Exploring Potential In Promoting Community Mental Health In Nigeria

On the 17th of November, Gede met with N4A represented by Sophie McCann (Executive Director), Rebecca Tinsely (Founder) and Barbara Bauer (Trauma Psychologist) and a representative from AMES, James Ogenyi. Present from Gede was the Managing Director - John Minto, Performance Directors - Godwin Etim (Resource Mobilisation and Partnership Management), Cynthia J Ticao (Research and Advocacy) and Jeremy Boglosa (Organisational Development and Support Services). Also present from Gede were Kizito Ebhohimen (Monitoring and Evaluation Manager) and Zunzika Thole-Okpo (Media Officer). 

Brief and detailed histories of Gede and N4A were given and James gave a snapshot of what is happening in North East Nigeria. The situation in the north is most dire and needs more NGOs to help not just with nutritional services but with the mental health and psychosocial aspects. He noted that, often, his team travels with local vigilantes in order to access those in the camps and provide them with the little help they need. Some locals are so traumatised that they cannot speak at all. Those in the camps are exposed to some relaxation techniques so as to take their minds off of that has happened and is still happening. Some Boko Haram wives are also present in the camps and the name brings with it some level of stigma. A number of suicides have taken place in the camps and one well has been termed the ‘well of death’. This is where some people have gone to commit suicide. The well is still in use despite its name and negative connotations. 

Going forward, James noted that what is needed is for more NGOs to come together and help, much like what N4A have done in Rwanda and Uganda. Sophie McCann agreed that there are indeed many similarities between what the Rwandan Liberation Army (RLA) did and what Boko Haram is doing. 

Given the positive outcome they have had in Uganda and Rwanda, Nigeria would benefit from N4A as people try to rebuild their lives and overcome the wounds, physical, emotional and mental, that Boko Haram has caused. 

On Friday, November 18th, Gede and Network for Africa (N4A) met with the National Primary Healthcare Development Agency (NPHCDA). The meeting was primarily for Gede to introduce N4A to NPHCDA and for the Agency to discuss their emerging plans related to community based mental health.

N4A explained, in detail, the amazing work that they have done in post genocidal Rwanda and post war Uganda. They have done tremendous work in reaching over 9000 people in both Uganda and Rwanda and equipping them with skills such as conflict resolution, counselling in trauma and sustainable livelihoods as they embark on rebuilding their lives. They asked what they could do in the case of the Boko Haram insurgency in North Eastern Nigeria. 

In return, the NPHCDA was very excited to host N4A and assured them that working together in addressing mental health issues of the survivors is of the utmost importance. They also commended the N4A for their efforts in other parts of Africa and hope that the success they had there, could be replicated here. Furthermore, N4A was applauded for going through the right channels in trying to help Internally Displaced Persons (IDPs) in Nigeria. 

Please return to the blog for more news!

Stigma (Often) Begins At Home

By Susan

‘Drama queen’, ‘attention seeker’, ‘too emotional’, ‘easily offended’, ‘cry baby’; Those are just a few terms I heard growing up. I did not know how to express myself without feeling judged by those closest to me. Therefore, from an early age, I learned to put a lid on it. 

My first suicide attempt, at age 11, was never discussed. I was diagnosed with cerebral malaria. To this day, I have no idea how. I’d taken two handfuls of pills and everyone in the house knew but no one questioned the doctor’s diagnosis. Perhaps they were trying to protect me. I do not know. The only person who came forward told me, ‘I know what you did, don’t even do it again.’ That was the end of it. I found solace in books and writing and another cringeworthy practice - self harming. I’d burn myself or use a razor to cut myself and cover things up pretty well. This, at least for a while, seemed to keep my emotions in check. I have numerous scars everywhere. I tell people I was a tomboy. I was but that is not the reason why I have so many physical scars.

I recall writing numerous suicide notes, expressing my feelings in detail and leaving them for my mother to find and I was told to stop being dramatic. For instance, in another failed attempt, my mother got extremely upset and told me to use something stronger next time and get it right. What’s a 15 year old supposed to do with that? 

