Living in Constant Fear - Mental Health Camp in Waru IDP

By Zunzika Okpo

Fatima* is 19. She lives in Waru IDP community. Even though she is far from Borno State and far from the insurgency, she lives in constant fear. Any small noise scares her to the point that her heart starts to palpitate and often she feels as though she is about to pass out. She has been in the IDP camp for over 3 years now and she has small children. Sleep? She has not gotten a good night’s sleep in years. She may sleep for two or four hours at the most. Her children, innocent as they are, sleep through the night. However, she noted that sometimes she is happy when they awake at night because that gives her some comfort. 

Four years ago, Fati, as she was fondly called, lived in a big house with both her parents and her siblings. They were a happy family and did not want for anything. They had three score meals plus extra, clothes on their backs and a more than decent roof over their heads. They ate and prayed together. The girls helped their mother in the kitchen while the boys learned about the farming with their father. Their lives were relatively peaceful even though they were aware of the insurgency in their state. Every so often they would hear gunshots but little did they know that it would get to them. One day, their father did not return home. On that same day, Boko Haram insurgents raided their compound. Fati, her sisters and brothers made a run for it. Their mother was behind them, trying to beg for her life when she was beheaded right in front of her children. The children made a run for it, in different directions. The older ones tried to carry the smaller ones but some were shot in the process. While she was running, Fati jumped over someone she recognised. It was her father; dead and left there for people to see. With tears and fear, she kept on running. She ran until she found others who had been displaced and managed to escape from their villages. She did not see any of her brothers or sisters. 

For a long time she could hardly keep food down. She did not even want to eat. She had witnessed her mother die in front of her. She had seen her dead father. She had no idea where her other family members were. For all she knew, she was alone in the world. Often, she wondered why she had been spared, if she would be better off dead. 

Once she got to Abuja, she found someone who wanted to marry her. She jumped at the idea because she had no one else. Her husband left for Lagos after their third child was born. She feels alone again, save for her children. Her fear is always with her. When she came for the Mental Health Camp held on September 11th 2017, she felt a sense of progress for once. She wants to get better. She wants to forget what happened to her. She is not alone in this anymore. This was the sentiment expressed at the virgin Mental Health Camp held in Waru IDP community. Most of the occupants there have seen so much trauma that they are afraid to sleep. With the BasicNeeds team going in there, support groups will be formed, livelihoods will be given, psychotherapy will be given and they can begin to heal.

As always, do come back to the blog for more updates on our work with IDPs both in Abuja as well as in Borno State. 

The ‘Madman’ Is Back in the Building

By Zack Mcdermott (New York Times)

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What do you wear the first day back to work after a 90-day leave of absence because of a psychotic break? This is the question I found myself asking a little more than a year after I joined the Legal Aid Society of New York. The last time my colleagues had seen me, I’d been wearing a handlebar mustache better suited to a Hell’s Angel than a 26-year-old public defender. I’d also taken to wearing a Mohawk — tried a case like that even. We won, thank God.

At the happy hour following that trial, I stripped down to my underwear and did a titillating strip tease for a bunch of law students who were there as a part of a recruiting event for a white shoe law firm. It didn’t go over well but I didn’t care. I thought I nailed it.

For my first day back to work I dressed in a sober navy sweater and a pair of dark slacks. Normal haircut, neatly trimmed beard. I got there early to avoid the morning rush and the inevitable stares and whispers. I had been “away with some issues” — that was the official company line, but offices are gossip hotbeds, and I wondered how much of the real story had filtered through. Did they know that I’d marched through the city for 12 hours — manic, psychotic and convinced I was being videotaped by secret TV producers, the star of my own reality show? That the police had found me later that evening shirtless, barefoot and crying on a subway platform? That I’d been involuntarily committed to Bellevue, the notorious psych ward to which we at Legal Aid routinely sent our most mentally ill clients?

For most, an involuntary stay in a locked psychiatric ward becomes a closely guarded secret. But part of me wanted everyone to know. I wanted them to know that I had received a Bipolar I diagnosis — that the “madman” they’d been covering for was actually a very sick young man who did things he feels guilty about, but who also knows that he had no more control over the doing of those things than a cancer patient has over the state of his lymph nodes.

