Tushemereirwe on battling mental disorder and suicide attempts

A dog barks when a visitor enters the enclosed premises of the family residence of Sarah Tushemereirwe on a Tuesday morning. The home is in Namugongo, a suburb located in the outskirts of Kampala.
An unidentified female occupant of the house opens the gate and leads me inside the compound. The dog which is tied to a pole barks even lounder.
“Don’t worry, it [the dog] won’t bite you,” the woman tells me.
She leads me to a neatly organised living room where I find Tushemereirwe seated in a wheelchair. As she signals to me for a hug, I notice numerous scars on her arms. They look like healed cuts obtained from sharp instruments.
“I have similar marks on my tummy,” she says as she slightly opens the lower part of her blouse.
She adds that her left leg also has a few related scars.

Why she cut herself?
Tushemereirwe, 31, started cutting herself at the age of 18 years. The first time, she used a sharp stone to hurt herself.
“I used to hear voices in my head whispering that I should cut myself that in the end, I would feel much better,” she says.
She heeded to the voices and cut herself, an addictive habit that continued until her mid-20s.

“Sometimes I did it to release emotions such as anger, and it made me feel alive.”
Tushmereirwe is soft spoken. Her words are calculated.
“I accompanied my actions at times with loud screams,” she says.
When she was not using a sharp stone, she would use any other piercing instrument including shavers or any other broken item such as a bottle or cup.

For this reason, Tushemereirwe’s mother had to always ensure there was someone watching over her daughter.
“Sometimes it was a maid or any other family member designated with such responsibility. But I would always sneak out from them to any hidden place and cut myself,” she says.

Every time she was found after cutting herself, Tushemeirwe would burst into tears and uncontrollably apologise for her actions. She would then be rushed to receive urgent medical attention. There were occasions she would be taken to Kololo Hospital, Mulago hospital (the psychiatric ward) or International Hospital Kampala (IHK).
Tushemereirwe’s mother, Monday Edigold, was very understanding and always ensured to nourish her daughter with care and love.

“She never scolded me for my actions. Never. Instead, she always hugged me and said everything was going to be alright,” she says with teary eyes, adding, “She would also assure me at all times that God will heal me.”
Her mother single-handedly raised her and four other siblings.

Battling other health issues
Besides cutting herself, she was also battling mental illness which was diagnosed when she was 12 years old. At the same age, she also underwent an appendectomy, a surgical procedure used to treat appendicitis, a condition in which the appendix becomes inflamed and causes discomfort and pain.

Later, at the age of 14, she started taking prescribed medication to handle her depression and other related psychotic disorders including hallucinations (an experience involving the apparent perception of something not present).
She was not like many other children. “I was always scared and feared going out of the house to play with my peers. I kept to myself,” she says.

Similarly, there were tendencies when Tushemereirwe told people (who were imaginary) to stop following her and yet in reality, these people were never there.
Despite her health issues, she strived hard at receiving an education. She completed Primary Seven in 1999 at Nakasero Primary School and Senior Four in 2003 at Aga Khan High School, Kampala.

Dropping out of school
During first term of Senior Six at Aga Khan High School, Tushemereirwe dropped out of school after her health deteriorated.
“I faced many challenges at school because of personality changes that made it difficult for me to interact with other students,”she says.
“One moment I was happy, caring and calm before suddenly becoming angry and irritable. Sometimes, I burst into tears, scream and shout or just sit quietly for hours and not say a word to anyone,” she adds.

Most of the doctors she visited kept giving her similar diagnoses including bipolar disorder, depression and split personality disorder which tend to exhibit similar signs and symptoms.
“For these reasons, they advised I take some time away from school to get treatment and fully recover,” she says.
Tushemereirwe was left with no choice but to drop out of school. She went back to study at the age of 21 at Vienna College, Namugongo. While here, she repeated Senior Five in 2008 and sat her Senior Six in 2009.
Rosebel Sherina Byaruhanga, a friend and former classmate, says when Tushemereirwe was unwell, she would complain of headache and stomachache.

“Her energy levels would also go low,” Byaruhanga says, adding, “Since I was aware of her condition, I tried as much as possible to support her through motivation and ensuring she takes her medication.”

Suicidal tendencies
In 2010, she enrolled at Mbarara University of Science and Technology to study a Bachelor’s degree in Medicine. However, she suffered a relapse which was worsened by her making several attempts to take her own life.
“I never used public means of transport but often moved in the cars of different family members and friends. So, as the driver was behind the wheel and I was probably in the back seat, I would open the door and throw myself out. I was always lucky to escape with minor injuries,” Tushemereirwe says.

As a precautionary measure, respective drivers always had to ensure that she either takes the front seat or there was another person in the vehicle to keep watch of Tushemereirwe.
When she was not throwing herself out of cars, Tushemereirwe was overdosing on her psychiatric prescriptions.
“I would take numerous tablets at once and black out. A few days later, I would wake up in hospital,” she recounts.
Upon realising that she was taking more medicine than required, her close family members kept the prescriptions out of her reach. They only gave her the required quantity at the right time.

