The first thing that strikes you about Lobatse Mental Hospital is how difficult it is to see inside from outside. That is the point.
A group of nurses from the hospital this week helped Sunday Standard piece together a grim catalogue of sexual abuse, violence, drug abuse, loan sharking, rape and high HIV/AIDS infections behind the concrete curtain.
It’s Wednesday afternoon. We are sitting shoulder to shoulder with a huddle of six mental hospital “concerned” nurses propped up on the bar stools of the Cumberland Hotel cocktail lounge. All have harrowing stories to tell.
One of the male nurses, a bony-faced bundle of temperament, shakes his head as he recalls how a colleague walked in on one staff member with his pants down, raping a patient. He is bubbling with anger and patches of humour as he relates, “this is all in the day’s work. There is even one staff member who is known to have raped a lot of patients, but no action was ever taken against him.”
They also spoke about a female nurse who was raped by a colleague after the nurse fell sick and was committed to the mental hospital.
There was another patient who was admitted to hospital with a flat tummy. Months later she was walking around with a bulge and not knowing who the father was. With preliminary surveys showing that the institution has more HIV/AIDS infections than the national average. Lobatse mental hospital may be sitting on a time bomb.
Another nurse sums up horrors of the mental hospital in one memorable image: One afternoon, commotion flared inside the ward. A female patient lay prostrate in a pool of her own blood on the concrete floor, a jealous lover hovering over her, his knife still dripping blood. This was the gory end to a love triangle that had turned nasty inside the hospital. Luckily the lady survived.
When we met the concerned nurses, some time had passed since their ordeals. But they could still feel the shock of walking in on a colleague raping a patient and the trauma of watching a mental patient brandishing a blood stained knife over a prostrate body lying in a puddle of blood.
Their problem, they complain, is not helped by the huge contrabands of cannabis that is increasingly being smuggled into the hospital.
They say the “widespread abuse of cannabis” is undermining their treatment regimes and makes patients more aggressive and dangerous.
The nurses painted a picture of a free for all hospital where anything goes. For example, some patients are running micro lending business from their hospital wards, with staff members being their major customers. At some stage a patient allegedly flew off the handle and attempted to kill a staff member who was refusing to pay him. The nurses have already petitioned the Ministry of Health to intervene and save the situation.
In a letter dated 9 February 2006, the nurses complained, “patient care procedures and protocols are not followed.” In some instances “patients stay up to two months without getting specialist attention.” They cited an incident in which a murder convict was referred to the mental hospital for psychiatric evaluation but was discharged before a specialist examined him. No sooner had he walked out of the hospital than he committed another murder.
Some hospital officers “do not respond promptly to calls, while others do not respond at all, especially at night. On many occasions officers could not be located around the hospital premises when they were supposed to be on duty,” states the petition.
The nurses further complain, “This hospital has a culture of misinforming the Ministry of Health and creating false impressions.”
The low staff morale at the hospital is not helped by “the risk of infection and the reality of physical and mental abuse. Staff members have sustained fractures and one lost six teeth at a go. In the month of October 2005 alone, six staff members sustained injuries; two suffered human bites while four others were seriously assaulted by patients. Some patients have threatened our lives and some of them had to be nursed from prison and police cells,” states the petition.
Responding to a Sunday Standard questionnaire, the hospital Specialist Psychiatric Consultant Paul Sidandi confirmed that patients have been running loan sharking businesses from their wards, lending money to staff. “The hospital had an incident in 2001 and measures were taken to ensure that patients do not keep money in their possession.
This worked well but unfortunately about 3 months ago we became aware that one of our patients had borrowed money to some of our staff members. Immediate corrective measures have been instituted and the process is not yet complete. The relatives of such a patient have been informed and they are assisting us.”
He further confirmed the high HIV/AIDS prevalence at the mental hospital, “Our preliminary surveys do show that we may be having a higher HIV/AIDS prevalence in our hospital than in the general public. This is not surprising because one of the complications of this disease is mental disorder, which may lead to the affected being admitted into a hospital for the mentally ill. We do expect our prevalence to be higher because of the above reason, not because people are involved in sexual acts whilst hospitalized here.”
He, however, stopped short of confirming the alleged widespread cannabis abuse at the mental hospital, saying: “Some patients’ behaviors have, in the past, raised some suspicion that their behaviors could not be due to the primary illness that brought them to the mental hospital, nor due to the drugs we give them. However, our investigations have not yielded any positive results. As far as the hospital is concerned, there is no peddling of drugs in our facility. There could be isolated cases of one or so of them taking dagga if the public somehow manages to evade our security.”
Although the petition by nurses cite an incident where no disciplinary action was taken against a staff member who was caught trying to rape a patient, Sidandi denies allegations that staff members have been known to rape patients saying: “There have been no cases of rape involving staff members and patients at this hospital. Over the last five years there has been one allegation of an intimate relationship between one of our staff members and a patient but this has not been proven. The hospital has, however, taken appropriate precautionary measures against possible occurrences of such nature in future.
Our records reveal that in the last five years, one patient was discovered to be pregnant but we could however not establish that the pregnancy had occurred before she got admitted to us or not. She had also been to another non-health institution before. Fights do take place in the hospital for a variety of reasons due to the violent nature of mentally ill patients. It must be noted that patients with mental illnesses can sometimes behave inappropriately in public. The behaviors may include hurling insults, assaults, undressing, or sexual advances. Such patients can in no way be said to be ‘fighting over a female patient.
The mental hospital is a stressful place to work in and this has come to the attention of the Ministry of Health. Steps are under way to improve the working conditions of the staff members by posting extra staff and building a new hospital that is expected to be completed in July 2008. In addition, 60 new staff houses have been built a few years ago. Although these are not enough, this was an effort by the Government to try and improve the conditions of service for our staff.