It should not be a surprise that I started to self medicate to manage my feelings. I was content being hazy, emotionally numb, just floating through life. I used to be fun and funny but at some point I was just existing - going through the motions, doing the bare minimum of what was expected of me.  When I started having panic attacks, I confided in a close relative and she laughed and told me those were ‘white people problems’. In trying to find the reason for my constant hyperventilating, breathlessness and all that comes with panic attacks, I was taken to a few hospitals to find the source of my problem. I saw every specialist my mother could afford (I suppose at this point it was getting quite serious) and they all told her the same thing; ‘let your daughter see a psychiatrist as there is absolutely nothing wrong with her physically.’ Her response was that her daughter was not a crazy person and therefore had no business seeing a psychiatrist. Of course I was depressed and suicidal and genuinely scared to be alive but I was not supposed to be. It just did not happen. I’m supposed to be a strong black woman. Eventually she agreed for me to see a clinical psychologist. It took a while for her to break me. Even when she did, nobody else in the family knew about it. No one knew I’d seen a psychologist. I continued to self medicate even after diagnosis, at this point it was like second nature to me. 

Sometimes I wonder if I would have been a different person had I been diagnosed earlier. I would like to help other people dealing with the same problem but I have often been asked about the effect that would have on my family. So I am shut down again. How can I help?

GEDE AND THE ROYAL SOCIETY FOR THE ENCOURAGEMENT OF ARTS, MANUFACTURES AND COMMERCE (RSA)

Gede is delighted to announce that the Foundation’s Managing Director, Mr John Minto, has been invited to become the RSA’s first “Connector” in Nigeria.

In accepting the role, Mr Minto noted that, “the RSA is one of the most reputable civil society organisations in the world and has been in existence since 1754. The RSA’s Mission (seeking to address the world’s challenges by unleashing the creative potential in every individual) is mutually compatible with that of Gede (bringing stigmatised and underserved health burdens ‘out of the shadows’ through research, partnerships and advocacy). I look forward to Gede and the RSA developing a Nigeria specific programme which will bring a wide range of people together to address many of the challenges facing the country both now and in the future.”

As an initial programme, Mr Minto noted that Gede and the RSA have started discussions focusing on ways in which “creativity” can be engaged to address the challenges facing Nigeria (and many other low and middle income countries) in relation to population and disease changes, with more people living longer coupled with the increasing prevalence of non-communicable diseases (such as mental illness, diabetes, cancer) which impact significantly on lives and health systems.

Please return regularly to Gede’s website to learn more about the Foundation’s collaboration with the RSA (www.thersa.org). You can also discuss the evolving programme with Mr Minto through jminto@gedefoundation.org

Loss. Relapse. Recovery

By Susan (From ‘Clarity of Mind’)

He ‘gave’ me my first Bible. I say ‘gave’ because he came back from boarding school, forgot it, and I took possession of it. That was my first Bible which I read from beginning to end. It was called Bible Stories for Children and I treasured it. I think it was the first book I ever owned. When he came back for holidays, my name was scrawled all over to let him know that I was now the owner. There wasn’t much objection but we fought a little. The next book I acquired was a story book with over a hundred fairy tales. Again, as with the Bible, I scrawled my name all over it and eventually this became our tradition. He would bring me a book each time he came home. We would fight about why I did the crossword puzzle instead of leaving it to elders - him. We would fight about taking books before one finished reading. We fought about so many things but we were the only ones allowed to hurt each other. An outsider would not dare come between us. I suppose that was how we showed love. This was my brother. And then my brother died. And once more my world came crushing down. The hole my mother had left in my heart, he took a bull dozer and dug even deeper. That is how my heart felt.

I had to be the strong one this time around. The others had been there for me when my mother died. They rallied around me when they discovered I went to visit her gravesite and helped me accept her death. It was therefore my turn. In order to keep my depression in check, which I knew would eventually creep up on me, I decided to start numbing my pain once more. I was very efficient. I helped everyone else but myself. There were people around me too but I did not want that. I went further into my Codeine and all was well. Or so I thought. On one of those days I decided to quit, I broke down. I did not want to leave my bed. I just wanted to sleep and never wake up. How could my brother be gone? I wanted to be gone too. Everyone would be better off without me. I made plans. I bought sufficient drugs, a mix of them to ensure that I would not wake up. To further ensure success, I also got hold of surgical blades sharp enough to slash my wrists and finish the job. If you recall, I’d mentioned memory problems and when it was time to get the job done, I could not for the life of me remember where I had hidden my drugs. The drugs were to numb me so I would not have to feel the pain of the blade. I could not go through with it with only the blade. And that’s when the flood came in and completely overwhelmed me. I did not get out of bed for a week. I had responsibilities but I could not be bothered. Person after person came to talk to me. My partner brought his friends, my friends, his family, mine, my child. I looked at my child’s sad little eyes, not knowing what was wrong with mummy and I pulled myself out of bed. It was probably the hardest thing I ever had to do. However, I did not stop with the codeine and Valium completely.

