It’s been more than a year since Boko Haram brazenly kidnapped more than 200 girls from their boarding school in northern Nigeria. Since then, the same jihadis have massacred 2,000 people in a nearby fishing community on Lake Chad.
In the face of such wanton bloodletting — which occurred near a military base meant to curb radical violence — it stands to reason that many would seek aid from trained medical professionals in coping with or dispelling the resulting emotional damage. However, survivors were quickly and dispiritingly reminded that such assistance is beyond scarce in this corner of the world.
A video report featured this week on the Al Jazeera website showed Nigerians turning to traditional healers and noted that those who opt for remedies rooted in ritual and history do so not simply to preserve a link to their cultural heritage or out of distrust of Western medicine, but because there are few options available.
According to the World Health Organization, 20 million Nigerians currently exhibit symptoms associated with at least one recognized mental illness. Here’s an even grimmer statistic: In the whole country, there are just 130 psychiatrists available to treat them. A “brain drain” has led medical specialists to establish themselves in other countries, mainly the United States, leaving behind a distressing vacuum of care and expertise.
The W.H.O. estimates that Nigeria devotes only about 3 percent of its healthcare budget to mental health. The impact of such policy can be readily seen in the dearth of licensed practitioners. In 2011, the W.H.O. reported that for every 10 million Nigerians, there were six psychiatrists, 19 nurses trained in mental-health work and two psychologists or social workers. Perhaps even worse, only 44 outpatient facilities and eight mental hospitals were tasked with serving a population of 174 million people.
There is hope, however, such as it is. The long-neglected plight of the non-radicalized members of this society is finally getting attention from on high. Al Jazeera reports in the aforementioned video that the governments of Ghana, Kenya, Nigeria and South Africa are pooling their resources to launch a pilot program that would blend Western-sanctioned and traditional African treatments.
It is likely that the Nigerian government has taken steps to expand coverage not because it fears that traditional healers will do harm — practitioners are highly regarded in the country, after all — but because there looms a crisis that the government knows it cannot afford to ignore: the fragile mental health of Boko Haram’s survivors.
A raid by Nigerian forces on the terrorists’ stronghold in the dense Sambisa Forest resulted in the rescue of hundreds of women and children. But while they summarily received medical care for their physical injuries, their emotional trauma went largely untreated. The result: unresolved depression and anxiety, disorders typically found among victims of physical, verbal and, in this case, explicitly sexual abuse.
In another Al Jazeera article, a Nigerian woman who was held captive for 11 months with her six small children said that she tries every day to move on with her life but that “the memories are rooted deep in her mind.” Other former captives echoed that sentiment. One recalled witnessing the murder of her husband and eldest son before the militants forced her and her remaining children into the woods.
The Wall Street Journal found nine psychiatrists attached to the Federal Neuropsychiatric Hospital in Maiduguri, Nigeria, whose caseload had doubled as a result of Boko Haram atrocities, leaving them to struggle under a staggering backlog of 52,000 cases.
The doctors each said that he or she was too loaded down to spare more than a few minutes to each patient. In the end, they often found themselves issuing prescriptions for antidepressants that they knew some patients might not even be able to afford.
Nigeria is still working out the details of its initiative to blend traditional healing techniques with its scarce mental-health resources. Unfortunately, even if the program as envisioned is actually ever launched, for many a victim of Boko Haram’s excesses, it will have come too late. And those citizens could be forgiven for holding their government — whether because of a lack of resources or a lack of political will — complicit in extending their psychological pain.