell out the curse. Many a times this remedy failed and the victim would be condemned to isolation and ridicule from the entire community.

So one bright morning when the lady had left for her business premises, the villagers broke into the discreet room and found a frail, wasted lady of about 25yrs who was tied to a bed, with crouched knees and the blank stare typical of the mentally ill. It is important to realize that the isolation of this patient is a reality of the first assylums which were built like prisons to confine individuals away from the ‘normal society’. The World Health Organization has raised deep concerns about the increasing number of mentally ill and in its effort low income countries have been put in the limelight to reconsider a community approach towards mental health care. Could this have saved the young girl?

Upon arrival of the mother at home, the police demanded that she report to the station for interrogation. An utterly frightened lady, with shock registered over her face had this to say, “This is not my undoing, I was protecting my daughter from being injured or even raped by people in the village”.

Historically mental illness has held complex gender issues which reflected societal biases against women. During the nineteenth century the male-held belief about women role led to the kind of psychiatry practices that are still influential today. At one point in history women outnumbered men in the asylums and had been labeled as hysterical, the word hysterus coming from Greek word womb. During this period a common treatment was mutilating sexual organs in the belief that madness in women arose from sexual arousal. The partrichial system towards mental health made women ascribe to the ‘ideal societal norms’ that a mother is a carer, child rearing, and only has herself to blame when family fails, hence her value being questioned.

Providing care for the mentally ill present challenges to a constrained health workforce. A shortage of psychiatric nurses and doctors has led to lack of early diagnosis and treatment. In the absence of treatment options, the mentally ill may be shunned or withheld in mental institutions. The pain of having a mentally ill daughter addresses the need to reconsider a community model approach and the special reproductive health needs. Coping with pregnancy related issues,contraceptives and who consents for this carries dogma into the kind of care needed for mentally ill women.

The World Mental Health Celebrations for 2012 is a turning pointing in redefining the community approach to address the stigma. A community based approach to mental health care is the best practice. Mental Health Chapter of Nurses in Kenya has a mission to reach out to people through health education in diagnosis, early treatment and family support networks other than institutional mental health care. This preparation is ongoing ahead of the big global event.Mental Health care is needed now more than ever.

This article is part of a writing assignment for Voices of Our Future, a program of World Pulse that provides rigorous new media and citizen journalism training for grassroots women leaders. World Pulse lifts and unites the voices of women from some of the most unheard regions of the world.

Further Reading: health day/2011/en
Thompson.T(2000) Mental Health and Disorder ,3rd Ed,Baillere Tindall



Stella Paul's picture

Very thoughtful

A very important issue you have raised here Dear Lucia. And I will say, this is not an issue usually talked about. In India, we get to talk only when something terrible happens ( like it happens in your place) such as a mentally unstable girl is found to be locked, chained for years or found pregnant. I thank you for choosing this topic and hope, across the walks of the society people will be more thoughtful, more sensitive towards the need of the mentally ill.

Stella Paul
Twitter: @stellasglobe

Okeny-Lucia's picture

Very Thoughtful

Thank you Stella,It has taken me a while to comprehend about this subject,one I know many times I have had stressful situation and got help,then there is this lady or gentleman who will never be able to get the support I have had.Hence the need to talk through about it and share the tribulations of ourselves in the society and how we can help one another.

Lucia Buyanza
Reproductive Health

Ruun Abdi's picture

Dear Lucia, Thanks for

Dear Lucia, Thanks for choosing this topic in which people dont usually point it out. This happens in many places around the world, even in my country people mostly talk the belief that madness in women arose from sexual arousal. All they need is care and been friendly with them instead of isolating them which will in fact worsen their condition.

Much love,

Okeny-Lucia's picture

Thanks Ruun

The world is full of mad people,the high lifestyle conditions and the new trends in technology,have put alot of demand on people.
We have very few experts to take care of these people.

I wish you well in your work.Thank you once again for taking time to read.

Lucia Buyanza
Reproductive Health

Celine's picture

Dear sister Lucia, I am not

Dear sister Lucia,

I am not surprised at your topic for op-ed writing. You are always passionate about health related issues. You indeed live out your professional life, I always read compassion in every of your writing. It goes to show that you are indeed compassionately working-- saving and touching lives.

I am not a health personnel but your writing on this issue reminds me with nostalgia, an experience I had a few months ago with somebody very close to me. Health issues can be complex especially in this our part of the world where we lack facilities to urgently attend to them.

May God bless you dear sister.

Okeny-Lucia's picture

Thank you my dear Sister,Celine

I hear you and agree with you totally,we are so disadvantaged sometimes it hurts to know that the people whom you need expertise from are not available,Africa is the major exporter of health work force to America,Europe and Australia.It is vanity at the end of the day.

