Health

Amid Dearth of Drugs for Mentally Ill, Same Medications Are Abused on the Street

 

Article Highlights

 
Tendai Mutyasira (right), with his mother, Molly Nyakonda, outside their home in Hopley Farm, a slum in Harare, Zimbabwe. He says he became ill and was treated for more than five months after he abused diazepam. Linda Mujuru, GPJ Zimbabwe
Zimbabwe

At a time when Zimbabwe is struggling to provide adequate medications for mentally ill patients, the drugs are easily accessible to abusers in Harare’s poorest neighborhoods. Unemployment and lack of drug regulation are cited, and one psychiatrist says families, schools, and rehabilitation centers together must target the problem.

HARARE, ZIMBABWE — A group gathers outside of a house popularly known as Gaza, at Hopley Farm, a Harare slum. Music blasts. Some sit near the gate separating marijuana leaves from seeds. Some drink blue water out of bottles.

What they are drinking is called “mablue,” “madembare” or “mangemba” — Shona names for water laced with chlorpromazine, diazepam and other drugs meant for the mentally ill.

At a time when Zimbabwe is struggling to provide adequate medications for mentally ill patients, the drugs are finding their way to the streets in Harare’s poorest neighborhoods like Hopley Farm and Mbare.

Hopley resident Tendai Mutyasira, 22, says he started using drugs when he was 16, mostly BronCleer cough syrup and marijuana. About a year ago, he says, he started abusing the antianxiety drug diazepam, which can be bought on the street for 10 cents a pill.

“If one drinks 12 pills, they can be drunk for the whole week. If you drink water, drunkenness increases,” he says. He eventually was taken to a psychiatric hospital last August after he started falling uncontrollably. “I could not move some of my body parts. If it was not for my family who intervened, I would have suffered a lot,” he says.

After he was treated for a month, Mutyasira says, he thought he had recovered, but he relapsed and returned to the hospital, where he stayed for more than four months.

While diazepam is readily available on the street, the two main hospitals that provide psychiatric treatment in Zimbabwe — one here in the capital, and the other in the second-biggest city, Bulawayo — have suffered shortages, from food to fuel to drugs, as well as the lack of specialized personnel, because many doctors have left the country, according to a report by the Refugee Review Tribunal.

If one drinks 12 pills, they can be drunk for the whole week. If you drink water, drunkenness increases.

Fifty percent of those admitted to mental institutions are, like Mutyasira, admitted for conditions linked to drug abuse, according to the Zimbabwe Civil Liberties and Drug Network, a group that works on strategies to address abuse. Eighty percent of those admitted are between 16 and 40, and most are male, according to the Health Professionals Empowerment Trust in Zimbabwe.

Tawanda Mafuta, programs manager at Communities Against Drugs and Substance Abuse in Harare, says diazepam pills are easily accessible on the street and cheap at 10 cents each.

“Some get them from hospitals, clinics and pharmacies through corrupt means,” he says.

Mafuta says the lack of clear legislation also makes it difficult to control drug abuse. “The Dangerous Drugs Act in Zimbabwe was last amended in 1996, when drugs that are being used now were not there,” he says. “It’s not yet government’s priority to control drug abuse.”

Munyaradzi Madhombiro, a psychiatrist and consultant at Harare Central Hospital, says many pharmaceuticals, including antiretroviral drugs, are abused. “In the province of drugs that are meant for psychiatry which end up being abused, it is almost everything. … [But] the biggest of them is diazepam,” he says.

The side effects can be severe. “One can be admitted at hospital drooling saliva or having some parts of their body being stiff,” Madhombiro says.

While psychiatric treatment in Zimbabwe is free for those who cannot afford it, resources are not always available, he says. “As one who works at Harare Central Hospital, lately we have struggled to get medication for patients, but these medications are there in pharmacies.

“The mental health system in Zimbabwe is strained,” he says.

Madhombiro proposes a three-level solution plan to stop the abuse of drugs here.

“The primary level is the family, family guidance … and having drug abuse included in the school curriculum. Secondary interventions target people in colleges who are drinking and educating them on safe drinking. In tertiary interventions, there is need of rehabilitation centers to stop the continued abuse of drugs,” he says.

Stembile Mukohwani, 46, who says her son is recovering after abusing diazepam, believes many youths abuse drugs because they don’t have jobs.

“If these young people can find employment, it will help them change,” she says. “The police sometimes come to restore order in these drug abuse centers, but as parents we feel that they are not taking these matters seriously because nothing has changed; youths continue to abuse these drugs.”

 

Linda Mujuru, GPJ, translated some interviews from Shona to English.