My first day in the psychiatric ward

Having been nurtured, groomed and certified by Nurses' and Midvives Council of Ghana as a staff nurse, after undergoing a programme in tropical health nursing for three consecutive years, plus one controversial year called internship/national service, I was unquiet to enter the ward and see for myself once again the usual bizarre behaviors associated with the patients in the acute wards in a psychiatric hospital. It was common at first to see patients in the acute wards prowling within the inner parameters of the ward and some welcoming you in a deja vu manner. The grandiose delusion patients are often seen hitching their shoulders as if they are trying to shift the weight of the world to a more manageable position. In the female wards, you are likely to be welcomed with a gleeful smile by those with "de Clerambault's syndrome" (erotomanic delusion) as if their dreams have finally been realised. I was expecting to see most of the countless signs and symptoms that I have imbibed over the years in the classroom and put into practice the theory-based learning that is typical of African educational systems.

As I strode towards the ward on the day of reporting, I met many faces with strange behaviors, upon approaching the security gate, one hefty man sharply dressed in traditional colours approached me with a rueful expression on his face and told me he was once a patient in this hospital, before I could ask any question, he wended his way through the bush like a palm wine tapper, I noticed all wasn't well with him. In the hospital premises I spotted two of them on the road, one holding bible vigorously preaching in a trancelike state and the other one whining in tears while peeping through the windows of the ward dormitory(perhaps missing his psychotropic drugs or favourite delicious meals). Little did I know that those patients have managed to escape the eyes of the security men at the gate into the hospital premises. On the ward, I saw three patients in the midst of twenty seven (27 ) affilliates and 4 rotational nurses at the TV parlour, all I thought was may be the rest of the patients have been treated and discharge home in good faith. That would have been a good news, because it is the dream of every sound minded health worker to see their patient/client treated and discharge home to continue his or her occupational functions without any psychological or physiological challenges. As I was taken round the ward for orientation I saw seven (7) patients taking a cosy rest on their beds, so I asked to find out the total number of patients in the ward, and there I was told the unfortunate news; the rest of the patients have all been discharged home last year and the hospitals are no more admitting patients because they are not receiving enough funds from the government to cater for their feedings. The ward used to admit over hundred (100) patients but as at the time of writing this material it has only ten (10) patients. All my hopes as a health worker ebbed, and dwindle suddenly like a puntured balloon in the sky, then the questions kept boggling and flooding my mind like an angry labour union threatening a general strike: what if in the next one or two years, this problem is still not addressed, the fews patients left have also been discharged home leaving the wards empty and the mental health bill also not implemented by then? what will happen to the psychiatric nurses on the wards? are they going to be incorperated into the general health care settings or the already congested OPD's? why should the sector even be experiencing this at a time when the mental health bill has been passed into law with provissions to shift the focus of mental health treatment from institutionalised care to the development of community services with the care of persons with mental disorder in general health care settings. Could the ideology behind the mental health bill be the reason for the current malady afflicting the sector or a real financial problem? If that is the case, then the government should expedite action on the formation of the mental health board so that psychiatric nursing will for once see the light of the day. This is how the Chief Psychiatrist, Dr. Akwesi Osei described the situation; "Already Ankaful and Pantang have stopped admissions and Ankaful, for instance, has less than 50 patients on the wards which earlier had 300 patients. The rest of the patients, as may be expected, are on the streets in their homes or in chains in the prayer camps, further worsening our human rights record."

There is now pressure on the few psychiatric units in our hospitals across the country and many have found their way onto the streets and some at the prayer camps where they are being subjected to inhumane treatments, chained under the sun and rains, forced to drink concoctions and beating in all forms of exorcisms, further abusing their human rights. It is time the government and other corporate agencies turn their attention to the sector because the image of psychiatric nursing in Ghana seems to have been gragging through the mud for far too long. Mental illness is no respector of persons, today it's somebody tomorrow it could be you! May God bless all nurses in Ghana. Shalom.

From Chibaro Ali chibaronet@gmail.com

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