Thousands of people with mental health conditions are chained and locked up in various facilities across Nigeria where they face terrible rights abuse, the Human Rights Watch said on Monday in its latest monitoring report.
The report said detention, chaining, and violent treatment are pervasive in many settings, including state hospitals, rehabilitation and traditional healing centres as well as both Christian and Islamic faith-based facilities.
A mental health condition refers to a range of experience that affects a person’s mood, thinking, and behaviour. These include depression, anxiety, schizophrenia, and bipolar condition. It can affect anyone, regardless of age, gender, race, ethnicity, religion, spirituality, sexual orientation, or any other background.
A senior disability rights researcher at Human Rights Watch, Emina Ćerimović, said: “People with mental health conditions should be supported and provided with effective services in their communities, and not chained and abused.”
“People with mental health conditions find themselves in chains in various places in Nigeria, subject to years of unimaginable hardship and abuse,” the official added.
It quoted President Muhammadu Buhari saying last month that his administration would not “tolerate the existence of torture chambers and physical abuses of inmates in the name of Islamic rehabilitation centres.”
But the report said the Nigerian government is yet to acknowledge similar abuses in government-run facilities too.
The HRW said between August 2018 and September 2019 its representatives visited 28 facilities ostensibly providing mental health care in eight states and the Federal Capital Territory, Abuja.
The places visited included federal psychiatric hospitals, general state hospitals, state-owned rehabilitation centres, Islamic rehabilitation and traditional healing centres, and Christian churches.
During the visits, it said about 124 people were interviewed, including 49 chained victims and their families, staff in various facilities, mental health professionals, and government officials.
“Deep-rooted problems in Nigeria’s healthcare and welfare systems leave most Nigerians unable to get adequate mental health care, or support in their communities.
“Stigma and misunderstanding about mental health conditions, including the misperception that they are caused by evil spirits or supernatural forces, often prompt relatives to take their loved ones to religious or traditional healing places,” the report said.
Findings
HRW said during the visits, it found that people with actual or perceived mental health conditions, including children, were placed in facilities without their consent, usually by relatives.
In some cases, it said the police would arrest people with actual or perceived mental health conditions and send them to government-run rehabilitation centres.
“Once there, many are shackled with iron chains, around one or both ankles, to heavy objects or to other detainees, in some cases for months or years.
“They cannot leave, are often confined in overcrowded, unhygienic conditions, and are sometimes forced to sleep, eat, and defecate within the same confined place. Many are physically and emotionally abused as well as forced to take treatments,” the report said.
In one of the state-owned rehabilitation centres in the southeastern part of Nigeria visited, the HRW said a nun in charge said they chain people to their beds “so they do not run away.”
The HRW did not give the nun’s name. In other cases, it said the names of the victims were deliberately changed to protect their safety.
The HRW said the nun defended the chaining of a woman who had HIV “to stop her from going around the men.”
Nigeria has fewer than 300 psychiatrists for an estimated population of over 200 million. In 27 of 28 facilities visited, all residents had been unlawfully detained. They did not enter the facilities voluntarily and could not leave if they wished to do so.
Also, it said it found another woman at the same institution chained naked to her bed.
The staff, except one older guard, the report said, would, at 6:30 p.m. each day, leave residents, including children as young as 13, with no one to help them.
The facility has no electricity. So, people are chained to their beds in total darkness. The nun said that “the patients are given flashlights to use at night.”
In a traditional healing centre close to Abuja, the federal capital territory, HRW said it met a woman who was pinned to a tree trunk with an iron ring.
The woman was restrained in that position for more than three weeks with her upper body naked. She was unable to move and so she was forced to eat, urinate, and defecate where she sat.
Impact of chaining
Chaining for a long period, the report said, could cause serious injuries and psychological distress.
The report quoted a 35-year-old woman chained for 10 months in an Islamic rehabilitation centre in Kano, northern Nigeria, as saying: “Everything about this (chaining) is difficult. You feel like you want to commit suicide … regardless of how you felt before coming here, you will get worse.”
Besides, the report said adults and children in some Islamic rehabilitation centres were reportedly whipped, causing deep wounds.