What continues to bother me as I continue in my recovery is that those that know about my situation treat me like an egg, like if they said something hurtful, I’d break. Maybe I would, maybe not. The constant whispers and looks, the ‘are you sure you can do it?’ questions make me want to stay caged in my head. It is comfortable there. I come out once in a while to the real world and its terrifying but as I said earlier, I have good days and great days. At this point I should add that I also have bad days. But every morning I get up and every so often I ask myself if it is worth it. And you know what? I’m still here so it must be.  Till next time - This is Susan.

Catch up with Susan's earlier blog here http://www.gedefoundation.org/blog/2016/10/31/clarity-of-mind

FGDs Completed for the CRS-SMILE Validation Project

For those of you who have been following Gede’s project with Catholic Relief Services (CRS) on the Validation of Mental Health Screening Tools for Vulnerable Children as part of the Sustainable Mechanisms for Improved Livelihoods and Household Empowerment (SMILE) Project, we are happy to report that as of the end of October 2016, the team has made good progress in the validation process.

A total of 25 Focus Group Discussions (FGDs) to review the screening tools on Depression, Behaviour Disorder and Post-Traumatic Stress Disorder have been completed in 12 communities in 4 LocalGovernment Areas in the Federal Capital Territory.  Another set of 2 FGDs were facilitated on Resilience.  FGDs were facilitated in Hausa or Pidgin English – the languages into which the screeners were translated.  The participants to these FGDs were male and female children aged 12 to 17 years old, enrolled in the SMILE Project, through the Civil Society Organisations (CSOs) that work with CRS for the project.  They are, (i) Catholic Action Committee on AIDS, (ii) Elohim Foundation, (iii) Justice Development and Peace Commission, and, (iv) Society for Community Development.  

With the completion of the FGDs (plus transcription) and the final review of the translated screeners, our team of researchers and clinicians will soon go back to the communities to validate the screeners with a target of 400 respondents.  

Please come back for more exciting updates.  

Secondary Scholarship Programme 2016 In Calabar

Public schools in Cross River State resumed on September 14, 2016 for the 2016/2017 academic session.

Currently, the Gede Foundation – Lafagre Africa Plc Educational Support Programme has 100 secondary school students spread across 26 schools within six Local Government Areas (Calabar municipality, Akpabuyo, Bakassi, Akampa, Ogaja and Calabar South).

The scholarship covers six years tuition fees, school levies and books for candidates in secondary school. Below are collages of some of the students across schools that have received this support.

The scholarship programme improves school attendance, participation, performance and improvements have been noted in the aforementioned areas as well as an increase in academic performance recorded from collated students’ academic reports of 2014/2015 and 2015/2016 sessions.

Academic performance is not only dependent on fees and books but also on factors such as the availability of trained subject teachers (especially in the sciences), mental, social and physical health of students, study attitude and reading styles and parental influence. Other factors include instructional materials (including library and equipped laboratories). 

The picture collages show students across the 26 secondary schools whose fees have been paid and books given, according to the provision of the programme.

Collages show cross section of some of the 100 students for the 2016/2017 academic session. 

For this new session, Gede Foundation plans to include other academic and health programmes to boost the scholarship effectiveness. Watch out on our blogs to catch-up on the activities as they unfold.

When a Colleague Questioned If It Was Safe for Me to Work Because I Experience Psychosis

The story below was published on the Mighty.com and written by Anne L. She writes about her experience with psychosis. 

“Hey, when are you free? I’d like to check in with you.” That’s the message I got from a colleague of mine, with whom I volunteer. We normally don’t text each other at all. So I felt a little uncertain as to what it was about. Incidentally, I was in hospital for intrusive audible thoughts and low mood. I messaged her back, telling her I was sick and in hospital, and would meet up with her once I was out. I handed my phone back to the nurses. A few weeks later, the colleague and I met at a Starbucks. I asked her what she wanted to check in about.

