Africa, Development & Aid, Gender, Headlines, Health, Human Rights, Population, Women's Health

SOUTH AFRICA: The Invisible People

CAPE TOWN, Apr 4 2011 - Since psychiatric care was decentralised last year in South Africa, patients have been moved from hospitals into community day hospitals that don’t have the appropriate resources to deal with mental illnesses. As a result, many of society’s most vulnerable have slipped through the cracks in the system and now walk the streets like invisible people.

You see some walking the verge of highways, muttering and gesticulating to themselves, while others crouch on the pavements outside busy eateries, unseen by the well-heeled patrons. The invisible are not ghosts of souls passed over, they are people who live among us, with beating hearts and blood flowing through their veins, mothers and fathers, sisters and brothers, each with a unique story to be told.

Nosipho* is a 36-year-old woman who hails from the Eastern Cape. Although she grew up under apartheid, she was able to attend a local convent school where she thrived under the tutelage of a benevolent English teacher. She was a bright student who enjoyed writing stories in which she fantasised of escape from her small, poor community.

In her stories she was a gospel singer who would travel the world and sleep on soft beds with many clean crisp sheets which would keep her warm and safe. Even at 15 she knew that she wasn’t going to be famous, that she would probably have to drop out of school soon in order to look after her small sister because her grandmother was ailing fast, but the fantasy lingered and soon she began to discover the signs.

At first, the signs were few and far between; a stone turned over in the dust was a clue to be followed. Nosipho heard her name mentioned on the radio whenever she came into her grandmother’s room and seemingly random events began to appear linked. Soon the signs multiplied, one upturned stone led to another. She would hear her name whispered on the wind and yet, when she turned around, no one was there.

Her friends began asking her if she was smoking isango [cannabis] because she appeared entangled in a dream-like stupor. A grin became the mask she wore to fend off the constant questioning of her peers, a grin she wore to trap the tears at her grandmother’s grave. After the funeral, her mother returned to Cape Town to look for work, leaving Nosipho with her eight-year-old sister. It was hard to be a mother when she was still just a child herself.

The days were long and difficult and when she could finally rest, the cacophony of voices would begin their weaving dance. The voices she heard sounded as if they came from the space outside of her: sometimes they would shout incoherent nonsense right next to her ear, at other times the voices would sound as if they came from far over the barren horizon.

One of the voices was recognisable – it was her grandmother who told her that she had been bewitched by an inyanga [medicine-man] and that if Nosipho did not go and find her mother in Cape Town soon, her sister would die. Every day the voices grew in strength and soon Nosipho would not leave the house for fear of being attacked by spirits sent by the inyanga.

She would leave the house just before dawn, when the voices were still asleep, to arrange small piles of stones around the home to protect the sisters. Soon she forgot to wash or get food and her worried sister brought shuffling, concerned elders into their cluttered room where they found Nosipho muttering into her tattered shawl.

People in the village began to look at her strangely and whispered behind their hands when she passed. One night, after a particularly harrowing day during which she had been viciously beaten by other children who had called her cursed, she fled to Cape Town to find her mother. That night was some 20 years ago.

Today Nosipho is still searching for her mother. Miraculously she has managed to eke out a thin existence living on the baking streets or in caves scattered through the rain-soaked mountains of Cape Town. For the past month she has sought shelter behind the blazing red bougainvillea beneath my balcony where she laboriously wraps black plastic bags around her head to fend off the razor sharp voices that continually torment her, even in her sleep.

A week ago I went with Nosipho to the day hospital to see the psychiatric sister in order to get her antipsychotic medication, which could radically change Nosipho’s quality of life. But after three hours of waiting in line – with no identification documents – I had to return to work and Nosipho fled soon after, citing the accusatory stares of others as the reason.

A 2007 study by the Medical Research Council revealed that one in six South Africans struggle with a mental disorder. Many of us have experienced bouts of mild depression and anxiety in our own lives, but living with severe mental illness requires great courage and the road to recovery is often long and hard.

Patients admitted to psychiatric hospitals like Valkenberg, in Cape Town, often come from disadvantaged communities where there are insufficient resources to provide the necessary support. Many families and communities are overwhelmed by the strain of caring for a person with a severe mental illness.

Thankfully, there are small groups of volunteers who work diligently to offer people like Nosipho some measure of support. Organisations such as The Friends of Valkenberg Trust and Cape Mental Health are always in need of volunteers and donations of any kind. South Africans have overcome a lot in their own troubled history.

Support groups like Friends of the Valkenburg Trust believe that if anything, this should be more reason for South Africans to open their hearts and find their compassion for those who are in such desperate need for help.

As Mahatma Ghandi said: “You can judge a society by how they treat their weakest members.”

*The story of Nosipho is a construct, a semi-biographical montage of two women’s stories in order to protect both their identities. The images and information were obtained with informed consent. The writer, clinical psychologist Jamie Elkon, and the photographer, Charlie Sperring, would like to thank Anton White at Kinetic for his support in bringing awareness to those with no voice.

Published under an agreement with Street News Service. Originally published by Big Issue South Africa.