Timothy Olanrewaju, Maiduguri
The decade-long insurgency in the Northeast is taking a toll on the mental state of people in the area, particularly displaced persons who have lived longer in the refugee camps, haven been forced out of their homes by Boko Haram.
Borno accounts for 1.8 million of the three million people displaced from their homes by insurgency, a 2019 report by the UN Office of Humanitarian Coordination in Nigeria has revealed. More than half of this population is still stuck in garrison-like camps for internally displaced persons (IDP), unsure of their future and uncertain if they will ever return home.
“I wake up each day and ask my wife if we will ever return to my place. I leave everything to Allah,” Ali Saleh, a septuagenarian, told Sunday Sun.
He is among scores of IDPs striving to cope with the impact of the violence and boredom that has resulted from the prolonged stay at an IDP camp in Maiduguri.
Saleh arrived at the camp in the late 2014 after Boko Haram raided his community in the northern part of Borno State.
The silent killer
Not many are aware that mental health could be a silent killer. Experts revealed that most victims struck by post-trauma disorder and mental health problems hardly believe they need help because they are not aware of their condition.
“They still believe they are normal and may not be aware of the change in their attitude,” Dr Ibrahim Wakawa, medical director, Federal Neuropsychiatric Hospital Maiduguri, said.
Such is the case of Mustapha (other names withheld) an IDP. He owned a thriving fish business and other trades in Baga, a once thriving commercial town on the shore of Lake Chad in the northern part of Borno. But his circumstances changed in 2014, when Boko Haram struck. He was forced to flee his home, left behind his well-furnished bungalow, two cars and shops.
He lived in a temporary shelter that can barely accommodate half of his 13-member family at an internally displaced persons (IDPs) camp in Maiduguri.
“He often complained he wasn’t happy waiting for food every time on a queue. He said he was tired of staying at the camp. He started withdrawing from people and would no longer wait to chat with us after the morning (Muslim) prayers,” Bukar Aishemi, an IDP and friend to Mustapha, told Sunday Sun.
Mustapha’s case is just one of many instances of depression among IDPs in the various camps in Borno. Sunday Sun discovered that scores of IDPs are experiencing psychological or mental health challenges not only because of gruesome killings of loved ones, loss of their homes or livelihoods, but also due to fatigue in camps and lack of economic activities
Nearly half of the estimated 2,600 households living in three formal and other informal IDP camps in Gwoza, a town located Southeast of Maiduguri, have manifested varied mental or psychological challenges largely caused by the pressure from the decade-long violence, concerns over survival and prolonged crisis.
“People in Gwoza have a wide range of mental health needs. While some of these are typical of the pressures related to daily life anywhere in the world, many are directly and indirectly related to the recent insurgency and the ongoing conflict. Issues such as grief and loss, trauma, the stress of living in a camp for displaced persons, lack of employment, constant safety concerns and food insecurity can affect the ability of people to cope and function,” a mental health activity manager with the international medical volunteer organization, Medecine Sans Frontiers (MSF), Kyla Storry, said in a recent report by the organization.
In the report entitled, Children Can Draw Assault Rifle Better Than a Football or an Animal, Storry chronicled her experience, especially with children who have clear manifestation of mental health in Gwoza’s IDP camps.
With exposure to incessant gun duel between the military and Boko Haram, displacement and closure of schools, crowded shelter and uncertainty about returning home, children in Gwoza camp now express their mental state in drawing assault rifles.
“Kids tend to act out what they know, so some that have been exposed to violence engage in play that includes shootings and killings with their friends. When given paper and pencils for drawing, some children can draw assault rifles better than a football or animal,” Storry said
Triggers of mental health issues
IDP camps in the state are mostly crowded. Movements and other rights, including privacy of displaced persons are largely restricted. People have lost their means of livelihood and as such mostly rely on food and some other essentials from the federal and state governments as well as aid organizations. The reporter observed that the foods are oftentimes in short supply. Some IDPs said they are tired of the types of foods being given to them in the camps. They expressed eagerness to return to farm in their ancestral homes where they can produce food for consumption.
Experts identified increasing desire to return home, unending security challenge and brutal killings of loved one in the violence as some conditions that trigger mental health challenge among IDPs in the Northeast. They said these factors are further complicated by post-trauma stress or condition from the Boko Haram violence.
“War victims are regarded as one of the highest risk groups for mental disturbances,” a professor of psychology, Abdalla Hami, stated in a 2010 research work on mental health problems among IDPs published in the National Library of Medicine. Abdalla attributed lack of employment, unsuitable food items and insecurity around camps as some pf the factors fueling mental problem and psychological stress.
Borno State government said it was mitigating mental health issues in collaboration with other partners, including the World Health Organization (WHO) and other UN humanitarian bodies in the state.
Permanent Secretary, Ministry of Health, Dr Mohammed Ghulize, told Sunday Sun that the prevalence of mental health among IDPs necessitated the development of a framework by the state government. He said 48 per cent of the displaced persons have mental health challenge.
“Most of the IDPs never envisaged they will be out of their ancestral homes. We all thought the insurgency was going to be for a short while when it started, but unfortunately, it has dragged on for over 10 years now,” he said.
Ghulize who once headed the state team that developed the mental health framework, said the government has done massive training of health personnel to give psycho-social support to the community.
He said 2,120 Community Health Workers (CHEW) had been engaged. He said the volunteers are to seek for IDPs and community members who will need further care for minor cases while those requiring referral for more treatment will be sent to psychiatric hospitals.
The state psychiatric hospital in Maiduguri has been renovated by the World Health Organisation (WHO) to support the Federal Neuro-psychiatric Hospital. WHO Country Representative to Nigeria, Dr Walter Mulombo, said during the inspection of the hospital.
He said that the hospital was renovated in recognition of the increasing need for mental health and psycho-social supports to the people affected by violence in the area.