The closure of religious places, schools, ‘non–essential businesses’, entertainment places; banning of public transport, the shelter-in-place and social distancing measures to combat the coronavirus pandemic have greatly disrupted our ways of life.
Perennial disasters such as floods have not spared us either. People are battling psychological distress due to unemployment, job losses, poverty, hunger, pending bills, loans and for some, the fear of contracting Covid-19.
Patients and ‘suspects’ in quarantine regret the isolation from friends and family, before they return to stigmatizing publics.
Locking families in homes for long hours has given way to the opportunistic ‘infection’ that is domestic abuse, with women and children as prime victims. And if normalcy does not return soon, a mental illness offshoot will be eminent.
Ruth Ndengire, an administrator at Makerere University, loves being indoors, but she had never taken her 30-day annual leave at once. She usually takes 10 days at a time.
Since President Museveni ordered schools and universities to close by March 20, to contain Covid-19, Ndengire has been grounded at home for nearly two months now, something she says has taken toll on her.
“As I walked back home that evening, it hit me that I would spend much time at home,” she recalls. On the phone, friends were telling her similar stories. “It was so frightening, I didn’t know how to handle it,” she says.
Stories on TV were not different either. “Some countries registered 1000 deaths in a day. I got a feeling that if I ever move out, I would be a Covid-19 statistic,” she says.
Ndengire, however, was dealing with other anxiety issues. She once spent four years without visiting her family in Rukungiri because she was scared of travelling.
“Now with the lockdown, all these other fears resurfaced. I felt I needed to distance myself from everyone because I don’t know who was safe or who wasn’t,” she says.
Living near Mulago Hospital and the rowdy Kalerwe Market worsened her fears. For more than a month, Ndengire battled anxieties worsened by a repetitive lifestyle in the confines of her lonely home.
Her routine was: “Wake up, make breakfast, rest, make lunch, watch TV, scan through social media platforms or read motivational books. Sleep again,” she needed help.
Despite all this, Ndengire was at least assured of a salary and perhaps returning to her job. But for some, loss of incomes could have triggeredmental health challenges that turnout to deadly.
Yasin Mbago, 46-year-old, is serving a jail sentence for charges of murdering his wife and two sons. Residents of Banda, Nakawa, a Kampala surburb, say Mbago was an abusive husband. When boda-bodas were limited to cargo deliveries, during the lockdown, his meagre income shrunk even further. Wrangles at home became wars as his wife, reportedly, ridiculed him for failing to provide for the family. He decided to strangle them to death.
Earlier this month, another man in Mubende killed his two teenage relatives, with a machete before reportedly setting himself ablaze. His beastly anger, police suspects, begun with his wife leaving home and relocating to town market to abide by the president’s directive.
In a recent report on regional training facility on prevention of sexual and gender-based violence, Nathan Byamukama, the regional director of the International Conference on Great Lakes Region (ICGLR), cited a case of a woman under threat from her in-law in Buhweju, South Western Uganda.
When she returned from Mbarara on April 8, where she had gone to attend to her relative in labour, she found her brother-in-law traumatising her three children and the maid at night.
When she intervened, her in-law threatened to kill her.
“I will kill you and bury you myself without anybody knowing.” Threats became a habit. When the woman sought police intervention, her in-law went in hiding. The woman and her children have been unsafe, but her husband, who is trapped in Kampala by the lockdown, cannot do much and this is stressing the family.
As of April 2020, Police had recorded at least 328 cases of domestic violence, including five deaths, and 102 cases of child neglect, abuse or abandonment across the country in just 14 days of the lockdown. Yet this was before the aforementioned atrocities occurred.
Although Uganda has not registered any Covid-19 death, experts have observed that the rising Covid-related deaths could defeat the purpose of locking ourselves home and surrendering our freedoms, fearing the coronavirus, yet our families can pose more danger than the virus itself.
