By Tereza Jeremiah Chuei
Many Health issues are being faced by human beings within this planet and South Sudan in particular is not an exception, Mental illness has been seen to be a very crucial issue that needs attention as the country continues to face it rough, since it lacks specified hospitals for mental health to keep patients with severe symptoms of psychiatric issues among other related illnesses.
According to the Undersecretary of the Ministry of Health, Victoria Anib, the Ministry lacks finances at the moment making it hard to build the hospital for mental healthcare, citing that they are still fighting to pay staff salaries currently.
However, as a result, doctors like Atong Ayuel Longar a Consultant Psychiatrist and Dr. Richard Wani among others are left vulnerable but opted to save patients by sending them to psychiatric wards within the prison after getting a proposal from the parent or guardians of the patients.
Doctor Richard and Dr. Atong are urging the public to opt for hospitals like Juba Teaching Hospital Psychiatric ward and Queens Hospital among other hospitals for mental treatment of their loved ones.
Both doctors argued that Mental illness is a condition that needs treatment.
Atong on the other hand mentioned that they are fighting to stop the problem of patients being sent to the prisons, interjecting that she hopes it will come to an end soon.
“Mental illness is a medical condition that needs treatment, and when people get treatment they always come back to their line, and they can function well, it’s a matter of knowing where to take your child, when they are not behaving themselves,” Atong said.
She also argued the reason why people should choose hospital and not witchcraft, placing up the delay and its result to the patients’ health, citing as to why she can’t judge witchcraft but rather that she believe in science.
“Sometimes we need to go to the ground to the communities telling and trying to treat people on the ground to give successful stories, convincing our people that mental illness “de ma-haja ta kujur,” loosely translated (not for witchcraft) people have to come to the hospital,” she advocated.
Atong stated that the Country still has a long way to go when it comes to scenarios of Church, Sheik, witchcraft among others, citing that “they bring the patient here (Hospital) and then take the patient there (Witchcraft) and stay for long then they bring the patient back, or they take the patient there and until its late and then they bring the patient here,” she lamented.
“I believe in chemistry because I have scientific explanation on what is going on, why people get mad and not behaving themselves, so it’s a matter of brain chemistry imbalance and that is always brought back to normality with medication, I can’t judge what the witchcrafts are doing, I don’t know, and I don’t know what base they are placing on, so I can’t judge it, but I believe in science,” she argued.
“Mental health is a big name, if he or she is a psychiatric patient and the family decides to take him or her to the prison, it’s not the decision of the family, the decision (has to) come from the doctor” Dr. Richard Wani advised.
Dr. Richard explained that if the patient is violent it might be a problem anywhere and the family fear maybe the patient can bring problem to the family, saying the family should decide to bring the patient to the doctor first after that he/she will be diagnosed, if its psychiatric problem or it’s just something that the family wants to take their guy to the prison for no reason.
He further explained what should be done after receiving the form from the attorney.
“Then I will send them to attorney general to give them form, after that I will make my diagnoses, talk to the patient, and see the patient, and their symptom of psychiatric illness. Then I will decide if I can send the patient to Juba Teaching Hospital psychiatric Unit” Dr. Richard said.
“Then the patient will be there for two to three days taking the medication” he continued.
He noted after administering medication for two to three days and the patient is still violent then we will decide to send (Patients) there to the psychiatric wards in Prison,” he said.
Results of Awareness within the communities
Dr. Atong Ayuel declared that awareness has reaped fruits “of recent there is an increase in clinical presentation, cases with mental health or mental problem have been noted in our private clinics”.
She also said the number of patients with mental illnesses is increasing, adding that they are currently facing issues.
“We cannot say that it reflects that there is an increase in the community, it could be because people are getting to know that mental illness could be treated,” she said.
Atong attributed the increase in number of mentally ill patients to their advocacy that it’s a medical condition that you need to come to the hospital, saying maybe the cases were there in the communities and with the increase awareness is the possibility of them being treated, so they are coming to the hospital, and this increases the rate of the presentation but yet more studies are needed.
She said generally they have verities of presentation in mental health, citing that people get aware when it comes to violent symptom, because that is one of the stages and they take it as a threat to the community.
She adds that, although they do have other presentations that state the patients need to be taken to the hospital, “They do have all the verities and all the diagnoses, in particular sub-….disorders which are the main problems currently, because there is increased use of illegal drugs.
