There I was, minding my own mental health business when someone I know (read my husband of the last 20 years who is growing on me) suggested I travel with him through rural South Africa. He is doing a review on the state of rural health, whether there are sufficient doctors, nurses and other necessary stuff for health to be delivered in a context where everyone – let alone people with mental health challenges – are vulnerable. At first I wondered why on earth he would want me, the multiple mental illness disordered someone to travel with him, as I’m not really the kind of gal you can take pretty much anywhere (and who has consistent unreasonable demands that cannot be met). For example, I was completely outraged that they did not have a cappucino (extra shot of espresso with cream) at a petrol station in the very rural parts of the Eastern Cape Province of South Africa. I mean honestly, rural health is a challenge, but no proper coffee? This could lead to war and I am the most concerned for these coffee poor people. Anyone with mental illness within a 500 km radius is clearly suffering – if you can’t get over your pill hangover with proper coffee what can you do??
More seriously what struck me was a number of stark, non mental health friendly realities that exist in this environment. Firstly (in no order of priority): everything is FAR (like really far) and that means that healthcare (regardless of the reason) is difficult if not impossible to access. If I think about the times that I needed to go to hospital, urgently (cryingly / psychotically etc) needed to see my psychiatrist / psychologist, the mind boggles at how you would access these kinds of services in rural areas in Africa when you are EXTREMELY vulnerable. Second: I know for a fact (and it’s confirmed by research) that mental health / illness awareness is low if non-existent. Coupled with this, as we all know, there are also many mental illnesses where insight into your own illness is low (and most likely to be some of the most severe illnesses). Thirdly: even when you know you’ve I dunno, felt sad and manic your whole life, and would like treatment, you are likely to be made to feel worse by way of reception from your local family / community / health workers (or all of the above) whom you may or may not be able to access after travelling loads of km’s with money or food that is in very, very short supply.
And then my personal favourite: let’s assume you’ve been able to jump all these hurdles: if you need to be hospitalised, a “bed” is usually on a first come about to die basis, so if you’re not in the act of death and / or dying there usually isn’t a bed, an actual psychiatrist on call, or available, approriate medication to treat you with what is often considered to be a rather minor, made-up ailment. I have personally been told on admitting that I was suicidal and needed hospitalisation that I should come back later. Insert witty comment here, as I have no words. This was certainly my experience in urban areas, so I imagine that in rural areas, this must be very, very much worse. Added to this, Emergency Medical Services in the Province has been known to go on STRIKE. Yes. All available ambulances were on a um, go slow.
If I lived here, I would participate in the strike and my own mental health by asking them to put me out to pasture with the cows, and hope that I be struck with lightening as a manner to reset my clearly broken brain and body. Better than waking up without coffee, to have to walk / hike far to a facility that would be too full, or to be “turned away” by an ambulance that wasn’t working that day. Am I making fun of this situation? What would I suggest in this deplorable state of affairs? I really don’t know. I don’t know how many people with mental illness live here, what they need, and how we can help and make sure that things change. After all – we live in the country with one of the most enabling constitutions in the whole world – and further rights that are enshrined in our bill of rights. Unfortunately though – in the past couple of days, I have seen that this means very little if anything – to people who don’t even have their basic human rights respected, let alone access to health. We need help, we need to make a noise, and not stop until it changes. And YOU need to be part of it. African Mental Health Matters Too! Be part of those who support us as opposed to those who don’t. I 4 M’s Bipolar Mom.