By Moses Mugugunyeki
“My brother, I need shoes,” says a patient as he points to his bare and cracked heels. He also tugged at his shirt showing a swollen navel.
Tencen Moyo* is among 149 mentally ill patients admitted at Ngomahuru Psychiatric Hospital about 50km south of Masvingo town. This once well-established and reputable mental health institution is now a pale shadow of its former self.
Where several hundred mental patients used to be comfortably accommodated and treated, there is just 149 mental patients left, but the institution can hardly look after them. Basic needs such as medicines, food, linen, soap and even water are now difficult to get and inmates have been reported to be going hungry most of the time.
A recent visit to the hospital seemed to confirm the fears that the institution also has become critically short-staffed.
The appalling state of Ngomahuru Psychiatric Hospital, one of the four psychiatric health institutions in the country, are a tip of an iceberg and illustrates government’s failure to sustain the country’s health sector.
Zimbabwe on Thursday joined the rest of the world in commemorating World Mental Health Day which ran under the theme: Suicide prevention.
According to the World Health Organisation (WHO), one in four people in the world will be affected by mental or neurological disorders at some point in their lives.
Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.
The Health and Child Care ministry says at least 1,3 million people are living with mental illness in Zimbabwe.
A recent visit by The Standard to Ngomahuru Psychiatric Hospital, revealed harrowing tales of hunger and neglect.
Moyo is among a group of male patients housed at some cottages outside the main hospital wards. Although the place depicts a rural home, the structures are obsolete and lack security.
“We call this area Rural Halfway Home where we release patients whom we think would have improved. They come here and we monitor them as we try to integrate them in a family set-up,” said Ngomahuru Psychiatrist Thomas Hwami Mahwehwe.
“It’s unfortunate the structures are old and there is no security. Many times some of the patients run away. We don’t have female patients here because our facility is not friendly to females.”
Among the patients at the Rural Halfway Home was Alick Chikange, who according to officials at the institute, has responded well to treatment, but he complained of hunger.
“We don’t have food to eat, please help us,” Chikange said.
Hwami Mahwehwe concurred: “The biggest challenge we have here is food. We largely rely on government handouts, but as you know, the environment is not that conducive, we sometimes have to do it our own way.”
“We used to be self-sustaining, but most of our projects fizzled out due to lack of funding. The only project left is the tuckshop where we sell beverages and food, but it’s no longer viable due to the harsh economic challenges.
This publication established that part of the diet at the institution was mainly sadza and dried vegetables (mufushwa).
A chef at the main hospital said they were left with three months supply of food in reference to a handful of bags of mealie-meal piled in one corner of the hospital’s expansive, but largely empty warehouse.
According to a 2018 WHO report entitled, New Understanding, New Hope, governments should integrate mental health care into primary health care and the general health care system.
“The responsibility for action lies with governments,” the report says.
As such, Zimbabwe has come up with a number of policies and frameworks aimed at harmonising mental health activities, but the magnitude of mental health burden is not matched by the size and effectiveness of the response it demands as evidenced by the situation at Ngomahuru.
“From the beginning, this institution was never established for mental ill health patients,” said Hwami Mahwehwe.
“In that respect, this facility is not suitable for mental health care.”
Ngomahuru was established in the 1920s as a jail for prisoners of war shortly after World War 1 before it was later transformed into a confinement of leprosy patients, run by the Dutch Reformed Church.
It was later transmuted into a psychiatric hospital after leprosy patients were transferred to Mutemwa Centre in Mutoko.
Mental health care in Zimbabwe is governed by the Mental Health Act of 1996, Mental Health Regulations of 1999, the Mental Health Policy of 2000 and activities are being implemented through the Mental Health Strategic Plan 2019 to 2023.
Community Working Group on Health executive director Itai Rusike said despite Zimbabwe having various national legislative instruments and policies aimed at guaranteeing mental patients’ legal and constitutional rights, mental health care leaves a lot to be desired.
“The right to health must address mental health as well as other modalities of psychosocial support. The health situation as widely reported at Ngomahuru is sad, deplorable and totally unacceptable,” Rusike said.
“Arrested and detained mental patients have the right to conditions of detention that are consistent with human dignity, including the opportunity for physical exercise and the provision at state expense of adequate accommodation, ablution facilities, personal hygiene, nutrition, and medical treatment.
“As a result some people end up finding solace and comfort in drugs, alcohol abuse and other risky behaviours.”
Rusike said government should increase the health sector budget to at least 15%, as agreed in the 2001 Abuja Declaration in order to ensure services to the poor and vulnerable populations, like people suffering from mental disorders.
In his statement to mark World Mental Health Day on Thursday, MDC president Nelson Chamisa said managing mental health disorders in Zimbabwe was now complex due to a plethora of challenges.
“These mental health disorders are easily treatable, but because of the huge treatment gap for such conditions in our country, 90% of those needing evidence-based care do not get it because we don’t have enough professionals to treat them,” Chamisa said.
Health and Child Care minister Obadiah Moyo on Thursday conceded that all was not well as far as mental health care was concerned in Zimbabwe.
“In Zimbabwe, we only have 17 psychiatrists and 900 mental health nurses. There is a need to train mental health workers to bridge the gap in mental health system,” Moyo said.