She said, “First of all, I want to say I really appreciate you sharing with me about your mental illness the other week while we were on duty.”

We volunteer as first responders, and we were on duty at an event, providing first aid. While we were chatting, she had shared with me that she also volunteers at one of the psychiatric units in a local hospital and for the local crisis line as well. Pleasantly surprised, I continued the conversation by disclosing to her I had been in the same hospital a couple times, once for psychosis and another time for depression.

“No problem. Thank you for sharing your experiences. It made me feel OK to share with you.”

“I just wanted to check in with you and ask if there is anything I should be concerned about? From what you disclosed to me, it seems like your illness can affect your judgment.” She then proceeded to ask me if the safety of the public and the safety of our fellow coworkers are a concern when I am on duty and if I can perform my job safely.

I reassured her, “No, you have no need to be concerned. My judgment is fine. If anything, when I’m ill, I’m more of a safety concern to myself. Plus, I don’t come volunteer when I’m unwell.”

She didn’t seem content with my response and she asked if I would be willing to meet with our supervisor and another coordinator to discuss my illness. This made me feel a bit uncomfortable, but I wasn’t sure how to respond in the moment. So I told her I would go consult with my support system and get back to her.

After speaking to a few close friends in the mental health community, they told me I am not obligated to disclose any health information to my employers/supervisors. They have never been asked by their employer about their health history and current health status or treatment plan. The only reason I would disclose anything, would be if I needed accommodations. Even then, I wouldn’t have to explain or give any details. When I brought it up with my psychiatrist, he was indignant and said my colleague had absolutely nothing to worry about. He was willing to back me up and talk to her if necessary.

Three days later, I called my colleague back. I told her I’d spoken to my disability advisor at school, my psychiatrist and my friends, and all of them gave me the same advice, that I have no obligation to speak to our supervisor about my illness. I also pointed out her questions were actually quite stigmatizing, assuming my psychosis skews my judgment in a way that poses a threat to others. I ended with emphasizing I disclosed my illness to her in confidence and hoped she respects that. My colleague thanked me for getting back to her, and admitted she realized she had been unintentionally stigmatizing in our conversation.

We’ve since moved on. My colleague feels more comfortable with the information I’d shared with her now, and we continue to work well together as first responders in the community. What strikes me the most in this situation was not only the fact that my colleague held misconceptions about what psychosis looks like, but the fact that she was not unfamiliar with the mental health community. As a crisis line worker and someone who volunteers on a psychiatric unit, her reaction to my disclosure came as a shock to me. Fortunately, we were able to get on the same page eventually, and dispel the misconception she had initially held.

Yes, it’s true in times of acute psychosis, our judgement can be impaired, and we may become a risk to ourselves or others. When in psychosis, I have delusions that lead me to believe I must sacrifice myself for the greater good. I get paranoid that people are following me and monitoring me through security cameras. I isolate from people. I have audible thoughts that tell me not to trust anyone or to kill myself. Needless to say, I don’t go to school, work or volunteer when I’m in that state.

However, when I am well, the delusions aren’t as intense. The audible thoughts are silent, and I feel safer around people. I have insight into when I am able to be a functioning, contributing member of society. SANE Australia states that violence is not a symptom of psychotic illnesses, and if a person is being effectively treated and not abusing substances, then there is no more risk they will be violent than anyone else. BC Early Psychosis Intervention Program (EPI) also reiterates that people with psychosis are rarely violent and, in fact, they are at a much greater risk of causing harm to themselves than to others.

To the people (friends, colleagues and supervisors) who hold the misconception that people with psychosis are a danger to other people, this is only true to a small minority of actively psychotic individuals. Psychosis comes in many different shapes and forms. Before you ask someone if they are at risk of harming others, ask them, “What does your psychosis look like?” Try to learn about their illness because psychosis is unique to the person. It is not a stereotype. The thing to remember is when we are well, our judgement isn’t any more skewed than the average person. We can think clearly and perfectly fine for ourselves.

