CHAINED: Helpless families, communities troubled by untreated mentally ill persons

Around midnight of February 5, 2016, a mentally ill young man, Kingsford Akagiire, unleashed a sudden attack on his mother, Atampoka Akagiire, at the family’s home in Zorkor, a community in the district.

While his mother was asleep, he appeared on the cemented compound of the house and smashed her head with a stone.

“The stone was so huge he must have lifted it with both hands before he crushed her head with it,” Kingsford’s elder brother, Clement, told The Fourth Estate.

The 52-year-old woman was rushed to the Bongo District Hospital in an unconscious state and referred to the Tamale Teaching Hospital for a head surgery, according to Clement. She died in Tamale on June 16, 2016.

“He just returned from the Zorkor market that night and carried out the attack,” Clement recalled. “Our mother was sleeping on a mat outside at the time because there was heat in her room.”

“Seeing the blood spilling out from our mother’s head and a crowd gathering around, he realised that his action had stirred up anger and so he fled the house immediately.”

Inside a two-room old mud house a few metres away lives another woman, 75, who was almost burned alive in 2019 when his mentally ill son, Atampubire Ayambire, set fire to the house.

The woman, Azaare Ayambire, told The Fourth Estate she was traumatised because the actions of her 42-year-old son were posing danger to her life.

She said the latest attack came at dawn on December 31, 2022, when he whacked her on the waist with a stick.

“After he set the house on fire, I became more frightened and resolved to leave the house. I packed my belongings,” she told The Fourth Estate. “But I reconsidered the decision because I couldn’t go and leave a biological son behind in his condition.”

Standing in front of the partly burnt house with the same stick her son had used to hit her waist, Madam Azaare said she hardly had enough sleep because of fright.

“He is often emotionally charged. He can be in that mood all night, walking up and down in the house, talking loudly to himself and acting violently.

“I hardly close my eyes on such occasions for fear that he might break into my room and attack me. This prevents me from getting enough sleep almost every night,” the old woman added, her voice quavering. Her son was wandering in the main market at Zorkor at the time.

Scared families resort to chains to avert attacks

Mental healthcare givers say most of the mental health cases in the district are due to drug and substance abuse. There are oral medications and jabs at health facilities in the district for treating mental illness.

The costs of the medications and injections vary. Depending on the medicine and the brand, they range from Gh¢30 to Gh¢200, or more.

The medications and jabs are administered periodically, generally every month, until the illness is treated. Several families in the district cannot afford them.

Poor families, whose mentally ill relations are aggressive, mostly resort to chaining them up to prevent them from causing harm to life and property.

Several mentally ill persons are in chains in the district. No fewer than five mentally ill people, two of whom have been in shackles for years, are regularly seen in ragged appearance at the district’s central market.

One of them, a shaggy-headed man called Anaba Azure, gained notoriety for attacking people at the central market and on the streets before his feet were shackled.

“We don’t have the money to treat him. When his violent attacks on people in public places got out of control, all we could afford was a chain,” said Anaba’s auntie, Akiske Azure.

“We got some men who overpowered him and chained him. Even with the chains on his feet, he is still dangerous. We fear to go near him to change his clothes.”

Apodola Abenaba is shaggier than Anaba. Both his hands and feet are in chains. He frequents the central market, begging traders for food. He eats from the market’s dustbins when nobody seems to have any food to spare. He was chained up after he unleashed a string of attacks on people, including one attempt on his mother.

“One night, he attempted to beat me. He was holding a stick. I told him to let me lie down so he could kill me because already it was no use for me to live a life which had been rendered meaningless by his condition,” his mother, Asampana Abenaba, told The Fourth Estate at Anafobiisi.

She continued: “He was raising the stick; then, he paused and stared at me. After a while, he threw the stick away and left the room.”

The chain on Apodola’s feet, which he has worn and walked with everywhere for many years, has peeled off parts of the underlying skin around his ankles. He is often seen using his chained hands to scratch around the bruises inflicted on his ankles by the itchy chain on his feet.

“I weep each time I see my own son at the market this way. He was extremely violent, hurling stones at people and vehicles. We had to chain him as there was no money to treat him,” said his mother.

Similarly, Kingsford, the mentally ill young man who committed matricide at Zorko with a stone, was later captured and chained in both hands and feet after that attack.

Mentally ill man warns parents

A mental health nurse at the Zorkor Health Centre, Norbert Akayeti, observed that families were resorting to chaining up their mentally ill relations not only for the safety of the public but also for the protection of the mentally ill.

He cited an example of a mentally ill young man who once attempted to take his own life in a dam at Zorkor but was obstructed by somebody who saw him heading towards the dam.

He was later put on treatment at home. But while undergoing treatment, one day he told to his parents that he had plans to physically harm people or himself sooner or later. After putting his parents on the alert, he also urged them to chain him and lock him up in a room to avert the intended attack. Although his parents took the warning into account, they delayed in putting preventive measures in place.

Soon after the warning, he appeared at the door to his parents’ room and, with a threatening tone, demanded that his father come out.

“The father was fortunate that the door was locked. When I visited the house later, he was in chains. Nobody can convince the family to release him.

“Meanwhile, the same area has a history of a mentally ill person drowning himself in water. Mentally ill persons are dangerous to themselves, too,” said Akayeti, adding that at least five mentally ill persons were in chains in Zorkor alone between 2019 and 2022.

Akayeti said he did not subscribe to the idea of keeping mentally ill persons in shackles because it was a violation of their human rights. But he admitted that there was a limit to how far mental healthcare givers could go in persuading some families to avoid the use of chains and focus on medications alone.

