ZAMBIA’S TICKING TIME BOMB OF PSYCHOTIC KILLINGS, SUICIDES AND DRUG ADDICTION

On the evening of Monday, July 3rd, at the edge of Luanshya's Gedion Dam, with this year's International Trade Fair in full swing in nearby Ndola, 32-year-old Samson Zulu stripped off his clothes. First, his grey t-shirt, then his black plastic belt, followed by his blue denim jeans, and finally, his slippers.

Zulu then proceeded to hurl himself head first into the chilly waters of Gedion Dam. Taxi driver Chris Kasonde, who witnessed this unfolding incident, later reported it at the nearby police post.

The next day, Zulu's lifeless body was found floating in the dam, leaving his grieving mother, Elly Mutale, to identify him. She tearfully recounted to the police that her son had approached her for K2, an amount she couldn't provide, and that was the last time she saw him before he departed from home.

Regrettably, such heart-wrenching occurrences are growing alarmingly prevalent in present-day Zambia, with an escalating number of suicides and deaths linked to psychotic episodes.

Tertiary Institutions struggling to cope

At the University of Zambia (UNZA) alone, there have been five student suicides so far this year, and the management is struggling to handle the influx of students seeking counseling.

UNZA administration cites understaffing as the primary cause of the counseling centre's issues. Despite having over 10,000 students at its Lusaka Great East Road campus, UNZA only has one qualified counselor. Two staff members from other departments have been seconded to the centre.

Ideally, the counseling centre should have no fewer than six qualified counselors as staff members. Last year, three counselors had to conduct sessions running into the night and even on weekends to address the backlog of 928 students who visited the centre.

James Nyimbili, the only qualified counselor at the centre, explains that most students who seek help at UNZA counseling centre do not return due to their frustration with the lack of staff to address their pressing issues adequately. He mentions that students take time from their busy academic schedules to visit the centre, only to be disappointed by the understaffed facility.

Nyimbili further discloses that UNZA's Dean of student affairs, John Munkombwe, has expressed concern about the high number of student suicides and has indicated the possibility of hiring additional qualified counselors to strengthen the staff.

Research conducted by psychologist Namanje Mwiinga reveals that a high percentage of UNZA students are at a high risk of developing depression, anxiety, or alcohol use disorder.

‘‘The study found a prevalence rate of 36.6% of students were screened positive for symptoms of depression, 25% for anxiety and 21.3% for alcohol use disorder,’’ the research paper disclosed.

Mental health on the rise globally

According to Dr. Ravi Paul, a consultant neuro-psychiatrist at the University Teaching Hospital (UTH) in Lusaka, mental health conditions are increasing worldwide, and Zambia is no exception.

Over the past four years, mental health problems have skyrocketed, partly due to an upsurge in gender-based violence, depression, anxiety disorders, post-traumatic stress disorder (PTSD), and marital disputes.

Dr. Paul explains, "During COVID, we observed that drug abuse became a significant issue as people started abusing more drugs to cope with the stress induced by the loss of a family member or a friend. Drug and alcohol abuse and dependence increased."

Dr. Paul also notes that the youth have become impulsive, seeking instant gratification and wanting to fulfill their needs and desires quickly. They lack a vision for the future and a desire to contribute to society. He emphasises the importance of parenting and resilience-building, suggesting that the high suicide rates in the country, particularly among adolescents, may be attributed to a lack of resilience and patience.

“Youth have become very impulsive. They want instant gratification – to fulfil their needs and desires way too fast. They want to achieve everything not in years, but in months. So in doing so they get exposed to these drugs easily, sexual intimacy much earlier in their lives, and having done it they feel that there is nothing left in this world for them to carry on.

“They don’t see a vision, future, that there is something they want to give back to society. They are very self-centred, very selfish and they just look at their own need,” he observed.

In an exclusive interview with MakanDay, Dr. Paul provides a comprehensive analysis of the problem, offering invaluable critical insights.

“Maybe it’s our parenting which has made them very soft, which makes them not to fightback with adversity, not to be patient to wait for the appropriate time, and therefore because of all these reasons, the suicide rate in this country has gone very high. And it’s mostly youngsters, adolescents,” he notes.

“Failure in a class, they are committing suicide. Failure in love, they’ve taken doom or any other pesticide, or they’ve cut their wrist, or they have done something which is very nasty. You try to talk to them and you find that they have no desire to live. What will I live for?

