We went to the Psychiatric hospital in Mmbarara yesterday, Gabriel and Muhindo and I. Muhindo began displaying a “mental disorder” a few months ago, hearing voices and then seeing hallucinations of terrifying black hooded creatures with horns. Being around the other children hurts his ears. The first doctor called it epilepsy, but Gabriel and I talked and he found a good psychiatrist in the regional specialist hospital, about two and a half hours away.
The voices are gone, but Muhindo is displaying what I’ve heard called the “thorazine shuffle.” He sits rigid and still on the edges of the group, speaking softly when you draw him in. Mostly the other kids navigate around him.
Muhindo is 16.
Schizophrenia is not a kind disease in North America, even well managed. Muhindo has a family, a grandfather who works as a palace guard at the local king’s compound, and who is rumoured to be a witch doctor, with a shrine in his garden. His mother lives deep in the bush in a tiny village. Muhindo was born with a disability that makes his leg stiff and his left arm unusable — he’s not of much use in the village. He’s been in the project since he was tiny.
There was a flurry of drama the other day, the family triggered by our visit, an attempt to take him away to the witch doctor, accusations that the madness is from bewitchment, a demand for a goat to sacrifice to remove the curse. Much noise.
Muhindo told his mother that he would be more comforted if she stopped moving about and stayed with his grandfather nearby. He came to us later and asked if we could give her money to start a small business. We talked about how we are supporting him to go to school so when he is grown he can look after her. “I am saving some small coins now,” he said. My heart broke.
We went yesterday for his second visit to the psychiatrist, a good kind woman I immediately trusted.
I’ve been to local hospitals before, chaotic loud places filled with unsalved pain. The specialist psychiatric clinic was clean, orderly. Mostly ambulatory, a few in-patient beds, people sleeping quietly on spare beds, just two or three to a room. Basic but competent.
The questions are many, with scrawny answers. Where does he go for the holidays this year, while he’s in a slow-moving, staring state? The village would be disastrous. He’s starting secondary school in February, boarding like all students — how do we toss him into the chaos of a big school with his need for gentleness? What can his future possibly look like?
Gabriel connected to me someone who works for the national mental health organization the other day for advice. Everyone agrees that most Ugandans are frightened of madness, assume it’s from bewitchment, want to treat it through “cultural” means. “But as you know,” said Vincent, “schizophrenia does not go from being smoked.”
I loved the doctor. She talked to Muhindo, and he made slow replies. We made a plan to adjust the chlorpromazine dosage to reduce the sedation, to maintain the anti-depressant, to move in a month to a monthly injection of the anti-psychotic so he’s not as dependent on taking his meds daily. She suggested a small vocational high school near the regional health centre where he can come monthly to see her. And gain some skills that might enable him to earn a living.
We had our big boys and big girls meetings yesterday, talking about setting goals, academic and personal, for the next year. At the end, I asked the four boys entering their first year of secondary if they had anything they needed the bigger boys to help them with.
Muhindo was the last to speak. Quiet, halting, flat.
“Help us find our good friends.”