Because that’s the thing about mental illness — our brains betray us. Our symptoms are our behavior, and the disease makes us do humiliating and dangerous things.

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In the weeks leading up to my break, I knew something was up with me. I couldn’t sleep for more than a few hours each night, but seemed to have limitless reserves of energy. At times, I felt like electricity was shooting through my spine, that I was breathing in secrets of the universe.

I cried a lot, too. I’d listen to Bruce Springsteen sing “41 Shots” and weep in my room while I meditated on police brutality. These, I would learn, are all classic symptoms of bipolar disorder: the delusions of grandeur, the insomnia, the rapid cycling moods. And I was in my mid-20s — the textbook clinical age when bipolar disorder tends to present.

I wanted to tell my colleagues that the “madman” — the drunk, naked guy who ran through oncoming traffic and covered his wall in Sharpie — was gone. That he didn’t go easy, that he had to be killed with a drug regimen that had left me drooling and impotent, with my hair falling out by the fistful, rapidly packing on weight.

Now I had to clean up the mess he’d made. The “madman” had raided my checking account, and there was no overdraft protection for “Sorry, I had a manic episode and rang up $800 worth of novelty T-shirts at Urban Outfitters.” I’d lost friends, an apartment, maybe my job and reputation, too.

Mercifully, one person stuck by me through it all — my mom, nicknamed the Bird on account of the choppy, avian head movements she makes when her feathers are ruffled. She had been my tether in a hurricane.

During my leave of absence, I’d taken to calling the Bird in the middle of the night, every night, to hear her voice. I knew the toll it was taking on her. I could feel her heart breaking for me. She couldn’t tell me that everything was going to be O.K. because the truth was, she wasn’t sure. All she could do was make sure she kept answering the phone.

What I wanted to hear was, “This will never happen again.” I wanted to hear that I’d never again be restrained and injected with anti-psychotics. That I’d never have to smell that place again or eat that food. That I’d never again wonder if the orderlies would tackle the flailing patient before he really starts swinging. That I would never again fear the worst in a communal psych-ward shower. But no one, not even the Bird, could tell me that.

I buzzed my security card and entered the interior office. The halls of the Legal Aid Society felt nearly as claustrophobic as the psych ward. I wanted to believe that these people understood mental illness. They make their paltry living arguing on behalf of the poor and mentally ill, citing poverty and mental illness as an explanation for “bad” behavior every day in criminal court. But I was terrified of them.

I had to go talk to my supervisor. But just before I rounded the corner, my body made a U-turn back to the lobby and dove into the restroom. I fished my phone out of my pocket, scrolled to the Bs, and tapped Bird.

It was 8:30 a.m. in Kansas — she’d be busy setting up her students as they trickled into her class. She answered on the first ring; her phone had become an appendage since I moved back to New York.

“Gorilla report?” (The Bird nicknamed me Gorilla, because of my barrel chest and hirsute body.)

“Gorilla is at Legal Aid.”

“First day of school? Not good?”

“Not good.” I spilled it — sobbed, breathed, sobbed. “I shouldn’t be here. This is so ridiculous. I feel like such an idiot. Idiot! I can’t see these people again yet.”

“Steppers keep on stepping. You’re a …”

“Not a stepper! Not a stepper. No steps.”

“Three months ago you were in a locked psych ward. You’re at work now. You’re still an attorney. It’s not easy, what you’re doing.”

“I’m scared. Of everyone. And everything — all the time,” I told her. “The subway. Confined spaces. Walking through the halls, waiting for everyone to stare at me, and think, The Madman is back in the building.”

“You need Mama Gorilla to open up five cans of whoop ass on somebody?”

I laughed. I knew she’d love to.

“Boy, we been through the fire with gasoline soaked drawers on. You got this. Puff out that big gorilla chest and go rip it off like a Band-Aid. Call me if you need me.”

