For Nigeria’s Mentally Ill, the Cure Can Be Worse Than the Disease 

Stories from Roads & Kingdoms
Nov. 29 2013 1:41 PM

Medicine Men

In Nigeria, the mentally ill have little more than faith on their side.

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For his part, Mojeed seems like an unlikely candidate for compromise. Although the head surgeries he performs are technically illegal, he believes in the procedure and views Western medicine as ineffective against psychosis. There may be physical causes for anxiety and depression, but psychosis, Mojeed explained using a Quranic term for spirits, is caused by “djinns taking over a person’s mind.”

Where psychiatrists see cycles of remission and relapse, traditional healers see the failure of Western medicine. “The treatment at UCH doesn’t reach the brain,” Mojeed said, referring to the University College Hospital of Ibadan. “It only manages, never heals.” His consultation room is decorated with local news clippings heralding outright cures against the odds: “Madwoman completely healed after 21 years,” one reads. Since 1997, Mojeed has run an association called Atorise—in Yoruba, the name means “repairer of heads”—organizing the ranks of Ibadan’s traditional mental health practitioners with an eye toward proving their legitimacy to the Nigerian medical establishment. Last year, Mojeed suggested that the university hospital should refer patients to him they are unable to cure, a proposition he says they rejected out of hand.

As horrifying as Mojeed’s methods may sound, he is considered more progressive than most. Wole Adejayan, a researcher at UCH, says Mojeed stands out among dozens of traditional healers for his efforts to temper the methods used by his colleagues. Through Atorise, Adejayan says Mojeed has argued against beating or withholding food from patients. His facility is one of only a handful that requires the presence of a caretaker alongside the patient for the duration of the treatment.

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Indeed, a few decades ago, techniques performed in U.S. asylums were every bit as cruel. A 1946 article in Life describes life-threatening beatings routinely visited on inmates of psychiatric hospitals by their attendants, as well as long periods of confinement in dank cells where patients slept on the ground and wore thick leather handcuffs. Three years later, in 1949, a Portuguese neurologist won the Nobel Prize for developing the lobotomy—a procedure no doctor today would recommend. Insulin shock therapy, designed to induce a comalike state in schizophrenic patients, was common in the United States through the 1950s.

Most Nigerians have little choice but to visit a spiritual healer for psychiatric care.
Most Nigerians have little choice but to visit a spiritual healer for psychiatric care.

Photo by Rowan Moore Gerety

Mojeed remains leery of participating in collaborative treatment for psychosis. His concern is actually based on medicine; he’s worried about the possibility of negative interactions between pharmaceutical drugs and the sedative, plant-based concoctions he gives his patients. Unless, that is, it could be done sequentially by making referrals when one form of treatment proves ineffective. In that case, he said, “If the government will provide shelter and food for patients, members of Atorise will provide our services for free.”

Other faith healers are similarly open-minded. In Ibadan, I spoke to a pharmacist who says he periodically sells Largactil—the anti-psychotic chlorpromazine—to robe-wearing pastors who administer the drugs dissolved as a cocktail in a glass of holy water.

One problem, as with so much in Nigeria, is money. Psychiatric treatment is expensive, and even the government can’t always pay its hospital bills. In July, when Ogun State’s funds were tight, officials stopped sending homeless patients with severe mental illness to a more expensive government-run psychiatric hospital, instead opting for Ademola Mental Hospital. Ademola is a traditional healing center that practices diagnosis by incantation, reciting verses to invoke the presence of gods responsible for mental illness. When I visited in the middle of October, two patients were chained to pillars on the front porch.

It’s hard not to see psychiatric hospitals and traditional healers remaining in direct competition. For now, though, it’s the psychiatrists whose livelihood seems most uncertain. Last month, residents in Nigeria’s public hospitals went on strike for more than three weeks; some doctors hadn’t been paid in more than four months. Most patients were left to look elsewhere for treatment.

This story was made possible by a grant from the International Reporting Project (IRP).

Rowan Moore Gerety is a writer and radio producer based in California.

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