Mami Sandow started hearing voices when she was nine years old.
“She used to roam, talking anyhow, climbing some kind of trees, ” says her brother, Fatawu Sandow. ” You asked her to stop, but she wouldn’t stop. She would just run and hit anything [and fall] down. ”
Mami is 16 years old now and is being treated for epileptic psychosis at Tamale Teaching Hospital She pulls down the left shoulder of her screen-printed dress to show deep scars on the shoulder blade. Her left ear is mangled; the lobe tattered and hanging loosely. Her injuries are self-inflicted; when she hears voices she throws herself at walls to get them to stop.
Seven years ago, when Mami first started exhibiting unusual behaviour, her family thought she was just misbehaving, says Fatawu. The severity of her symptoms increased until they realized she needed medical treatment.
“We thought it was jokes [but] it came to a time, we had to send her to the hospital,” says Fatawu.
When Mami first became sick, the family sent her to a hospital in Bolgatanga, about 150 km north of Tamale. A private hospital, her treatment cost over 3,000 GHC ($1,500 CDN). To pay the hospital fees, the family had to sell off property and rely on remittances paid from siblings in Accra.
“We sold everything, just to take care of her,” says Fatawu.
Mami needs around-the-clock attention, to prevent her from injuring herself or others. Fatawu is the sole caregiver, because his mother and father are too busy to help. Staying at home as come at a personal sacrifice to Fatawu.
“It’s even effected my education,” he says. “I was attending [the Tamale Islamic Senior High School] … but because of the sickness, I must come home to take care of her.”
Mami’s epilepsy is treated as a psychiatric illness because of the stigma attached to her behaviour, explains community health nurse David Agyarwa. He says poor understanding of mental health issues stops patients from getting treatment.
“Most people think that when somebody suffers from mental illness it is due to sin an individual committed or the individual is demon possessed,” says the native of Accra.
Agyarwa says there is a great need for psychiatric care in Tamale, yet the hospital does not have a ward. Today he’s conducting interviews in examination room 52; an overcrowded room that houses urological, pediatric and orthopaedic appointments on different days of the week.
“We are compelled to sit at any place [in the hospital] that we can get and do our [patient] history taking,” he says.
Agyarwa says this is problem for psychiatric patients with delicate temperaments. Also, if appointments are conducted in open waiting areas, it violates patient privacy.
The Tamale Teaching Hospital unveiled a new wing on April 30, with maternity, intensive care, neo-natal, radiology and surgical wards, but no provisions for psychiatric care. The $54 million CND building took two years to build and was funded by the Dutch and Ghanaian governments. Psychiatric patients will be housed somewhere in the new facility, says the hospital’s public relations officer Gabriel Nii Otu Ankrah.
“Because of the importance we attach to psychiatric care, the space will be created for them in the new building, temporarily,” says Ankrah. “[But] the original plan didn’t include space for the psychiatric unit.”
The Ghanian government is prioritizing mental healthcare after the March 2 passage of the country’s Mental Health Bill. The bill promises to de-centralize treatment from the three mental hospitals in southern Ghana, to community hospitals across the country.
Unaware of the government’s new mandate on mental healthcare, Fatawu is simply grateful for his sister’s new course of treatment. Mami hasn’t had a psychotic attack for one week, he says.
“Now it’s good [since] we started coming here, collecting the drugs,” he says. “Now [the illness is] no more [affecting] her, so now she is free.”