Growing up, every time my siblings and I would do something that would drive my parents mad, they would jokingly tell us they will end up in Tigani ElMahi. As a result, I began associating mental illness with the late Dr Tigani ElMahi.
Dr Tigani El Mahi (1911–1970) was a distinguished Sudanese intellectual, a psychiatrist and social scientist who recognised that belief in supreme beings or supernatural existence is widely accepted by Sudanese people, not only among illiterates but also among well-educated people, influencing all aspect of lives of both groups.
According to the article, ‘Traditional and Spiritual Medicine Among Sudanese Children with Epilepsy‘, by Inaam N Mohammed and Haydar E Babikir, in rural areas, cultural beliefs and practices often lead to self-care and home remedies for epilepsy or consultation with traditional healers that would impact the care of people with epilepsy. Religious individuals or clerics known as wali, fagir or sheikh in Sudan have the privilege of exercising power through the baraka (blessing) or shifaa (intercession) acquired from their ancestors or from learnings. Those holy persons use their blessing of God to heal through prayer, charms, summons and amulets.
Pagans, in some southern parts of Sudan, and other African countries, believed in one Supreme Being who manages human life through a number of uro spirits living in the next world. They act through mediums on earth, like the kujurs who are capable of producing a state of trance, and dissociation interpreted as spirit possession; and act as intercessors between spirits and people.
A study by M. A. Sulieman titled ‘Primary Care and Mental Health Services in Sudan’, reiterates Mohammed’s and Babikir’s article about what some Sudanese believe to be the cause of mental illness and the using of spiritual healers. According to the study:
‘A large proportion of Sudanese people still believe in demons, evil spirits with evil eye, black magic, witchcraft and other supernatural forces as cause of mental illness. A considerable prejudice against mental illness exists; and social stigma is strongly attached to mental disorders. Therefore, in rural areas, help for a person with a mental problem is first sought secretly from an indigenous practitioner, like a religious healer or a zar spirit exorcist or kujur therapist, depending on the ethno-cultural background of the patient.’
The neuropsychiatric disorders prevalent in Sudan do not differ from those seen in other parts of the world, but as in other developing countries, toxic factors, nutritional deficiencies and infections play a major role in the relative increase of acute organic psych syndromes. Schizophrenia, manic-depressive psychosis, anxiety and epilepsy are the major causes of psychiatric morbidity. Hysteria with gross conversion symptoms in young women is also commonly seen. Alcoholism is causing a lot of concern in many urban communities functioning under conditions of rapid socio-economic change. Low prices and easy availability of native wines ‘marisa’ and spirits ‘aragi’ are aggravating the situation.
Growing up in Sudan, I also remember hearing stories like:
Reverend Apostle S. B. Esanwi, Doctor of Divinity, treats people suffering from mental illness with prayer and traditional medicines which usually consist of roots and leaves crushed in water. He claims to have cured hundreds of patients. Many stay for months in his compound. Some are chained throughout their time there. In regions where both fortune and sickness are attributed to the spirit world, mental illness is considered a curse. Spiritual remedies are often sought, and chains regularly used as restraints.
And this story/situation is not unique to Sudan; other African countries share similar practices and some even bring their practices to the diaspora. The reality we face is that mental illness is still viewed by many Africans as a form of karma or demonic possession.
In a book titled ‘Condemned: Mental Health in African Countries in Crisis’, photographer Robin Hammond captures both the deplorable conditions that the mentally ill endure and the overwhelming challenge that mental health workers face with limited resources and inadequate or failed health care systems in which the mentally ill have the lowest priority.
Interviews with both the incarcerated mentally ill and those working to heal them – secular mental health workers and both Christian and Muslim faith healers – provide blunt evidence of the past trauma and current suffering of the subjects, and the challenges and frustration of those struggling with limited resources to address the needs of the vast numbers of those mentally ill. Shame and prejudice based on traditional and religious beliefs about mental illness add cultural obstacles to the effective treatment in many regions of Africa.
Hammond documented his visits to Uganda, Somalia, the Democratic Republic of Congo, Dadaab refugee camp in Kenya, Port Harcourt, Nigeria, Sierra Leone and Liberia and found that most people with mental illnesses are sent to prisons and, in almost every country he visited, the photographer saw people chained to the floor. ‘That’s why the project is called Condemned, because, for a lot of these people, in these societies, that is what they are.’
As if their mental challenges weren’t enough, they are physically chained and restrained either in private rooms or out in public. The photos I saw in Hammond’s book were extremely painful to look at but it fuels me to put a magnifying glass on an issue that plagues my beloved Africa, so we can work together to change it and help break this chain of pain, shame and suffering.
References:
Terhas Berhane-Rwakaara is an Eritrean-Ethiopian, born and raised in Sudan. Now based in the US, she is currently a full-time management employee with two children. With high family and community values, faith and family are her priorities. She is also a huge advocate of civic duty and volunteerism, and is passionate about mentoring women. Diagnosed with ADHD as an adult, she feels the responsibility to do more to raise awareness and remove the stigma associated with mental illness in her culture.
Stay tuned for more articles from Terhas, where she shares her personal journey dealing with ADHD, and stories of women and expert interviews on mental health.
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