I wiped my eyes, left the stall, and splashed some cold water on my face. Game time. Don’t let them see you sweat. Steppers keep on stepping. I looked in the mirror — You look good, you look normal. You’re a normal guy. Then I slapped myself in the face as hard as I could.

I knew I had a lifelong disease and that bipolar disorder is something to be managed, not cured. I knew I’d need to take medication for the rest of my life and that I’d humiliated myself in front of countless friends and strangers alike. I knew that I had more in common than I’d have liked with my schizophrenic uncle Eddie who lived the last 15 years of his life in a state mental institution. That no matter how early I got to work, no matter how useful I made myself, no matter how reasonable and modest my khakis and my sweater were, I was and would always be the “crazy” dude.

I finally bucked up and made it to my supervisor’s office. I knew we’d have a come-to-Jesus talk soon enough — my practice was in disarray when I left — but he seemed genuinely glad to see me. “You look great,” he told me. “Got some meat back on your bones. We’re thrilled to have you back.”

Twenty minutes later, he was forced to dismiss me. I needed a note from my psychiatrist declaring me fit to return to duty. “Sorry,” he said, “it’s just policy. You can’t be in the building without a note.”

“Them’s the rules,” I said.

I was relieved to have an out but I was humiliated all the same. The note requirement didn’t feel like the fulfillment of a bureaucratic requirement; it felt like a request for proof of sanity. We’re thrilled to have you. Now we’ll be needing certification that you’re no longer certifiable.

I got the note the next day and returned. I knew I had no choice but to keep showing up every day, take my meds, keep my pants on and channel my trauma as best I could to find a way to be someone else’s Bird.

It did not work.

What I’d once viewed as my dream job became a pressure cooker I couldn’t withstand. The cramped jail cells where we public defenders spend so much of our working day frequently triggered PTSD symptoms, bringing me right back to the claustrophobia of forced confinement. But it was the anxiety attacks after work that eventually did me in. My philosophy as a public defender was that no one should spend an extra hour in jail because of a mistake I made. It’s probably an impossible standard to meet, but I couldn’t shake the fear that I wasn’t cutting it. After two more psychotic breaks and hospitalizations, I left the Legal Aid Society.

It’s been two years now, and thanks to the love and support of the Bird and modern pharmacology, I no longer live in constant fear that my mind will abandon me at any time. I also live with the knowledge that millions of others with mental illness live with that fear, and suffer through it alone, and far too many are sucked into our hyperactive justice system and treated as criminals for an illness they are powerless to fight. A 2015 investigation by The Times found that nearly 40 percent of the population at Rikers Island, a total of 4,000 men and women at any given time, suffer from mental illness. In other words, our jails have become our de facto mental health facilities.

 

Ultimately, I couldn’t take the pressure of having lives hanging in the balance when I went off the work in the morning, while also keeping my bipolar in check.

What I could do, though, was speak and write honestly about being utterly at the mercy of my illness, and being pulled from the brink by the care of one person’s love. And that’s what I am doing now.

Gede Goes to Borno

By Samira Koko

Gede Foundation, in partnership with Catholic Relief Services (CRS) is conducting a project with Internally Displaced Persons (IDPs), in Borno State. 

Prior to their departure, the team had a training in identifying mental health and psycho-social support among IDPs in Maiduguri. The 5-day training with Bonnie Kaiser also included basics in research. Topics discussed included introduction to mental health, qualitative & quantitative research, ethics & mental health stigma, psychosocial first aid and involved a practice interview with actual IDPs in Abuja. 

Pictured below, are our Research Assistants right before they left to Borno State on the 13th of September, 2017. 

Binfa and Yusuf left for Borno State and Samira is working from Abuja. 

Binfa and Yusuf left for Borno State and Samira is working from Abuja. 

Please return to the blog for more details!

Sitawa Wafula Visits Gede

Sitawa Wafula's visit to Abuja

Good afternoon Beautiful people,
In today's post, which is the second part of my chronicles from Keffi and Abuja - Read Part 1 on things to do in Keffi and Abuja - I will share the mental health service providers I met with in Abuja.

