ZADHR NEWSLETTER: Volume 7, Issue 2 - June 2009

Contents

* Conditions at Psychiatric Institutions in Zimbabwe: The Case of Ngomahuru Psychiatric Hospital
* Promoting and Protecting the Rights of People with Mental Disorders: WHO Guidelines
* Personal Accounts of Human Rights Violations of People with Mental Disorders
* User Fees and Access to Health Project in Mutare
* ZADHR Chairperson wins the 2009 Jonathan Mann Award for Health and Human Rights
* ZADHR elected onto the Zimbabwe Country Coordinating Mechanism (CCM)
* Report on Chinhoyi Workshop, 13 June 2009
* Chinhoyi Workshop Report: Strengthening Zimbabwe’s Health System: What Can a Right to Health Approach Add?

Mental Health and Human Rights in Zimbabwe

Conditions at Psychiatric Institutions in Zimbabwe: The Case of Ngomahuru Psychiatric Hospital

A report by the Zimbabwe National Association for Mental Health (ZIMNAMH)

The plight of people living with mental illness in Zimbabwe is a challenge that calls for the concerted efforts from all stakeholders. Family, institutional and societal attitudes need to be radically transformed in order to attain acceptable and effective reintegration of the affected people back into society.

Unfortunately, the rights of people living with mental illness in Zimbabwe have been abrogated and they are usually treated as second class, peripheral members of society. They are neglected, stigmatised and abused physically, sexually and emotionally. Their lives tell of deprivation, and suffering. The absence of social protection mechanisms for people living with mental illness is deeply entrenched.

In light of this, the Zimbabwe National Association For Mental Health (ZIMNAMH) embarked on a collaborative effort with the Ministry of Health and Child Welfare’s department of Mental Health Services. The initiative arose after receiving numerous requests from stakeholders to consider the state of Mental Health Institutions in Zimbabwe.

On 19 May 2009, a team comprising the Director for Mental Health Services in Zimbabwe, Mrs. D. Sithole, two psychiatric Doctors from Parirenyatwa, Dr. Nhiwatiwa and Dr. Muchirahondo, the Director for Tariro Psychiatric Institution, Mr. Pasina and the ZIMNAMH Programme Officer, H.T Mayuni visited Ngomahuru Psychiatric Hospital in Masvingo Province.

The Institution’s Status

Ngomahuru is one of the country’s largest psychiatric institutions catering for people with mental illness. It serves as the provincial referral centre for Masvingo Province. It has the capacity to accommodate up to 200 patients when fully operational. However due to a battalion of challenges, the institution is currently only accommodating 76 patients, all of whom are adults. What follows is an exposition of some of the challenges faced by the institution.

Psychiatric reviews and consultations

Psychiatric patients are expected to undergo medical reviews once every month. The monthly assessments will ensure that the prescriptions are in line with their response to medication. However, the patients at the institution have not been examined by a psychiatric doctor for over five (5) years. Consequently, they are continued on the same medication thereby posing a great risk on their health and their ability to recover.
Hence the ZIMNAMH coordinated visit, which included two psychiatrists, went a long way in addressing their medical needs. However there is need for such visits to be sustained.

Clothing

The state of clothing for the patients needs urgent intervention. The clothes they wear are very old and sometimes tattered and torn. Even the jerseys they wear are incapable of keeping them warm. Given the prevailing severely cold winter, clothing is one of the most urgent requirements.

Hygiene

Basic hygiene items such as tooth paste, tooth brushes, soap, body lotion and towels are also required for the patients. Currently these are not available.

Transport

The institution does not have an ambulance in spite of its size and this has led to deaths of some patients on account of  physical health conditions requiring referral. This is exacerbated by the fact that the Institution is located about 52 kilometres from the nearest town of Masvingo.
Reunification with families
There is no social welfare officer to unite the fully recovered patients with their families. A vehicle would also be required to facilitate this process. Consequently, there are some patients who have been living at the institution for over 10 years though they no longer need to be there. Institutionalisation is supposed to be a stop gap measure and not the ultimate goal. The patients needs parental and family support.
Alternatively, the patients can be assisted with bus fare. Unfortunately, the authorities pointed out that cash is an inhibiting factor to this initiative. Failure to discharge the patients means that the institution can not admit new people.

Absence of support grants from Social Welfare

Another area of concern is the apparent lack of financial support in the form of grants from the Department of Social Services. This further compounds the challenges related to operational efficiencies.

Absence of safe water and electricity

The water situation at the institution was a cause for concern. The hospital has no running water. The electricity transformer was vandalised in May 2009 and no plans were in sight regarding when it would be fixed. As a result, the water pump was out of order.

Currently the patients and staff are having to fetch water from a river using buckets. The river was reported to be crocodile infested. This poses a life risk to the patients and a health risk to all.
Recreational materials

There are no radios, televisions or other recreational equipment for the patients. As a result, they are out of touch with reality and current affairs as well as other critical information such as on HIV/AIDS.
Other utilities

The canteen has no functional cold room. All the cold rooms for food storage are down. The stoves are also not working. There are no brooms and mops and disinfectants at the institution.

Nutritional needs

The prevailing economic challenges have not spared the institution. Access to food is a human right. The patients are not getting a balanced diet as food supplies are erratic and mainly dependent on well wishers.
Resumption of productive activities

The hospital has a farm which used to meet the patients’ consumptive requirements. However, the farm is currently derelict and unproductive. All the equipment such as machinery and the tractor were confiscated by ‘higher authorities’. This has compromised the productive utilisation capacity of the farm.
The afore-going observations are just the tip of an iceberg. There is need for urgent intervention in order to redeem the situation.