Alagi Yorro Jallow
Mamudu: Felije Danso did not have a shirt on, revealing skin caked with so much dirt you could tell that the last time he probably had a bath was during the last rain season. A bath had not by design, but by being subjected to the elements of nature. He wore a pair of tattered trousers cut just below the knees. He was carrying what appeared to be a heavy bag of everything that everybody else had thrown away. As he passed me by, I caught a whiff of what distinctly smelt like a rotting corpse. I turned around to catch another glance at him. The back of his trousers was completely missing. As he walked, you could see the part of a human being’s anatomy where the sun does not shine. In between the legs, something was dangling and flipping from side to side as he walked.
A bus stopped at the bus stop, and over a dozen people disembarked. They passed him by as they crossed the road to Serekunda, the city’s most prominent and busiest shopping center. They appeared oblivious to his plight, almost as if he was the invincible man. A thought crossed my mind, what happens when he falls ill? Does he lie down and die?
One might be misled to think that this is a unique case of a mentally ill individual roaming the streets and surviving garbage. Unfortunately, it is the fate of most mentally ill persons in the Gambia. Living out in the open and surviving on whatever garbage society throws away. It is not a half-eaten cheeseburger for someone who watches too much television, and a can of coke tossed out in a litter bin. It rotten ‘matter’ that he finds on the bare ground or in the few waste disposal areas at markets. How can fellow Gambians let their brothers and sister live an inhuman life only by learning disability? Sometimes they even treat their pet dogs far much better than they treat their brothers and sisters. Offering shelter, food, and even medical (veterinary) attention for their dogs, things that they deny their fellow human beings! A combination of factors has led to many mentally ill individuals being abandoned on the streets in the Gambia.
Mamudu: I believe that the Gambia government ratified the UN Convention on the Rights of Persons with Disabilities on July 6, 2015, thereby committing to upholding the rights of all people, including people with mental health illnesses. An archaic piece of legislation is still governing the Gambia’s mental health system. The “Suspected Lunatic Act” of 1942 is outdated and fails to protect people’s human rights with mental disorders. That legislation was drafted to ‘safeguard’ public members from perceived’ dangerous’ patients by isolating them from the public and the deprivation of their human rights. In 2004 the Gambia government, in collaboration with WHO, embarked upon developing a Mental Health policy and strategic plan for the Gambia.
Mamudu: In most countries with sound legislature and economy, people with mental illness are provided by the state either through supported living accommodation or mental health institutions. It ensures that individuals with mental illnesses have access to food, health facilities, and the support to attend amenities available to other society members. Unfortunately, in the Gambia, that is not the case. People with mental illnesses are at the bottom of whatever social services are available. Unlike people with physical disabilities, individuals with mental illnesses also have very little advocacy. A discussion of mental illness is almost taboo. Most people think that people with mental illness are less human than themselves, therefore denying them fundamental human rights entitled to every human being. This is exacerbated by cultural beliefs and plain ignorance that, in most cases, attribute mental illness to witchcraft. Mental illnesses such as major depression, bipolar disorder, schizophrenia are more common than cancer, diabetes, or heart disease. Against popular belief, most mental illnesses can be treated or managed. The greatest challenge, if anything, for people with mental illness, is negative societal attitudes towards them and the lack of support in managing their conditions.
Those fortunate to find themselves in health facilities find themselves almost warehoused in overcrowded, dilapidated, and unhygienic psychiatric wards. It is common for places like Tanka Tanka psychiatric hospital that replaced the old Campama psychiatric mental home to unlawfully ‘detain’ patients for prolonged periods and usually on potent psychiatric drugs that are sometimes detrimental to the long-time recovery of the patients. The evidence for serious human rights violations, in the community, in conventional psychiatric facilities, and respect of the justice system is merely overwhelming.
There is a need to carry out education, advocacy, and sensitization programs in communities across the country based on human rights standards to challenge myths about mental illness, led by, among others, people with mental health illnesses themselves. This should include training for community leaders, traditional healers, families, and cares. There is also needed to create opportunities for social entrepreneurship, supported employment, and other income-generating and community empowerment ventures for people with mental health illnesses in helping break the cycle of poverty and discrimination.
Mamudu: People with mental illnesses need to access readily available mental healthcare services at the primary healthcare level, which specifically address their rights and the needs of people with mental health issues. This should be coupled with allegations of abuse and ill-treatment against people with mental health issues being promptly and effectively investigated, whether the abuse is alleged to have taken place in the community, traditional health settings, psychiatric facilities, or within the justice system.