1. On Sunday afternoon, I facilitated a support group meeting, hosted by She Writes Woman  - a forum that brings women going through different types of mental health issues together to speak and support each other through monthly sessions in Abuja and Lagos. Since support group meetings are private closed door affairs, I will not divulge more.

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2. On Monday morning, we went for a hospital visit, the Behavioural Medicine Unit in Abuja - the main state referral unit in Abuja - where we met Samuel, a psychologist at the hospital. He was very instrumental in helping us understand the mental health structure in Nigeria. The Behavioural Medicine Unit does both in and out patient services and can host up to 40 people at a time - space is definitely an issue, but hey if we did more awareness and preventative mental health, we will not need to worry about space. Samuel informed us that the most common admissions are on substance abuse and substance induced mental health issues, bipolar, clinical depression and schizophrenia.

He also shared some success stories and I loved how his face lit up when he took us through various recovery journeys that he had been part of or seen at the unit. I loved that the unit works with social workers to help with the transition process from hospital to home and has a trial release program where one is allowed to go home over the weekend before being officially discharged from the hospital. Samuel informed us that stigma even among staff is an issue and told us of an interesting initiative by WHO where staff got free lunch if they ate with those who had been admitted at the hospital. 

3. After the hospital visit, we went to Gede Foundation  which one of the largest mental health NGOs in Nigeria. Godwin, the partnership manager, received us and took us through a brief history of the foundation. Gede started with work on HIV where they saw the burden of mental health issues in people living with HIV, this is what formed the foundation of their work in the mental health space. They have various projects going on including implementation of the Basicneeds model to various  communities including IDPs - I have worked with the Kenyan arm of Basicneeds and visited with the Ghanaian and been in conversations with the US arm so I am very familiar with this model and it is exciting to see Gede adopting it. It basically works around inclusion of community in addressing mental health issues as well as looking at livelihood and self advocacy of those going with a mental health diagnosis. 

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Gede Foundation has also been involved in research and policy work - where they have successfully gotten mental health care on the HIV guidelines, they also host a mental health CSO coalition that brings together 54 mental health organisations in Nigeria among many other exciting things. 

When a Sibling Attempts Suicide

Over the weekend, I got a text saying my older brother had been talking about taking his own life. He had threatened to do this so many times we brushed it aside and even laughed about it. Little did we know that he was serious.

The next text I got said he had climbed onto the power lines (NEPA lines) with the hopes of electrocuting himself. Somehow he was talked down and then disappeared for about 2 weeks. 

A little backstory. My brother is not only the smartest in the family but the most talented. He is a self taught artist; he can draw, paint, sculpt, mould, sing, write, you name it. However, at some point in his life, he fell into drugs. When the pocket money he got could no longer sustain his habit, he resorted to stealing. He was/is the type of relative that when he comes around, you hide all the valuables. I always protected and defended him because he was my smart and handsome big brother - until he stole my new shoes. Even then, though, I gave excuses for him. I recall one time we were woken up at 4am by policemen holding my brother who had our TV with him. He had told the policemen that he was on his way to fix the TV - at 4am. Looking back, they were really nice policemen because they brought him to the house to ask if this was true and if he truly stayed there. As we slept, he left all the doors open, took the TV and he went out with the hopes of selling it. We were saved that day. Another time he stole something very valuable from my mother. She insisted he take us to where he sold it. He took us around the neighbourhood until we got to a deserted house and then he took off. This was about 10pm on a dark, cloudy, starless night. As no cars were passing, my mother and I had to walk back hoping we did not run into hoodlums.

Another thing that my brother is, is a charmer. Once he was done with all his shenanigans, he would return home and our mother would be strict with him but he would play her tune (and the rest of ours). For 2/3 weeks he would be the perfect brother/son and just when you lower your guard, he would strike. I recall my mother crying because he stole her gold watch and sold it for peanuts - just to get a fix. She tried having him locked up, kicked him out of the house but he always charmed his way back. One time, he took rat poison and we all got scared and tried to ‘understand’ his situation as best as we could. 

