RACE, CULTURE, AND THE UNDERSTANDING OF MENTAL ILLNESS – — By Femi Olugbile
Mental Illness is a problem that has been present in all human society from the beginning of time. It is quite common, in its several varieties, from relatively mild Anxiety to a chronic and debilitating Schizophrenia that may leave an individual unable to function. Up to one in every five Nigerians may expect, at some point in their lives, to experience the symptoms of one or other of these illnesses.
The advent of COVID19 and the mental health issues associated with the ensuing protracted lockdown has brought into focus the need for every society to pay particular attention to the mental health of its citizens.
Most of the treatments deployed for mental illness fall under the category of ‘Western Medicine’. There is a tantalizing alternative, or complement to this, in the form of Traditional Medicine, which has acquired a certain amount of recognition in places such as China and India, though some of the claims may appear dubious, even bogus. In Africa, there is ambivalence concerning traditional care which sometimes rises to the level of hypocrisy. The reality is that many Africans seek help from traditional healers for mental health problems, instead of, or in addition to, Western interventions of psychotherapy and medication.
Going through some old papers, I happened recently upon my published report of an interesting encounter with a ‘witch-doctor’ in Zimbabwe. The encounter, described below, raises issues that should be of concern and interest to the public, despite the fact that it happened almost forty years ago. Next week this column will focus on a more recent encounter with traditional healers that took place in – yes, Lagos.
Bulawayo – ‘The Place of Slaughter’, is the second major city in Zimbabwe and contains some of the most beautiful sights on earth. Working in the old Psychiatric Hospital at Ingutsheni, located on the outskirts of town, I quickly discovered that many patients who came to see me had either seen the ‘nganga’ (‘witch doctor’) beforehand or would hasten to see him when they were through with me.
I visited one of these ‘doctors’, curious to see traditional mental healthcare from the inside.
He was a little slip of a man in a rather shabby white overcoat. He walked with a pronounced limp. Large blue letters on the glass front of his office proclaimed his name – Hlabangana. It was a famous name in Matabeleland. His great grandfather was a powerful medicineman and had been King Lobengula’s emissary to the court of Queen Victoria, according to him. His ancestor came back from his journey to England awestruck, to announce to the warlike Matablele that the white man was too powerful, and impossible to defeat in war at that point in time, with what they had. They had to adapt, to learn new ways, before they could hope to compete. His valiant countrymen, as the story went, were affronted. They accused him of cowardice. Great grandfather Hlabangana fell on his spear to prove to them that he was not a coward – a very final proof.
What was Hlabangana’s view of disease, I asked, as we settled down to an interview?
Disease, he replied, had two groups of causes – physical and supernatural. The supernatural was through ‘bewitchment’.
And specifically, Mental illness – I pressed him?
There were different categories of mental illness, he said. Those who spoke reasonably some of the time but occasionally got ‘confused’. Those who showed excessive and uncontrolled violence. Those who were completely out of touch with the real world. And those who had been bewitched. Two prominent causes of illness, he added, were defective upbringing of a child and disappointment in love.
It was difficult, but not impossible, I reasoned, to fit his descriptions into approximate ICD and DSM categories.
And what about treatment, I asked him?
This, he said, depended on the type and level of disturbance. He allowed the ‘spirits’ to guide him as to where and when to collect the herbs he needed for treatment.
He had eleven beds for patients in the compound that was his home as well as his hospital. These beds were reserved for severe cases only, he explained. Most of his patients came and went.
What was the general outcome like for his patients? Did they get their lives back?
His face lit up in a proud smile. At least 75% of his patients received a total cure from illness, with no risk of relapse, he said, setting his jaw firmly, as if expecting to be contradicted.
The talk became general. I asked him about the rumour that Ian Smith, the former Prime Minister of what was then Rhodesia, had his own ‘nganga’ who he consulted near his home in the Midlands. Hlabangana would not comment on specific persons. He averred, with a knowing smile, that many white people came to him with their problems.
‘They pay big money.’ He smiled, rubbing his hands together, as if he could feel the crisp crackle of new Zim-dollars between his palms. I pondered what the psychologist of the Collective Unconscious, Carl Gustav Jung would have felt sitting here in Southern Africa with the descendant of Lobengula’s medicineman and hearing the story of Europeans ‘going native’ in Africa.
What was the nature of the power he had, I asked?
It was a gift that came naturally, he said. He did not fully understand it himself.
‘Do you believe in God, I asked?
‘If you mean – do I believe in one God, my answer would be ‘I don’t know’. There are certain powers. There is a hidden Science known only to a select few and understood by even fewer.’
He laughed at my apparent bemusement.
A group of male and female apprentices appeared from somewhere within the compound. Naively I got up to shake hands with them. He waved me back.
‘They do not shake hands. They are undergoing special rituals.’
I thanked Hlabangana for his time.
It was time to go.