My Guilt And How I Coped

I lost my mother last year. Before she died she was diagnosed with matted adhesions (intestine) or bowel obstruction. Bowel obstruction occurs when the normal flow of intra-luminal content is interrupted (that is the gastrointestinal contents are prevented from passing), leading to bowel dilation and retention of fluid within the proximal to the obstruction. The common cause (as I was told) is either postoperative adhesion or hernia. In mum’s case it was both. Her first two diagnoses said it was just hernia and that it could be managed without surgery but as pain and swellings increased another scan was done. This time is was matted adhesions and at this point mum’s case was an emergency. To make matters worse the resident doctors embarked on an industrial strike action four days to her date of surgery. 

Within the first month of the diagnosis, I traveled every weekend to take care of my mother as we lived in different towns. Seeing her struggle with excruciating abdominal pains, hungry but cannot eat, spewing the little fluid that she managed to take was the worst experience a child could see her mother pass through and not knowing how to help. The nights were worse, she was hungry but could not eat. I could not eat either because I didn’t see the reason or find any comfort from eating as my mother starved. Mum lost strength and was a shadow of herself.

When I returned to the office every Monday morning I heard her resounding plea that I should take my annual leave and be with her but it was not the right time to go on leave as I was already behind schedule on the scholarship programme. However, I promised to take 2 weeks off to care for her post-operation. The guilt of leaving her every Monday morning lurked in my head all week long till I returned the next weekend. I called every hour but a phone call could not take the place of a daughter’s tender and reassuring words.

Weeks after the last diagnosis we finally got a surgeon who rounded up a team of three other doctors to operate her in his private clinic. The surgery lasted six hours with a ‘minor’ complication because she was hypertensive but she came out fine.

Caring for her post operation was the happiest moment for me. The girlie chats, staying up at night to tend to her every need helped me to appreciate motherhood and caregiving, I spent quality time with mum and this brought us even closer. She recovered very fast and three weeks after the surgery she was discharged. 

She was a strong woman and her wounds were healing fast. Mum went for post operation check up every fortnight for three months. The doctor said she was strong and could come once a month. In April, four months after the surgery she complained of shortness of breath. The doctor said she should rest more often and not lift anything heavier than a glass of water! In May mum called one evening and said I should come take her to the hospital but I told her my brother could do that and that I would take my turn the following month because I had a tight schedule and could not travel. I should have gone that day may be I would have understood the shortage of breath and swelling in the legs (like fluid retention). 

She went to the hospital but the doctor handling her case had sent her file to another because he had to tend to a more serious case. The doctor who saw her said the fluid retention was due to the hypertensive drugs and stress but her heart was fine. In June she complained once and I told her I would be home to take her on the next appointment. Unfortunately, around 4:00am on June 25, four days to her next appointment, I was called that she choked while breathing and it was all over. Mum had embolism months after her surgery we all thought it was stress, she complained of shortness of breath, pains in hers legs and fluid retention. 

I cared for her for two months pre and post operation, I thought the boys would give the level of precision I gave to her caring but I was wrong. I only saw mum’s cold body I didn’t get a chance to take her for the next appointment. I didn’t even pay much attention to her complaint. I thought the worst were over and I felt she was stressed and needed to just rest! I feel guilty each day, I would have done more if only I had taken that leave to spend time with her. After all that was all she asked. I should have been there to watch her myself. 

Today I have decided never to leave anything to chance. I find solace in caring for the elderly, monthly I make out time to visit a widow or an elderly women (from the church or within my neighbourhood). I also give psychosocial support and counsel to women who are members in of the same Church as I. This guilty may not go away anytime soon. I have not done much but I know I can make another mother happy. As I pencil this I don’t know whether to feel inspired or haunted.

Culled from Ekaette Udoekong's memoirs

Epilepsy Does Not Define Me

By Zunzika T. Okpo 

My brother has always troublesome. Maybe it’s because he is my younger brother and that’s what they are meant for. He was not only troublesome, he was also a little bit of a daredevil. Perhaps this is why we may have missed his first seizure.

Brother and Sister

We always played together when we were kids. Our mother would say ‘put your shoes on if you want to go outside and play’. What would we do? We would put our shoes on, leave them at the balcony and jump to the ground floor. It was during one of these events that he fell after jumping. He landed smoothly, as always and then shook a little bit and injured himself badly. Not wanting to get into trouble, I did not tell my mother what I saw. Instead, I just said he fell. He was treated for the wounds and that was the end of it - or so we thought. 