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There was always a darkness about him. Other girls would describe him as ‘dark and brooding’ but maybe that was the beginning of depression and we missed it. He did write several suicide notes as well as other dark literature. He found pleasure in inflicting pain on my younger brother but never me. He attempted suicide more than once but he got a scolding instead of a listening ear and treatment. Now he is older, married with children. Sometimes he calms down, best husband and father ever and then he goes on a bender. He’s been missing for two weeks. His phones are off. The family knows he will eventually turn up but what if he does not? 

As Dr. Stella Iwuagwu once said, empathy costs no dime. Perhaps if we had listened, paid more attention, gotten treatment for him, anything really, we might know where he is. He might have gotten the treatment he so desperately deserves. Even worse, what if he succeeds? How does the family recover? How do we pick up the pieces? 

Written by Susan

Nigeria now includes MENTAL HEALTH in HIV/AIDS care and support

Original article was published on the MentalHealth Worldwide website. 

From our member in Nigeria, Gede Foundation, we are very excited to announce that
for the first time Nigeria has included mental health into routine HIV/AIDS care and support in the National HIV AIDS Strategic Framework 2017-2021(Gede Co-Chaired the Technical Working Group which looked at the key issues).

Gede has been published in BMC Public Health in a peer reviewed article on the prevalence of common mental disorders in a large sample of people living with HIV/AIDS in Nigeria. Access article from link below:

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Congrats to John Minto, Gede Foundation and to all working so hard in Nigeria!

Contact information for further information:
John Minto
Managing Director
Gede Foundation
Abuja, Nigeria
http://www.gedefoundation.org

Entering New Communities

She remembers running, her heart pounding. She vaguely remembers falling and then drifting in and out of consciousness. When she came to, her worst fears came to life. Her brother had been killed by the insurgents. She could still hear the gunshots. It got so bad that every time she heard something loud, she would hear her heart pounding, her palms would get shaky, she would suddenly be out of breath and she would be very terrified. This had continued even after leaving the North-East of Nigeria.

Another woman described how she saw people falling as they run away from their homes, amid a torrent of gunfire. As they were running, they jumped over dead bodies. Once they got to a relatively safe location, she could not stop shaking and could not hold on to anything. Others described scenes where children died as they could not keep up with the running or were not fed for days due to lack of food. Sometimes there was food but no way to cook it. 

These are just a few experiences shared by Internally Displaced Persons (IDPs) in the new communities that the BasicNeeds team is entering. After wrapping up from Mpape and Mararaba communities, the team is moving to Guruku (Mararaba) and Waru (Apo) communities. August 15th and 16th marked community consultations in the two communities. The consultation was aimed at giving the stakeholders a general overview of the project as well as getting an idea of what their expectations from Gede are. The attendants were introduced to the BN model and how it can be of help to them. 

Both communities expressed a need for empowerment as they have been away from their homes for a long time and having something to do will keep their minds busy. Furthermore, they acknowledged that they need assistance as some of their members have been adversely affected by the insurgency in the north. The trauma has led some of them to substance abuse, while others usually seem lost in thought, talk to themselves, wander around aimlessly and often cannot get a goodnight’s sleep. 

The community consultation gave both Gede and the new stakeholders an idea of what to expect going forward. Please check out website regularly for updates from the field. 

'I am a survivor of suicide'

Culled from Mental Health Today

Charlotte Underwood with her father

Charlotte Underwood with her father

I am a survivor of suicide, in both the senses.

I have survived my own suicide attempt and survived my father’s suicide.

Ignoring mental illness and letting stigma control what support and treatment people are offered will only result in more fatalities, like my father’s. 

That’s why campaigns like The Samaritan’s Big Listen are so important, listening to someone can save a life.

Losing my dad to suicide opened my eyes to the modern world, how there is a huge stigma attached to mental illness and a huge lack of support.

It hurts me to know that we live in the 21st Century and yet some still pretend that depression, anxiety and other mental illness aren’t real.

I know first-hand how real they are.