“I found it a little surprising though over the years that as I continued taking psychiatric medication, I was gaining a lot of weight. Deep down, I thought it was from the numerous prescription,” she says. This was however, not verified by any doctor she visited.

The coma that crippled her motion
In September 2013, things turned gloomy after Tushemereirwe fell into a coma. Her kidneys had started shutting down as a result of numerous medications. Although she was rushed to Nakasero Hospital, she had been receiving dialysis treatment from Case Hospital, Buganda Road-Kampala. When the kidneys fail, dialysis helps removes toxins from blood through a machine.
“I came out of the coma after one month but could not talk, walk or move my body. My family members had to start looking after me like a newborn baby from bathing to feeding me,” she says.

Seeking further treatment
In 2014, she joined her mother in Rwanda who was then the managing director, Crane Bank, Rwanda.
“Since I could hardly move my body and needed a lot of assistance, I went with Sharon Mbabazi, a caretaker and Evelyn Nakiganda, a nurse. They were hired by mummy during an earlier visit to Uganda,” she says.

While in Rwanda, Dr Lawrence Rusungu from La Croix du Sud Hospital recommended Tushemereirwe for further treatment in India.
In the company of her mother and Nakiganda, she travelled to India in 2015 and was first admitted at Kovai Medical Centre and Hospital (KMCH) in the Southern Indian City of Coimbatore for five months.

“At this facility, I underwent surgery to re-align my bones since they were stiff,” she says.
After the operation, she received physiotherapy which mostly involved stretching her hands and legs as a way of improving their flexibility and movement,” the smiling 31-yer-old recalls.
“But she [mummy] kept coming back and forth to see me in India as Nakiganda permanently remained looking after me. I was being attended to by specialists from the hospital,” she says.

Tushemereirwe was later referred to PSG hospital, India where she continued receiving physiotherapy as well as speech therapy, where she was being trained how to speak again.
“I spent four months there before returning to Rwanda, a healthier person,” she says.
She could now at least talk and move her hands. She could also walk although with difficulty.

Life today
Tushemereirwe returned home [Uganda] from Rwanda almost four weeks ago. Her mother stayed behind to work.
“I am now much better and have been off psychiatric medicine for slightly more than a year,” she says, adding, “And, I have not had any relapses in my mental health during this time.” Tushemereirwe has a close relationship with God and she believes He is intervening in her situation.

“I pray a lot and read my bible. God must be listening to me and that is why I am getting better,” she says.
From time to time, she also listens to messages from motivational speakers including Joyce Meyer and Bill Johnson, both renowned televangelists. She continues to do exercises including sit-ups and stretching at home to improve her mobility.
On whether she still receives dialysis, she says, “When I stopped taking psychiatric medication, my kidneys improved and I was removed from the treatment.”

Tusherereirwe who learnt how to bake cakes while in Rwanda does it to make a living. “The cakes as well as cookies are made here at home. Sharon, a family member helps me make them,” she says.
Although she is not married at the moment, Tushemereirwe believes this will happen at God’s own perfect timing.
Tushemereirwe plans on publishing a book about her trials and tribulations of coping with mental health disorder. She is still looking for funding from different sponsors.

Her typical day
“On weekdays, I’m usually awake at about 4am to pray and read the bible. I proceed to make a to-do list of the activities to perform on that particular day while either taking a cup of hot water or a mixture of dates and figs that are boiled the previous night. I read somewhere that a combination of dates and figs reduces constipation and eases food digestion. I take a bath at about 8am before proceeding to have breakfast. I love eating oats. As the day goes by, I join Sharon in the kitchen to bake cakes. We work from home since I cannot walk properly yet, I do almost everything including mixing the ingredients while seated on my wheelchair.”

Sharon does most of the running around in the kitchen. When I’m not in the kitchen, I research about mental health on the internet or host visitors. On some other days, I will do my own exercises like stretching and sit-ups. I also try to stand and move around the house while supporting myself using walls or my walking aid. I have my lunch between 1pm to 2pm. I love groundnut sauce with sweet potatoes. After eating, I will tend to any other errands. For instance, I may read a book or continue baking cakes. My supper is at 6pm and I usually take something light such as blended watermelon and ginger. I say a prayer before retiring to bed at about 10pm.”

caretaker says…
“When I first saw Sarah, she could hardly do anything by herself. My responsibility included bathing, dressing and feeding her. Since she could hardly move, Sarah often wore adult pampers. We have a strong bond. I’m happy that Sarah is much better today. Unlike in the previous years, she can bathe and feed herself.” Sharon Mbabazi, caretaker

Statistics on mental health
The World Health Organisation (WHO) reported in 2012 that 35 per cent of Ugandans suffer from some form of mental disorder. Mental disorders include depression, bipolar disorder, schizophrenia and other psychoses, dementia, intellectual disabilities and developmental disorders including autism. People with mental illness require social support, care and health-care services. They need help in accessing educational programmes which fit their needs, and in finding employment and housing which enable them to live and be active in their local communities.