A couple of years later, I was in Grade 7 and he was in Grade 5. I came back from school to find my brother with a swollen lip. A cousin of ours was telling the story of what had happened. He said my brothers arms were in the air, he stiffened, fell to the floor hard, and then started shaking uncontrollably. Not only was his lower lip cut and swollen, he also had other visible scars on his face, arms and legs. The boys made fun of each other and I joined in too as at that moment he had a swollen lip and somehow that was funny. He had a series of seizures and my mother did some research. She did not find anything conclusive so she sent him to my grandmother’s in the village. He was told not to eat chicken and if he must, it was to be cooked in green weird looking herbs. After about a school term in the village, he came back home. A friend of my mom’s also echoed my grandmother’s concerns about chicken and so my brother stopped eating chicken. The seizures did not stop. After a while, my mother, not particularly devout, started going to church in hopes that her son would be healed through prayers. The seizures did not stop. We were all quite scared, I was afraid to be alone with him because I did not know what to do in case he had a seizure. My mother had coached us; get a spoon, wrap cotton wool around it and put it in his mouth so he doesn’t bite himself. She also told us to turn him to the side so he doesn’t choke.

One time, my mother had travelled. It was me, my sister, brother and my cousin in the house. I remember the actual date - May 10th 2001. It was my older brother’s birthday. Also, this was the first time I’d seen him have a seizure right in front of me. He had the first one around 7pm. I held his legs, we couldn’t get the spoon and cotton wool on time so my cousin held his mouth. He finished seizing and we gave him some water and continued watching TV. An hour later, he had another seizure. At this point, my older sister was there so I just stood aside and watched. He had another one thirty minutes later, and then 15 and then the time kept getting shorter and shorter. His medication had finished and it was like the seizures were making up for lost time. Before he was taken to the hospital, I counted 9 seizures. I remember this day so well because I thought this was the last time I’d see my baby brother. He was admitted and given medication and the next morning my baby brother was back home.

Fast forward to early 2003, I witnessed a slight seizure. I say slight because one minute we were talking and then his head, only his head, started turning to one side. I thought he was joking so I asked him to stop, I told him it was not funny. He clearly had no control over it so I rushed to call my mother. When he eventually stopped, he said he could hear everything that was happening, he just could not answer me. 

When we got to university, I got called a few times because my brother was ‘shaking uncontrollably’. One very scary occasion happened early in the morning. He went to pee and his roommate heard a loud noise. He called out for my brother but there was no answer. He then rushed to my room to tell me what had happened. I went over to their room and sat by the bathroom door. I called out to him and there was no answer. The roommate went to get someone to break the door. I refused to leave and of course, I feared the worst. I prayed and prayed. I kept calling after what seemed like hours, he answered me. I asked him to stand up and open the door. Slowly I heard the key turn and he fell into my arms. I helped him to his bed, gave him some water and he threw up. That was my process. After throwing up, he was then able to take medication and keep it down. I put him to sleep and went to the bathroom. It was horrifying. There was blood everywhere. I cleaned it up, and went to sit by my brother. I watched movies as he slept. When he woke up, he looked at me and asked why I looked so worried. He was more concerned about me than about himself. 

The most admirable thing about my brother is he adheres to his medication. He has been through a lot. In 2015, he had what I’d term the worst seizure ever. He was burned but the strength he displayed leaves me in awe. I was worried sick and crying but he put on a brave face. I hope he knows that he has a strong support system. We love him and even though we worry, he reassures us and that’s supposed to be the other way round. He lives as normal a life as possible, he does not let the epilepsy control his life, he controls it. He knows his triggers and when he feels a certain way, he lies down so that if he has a seizure, he is safe. I think that is admirable.

Clarity Of Mind

I am a child of divorce. My parents divorced when I was 4 and I grew up with my mother and my other siblings. 

We were a family of over achievers. From a very young age, I read everything, including the dictionary. I was in love with words and other worlds that novels exposed me to. When I was 7 or 8, I started thinking that perhaps I was adopted. Nothing my mother ever did made me happy. Ironically, all my other siblings were jealous of me because I was the favourite. I did not see it that way. I therefore started slashing my wrists. Nobody loved me. Everyone would be better off if I were dead. Sure, my mother said some hurtful things and I couldn't shake them but she loved me. They stayed with me. I used to go up to the roof with food, a book and water and just disappear into these other worlds.

