I read with no consternation a story, “Witchcraft scare, internal fights hits Uganda’s embassies abroad,” in the Sunday Monitor of January 10. Whereas such wrangles may be shocking to some from a spectator standpoint, given the high status perception accorded to embassy workers abroad, the reality is that regardless of their social, economic, and educational backgrounds, the embassy workers are human beings just like any one of us.
Two major reasons, in my view, explain why this “witchcraft scare” does not surprise me. The first is the manner in which we resolve problems when we find ourselves barricaded by conflicts in a corner where it appears as if there are no escape routes. We are then gripped by a state of panic and anxiety that triggers impulsive decision-making, often leading to jumping on the easiest and quickest but not always the best solution we think will solve the problem. Here, witchcraft comes as handy as an antidote to our problems.
Secondly, mental healthcare is perhaps one of the worst managed and funded healthcare sectors in Uganda with only one psychiatric hospital, the 900-bed Butabika National Mental Hospital outside Kampala, built in 1955, now serving a population of 41 million people with only six psychiatrists (a ration of 1 psychiatrist to 6.8 million Ugandans) as of December, 2014.
The lukewarm attention that healthcare in general and psychiatric care in particular gets in Uganda means vulnerable citizens will find alternatives to mitigate their health problems. The culture of Ugandans finding solace in witchcraft has been exacerbated by incidents of unexplained phenomena, traumas or hardships in life that some people tend to come to terms with through the prism of witchcraft. And the witch-doctors are so unscrupulous in their game that they take advantage of peoples’ vulnerability for financial gains. There is no scientific justification for the existence of witchcraft or the supernatural powers that witch-doctors claim to possess.
As a counsellor to psychiatric and substance abuse patients, it is reasonable to argue that psychiatric problems affect every race, gender, social and economic class like any other illness. Since mental health illness is caused by only two ways - through environmental and genetic factors – a genetic predisposition of mental health illness may miss a generation before it manifests itself in the next generation.
Because of chronic lack of mental health education and care in Uganda, including the symptoms presented by psychiatric patients, it is very common to find relatives and friends of a genuinely suffering psychiatric patient making their own diagnoses as bewitching.
For instance, one of the commonly misdiagnosed psychiatric illnesses is schizophrenia, with symptoms of delusions of false beliefs not based in reality; hallucinations-seeing or hearing things that do not exist; and disorganised thinking and speech where answers to questions are partially or completely unrelated and putting together meaningless words in speech.
Numerous studies done on schizophrenia, including at Mayo Clinic, in the United States, show that its symptoms begin to show in early 20s and late 20s for men and women, respectively. These studies showed that it’s uncommon for children to be diagnosed with schizophrenia and it’s very rare in adults aged over 45. So for some Ugandans, when a previously healthy family member suddenly begins to exhibit these symptoms, witchcraft becomes the perfect etiology causing the illness.
Another apparent dichotomy in Uganda’s mental healthcare is the dearth of attention given to substance-induced organic mental disorders. Some of the psychiatric illnesses such as schizophrenia, psychosis, anxiety, and depression that often breed suicide ideations are also triggered by alcohol and drug abuse (cocaine, heroin, lysergic acid diethylamide or LSD, methamphetamine and marijuana, among others). Similarly, when a mental illness is caused by alcohol or drug abuse, it’s not uncommon for some patients and their relatives to jump on the witchcraft blame-game, a common diversionary mechanism that hinders timely and appropriate psychiatric treatment because we are in state of denial.
Accordingly, the “witchcraft scare” at Uganda’s embassies abroad is nothing but microcosm of the healthcare system in Uganda, where psychiatric care is not on priority list for funding, and where unexplained or poorly diagnosed illnesses give fodder to witchcraft/witch-doctors. One only wonders out of the 41 million Ugandans, how many of those who need psychiatric healthcare are suffering silently in the shadows!
Mr Asedri is a PhD student of healthcare administration and mental health and substance abuse counsellor, USA. firstname.lastname@example.org