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Mental health disorders on the rise
IRIN News
September 11, 2007

http://www.irinnews.org/report.aspx?ReportID=74224

James Kurai, 40, resigned from his clerical job in the capital, Harare, three years ago because inflation was eroding his income and he needed to boost his earnings to support his family.

Initially the gamble worked. "When I left my job I became an informal trader, selling used engine oil along highways. In the early stages I earned enough to ensure that my family had a decent living, but business went sour," Kurai told IRIN.

"I began to struggle to send the children to school, food was hard to come buy and I constantly quarrelled with my wife, who at one time ran away from me. That was when I developed frequent splitting headaches, suffered from constant fatigue and had a heart problem, probably because I worried too much." He consulted several doctors but his headaches recurred and he began to suffer memory loss; then he was diagnosed with a mental disorder.

Kurai has been receiving therapy and admitted, "even though you would not say I am insane, I know for a fact that my mind is not in its best shape. I guess there are so many other people out there who are mentally ill but do not know it, mostly because they don't seek help."

Zimbabwe's rapid descent into recession, which has seen official inflation rates climb to over 7,600 percent - the world's highest - and unemployment levels of 80 percent, has seen a steep rise in mental health disorders.

One in three suffer mental health problems

Dr Dickson Chibanda, a psychiatrist, formerly employed by Zimbabwe's health ministry, told participants at a recent workshop that 40 percent of the country's about 12 million people, or more than a third of the population, were suffering from poor mental health and he was concerned by the government's lack of national mental health assessment programmes.

He attributed the high level of psychomatic ailments to the country's seven-year long economic crisis and Operation Murambatsvina (Clear Out Trash), a slum clearance drive by the ruling ZANU-PF government in the winter of 2005 in which informal homes and markets were demolished, leaving more than 700,000 people homeless or without a livelihood.

Chibanda raised his concerns at a meeting organised by the Community Working Group on Health, a network of community-based organisations aiming to enhance grassroots participation in health.

A study published in November 2005, The Traumatic Consequences of Operation Murambatsvina, produced by ActionAid International, an international anti-poverty agency, in conjunction with the Counselling Services Unit (CSU) of the Zimbabwe Peace Project (ZPP) and the Combined Harare Residents Association, said Operation Murambatsvina had resulted in widespread trauma among its victims.

"There can be little doubt that Operation Murambatsvina has had devastating effects on the mental health of those affected. Combined with the effects of the destruction of their homes and their livelihoods, it is even more improbable that these people will heal unaided, and there is a pressing need to develop effective psychological assistance for this population," the report's researchers said.

Evil spirits or the economy?

Gordon Chavunduka, president of the Zimbabwe National Traditional Healers Association (ZINATHA), told IRIN there was an upsurge of people consulting with his members about mental health disorders.

"Our records show that traditional medicine practitioners are being visited every day by people who display clear signs of mental disorders; there is a definite rise in people affected.

"While there is a general belief that mental problems are caused by evil spirits, most of our patients, the majority of whom come from poor backgrounds, say they have severe stress and depression owing to problems caused by economic hardships," Chavunduka said.

He said a "significant number" of the patients were victims of family breakdowns as spouses left to seek employment in other countries or lived with constant quarrels in the home due to poor incomes and the inability to adequately fend for themselves and their dependants.

"Our practitioners manage to help the patients but, unfortunately, they keep coming back after experiencing new problems because of the continuing economic hardships," Chavunduka added.

Innocent Makwiramiti, an independent economist and past executive officer of the Zimbabwe National Chamber of Commerce, told IRIN that the high levels of mental problems were also a consequence of people engaging in activities that previously they would not have considered.

Job changes increasing stress

"A lot of Zimbabweans are now engaging in activities that are stressful and inevitably result in mental disorders. Because of the economic crisis, people are turning to illegal activities, such as selling foreign currency, gold panning and unauthorised vending. That means, daily, they live with the anxiety of being caught by the police.

"In the case of gold panners, besides the constant fear of being arrested, most of them live under subhuman conditions, away from home and their families. Panning is a strenuous job and, in most cases, the panners end up drinking heavily in the name of stress relief, but this worsens their condition," Makwiramiti said.

The rising level of illegal mining has mirrored downswings in the country's economy. In the early 1990s, there was a spike in illegal panning activities after the government introduced its Economic Structural Adjustment Programme, which led to higher levels of unemployment.

In 2000 President Robert Mugabe's government adopted its fast-track land-reform programme, which saw white-owned farmland redistributed to landless black Zimbabweans, and heralded the onset of the country's recession. This was compounded by drought, the government's failure to provide agricultural inputs to new farmers, and critical shortages of food, fuel and foreign currency.

Thousands of people have resorted to illegal mining activities as a primary source of income and, apart from risking arrest, often prospect in disused mine shafts, which has led to a number of deaths.

A report published by the University of Zimbabwe School of Medicine in 2001, Depression in Developing Countries: Lessons from Zimbabwe, said depression, a form of mental illness, was common in an environment of "absolute poverty" and poor public health services.

Researchers noted that "among adults, a quarter of people attending primary care, and a third attending traditional healers, had depression", and that women were more affected than men.

Moreover, "Economic stressors, such as having experienced hunger in the past month, were associated with the onset of new episodes of depression and the persistence of existing episodes."

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