Lucia Buyanza
Reproductive Health

Potter's picture

Yes! Yes! Lucia!!!

You have presented a compelling article. Thanks for your analysis and for your empathy. Great writing, Lucia!

Okeny-Lucia's picture

Thank you Jana

It was not easy to go through my own mental status at the time of writing,but as I aways say,going an extra mile is an act of courage

Lucia Buyanza
Reproductive Health

ikirimat's picture

Hi Lucia, You have pointed

Hi Lucia, You have pointed out an issue that is often neglected by society. I am also concerned that programmes for the mentally ill are not sufficient enough.

It is very common to see mentally ill people on the streets on Kampala and everyone is attributing it to drugs and alcoholism. In other words, they are being blamed for their conditions.It time we moved away from blaming these people and provide them with the services they require.
In Uganda, we have just a handful of psychiatrists that are not even enough to handle cases in the main hospitals

Grace Ikirimat

"It takes the hammer of persistence to drive the nail of success."

Okeny-Lucia's picture

Thank you Grace

Kenya is no exception in this issue.Infact last year there was no intake of psychiatry nurse students.It is awful and sad when priorities are lost in our health budgeting

Lucia Buyanza
Reproductive Health

Mary Ann M's picture

So needed to discuss!

Lucia, once again you have brought forth a subject that touches an issue that is present around the world.

Even the most developed countries have not yet learned how to create an environment that provides the understanding necessary for the mentally ill. This goes from the stigma of those seeking help with everyday issues as well as those with severe mental illness. It is interesting that in some cultures, those with mental illness were considered to be holy and are provided for and protected.

It is unfortunate that in many places today, mental ill family members are mistreated because those who should be protecting them see them as an embarrassment or a symbol of judgment against themselves, or a reflection on themselves. Thank you for bringing this issue forward and opening the discussion.

Many Blessings,
Mary Ann

Okeny-Lucia's picture

Mental illness is a challenge

This a huge challenge for society the world over .Each country is struggling to see the best practice so far available.I believe as we continue to discuss we shall get better solutions to deal with it.
Thank you

Lucia Buyanza
Reproductive Health

revchristie's picture

Making the invisible---visible

Those with mental illness are invisible in the most sophisticated and resource rich societies as well as those with less resources. Your story reminds us that we have shared opportunities to demonstrate compassion and that success for one village, or region or country can mean success in other places too. Thank you for your story.

I look forward to learning more about the community based approach to mental health care.

Okeny-Lucia's picture

It takes courage!

Thank you Christie for taking time to read.

Mental illness has to be addressed now more than ever,with the violence around us all the time it is inevitable not have mental breakdown.
I will share with you in due course.

Lucia Buyanza
Reproductive Health

Emily Garcia's picture

Thank you, Lucia, for your

Thank you, Lucia, for your article! I really enjoyed reading it and I appreciate the work you do related to mental illness. Also, I loved that you addressed the need to remove the stigma attached to it. I've learned that mental illness is not something distant, not something of the Other. It's very close to home, always; and yet so often ignored. Thank you for speaking out about this!

Warm wishes,


Emily Garcia
World Pulse Online Community Lead

Okeny-Lucia's picture

Emily the world is full mad people

Thank you,
Unless we address this issue head on life will remain in illusion.I will all the necessary noise there is for something to happen.
Thank you

Lucia Buyanza
Reproductive Health

mrbeckbeck's picture

Breaking the silence

Thanks for your bold work here, though I should expect nothing less! You're on the forefront, pushing issues to our attention. Mental illness is world wide, and unfortunately, so too is the stigma, shame, silence and fear around it. It can be so hard to understand the world inside another person's head, and so easy to just say "she is crazy". Your compassion and patience is so clear in this Op-Ed, and I only wish that your attitude was more common.

I look forward to knowing more about "community based approaches" to mental health care. My sister-in-law is a mental health nurse, I will ask her about this too.

Great work,

Scott Beck
World Pulse Online Community Volunteer

Greengirl's picture

You have a Very Large Heart

Permit me to describe you thus: You are your profession.

Your article is stimulating and very professional. You've brought to bare, in very concise terms, a very important but long overlooked and or neglected issue. I cannot agree with you any less that people with mental illness deserve love and care.

You have steered a wake up call, and I anticipate, that it will go a long way to reform people's perceptions about and attitude towards mentally ill people. This will be liberating, especially for women who as you rightly pointed out, are at the receiving end of all the blames, when there are such family crises.



MelissaGrace's picture

Your words touched my heart

Thank you Lucia. Mental health has a place in my heart because of my own experiences after the birth of my child. I believe when we are not informed our minds take us to horrible places and when people are not informed about mental health they believe the worst, the very worst. I have such an appreciation for you in bringing this subject to light.

I look forward to reading more about you and your work.

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