Recall that about a month ago, we dedicated a full week to writing and discussing mental health problems in Nigeria. The menace is on the rise. A recent report has been released by the Human Rights Watch, an international NGO that conducts research and advocacy on human rights, to support this claim.
Home to about 200 million people, Nigeria was recently described by the World Health Organization as a nation with a mental health problem. The seventh-largest country in the world, Nigeria has Africa’s highest rate of depression, and ranks fifth in the world in the frequency of suicide, according to WHO. Surprisingly, there are less than 150 psychiatrists in this country of 200 million, and WHO estimates that fewer than 10 percent of mentally ill Nigerians have access to the care they need.
The records are alarming, but what is worse is the lack of personnel and infrastructure to squarely face the problem and eradicate it. As a matter of fact, roughly nine out of every ten doctors in Nigeria are seeking to leave the country and find work elsewhere, according to a 2017 poll by the nonprofit organization Nigeria Health Watch.
In Togo, Ghana, and other Western African nations, mental health services are so scarce that many families still resort to shackling and prayer to drive out the demons they believe possess their relatives. Thousands of people with mental health conditions across Nigeria are chained and locked up in various facilities where they face terrible abuse, Human Rights Watch reports.
“In Nigeria, people with mental health conditions are often considered as being possessed by evil spirits or demons,” writes the nonprofit group Human Rights Watch, which is currently campaigning to convince leaders of African countries to end the practice of shackling mentally ill people. “In some camps, people are chained to trees, where they would bathe, defecate, urinate, eat, and sleep, some for years.”
A 22-year-old woman at a Christian healing center in Abeokuta, a city in southwest Nigeria, told the rights group she had been held captive in a church for five months and denied food as part of a “spiritual cleanse” for her condition.
“I was tied with chains for three days straight so I could fast. For the three days I had no food or water. It wasn’t my choice, but the pastor said it was good for me. Sometimes if they say I should fast and I drink water or take food, they (the church staff) put me on a chain,” she said. “The chaining is punishment. I have been put on chain so many times I can’t count,” she added.
To salvage the situation, authorities in Nigeria went out on a rescue mission last month. They rescued hundreds of people held under degrading conditions in a crackdown on religious rehabilitation centers in recent months. Police rescued more than 300 men and boys held in dehumanizing conditions from an Islamic school in the northern Nigerian city of Kaduna in September. Some of them told police they had been beaten, sexually abused and tortured by their teachers.
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Police in Katsina also freed 67 held captive under “inhumane” conditions from an Islamic rehabilitation center in October. Rescued people told police they were beaten with chains and denied food for days by instructors at the rehabilitation home. They were brought to the center by their relatives in the hope of “reforming” them, according to the police. Lastly, Nigerian police set free 259 people, including women and children, from an Islamic rehabilitation home in the southwestern city of Ibadan this month.
But HRW’s report shows that such interventions have fallen short of addressing a problem that is widespread across Nigeria and other African countries. Stigma and misconceptions, including beliefs that mental health conditions are caused by evil spirits or demons, mean that patients are often detained, abused and forced to “sleep, eat and defecate within the same confined space”, often in front of others, HRW said.
HRW criticised the government for failing to acknowledge that this abuse was rife in government-run facilities too.
The rights group said it visited 28 facilities providing mental healthcare in eight Nigerian states and the federal capital territory between August 2018 and September 2019. And that 27 out of the 28 used chains to treat mental illness. It found out that people with actual or perceived mental health conditions, including children, were placed in facilities without their consent, usually by relatives.
“Once there, many are shackled with iron chains, around one or both ankles, to heavy objects or to other detainees, in some cases for months or years,” the report said.
“They cannot leave, are often confined in overcrowded, unhygienic conditions, and are sometimes forced to sleep, eat, and defecate within the same confined place,” it said. “Many are physically and emotionally abused as well as forced to take treatments.”
Human Rights Watch said a shortage of mental health facilities and personnel in Nigeria were the underlying reasons why many of these centers exist. “But it’s not enough to raid these centers and shut them down. People rescued from these desperate conditions and other Nigerians experiencing psychological distress should have access to proper psychosocial support and mental health services,” Ćerimović said. The rights group also called for public education to improve citizens’ understanding of mental health conditions.
Read also: Strategy to Address Mental Health Disorders
“Shackling people because of a real or perceived mental health condition is no way to treat a fellow human being,” Dan Taylor, director of MindFreedom Ghana, told HRW. “People with psychosocial disabilities deserve the same rights and dignity as anyone else. And this will require the government and donors to invest in support services at the community level.”
“People with mental health conditions should be supported and provided with effective services in their communities, not chained and abused,” said Emina Cerimovic, senior disability rights researcher at HRW.
President Muhammadu Buhari has promised to look into the activities of some Islamic schools, which have long faced accusations of abuse. Following the recent raids, Buhari said his government will no longer tolerate the existence of “torture chambers” claiming to be rehabilitation centers. He also called on law enforcement to keep exposing illegal activities. More than 60 men and boys freed from ‘inhumane’ Islamic school, police say “No responsible democratic government would tolerate the existence of the torture chambers and physical abuses of inmates in the name of rehabilitation of the victims,” Buhari said last month.
The Nigerian government should ban chaining and urgently investigate chaining in state-owned rehabilitation centers, psychiatric hospitals, and faith-based and traditional healing centers in all 36 states and the Federal Capital Territory. The government should also prioritize the development of quality, accessible, and affordable community-based mental health services.