“That actually makes families take the kids direct to the prison, they will be reported as cases of drug abuse and rather than a mental illness, and when they had used drug they tend to be violent, and they sometimes jeopardize the safety of the surrounding environment”.
The Psychiatrist underlined that some of the violent patients pose a risk to the community which let them end up in prison, explaining that they also end up in prison because, there is a huge gap between the clinical presentation currently and the number of human resources and the infrastructure that the country has.
“So this gap makes the families think that taking the patient to Juba Teaching Hospital and to the private hospital or private clinic, would make them not get the services that they want.” “Because, in the hospital we admit them (patients) and we ask the parents to stay with them, so sometimes they just need an area to dump their patient, to leave their child there, so they take them there to the prison, so we are trying to fight in trying to stop that one” she said.
Atong also revealed that they have joined hands with the prison service authorities, Minister of Interior and Judiciary systems, adding that they hope soon the chapter of taking the mental Patients to the Prison will come to an end.
“Mental illness is a condition, it’s a medical condition that needs treatment, and people get treatment and they always come back to their line, and they can function well, it’s a matter of knowing where to take your child, when they are not behaving themselves,” she declared.
Atong further said “Juba Teaching hospital is ready to treat all the degrees of mental illnesses, myself in Queens Clinic, and I am available on calls in most of the Hospitals, so it’s a matter of taking the patient there”.
“We do have a group of psychologists, who are experts in doing the psychotherapy, if the case doesn’t need treatment, they need psychotherapy, we are ready to provide it, again in Juba teaching Hospital,” she revealed.
Patient and Prison
Atong revealed that there are well trained nurses in the field of mental health within the prison.
She said the doctors with her included do visit the prison to check on the patients routinely, where the nurse is assigned to exercise her duties by picking the admitted group who are not mentally upright.
Atong added that there are two groups within the Hospital wards, first ones are the voluntarily registered that they are sick mentally, while the second group are the ones that got sick while in prison.
“So, those groups of patients will be taken care of and managed and treated as mental health cases within the prison, and those who doesn’t have charges we release them, with our lords to the judiciary systems, those who have charges that they have to stay, within the mental wards and the wards which they are supposed to stay within,”
However, Dr. Richard Wani said “We are all the time turning the issue of the patient as Psychiatric patient, because mental health is a big name.”
Richard narrated that if the patient has a psychiatric issue and the family decided to take him or her to the prison then it’s not the decision of the family, arguing that the decision should be heard first from the doctor.
“Firstly, if the patient is violent it might be a problem anywhere and the family fear maybe the patient can bring problem to the family, then the family decides to bring the patient to the doctor first after that I will diagnose, if its psychiatric problem or it’s just something that family wants to take their guy to the prison for no reason,” he said.
“Then I will send them to attorney general to give them form, after that I will make my diagnoses, talk to the patient, and see the patient, and the symptom of psychiatric illness,” he stated.
Furthering that, he will then decide to send the patient to the Juba Teaching Hospital to the psychiatric Unit, citing that they would likely stay for two to three days taking the medication there.
Mentioning that if the patient’s condition normalizes that’s great but if the patient continues to be violent then the second option will be serving them by sending him to the psychiatric wards in Prison.
Causes of Mental Health
“Some people get stressed, and life becomes very tough, some people cannot tolerate the life, this all the time keeps them thinking and thinking, over thinking leads to mental issues, and the number is increasing all the time, including depression,” Richard said.
He added that “demands of human beings, someone is not working and staying at home, and even working but there is no salary, and wants to get himself house whatever, this one he or she just fail to do one, two, three and four, that will let to stress, and this stress can let to mental issues, well some of the patients are coming to the hospital but about 60% are not coming,”
Richard further mentioned that Mental health is a community problem, injecting that if the doctors solve the problem then the patient will be cured ‘if we solve the problem you will be okay’ adding that getting isolated and feeling guilt are symptoms of depression.”
Are there plans from the Ministry to build the Hospitals?
Well, according to the Undersecretary of the Ministry of Health, Victoria Anib the Ministry lack finances at the moment which makes it hard to build the hospitals, citing that the Ministry is still fighting how to pay their staff salaries.
“Yes, we are aware that there is no mental health hospital and we are cognizant that it is important to have a hospital, however resources stand as a stumbling block in front of us,” she said.