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| I have seen first-hand how the horrors of Mugabe’s Zimbabwe haunt our people | I have seen first-hand how the horrors of Mugabe’s Zimbabwe haunt our people |
| (5 days later) | |
| As a psychiatrist in Zimbabwe, I’ve witnessed the mental scars caused by years of death, deprivation and struggle. Post-Mugabe, we need a psychological salve | |
| Thu 11 Jan 2018 06.00 GMT | |
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| The euphoria that greeted the end of Robert Mugabe’s autocratic 37-year rule over Zimbabwe is giving way to a sobering realisation of what lies ahead to heal the trauma of our nation. The events of the past four decades have had a severe impact. It is thought more than 10% of the population are affected by mental health issues; among people using primary healthcare facilities, the figure is about 30%. | The euphoria that greeted the end of Robert Mugabe’s autocratic 37-year rule over Zimbabwe is giving way to a sobering realisation of what lies ahead to heal the trauma of our nation. The events of the past four decades have had a severe impact. It is thought more than 10% of the population are affected by mental health issues; among people using primary healthcare facilities, the figure is about 30%. |
| Four generations have had their lives marked by chronic fear. They have endured the liberation war, the Matabeleland massacres, enforced land redistribution, the destruction of homes, and a general atmosphere of violent suppression and economic struggle. | Four generations have had their lives marked by chronic fear. They have endured the liberation war, the Matabeleland massacres, enforced land redistribution, the destruction of homes, and a general atmosphere of violent suppression and economic struggle. |
| We are an emotionally and psychologically fractured people. | We are an emotionally and psychologically fractured people. |
| History will repeat itself until we open a national dialogue to heal. People are hungry to take a new, peaceful direction, but there has to be collective and individual healing, and we need to recruit and train people from our communities to drive this. | History will repeat itself until we open a national dialogue to heal. People are hungry to take a new, peaceful direction, but there has to be collective and individual healing, and we need to recruit and train people from our communities to drive this. |
| I’m one of only 12 psychiatrists in the country and, during my work, I am constantly reminded of how trauma haunts Zimbabweans across the racial, social and cultural divide. Zimbabwe has one of the highest suicide rates in the region. | I’m one of only 12 psychiatrists in the country and, during my work, I am constantly reminded of how trauma haunts Zimbabweans across the racial, social and cultural divide. Zimbabwe has one of the highest suicide rates in the region. |
| The experiences of just a few of the countless patients I have seen over the past 10 years demonstrate the wider problems huge impact of politics on the lives of four generations. | The experiences of just a few of the countless patients I have seen over the past 10 years demonstrate the wider problems huge impact of politics on the lives of four generations. |
| The liberation war veteran still fighting the Selous Scouts | The liberation war veteran still fighting the Selous Scouts |
| Simbarashe* was a 74-year-old veteran who spent eight years in the bush fighting in the Rhodesian war. He was brought into the consultation room at Harare hospital handcuffed to two police officers. “They want to kill me!” he yelled. | Simbarashe* was a 74-year-old veteran who spent eight years in the bush fighting in the Rhodesian war. He was brought into the consultation room at Harare hospital handcuffed to two police officers. “They want to kill me!” he yelled. |
| Simbarashe’s wife stood next to the police. “He has been saying this all week. It’s getting worse … He talks to himself half the time and it’s always about the war. | Simbarashe’s wife stood next to the police. “He has been saying this all week. It’s getting worse … He talks to himself half the time and it’s always about the war. |
| “I keep telling him the war was 30 years ago but he says, “Ma Selous Scouts arikuya!” [The Selous Scouts are coming!] And he wants his AK-47. Sometimes when we are walking down the road he will suddenly scream, ‘Take cover!’ and drop to the ground, and everybody laughs at him.” | “I keep telling him the war was 30 years ago but he says, “Ma Selous Scouts arikuya!” [The Selous Scouts are coming!] And he wants his AK-47. Sometimes when we are walking down the road he will suddenly scream, ‘Take cover!’ and drop to the ground, and everybody laughs at him.” |
| Simbarashe’s wife called in the police when she had run out of ways to cope with him. | Simbarashe’s wife called in the police when she had run out of ways to cope with him. |
