In Nigeria, the psychiatric hospital in the northern town of Kano covers all forms of mental illness. It also accommodates patients from other northern Nigerian towns and neighboring countries like: - the Republic of Niger and Chad. Isiyaku Ahmed in Kano visited the psychiatric hospital and has this report.
Dawanau psychiatric hospital is at the very peak of its activities this morning.
Nurses and other health officers are seen attending to patients who came from far and near.
The brown brick building is located in the suburb of Dawanau in Dawakin Tofa local government area some 10 kilometers north east of the state capital city of Kano state. Inside the premises is the out-patient department which has four nurse consulting rooms. Behind it is a door leading to doctors offices and four large buildings where people are locked in.
The chief medical officer,Dr. Auwal Abubakar is examining patients.
He explains that the Kano state mental health system handles all forms of mental illnesses.
"Commonly,"he said,"we treat major psychiatric disorders such as depression, schizophrenia and drug abuse. We see a lot of cases of drug abuse and then lastly but not the least we see a lot of epileptic patients. In drug cases you see less of female cases when compared with others, but both in depression and schizophrenia you see a lot of both sexes coming for treatment."
At the hospital most patients who come with simple cases of depression are treated and given a fresh appointment to see a doctor after four or eight weeks on prescribed dosages of drugs, but patients with serious mental problems are admitted for long-term care.
Hajia Hannatu Saleh lives in Kano. This morning she came over to the hospital with her neighbor who has been behaving strangely in the past five years.
Hannatu Seleh say her neighbor often talks to herself and sometimes sees things that are not there, so she believes she is mentally ill and needs medical attention.
He said, "I brought a patient to see the doctor. She is my neighbor and basically it’s madness I feel, because its been going on. For over 5 years, she’s been at home with her son but what makes me to do this, I realize they don’t have anybody and I have to bring her here."
Hannatu’s neighbor will likely be seen and evaluated by the doctor-in-charge, Auwal Abubakar. He explains the standard course of treatment for patients.
He said, "The simplest way is we use drugs, we use anti-psychotic drugs and if they have any other social problems, we try as much as possible as we can to address their social problems, and then we also use electro-combustive therapy. We have both in and out-patients coming to the hospital, the only difference is that most of the cases that require admission as in-patients, they are cases that are critically bad as a result we have more patients that are attending our out-patient department than those that are on admission."
The hospital can meet the mental health needs of between 100 to 400 patients on a daily basis, the majority of whom are young people between the ages of 15 to 35 years.
Abubakar says Kano state government is assisting the hospital to meet with the public demand for mental psychological care.
"Presently," he said, "we have over 100 patients on admission excluding out-patients. On an out-patient basis, (we) see nothing less than 300 to 400 patients. The Kano state government is trying its best in making sure that the man-power necessary for this is provided. We have doctors who take care of these people and equally have nurses who are assisting in one way or the other and we have other social workers who are also contributing their own parts. Once in a while we have some cases of death, but very rare."
Among the facilities in the hospital are four big asylums where patients with serious mental illnesses are confined -- but are often under medicated. Other facilities include a pharmacy, two doctors consulting rooms, a laundry hall, a kitchen, and staff quarters.
But Abubakar, says the mental health system is un-funded.
This hospital requires more facilities, more funding, more man-power, with this limited problems we are trying our best and we are achieving the best (we can). That is why you see a lot of patients are coming not only from Nigeria but even from across the neighbouring African countries. We are trying our best in terms of improving the welfare and the mental health services of the people. The government of Kano state has recently renovated this hospital and put some facilities and also made very serious effort to make sure the hospital is receiving a lot of attention.
Critics say almost every government agency needs some sort of improvement. Abubakar says in the case of the psychiatric hospital in Dawanau, it is training for hospital personnel that’s needed.
Right now, the hospital does not “offer talk-therapy” for it’s clients in terms of mental health service delivery.
"We don’t have a clinical psychologist actually," he said. "We have a deficiency of that man-power. Psycho-therapy is a very rare thing even in the whole country but I can say we only offer some less complex form of psychological therapy. Basically we need more facilities; again we need more training also need a lot of funding. The facility is going to be used for the patients and the building is equally going to be used for the patients at the same time the man-power, the staff will be occupying those buildings, so we need both."
At the psychiatric hospital in Kano, the state government provides support—called a drug revolving fund-- for patients who cannot afford to buy drugs. In this system the patients gets drugs supplied by the government at a subsidized price.
Also, the hospital has what it calls a mental health workers association which doubles as an NGO catering to poor peasants.
Not all mentally ill patients are treated. A number may suffer from depression and other illnesses in silence. Traditionally, some believe that mental illness is a form of spiritual possession, and in such cases; they are taken to the imam or a spiritual leader for deliverance.