Source: Inkscape
This post is mostly stuff I'm reading about from different places. I really do not know how I'm supposed to write about my personal experiences in the history of psychiatry in Africa. But stick around I might get some stuff that might interest you.
Before I go on
I need you to know that psychiatry is new to all this organization. The first college of psychiatry was established in 1841...that's 41 years after the establishment of the Royal College of surgeons and close to a hundred years after the college of physicians was made.
In the 1840s successful painless surgeries were done but not much was known about psychiatric disorders. Most of what happened in the 19th-century was organization and a large part of that was how those with mental health issues were treated. Patients of psychiatry were not treated as though they were people.
People who suffered from these conditions were kept in the worse states you could possibly imagine.
Among those who kind of changed things for the care of psychiatric patients was Benjamin Rush. Although even at that time he had some flawed thoughts about how psychiatry should be handled. It was part of the time.
For example, the centrifugal board was a thing. It was designed to increase blood flow to the brain and the thought was that low blood flow was the cause of psychiatric disorders.
But Rush, even though he was part of his time in treatment, he believed that some of those with mental health issues could handle minimal tasks like gardening and washing. He still believed in the use of chains for restrains anyway.
Africans don't feel sad
One of the things the colonialists thought when they got to Africa, was that Africans do not have the capacity to be depressed.
As shocking as this sounds, I do not find this shocking. Colonialists really thought very little of those they ruled over, so to have that thought about us is not such a big deal. What I really don't want to imagine is the amount of abuse that Africans might have faced.
Before Yaba Left
In 1699 in Cape Verde South Africa, the first documented hospital (I saw on the internet) was established by Jan van Riebeeck.
The patients were kept on straw stacks and were cared for by African slaves in Africa.
I'd keep talking about this dungeon more but nobody likes this part of history plus nobody except Jan's mom likes him.
Source
Yaba Left
If you check Yaba left on youtube all you'll find are stories of missing patients. Ewwww living conditions of patients...lots of stuff nobody should be looking at but everyone needs to see. It makes me wonder why this government institution is still functioning.
But the reason for all these pre-Rush living conditions could be as a result of loss of funding. I read papers that date back to 2017 when the Social welfare of the hospital lost some of its funding.
The hospital was established in 1907. The first building in this hospital was from an abandoned railroad and at that time less than 50 patients were being cared for by a doctor and asylum attendants. There were no nurses, beds, or pharmacists.
They were treated with conventional drugs at the time.
The 1950s was the first time qualified doctors and nurses were brought to Yaba and an outpatient and occupations therapy started. It was at that time called an Asylum but was later changed to a Mental Hospital.
Patients were sintered tranquilizers and deep insulin therapy. In addition to the psychiatrist who worked in the hospital were the nurses and pharmacologist.
The hospital is currently undergoing development in its infrastructure after over 100 years of existence. Currently, there are several news articles about the corrupt practices affecting the hospital's funding.
Traditional care for Mental health problems
If you are able to hear from any African elder...I'm really interested in having these answers.
Post Summary
- Most of what we practice in Psychiatry got organized in 1841 after the establishment of the Royal College.
- The initial thought by Colonialists about Africa concerning depression was that we were incapable of these emotions.
- Yaba Left, after 100 years of existence is still a work in progress.
Case Presentation
For this weeks I am presenting a case of depression in a COVID patient, just to remind any one who still has a Colonial state of mind that African can do this!
Do what Ebingo?
Get depressed.
The case report I am using is from Dr. Modupeola Olugbemisola Motojesi et al posted in SSRN
Ms. A.M is a 31-year-old to the Emergency Department with complaints of:
Sadness and poor sleep of 2 months duration
A month's history of suicidal ideation
And a 3 week history of suicidal attempts
She had other depressive symptoms such as lack of appetite, and loss of interest in previously pleasurable activities. No anxiety.
She had a 3 month past medical history of being diagnosed with COVID-19.
Her diagnosis led to a lot of ridicule on social media and rejection from family and all that progressed to the suicidal attempts previously noted.
A mental state exam showed a fairly well-dressed young lady with a sad mood and dull effect.
A diagnosis of Recurrent Depressive Disorder, Current Episode Severe without Psychotic
Symptoms was made.
Documentation of what was done for the patient is not available.