| The veteran had been experiencing these recurrent symptoms since he came back from Mozambique in 1980. Often, he got aggressive towards his wife and children. | The veteran had been experiencing these recurrent symptoms since he came back from Mozambique in 1980. Often, he got aggressive towards his wife and children. |
| Medication at the psychiatric unit has helped to suppress the outbursts but, in his mind, regardless of the strength of the tranquilisers, Simbarashe is still fighting against the Rhodesian Selous Scouts, nearly 40 years after the war ended. | Medication at the psychiatric unit has helped to suppress the outbursts but, in his mind, regardless of the strength of the tranquilisers, Simbarashe is still fighting against the Rhodesian Selous Scouts, nearly 40 years after the war ended. |
| The dispossessed farmer | The dispossessed farmer |
| Koos Von Tonder* was a Selous Scout who emerged from the losing side of the bush war relatively unscathed, and was fortunate to be able to return to his family farm outside Harare. Koos was one of more than 100,000 white Zimbabweans who decided to stay after independence in 1980. He lost the farm in 2003, during Mugabe’s land redistribution. | Koos Von Tonder* was a Selous Scout who emerged from the losing side of the bush war relatively unscathed, and was fortunate to be able to return to his family farm outside Harare. Koos was one of more than 100,000 white Zimbabweans who decided to stay after independence in 1980. He lost the farm in 2003, during Mugabe’s land redistribution. |
| Koos sat quietly next to his wife as he struggled to articulate the pain. “My farm was the best in the whole district,” he said softly. “I had a school, a health clinic and accommodation with electricity and running water for all my staff. I paid for university fees for my staff’s kids.” | Koos sat quietly next to his wife as he struggled to articulate the pain. “My farm was the best in the whole district,” he said softly. “I had a school, a health clinic and accommodation with electricity and running water for all my staff. I paid for university fees for my staff’s kids.” |
| He looked up to the ceiling, searching for his next line. “They woke up one morning and turned against me. They betrayed me after all I had done for them. Why?” His wife Betty, holding his hand, said: “It’s been a terrible time, doctor. We lost everything.” Then, turning to her husband, she said: “But Koos, you need to tell the doctor about your drinking. That is why we are here.” | He looked up to the ceiling, searching for his next line. “They woke up one morning and turned against me. They betrayed me after all I had done for them. Why?” His wife Betty, holding his hand, said: “It’s been a terrible time, doctor. We lost everything.” Then, turning to her husband, she said: “But Koos, you need to tell the doctor about your drinking. That is why we are here.” |
| The young women were raped in front of us. Some were bayonetted. I have not stopped seeing those visions | The young women were raped in front of us. Some were bayonetted. I have not stopped seeing those visions |
| Koos looked at Betty with contempt. “A shit government!” | Koos looked at Betty with contempt. “A shit government!” |
| The session didn’t last long. Koos walked out, adamant that he didn’t need to see a psychiatrist and didn’t have a drinking problem. | The session didn’t last long. Koos walked out, adamant that he didn’t need to see a psychiatrist and didn’t have a drinking problem. |
| Betty called me one day in early October, when the jacarandas were blooming, to say Koos had committed suicide. | Betty called me one day in early October, when the jacarandas were blooming, to say Koos had committed suicide. |
| The Matabeleland massacre survivor | The Matabeleland massacre survivor |
| When Gogo Ncube* spoke, she held her walking stick firmly. She was from Matabeleland’s Silobela. “They came,” said the 82-year-old. “They rounded us up. They put the men in a hut, closed it and set it alight.” Her granddaughter sat next to her, wearing an expression of indifference. She had heard this story many times. | When Gogo Ncube* spoke, she held her walking stick firmly. She was from Matabeleland’s Silobela. “They came,” said the 82-year-old. “They rounded us up. They put the men in a hut, closed it and set it alight.” Her granddaughter sat next to her, wearing an expression of indifference. She had heard this story many times. |
| Gogo continued: “The young women were raped in front of us. Some were bayonetted. I have not stopped seeing those visions. They called it Gukurahundi.” | Gogo continued: “The young women were raped in front of us. Some were bayonetted. I have not stopped seeing those visions. They called it Gukurahundi.” |