The suicide scare
After Mustafa Lule, 16, jumped off Mabiriizi Complex in 2016, he told this reporter in an interview that he had suffered enough. He cited mistreatment by his step mother, a battle with a mysterious illness to near death and derogation as street child. Before his attempted suicide, he had also lost a job as a broker in Kiyembe, was hungry and above all, did not have anyone to share his misery with.
“May be I was born to suffer. Let me end this once and for all,” he thought. Although his mission did not see the light of day, as he only fractured his left hand, Lule still attributes his attempt at suicide to his suffering. But experts say suffering itself rarely triggers suicide. According to a psychiatrist at Gulu University, suffering can lead to mental health issues such as depression, which is a trigger for 90 per cent of the suicides.
The World Health Organisation report in September 2019, shows one person dies every 40 seconds by suicide, meaning 800,000 people every year, around the world. With 18.7 per 100,000 suicidal deaths, Uganda holds the 17th position in the world.
The report further states that 79 per cent of global cases happen in low-and middle-income countries.Depression and alcohol-related disorders are an obvious cause for suicides but the report shows, many suicides happen impulsively in moments of crisis.
Further risk factors in the report include experience of loss, loneliness, discrimination, a relationship break-up, financial problems, chronic pain and illness, violence, abuse, and conflict or other humanitarian emergencies.
After a month, Ndengire broke her routine after seeking NTV’s attention. Her story attracted expert advice from therapists and she feels a change. She says more counselling sessions from mental health professionals are neeeded. “Counsellors are silent when people need their services most,” says Ndengire.
“People are desperate. Many have used up their savings, others didn’t have any. Others have lost relatives to suicide. Marriages are also crumbling because spouses are easily irritable, paranoid, and less accommodative,” says Mastula Namugenyi, a counselling psychologist and a lecturer at Kyambogo University.
She says, naturally, human beings either fight or fly during a crisis. WhatsApp, Facebook, Twitter, Instagram are our source of humour, especially in these gloomy times. But she warns against consuming every news about Covid-19. Namugenyi advises people to use this time to finish pending assignments. “I do counselling on the phone, I have finished setting exams and drafting marking guides,” she says.
Deal with real issues
Byamukama of ICGLR, urges couples to fight the pandemic, not each other. “If the big challenge is dwindling financial resources, discuss how best you can mobilise more and adjust the budget together. The family will understand.” If it’s negative masculinity, where the man wants to show his authority over women and children, embrace teamwork.
Disagreements, especially when people spend more hours in the same space, are inevitable. But Byamukama warns that quarrels should never degenerate into violence.
Senior economic consultant Dr Fred Muhumuza says anxieties over the current financial hardships are inevitable and advises companies to offer counselling services to their employees. “Everyone is stressed. Even the chief executive officers, who make decisions of laying off staff or reducing their salaries need therapy,” Muhumuza says. “A hotline for employees to talk to a counsellor in confidentiallity is important in addressing these anxieties.” Equally important, he adds, are online financial literacy lessons to enable people to manage their resources better.
“I know of bachelors who earn Shs4m but are they are also stressed in this crisis. What about a family man, who earns below a Shs1m?”
Anthony Odur, the Team Leader, Health Equity and Policy Initiative in an opinion article in The Independent magazine of April 27, expressed concern over a potential increase in mental health cases due to Covid-related anxieties.
He hence suggested that government should integrate mental health treatment interventions into the Covid-19 control mechanisms. This means swiftly considering allocation of more funds to facilitate psychological interventions to the current mental health challenges.
He also urged the Ministry of Health in partnership with media houses and other stakeholders to tailor positive messages to mitigate panic, restlessness, loneliness, helplessness, depression, pessimism, anger, nervousness and stress.
Angela Atuhairwe of Uganda Counselling Association, says the first step in addressing a problem is accepting it and seek medical attention, instead of living in denial.
She says counsellors are providing online services via the phone, zoom calls, and clients with urgent issues such as abusive spouses have found them useful.