A day in the world of the mentally ill

On the morning I was supposed to visit Caraes Ndera, a mental hospital located about 16 kilometers from Kigali CBD, I was tempted to change my mind. Although Ndera is a big sector with many schools, churches and hundreds of residents, when you tell any Rwandan that you are at Ndera, the first thing that comes to their mind is  that you have mental issues.
The staff at Ndera Mental hospital. All photos by Martin Bishop.
The staff at Ndera Mental hospital. All photos by Martin Bishop.

On the morning I was supposed to visit Caraes Ndera, a mental hospital located about 16 kilometers from Kigali CBD, I was tempted to change my mind. Although Ndera is a big sector with many schools, churches and hundreds of residents, when you tell any Rwandan that you are at Ndera, the first thing that comes to their mind is  that you have mental issues.

This is exactly how my neighbor perceived me when she found me at the Remera Taxi Park strapped in the passenger seat of a commuter taxi heading to Ndera. “Is everything ok? Anything we should be worried about,”  she asked with a concerned look. “Yes, I’m running mad,” I joked but to her, it wasn’t funny at all. The taxi took off, leaving her saying a silent prayer for me as I continued with my journey.

I reached the hospital in the morning and was glad that I dropped the idea of wearing a safety helmet(like the rest of you who have never been to this hospital before, I thought the place was crowded with mental people throwing stones and  empty  bottles  flying all over the place).

But the place didn’t look any different from other hospitals I’ve been to, I didn’t see any sign of violence. But still for my own security I asked my host Mr. Iyamuremye Jean Michel, the Director of Nursing, if the burly guys who grab and hold down violent patients when they get out of control were close.

 “We don’t have such people here. We deal with our patients mostly psychologically and not physically,” he said while laughing so hard that for a moment I thought I was the crazy one! After confirming that bodyguards were nonexistent at the hospital, my levels of anxiety hit the sky.

CARAES Ndera Neuropsychiatric Hospital was established in 1968 by the Brothers of Charity, an international pontifical religious congregation. The first patients were received in the hospital in 1972.

Today the hospital provides a variety of services which include outpatient care, inpatient care, referral services, pharmacy with somatic and psychotropic drugs, social work services, laboratory services, electroencephalogram (EEG), neurology, services to chronic patients, psychotherapy, counseling, physiotherapy and orthopaedic services, occupational therapy and voluntary counseling and testing services among others.

Also, the hospital has two other affiliated branches under the same management namely CARAES Butare and Icyizere in Kigali city. Hospitalisation of patients is organised in separate wards for children, female and male patients.

According to Brother Frere Nkubiiri Chares, the hospital’s vision consists of providing comprehensive quality health care to all referred patients and to become a teaching and a referral neuropsychiatric hospital in the sub region of central and eastern African.

 “The hospital’s mission is to provide the best quality care with professionalism and devotion to psychiatric and neurologic patients from the whole country and to ensure teaching for mental health professionals,” Nkubiiri said.

I entered the Men’s Wing surrounded by a brick wall, the gate is kept under lock and key at all times. Thirty or so men mostly in their mid or late 30’s were moving about in the compound, others seated on plastic chairs lost in whichever world they were in.

I joined them and acted like a newcomer. Soon, I made friends, a gentleman wearing a Red Sox sweatshirt watched me suspiciously from the corner of his eyes just like I was doing too. After a couple of minutes, he coyly approached me and whispered that he had a massage for me straight from God. According to him, God had dedicated a song to me. I nodded my head while holding back laughter, but before I could ask about the song title; he stood up, cleared his voice and started singing. Apparently God had dedicated a dancehall track to me. Other residents joined him and in seconds, we were all singing different songs at the same time. 

We croaked to Jose chameleon, Masamba Intore and Dr. Claude songs…my disturbed friends however added tunes I had never heard of before. For a moment, I felt guilty for enjoying myself.

A few meters from where our acapella soared through the air, an old schizophrenic man screamed and punched the walls (apparently he hears voices and sees monsters that aren’t there) it took a lifetime for the nurse to calm him down. After the ‘vision’, he cast his tired eyes on his feet as if embarrassed by his unbecoming behaviour; he slowly walked away stiffly like he didn’t want to rattle the bones in his weak body and disappeared inside a hall.

I continued socializing with the other mates but in just one hour my spirit had sunk down to the floor. The mood inside this place is not just eerie but also gloomy! Seeing dozens of young people with their heads bowed down like satellite dishes or seeing elderly men seated on the ground playing with imaginary friends is quite depressing.

But listening to Joseph, 46, who is now sane after weeks of treatment, made every bit of misery worth enduring. “I’m now well, I even went home last weekend and I think I will be discharged this week. I am only left with dealing with people who taunt those who have suffered mental diseases. But that’s not a big deal, as long as I’m well, I will let them talk,” said the visibly happy father of five. He was a taxi driver before he was diagnosed with Neurosis disorder.

People with mental health problems say that the social stigma attached to mental illness and the discrimination they experience can make their difficulties worse and make it harder to recover. “Most people who experience mental health problems recover fully, or are able to live with and manage them, especially if they get help early on. So I call upon all Rwandans especially friends and families not to discriminate against their brothers and sisters but give them the same treatment. After all, we don’t choose which disease we acquire, and anyone can get a mental health problem,” suggested the hospital Director.

We can all do our part to reduce social stigma attached to mental illness and make life easier for the millions of people who struggle with it. First, we need to educate ourselves about mental illness. Having the facts can help you challenge the misinformation that leads to this stigma. Support those with mental health issues. Treat them with respect.

Help them find jobs or schools. Encourage them to get or stick with treatment. Share your story. If you or someone in your family has had a mental illness, speak up about it. Your example could help someone else. Mental illness is nothing to be ashamed of but stigma and bias shame us all.

 

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