I have been struggling with depression and mental illness my whole life, it’s almost as if it is genetic. I am not the only person in my family with it.

I have been told I am a hypochondriac and that my physical illnesses are in my head. I’m scared for the day that I do get seriously ill and avoid the doctor, knowing that I won’t be listened to.

Going through all of this myself is the reason why I completely understand my father’s suicide.

I have never been mad at him and I know that he was trying so hard. For 16 years he tried to get better but he didn’t get the help he needed.

He once told me that I was the only person that understood him, I was an 18 year old girl and that made me so sad. Something needs to change.

Mental illness is just as serious and life changing as any other chronic illness, it can affect your working life, relationships and generally your quality of life, something I know all too well.

By speaking up and talking about mental illness, it gives others in similar situations a support network, somewhere to go when they need someone to understand them, it can make a huge difference, which is why I wrote my book ‘After Suicide’.

I wanted people to be able to understand grief and have a friend who they could relate to, though I feel my book can be so helpful for people who want to understand suicide more.

If I can give someone advice, I would say be patient with yourself or a person with mental illness, stick around and be ready to hold them if they need it but respect their space and time they need alone.

If someone is suicidal I would recommend just sitting with them, be gentle and help them find the words, together you can work through the problems and hopefully save their life in doing so.

If someone is grieving it is so important to understand that each individual grieves differently in their own time, do not make them feel guilty for their actions and tell them that they should be over it by now, it is the worst thing you can ever do.

Someone who is grieving needs constant reassurance and support.

Losing someone you love is the worst feeling in the world but losing someone to suicide can also add confusion and hurt as for some it can be unexpected or sudden.  

Ask someone how they are today and be ready to listen, it can make a world of difference.

    My Little Start-Up

    My name is Emmanuel Ekpo Okon and I am a second year student at the Cross River State University of Technology in the Department of Electrical/Electronic engineering. I hail from Akwa Ikot Efffanga community, Akpabouyo LGA in Cross River State.  My community is one of 10 communities hosting the Lafarge Africa Plc, one of Nigeria's largest cement manufacturers and suppliers of high quality cement.

    As part of the Company’s corporate social responsibility to it host communities, a few students from my community and other communities are selected annually to benefit from an educational support programme of the company. This support programme covers tuition, books and other levies which leaves very little for personal use. Although I was lucky to be nominated and selected to enjoy the support, I had thought on how the little I saved from the financial support could be used to bring more money to take care of other financial issues at school. 

    I have been in the programme for 2 years now. In the first year, an entrepreneurial and life building skills workshop was organised by Gede Foundation – the Consultant managing the education support programme for Lafarge. From the little I grasped in the 2day workshop, I thought outside my field of study and identified a problem within my institution which I could proffer solution. 

    At the end of every semester graduating students and students in dire need of quick money, go from one hostel to another with an intent to dispose or sell off their used laptops, fridges, electronics, personal effects and also to advertise their services such as event managing, catering, salon services and so on. I saw this as an opportunity to come up with an advertising platform within my institution. I knew for a campus such as mine, the best platform would be an application that can be accessed on an android, laptops, java phones and any devices with internet connection, but I have no skill in computer programming, so I shared the idea with a colleague in the computer science Department. From the little I saved from my financial support from Lafarge mava.ng was born.

    Mava.ng is an online advertising platform where students within my campus can place advertisement for their goods and services. It has a unique interface that enables a user to create an account, upload up to 12 pictures of 2.5MB limit of each picture. It also enables a use write about the product and can also chat with me or my partner on the platform. Mava.ng uses zara class theme written in php and hosted on whogo host server. Mava.ng was launched on May 26 2017 and it is accessible with android, laptop, java and other internet devices. mava.ng is not yet an application, it is a website which my partner and Iare still working on in the hopes of developing it further to an app that is downloadable. 

    This is just a start up for me but with formal training in computer programming and graphics, I will be able to birth more ideas to create wealth within my sphere, and also be a role model to young students from my local community.

    Written byEmmanuel Ekpo Okon

    200 level student

    Electrical/Electronic Engineering

    CRUTECH