After taking his mother’s life, Kingsford initially did not receive any medical treatment as his family could not meet the cost. He kept struggling in shackles in the streets of Zorkor, mostly wearing only a particular pair of underpants everywhere, until Akayeti put him under medical treatment, the nurse footing the bills himself. When The Fourth Estate visited Kingsford on December 31, 2022, he was not in chains. He was found weaving straw baskets for sale.

“While I make sure he (Kingsford) takes the oral medication or the jab every month so that he does not relapse at any point, I also expect that the family would do away with the chains,” Akayeti told The Fourth Estate.

“But the family does not want to take chances. I shouldn’t force them, either. I want to avoid a situation where I would be blamed should anything unpleasant happens.”

Some years ago, a mentally ill man died of malaria while in chains at Namoo, one of the district’s border communities. His death drew not only sympathy from a section of the public, but also condemnation over the neglect he suffered.

Clement said the shackles posed restrictions to his brother and stigma to the family. He said he wished Kingsford regained his freedom, but there was little or nothing he could do because the decision to tie him down was a collective one.

“I feel sorry to see him this way. He was a brilliant student at Bongo Senior High School. He completed there with good grades in his final exams.

“Nobody knows what caused the mental disorder all of a sudden,” he said.

Several individuals in the district are in the same dilemma as Clement. They maintain they resorted to the use of chains because they had nowhere else to turn.

The Assembly Member for Tarongo/Atiabiisi, Patrick Aduko, said he had tried to seek help for Kingsford but his efforts yielded no result.

“I went to the social welfare office in Bongo. They promised to work on it. I followed up but nothing has come out of it,” he stated. “These are not issues we can go to bed and sleep over. When hallucinations set in, they can kill. Authorities, including mental health organisations, need to act now.”

Aduko’s call was reaffirmed by the Assembly Member for Kanga, Prosper Atogyire, who said he sympathised with Atampubire but feared for the lives of those who lived close to him.

“It’s very serious. I feel sorry for him and the family. The trauma that the mother and the auntie are going through is very pathetic. He has been beating them. His brother’s wife came to stay in that house.

“She was pregnant. He beat her up. She has run to a different place. He has broken all the walls around the house. I fear for their lives. His case needs urgent attention,” he said.

“The youths are the most affected”

Speaking to The Fourth Estate, the Assembly Member for Atampiisi, Asampana Mba, said his electoral had a high number of mentally ill persons.

“In my electoral area alone, there are about 12 people I know as having mental disorders. Some of the mentally ill people are breadwinners in their families. You see them roaming, unconscious of where they are and causing problems for their families. The youth are the most affected. They need to be taken to the hospital and given drugs.

“But some families cannot afford the drugs because they are poor. I want to appeal to the Government of Ghana and the Ghana Health Service to come to the aid of these families, at least, by supporting them with drugs. I believe they will become normal and help society if they get the drugs,” he said.

Felix Giba, another mentally ill man, lives in the same electoral area, near the Bongo District Assembly. His brother, Peter, told The Fourth Estate that Felix was a successful kola-nut businessman until his goods were seized twice at a border checkpoint in the late 1980s.

“He became frustrated and developed mental illness following that experience between 1988 and 1989. He still sells kola-nuts at the market but this time on a small table.

“Sometimes, he abandons the kola-nuts on the table and starts roaming everywhere. Then, he returns home at night and starts talking alone. His condition surfaced gradually and grew to this point. We are afraid it might get worse with time if we don’t get help,” Felix said.

Another mentally ill person, Asale Atanga, lives in Atampiisi. His wife, Ndigura Atanga, told The Fourth Estate her husband’s illness began in 2014 when he returned home from the market, screaming while claiming that he was being chased by an imaginary aircraft. He reportedly kept pointing at the skies as he ran zigzag on the compound for cover in front of a bewildered family. According to his wife, nobody else but Asale saw the alleged aircraft.

“Since then, I have remained the family’s sole breadwinner,” Ndigura said.

She was sitting on the cemented compound of the family’s house and removing shells from a small heap of groundnuts by her side. Her husband sat a few inches behind her, interrupting her speech and voicing words that had no clear meaning.

“I am a farmer. The farm has been our source of survival. He does not consume any produce from the farm. He does not allow me and the children to eat anything from the farm, either.

“We normally sell our harvests and use the proceeds to buy food. There is no peace in the house. An entire family’s burden is squarely on my shoulders. I’m taking care of him and the children alone,” she added.

Ghana’s Chief Psychiatrist explains how a rescue mission failed

Some years ago, the Mental Health Authority (MHA) embarked on a nationwide mission to rescue all mentally ill persons from the streets.

Dubbed ‘Operation Clear the Streets’, the project was launched after a rapid study undertaken by the MHA in 2015 revealed there were 6,000 mentally ill persons on the streets nationwide.

But, after a reported promising start, the programme encountered a sudden flop.

Ghana’s Chief Psychiatrist and MHA’s Chief Executive Officer, Dr Akwasi Osei, told The Fourth Estate that all mentally ill persons would have been out of the streets today if the programme had continued.

“We went to the streets across the country. We brought 5 patients at a time to the hospital and treated them. Within one or two months, they were well. We sent them back to their communities, not the streets, and reintegrated them. Then, we looked for another set of five. All over the country, we treated 600. A time came we could not continue because we didn’t have funding coming from the central government and the civil society also was not supporting [us],” Dr. Akwasi Osei said.

“So, we had to stop, unfortunately. If we had continued, by now there would be no single person on the streets to be causing the havoc that we are hearing. These are real security issues. If you give us the money we need, we will take all these patients from the streets within two years and treat them,” he said.

He added: “I won’t be surprised we might be hitting between 10,000 and 12,000 of such patients on the streets today. That is the situation. It’s a huge problem.”

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