One day that I vividly remember, I was playing tennis with my brothers and their friends. I’d just finished eating breakfast and did not clean up. My sister came out of the house, really upset with me and dragged me by my dress, unknowingly and unintentionally exposing my underwear. I was 11 at the time. There were boys around and they saw my underwear and I was just torn. How could she do this to me? In my mind, I could never show my face to those guys again and my sister did not love me - in my head. I cleaned up like she asked and then went to her room. I grabbed a handful of pills and downed them. I took another handful and downed them too. I then slept on her bed, waiting to die. Next thing I remember is the dizziness. I stood up, walked to the kitchen and fell face down. A cousin of mine was in the kitchen and she immediately came to lift me so as to help me sit. At this point, I was drooling and incoherent. She called our aunt, who called my mother. My mother’s response? ‘Oh that’s how she is, the little drama queen.’ They convinced her that I truly was in need of medical attention and she drove home to find me seizing and forming at the mouth. I do not remember much. I woke up two days later. They told me I had ‘cerebral malaria’ but everyone knew what I’d done and nobody ever talked about it. I had also taken the liberty of trying to slash my throat - with a razor and blamed it on my sister. I do not know if it was a cry for attention or if I truly wanted to die. This was the start of many suicide attempts. 

As I grew older, I kept to myself, read books and tried to be a good decent girl that my mother could be proud of. For the most part I managed but every time I did not get my way, I’d slash my wrists or harm myself some other way. It was my escape. At school, they called me a loner, a loner with excellent grades. I seemed to keep it all together till my mother died. When I eventually stopped crying, I’d go visit her gravesite and talk to her. She answered me. We had conversations. I saw her a couple of times. In the flesh. I felt her warmth, she was there. We spoke about so many things. I neglected the few friends I had because you see, my sick mother needed me. I had to be there for her. Before she died, she told me she wanted me to be her eyes, her ears, her legs and all. I asked where she would be while I’m all that. She smiled and told me she’d be resting. I didn’t get it then. She was trying to prepare me. I went into shut down mode. And that is when the panic attacks started. Everyday normal activities freaked me out. Going to bath was scary because once, I had heard her voice calling me. My grandmother had heard it too and told me not to answer. Superstitions. Each time I heard my name, I’d have a panic attack. My early university life was marked with numerous panic attacks. Of course, being in Africa, I was treated for malaria, tested for HIV as they assumed that’d be the problem seeing that I had lost a tremendous amount of weight. People assuming I had HIV also fuelled my depression. I stopped eating. In one day, I’d have only a glass of orange juice. I lost more weight. Then quite by accident I discovered I didn’t have to feel these things. There were ways to numb them. Everyone was doing it. And so I started doing it. I started with Codeine then graduated to Valium. It was pretty easy to get. I was at my best while on the drugs and at my absolute worst without them. My life pretty much revolved around valium and Codeine. Still, my work did not suffer. I would be sad one moment, then after a sip of Codeine, I’d be so happy and fun to be around. I needed it for everything. The few friends I had, I alienated. My wake up call came when I could not remember things. I would be in the middle of a sentence and then nothing. I began to submit reports late. After having used drugs to numb my feelings for years, I thought I’d give quitting a go… on my own. This did not go very well. I was throwing up, irritable, very angry, sweating excessively, and gained a lot of weight. I decided it wasn’t worth the effort so I went back. I tried weaning myself off for some time and still it did not work. The last time I told myself, it was me or the drugs. They were going to kill me or I’d have to kill the habit. And so I got help. I spoke to someone who encouraged me and held me as I hurled, tolerated my fits of anger and stood by me. It took months to get back to normal. Even now, I cannot sleep properly but clarity of mind is more important. I am more alert even though I struggle to remember some things. I sometimes have panic attacks but I can manage them. I understand that everyday is a blessing.

I have good days where I want to use so badly and then I have great days where I want to use and I DO NOT USE. I haven’t thought of killing myself in a long time. Sure, the voice in my head that says I am not worthy and I should just kill myself won’t keep quiet but I am able to shut it down. Every single day is a struggle but everyday that I wake up is proof that I overcame that struggle; at least for that day. That is how I live everyday, and then repeat.

As told to Zunzika Thole-Okpo