Substance abuse and dependency amongst Botswana’s youth and adults in rural and urban areas no longer exists in the extreme end of the spectrum as they once were, but they have become the “new normal”. The effects of substance abuse are cumulative, significantly contributing to costly social, physical, mental, and public health problems some of which include teenage pregnancy, sexually transmitted diseases (STDs), domestic violence, child abuse, crime, amongst others.
With current data showing that the trend is snowballing, a drug and alcohol counsellor, Kitso Rantsopeng is asking a question on the lips of most Batswana: Will this cleft stick be resolved anytime soon before it deteriorates into unmanageable levels? Mental health data collection in Botswana is patchy since almost two thirds of people with a known mental disorder never seek help from a health professional. This is worsened by the fact that Botswana has generally turned a blind eye to mental health since less funds have been directed to treatment and reversing societal stigmas toward those suffering from mental health.
Rantsopeng says his view of public education campaigns and efforts to curb this problem are pitilessly cynical. “Substance abuse and addiction in Botswana is a disease that has been passed over and stigmatised for so long, and it will remain an epidemic thanks to the failures of government, medical health practitioners and society at large,” she says.
All the huffing and puffing in the current war on drugs has not been able to blow down Botswana’s house of substance abuse and addiction. “The human despair that addiction and abuse cause can’t be quantified and tabulated. The consequences of this epidemic are stark,” she retorts.
With more deaths in Botswana now being attributed to drugs and substance abuse, the United Nations World Drug report also paints a gloomy picture stating that apart from contributing to crime, instability and the spread of HIV, illicit drugs undermined economic and social development.
In an interview with this publication, Rantsopeng also hazards a muted warning: “of all the deaths that occur in Botswana as a result of tobacco, alcohol and illicit drugs, substance use and addiction are, by far, the most preventable — and most costly — public health and medical problems in this country”.
There are different kinds of mental illness but the most common in Botswana are depression and anxiety. Overall she says many people have reported rates of mild depression, low mood, despondency and pessimism as a result of uncertainty created by Covid-19. Rantsopeng warns that the country will see a lot of new cases of mental health issues and mental illness appearing even in people that previously hadn’t experienced this. She, however, notes that whilst attitudes are slowly changing, public attitudes have yet to catch up with science especially in areas such as substance abuse and addiction.
Studies show that over 80 thebe of every addiction related Pula goes to paying for the consequences of addiction such as escalating crime and hospitalisation. She also retorts that in order to ease addiction in Botswana, “there is need for more money to be channelled toward treatment as well as prevention, well before abusive substance use has an opportunity to become a deadly consequence”.
From her assessment of the health sector in Botswana, Rantsopeng says addiction is one of the most neglected diseases. Information also shows that numerous Batswana age 17 and over meet the clinical criteria for addiction involving nicotine, alcohol or other drugs.
“There a sizeable number of the populace who are regarded as “risky substance users” which means that whilst they are not addicted, they use tobacco, alcohol and other illicit drugs in ways that threaten public health and safety,” she says.
As for the health practitioners, Rantsopeng says despite the injection of money meant to treat people suffering from addiction, medical practitioners have been unsuccessful in providing satisfactory education and training in the area of addiction.
Rantsopeng also says stigma that society inflicts upon those suffering from addiction has potent consequences that work against abolishing the disease, “and involves processes of labelling, stereotyping, social rejection, exclusion and extrusion — all necessary elements of discrimination.
As calls grow from all quarters for Botswana to increase support for mental health services, Rantsopeng says the country must learn the early warning signs of diminished mental health and the steps needed to protect its citizens. In her assessment and warning to authorities, she says mental health issues such as anxiety and depression will be severe and prolonged in the coming months because of the uncertainty created by the coronavirus pandemic.
“Investing in mental health is the most essential investment Botswana can make now. By investing in people, we will also be saving millions of Pula in direct and indirect health care costs. For each person who suffers from a mental illness, each family and each community suffer as well,” she says.
With no clear end to the pandemic in sight, Rantsopeng is among many medical practitioners transitioning to remote consultations through telemedicine.
Unless the nation invests significant funds for treatment, this disease, which is treatable, will unnecessarily continue to devastate scores of individuals and families in this country.