| After a while, her granddaughter interrupted. “Doctor, can you stop these thoughts and constant repetitions about these events? Why has Gogo not moved on?” she asked, finally breaking into tears. “This has affected all of us.” | After a while, her granddaughter interrupted. “Doctor, can you stop these thoughts and constant repetitions about these events? Why has Gogo not moved on?” she asked, finally breaking into tears. “This has affected all of us.” |
| Gogo looked into the eyes of her granddaughter. “How can I move on when I have the ghosts of my entire village crying out for justice?” | Gogo looked into the eyes of her granddaughter. “How can I move on when I have the ghosts of my entire village crying out for justice?” |
| The single mother made homeless | The single mother made homeless |
| There was pandemonium when the police and military moved in to demolish “illegal structures” – informal homes and businesses – across the country. This was Operation Murambatsvina (Remove the Filth). More than 2 million Zimbabweans were affected, with 700,000 left homeless. Mufema*, a single mother, never recovered. Three months after the demolitions, under a tree along the Mukuvisi river, she fed her 18-month-old baby porridge laced with rat poison. She then took a sizeable amount herself. Holding her baby lovingly, they both fell asleep. | There was pandemonium when the police and military moved in to demolish “illegal structures” – informal homes and businesses – across the country. This was Operation Murambatsvina (Remove the Filth). More than 2 million Zimbabweans were affected, with 700,000 left homeless. Mufema*, a single mother, never recovered. Three months after the demolitions, under a tree along the Mukuvisi river, she fed her 18-month-old baby porridge laced with rat poison. She then took a sizeable amount herself. Holding her baby lovingly, they both fell asleep. |
| The consultation letter from the physician was brief: “Please see Mufema, a 22-year-old mother of one who ingested poison together with her son. The son died on admission. Mother in ICU but will need psychiatric evaluation once she is moved to the medical ward.” | The consultation letter from the physician was brief: “Please see Mufema, a 22-year-old mother of one who ingested poison together with her son. The son died on admission. Mother in ICU but will need psychiatric evaluation once she is moved to the medical ward.” |
| Mufema did not leave the ICU. She died four days after admission. | Mufema did not leave the ICU. She died four days after admission. |
| The disaffected, unemployed teenager | The disaffected, unemployed teenager |
| Komich*, 19, was brought to the psychiatric hospital in handcuffs, screaming at the top of his voice, actively hallucinating. He recovered after five days of anti-psychotic medication. | Komich*, 19, was brought to the psychiatric hospital in handcuffs, screaming at the top of his voice, actively hallucinating. He recovered after five days of anti-psychotic medication. |
| “Doctor, I can’t stop taking substances,” he said during a ward round. “I can’t function without them. All young people in my neighbourhood are taking these things. This is our only way to survive another day.” | “Doctor, I can’t stop taking substances,” he said during a ward round. “I can’t function without them. All young people in my neighbourhood are taking these things. This is our only way to survive another day.” |
| Currently, 80% of all admissions to psychiatric facilities in the country are due to substance misuse. An entire generation of educated young people are unemployed and helplessly depending on drugs to make sense of the socio-economic turmoil. | Currently, 80% of all admissions to psychiatric facilities in the country are due to substance misuse. An entire generation of educated young people are unemployed and helplessly depending on drugs to make sense of the socio-economic turmoil. |
| The collective trauma of four generations, often marked by rape and domestic violence, continues to be a characteristic feature of Zimbabwean families and society. There is only so much a dozen psychiatrists can do. | The collective trauma of four generations, often marked by rape and domestic violence, continues to be a characteristic feature of Zimbabwean families and society. There is only so much a dozen psychiatrists can do. |
| There is need for a national call to action: a peace and reconciliation effort driven by those affected, both within and outside Zimbabwe, but facilitated by the highest office in the country and rooted in an evidence-based approach that seeks to heal, compensate and unite. | There is need for a national call to action: a peace and reconciliation effort driven by those affected, both within and outside Zimbabwe, but facilitated by the highest office in the country and rooted in an evidence-based approach that seeks to heal, compensate and unite. |
| *Names have been changed to protect identities | *Names have been changed to protect identities |
| Global health | |
| Zimbabwe | |
| Africa | |
| Mental health | |
| Health | |
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