The daily life of madness in Africa

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RFI and the review Politique Africaine are joining forces for a special program on the occasion of the release this month of an issue of the Review devoted to "The ordinary of madness" on the African continent. Reports, guests and analyzes to listen to in replay.

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What care for madness on the continent? Family or medical? Are we “crazy” or considered “crazy” in the same way in Antananarivo or Accra? What can we learn from representations of madness on African societies and their evolution? Here are some of the questions addressed in the last issue of the African Political journal devoted to “The Ordinary of Madness” in Africa.

"  It was a question both of questioning the multiplicity of definitions and representations that we have of madness and mental disorder on the continent and of questioning their evolution  ", explains the historian Romain Tiquet, co-coordinator of this file.

Mental health remains the “  poor relation of public health policies ”, continues the researcher. States spend on average less than 1% of their health budgets, compared to 6 to 12% in Europe or North America. According to the WHO, less than 20% of the population on the African continent has access to mental health care. Most of the means and resources available in health tend to be concentrated on other diseases, in particular HIV / AIDS or malaria.

Patients not or misdiagnosed

In addition, reliable data on the prevalence of mental disorders are scarce. Many patients are undiagnosed or misdiagnosed. The mental disorder is still very often considered as a curse, relating to witchcraft or a demonic presence, which leads to marginalize the patients rather than to facilitate their access to care.

The ordinary of madness is therefore lived mainly "outside the walls", we can read in the review. Passing through psychological or psychiatric care structures constitutes "  only a moment in the trajectory of the patients  ". And patients arrive there most often late after a long therapeutic wandering, as illustrated by the report of our correspondent in Dakar Charlotte Idrac at the psychiatric clinic of the Fann hospital in Dakar.

"  Dakar concentrates most of the mental health structures in Senegal,  " notes Papa Mamadou Diagne, socio-anthropologist of mental health in Senegal. Elsewhere, “  it is very difficult to have recourse to a psychiatrist,  ” notes the researcher who has studied the divide between urban, rural and peri-urban in the management of mental illness.

Use of healers or other traditional structures

The financial aspect is also an obstacle to taking charge. "  Without knowing how much it will cost a family will be reluctant to go to the hospital. Especially since in Senegal mental illness is not taken care of by the social protection system,  ”further explains Papa Mamadou Diagne.

In this context, especially in rural areas, rural populations tend to favor the use of healers and other traditional structures. In Madagascar, it is in Toby, these reception centers of the Protestant Lutheran movement of Revival, that the sick are brought as a last resort, once their relatives have exhausted all "other" possibilities of healing. The Big Island has about 200, spread across the country. The patient's life is punctuated by the intensive liturgy, sermons, songs, prayers, as shown in the report by our correspondent Sarah Tétaud , who attended a healing session in immersion.

“  This Madagascan particularity is linked to the importance of the Revival movement, which is very attached to the Lutheran church. The expansion of Toby is therefore linked to the expansion of revival churches  ”, underlines Romain Tiquet. But the Big Island is not an isolated case. "The question of healing by religious or magico-religious therapies is very present on the African continent and has been well documented".

Show guests:

- Romain Tiquet , historian, researcher at the CNRS in contemporary African history and co-coordinator of the issue of the journal (with the anthropologist Gina Aït Mehdi.

- Papa Mamadou Diagne , socio-anthropologist of mental health in Senegal

The journal Politique africaine can be found here

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