Felije didn’t 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 copse. I turned around to catch another glance of 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 doesn’t 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 biggest 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 just 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 on 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. For someone that watch too much television, it’s not a half-eaten cheese burger and a can of coke tossed out in a litter bin. It basically rotten ‘matter’ that he finds on the bare ground or in the few waste disposal areas at markets. How can fellow Gambians let their own brothers and sister live an inhuman life simply by having a 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! There is a combination of factors that have led to many of 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 in July 6, 2015, thereby committing to upholding the rights of all people including people with mental health illnesses. The Gambia’s mental health system is still being governed by an archaic piece of legislation, the “Suspected Lunatic Act” of 1942, is outdated and fails to protect the human rights of people with mental disorders. That legislation was drafted to ‘safe guard’ members of the public from perceived ’dangerous’ patients through isolating them from the public and the deprivation of their human rights. In 2004 the Gambia government in collaboration with WHO embarked upon the development of Mental Health policy and strategic plan for the Gambia.
Mamudu: In most countries with sound legislature and economy, people with mental illness are provided for by the state either through supported living accommodation or through 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 members of society. Unfortunately, in the Gambia, that’s not the case. People with mental illnesses are at the bottom of whatever social services is available. Unlike people with physical disabilities, individuals with mental illnesses also have very little in the way of advocacy. Discussion of mental illness is almost taboo. Most people in society think that people with mental illness are less human than themselves, therefore denying them basic 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 is 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 has been alleging to unlawfully ‘detain’ patients for prolonged periods and usually on strong 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 in respect of the justice system is simply overwhelming.
There is need to carry out education, advocacy and sensitization programmes 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 needing 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.
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 couple with all 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.