“That vision to be someone, to help society, is lacking. Vision to help people in your country, to be patriotic, to live for your nation, to die for your nation. That is missing. They just live for themselves. When someone consumes an over-dose, they don’t even think of what goes on in their parents’ hearts, or their caregivers, what do they go through?” he asks.

“The only thing that parents want from you, after giving you a head-start in life, a good education etc, is that you have a healthy life and are successful. It’s very hurting and traumatic. We have run out of ideas on how to motivate young people.

What should we do so that youths look up to being good responsible citizens who can contribute in some way towards the betterment of society?”

Parallel to the mounting suicide rates, there has been a noticeable decline in the government’s allocation of funds, leaving health centres unable to obtain vital medication for patients. Mental health services have also been deprived of adequate support, with minimal investment being made.

The predicament in Zambia's health sector is exacerbated by the country's ongoing challenge to repay billions of dollars in loans to international banks, significantly impacting its financial stability. This, in turn, has led to a notable decline in the allocation of funds towards critical social services, including healthcare and education. According to Debt Justice, an anti-poverty campaign group, spending on these vital are as experienced a worrisome reduction of 21% between 2019 and 2021.

But what are the major risk factors for suicide?

Exploring the primary risk factors associated with suicide, Joshua Rodgers and Benjamin Weinstein highlight in the sixth edition of Neurology Secrets that "the most influential risk factor is the existence of a psychiatric disorder, particularly a mood disorder, accounting for 50% of all suicide cases."

They note that while men are more likely to complete suicide, women tend to make more suicide attempts. Additionally, approximately 25% of completed suicides occur in conjunction with alcohol intoxication, further emphasising its relevance.

Community psychiatry as a possible solution

Dr. Paul believes that to have impact, a robust approach towards mental health is necessary.

“We need many more Chainamas. One Chainama is not sufficient. But because of limited capacity at Chainama, it cannot admit a patient beyond a couple of weeks, whichis a very short period to control a mental health situation.

“At the least the patient needs a few months of stay in a high secure unit where client safety is paramount. But you find that in our units a patient can easily escape. Those that are secluded are very few, maybe 10 at a maximum, and catering for a 20 million population, I think Zambia needs to look into what is required or needed in Zambia,” Dr. Paul observed.

A possible solution is community psychiatry with community centres managed by the communities themselves.

As described by Farlex Partner Medical Dictionary, it involves “the detection, prevention, early treatment, and rehabilitation of patients with emotional disorders and social deviance as they develop in the community rather than as encountered one-on-one, in private practice, or at larger centralized psychiatric facilities; particular emphasisis placed on the social- interpersonal-environmental factors that contribute to mental illness.”

For Zambia to establish this approach would require massive funding, but as Dr. Paul observes, “our funding is minimal for mental health. Even generally for health it is less, but for mental health it is a bare minimum.

So we still need seclusion centres or mental hospitals, seclusion units where these patients can be kept and their safety ensured, and to also ensure the safety of caregivers, so that when their condition improves that is when they are sent to the community centres and they are monitored to see if they can transition back into society.”

Apart from Chainama, Zambia has around seven private rehabilitation centres, but specialising only in counselling, they do not provide medication. Furthermore, they come at a high price affordable only for a select few.

“What happens next is that parents negotiate with prisons, to keep their children for even a few months so that the drug withdrawal can occur and they are not aggressive and violent and they are not psychotic any more. That is when they are released. It’s a private arrangement which I think is still working because otherwise they will be aggressive and violent and cause so much trouble,” says Dr. Paul.

Escalating drug consumption & addiction

Cannabis is still the beginner’s initial drug of choice due to its easy availability.

Before 2010, Zambia was largely a drug transit centre with most potent drugs coming from Afghanistan.

But the transit days are long gone and Zambia now has a thriving local drug clientele.

“Now we have plenty users here. All drugs are now coming into Zambia – cocaine, heroin, ecstasy, LSD, christal meth, medical mushrooms – you name it, we have it here.”

Users are initially enticed by the ridiculously low prices, but once hooked, the price increases.

“You wouldn’t believe the cost is a bare minimum. Maybe for K5 you can get a parcel of heroin. It may not be pure heroin but it still is. Also the cannabis suppliers no longer sell pure cannabis. They mix it with other concoction, psychotropic medications, heroin, coke. So you find there is no pure cocaine user, and when they stop they don’t have withdrawal from purely cannabis but many other health conditions. It’s a mixture of withdrawal problems. This is a ticking time bomb,” explains Dr. Paul.