INGUTSHENI Psychiatric Hospital in Bulawayo says 90 percent of its patients in the acute wards are admitted for alcohol and substance abuse with over 2 000 more with the same problem being attended to in the out-patient’s department each month.
This has led to overcrowding in the wards with numbers constantly increasing month after month despite the hospital discharging at least 40 patients weekly.

The development comes on the back of police in Bulawayo on Friday busting an illicit alcohol distribution racket where truckloads of the illicit brew consumed mostly by the youths commonly known as injengu were confiscated.

The effects of abusing the cheap and sometimes fake “take me quick”’ illegal booze has strained the hospital’s budgetary allocations that is exacerbated by the fact that the institution does not charge user fees like other central hospitals.

The hospital is a 708-bed facility but has acute wards where there are patients that are very ill from alcohol and substance abuse.

Ingutsheni’s new Chief Medical Officer (CMO), Dr Nemache Mawere, explained the extent of the challenges being experienced in the acute wards.

“The Khumalo and St Mary’s wards are always overcrowded, particularly the Khumalo ward, as we speak has about 200 patients, yet it has a holding capacity of 89 patients and the facility is strained. We struggle to make things work in that area,” he said.

Dr Mawere said Bulawayo had a high number of mental health patients owing to drug abuse and gender based violence (GBV).

“The issue of substance abuse is the biggest we have in Bulawayo and beyond. Ninety percent of male patients at Ingutsheni have substance related problems, very few patients have other mental health issues which are not drug related. If you look at the female ward, there are a mixture of a lot of things, we are talking of the 16 Days of Activism Against Gender Based Violence. If you sit with those women admitted you will find that quite a substantial number of them are going through GBV issues which are leading to their mental health problems. A few are doing substance abuse but not as much as the males,” he said.

Dr Mawere said since the hospital, which covers the whole of the southern region was overwhelmed, he would want to decentralised treatment to local clinics in communities.

“My plan is to work on a community programme to appeal to the community to discharge patients back to them. If anything, I will be more willing to work outside the hospital to assist local clinics and those outside the city whenever they need assistance so that they do not send patients to Hospital but attend to them from their nearest clinics.

We have a place in Emakhandeni, it belongs to Ingutsheni, it is a half way home and currently it is not functioning. The place can work as a clinic and we see patients and dispense medication then they return to their homes. We also have some space where these patients can come from the community and do the same projects that we are doing at the main hospital,” he said.

He said they are now seeking to engage donors to reopen the centre.

“We have to go and appeal to donors and the Government and also our own resources to start using that centre since it is ours. We want to start seeing patients there. On average we see 2 000 patients in our out-patient’s department every month. That kind of workload is very huge and sometimes it affects the quality of work so we would rather go out there to where they are in the community,” he said.

However, the issue of medications, he said, would be the challenge because the City of Bulawayo clinics and other institutions do not have psychiatric medications and the medicines are centralised.

“We are struggling in terms of the centralisation of drug distribution as they sometimes get stock outs which causes problems as the whole of the southern region depends on Ingutsheni for medicines so when people come from outside Bulawayo and we do not have their drugs they have challenges and have no alternative,” he said.

“I wish we could replicate the model that is used for HIV treatment, if you have HIV wherever you are, you are known by a unique number that is used to identify the type of medication you take. So, wherever you will be they can see all that detail and they can trace where ever you will be collecting that medication such that if it shows you collected then you cannot access the drugs. But for our patients at Ingutsheni it is free treatment with no tracking mechanisms. We need to really work on capacitating clinics. So, I would really like to work with the clinics and work on a programme where they stop sending patients to Ingutsheni and we decongest in that way.”

On substance abuse, which is believed to be the main cause of mental health problems, Dr Mawere said: “At times communities are afraid of reporting or they do not know what to do as these peoples who do drugs are more like gangsters so they protect their territory. We need to shut out the suppliers and it will go a long way.” However, Dr Mawere said education on the detriments of drugs was missing the mark.

“In terms of education, I feel we are still missing the point, we are talking to the wrong people, the people in high school and colleges, I think we should go and talk to the children in Early Childhood Development (ECD) that is where it should start, they should grow up knowing that it is wrong from the onset. But when you educate them when they are older, they know the feel-good factor of taking drugs. It becomes hard to control and they will do anything to have that feeling,” he said. —Sunday News