A funeral is underway. Relatives and friends are mourning the untimely death of a family head. The mood is somber. Suddenly, a woman wearing a thick layer of clothes enters, panting and sweating profusely. In local dialect she shouts, “You’re taking long to finish!” Her loud outcry causes stares, murmurs and even laughter.

A security guard rushes towards her and on seeing him, she takes to her heels. She disappears out of sight with the security guard hot on her heels. “She has been that way since her mother died,” one of the locals is heard saying. That she has not been assisted to find medical care for her condition can be attributed to lack of awareness within the community. It is not uncommon for people suffering from mental illness to be treated as nothing more than public nuisances and subjected to all sorts of human rights abuse and discrimination.

An invisible spiritual curse?

What is it about mental illness that arouses fear and stigma? People with psycho-social disability have been beaten, tied up, locked up and even turned homeless. They lose their status in society, sometimes they lose their property to relatives, they lack platforms to express their challenges because nobody takes them seriously and they barely have access to justice. Even after they have received treatment, it is likely that previously mentally handicapped people won’t find complete acceptance and that they will find it difficult to reintegrate within their societies. Dr Charles Mudenge, a psychiatrist at the University Teaching Hospital of Butare (CHUB) says, “Due to lack of awareness, most people still think that mental illness is an ancestral curse or punishment for wrongdoing or disobedience from God.”

Sam Badege, the founder and head of the National Organisation of Users and Survivors of Psychiatry in Rwanda (NOUPR), agrees with Dr Mudenge saying that indeed, most people link mental illness to spirituality. Badege believes this linkage is caused by the “invisibility and intangibility of the disease.” Andy Behrman, an American author who suffers from Bipolar disorder, a type of mental illness, wrote an article in 2005 titled, ‘Dump the Stigma and Focus on Recovery.’ In the article, he talks about how he felt when he was first diagnosed with the disease. He says, “The guilt I felt for having mental illness was horrible. I prayed for a broken bone that would heal in six weeks. But it never happened. I was cursed with an illness that nobody could see and nobody knew much about.” Behrman also says that the biggest concern his parents had about the disease was that they would face stigma from society. Perhaps this stigma also arises from lack of awareness about the fact that mental illness has a variety of causes and risk factors.