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We at the Anne Sippi Foundation believe that it is very important for us to share whatever understanding we have of treatment in other parts of the world. It points out how willing the Finnish professional world is to offer support to
other needy countries. Perhaps it’s something that we should learn from them, that is to say, we need to reach out to the world and share information that might make their treatment more effective even though there is much to say about the
treatment in the USA which is far from being good enough.
The following was written by a Finnish reporter on the first country of Africa visited, the remaining countries will be sent in subsequent Newsletters, each month.
The Portuguese Monastic Order of Saint John established Mozambique’s first mental hospital on the Island of Mozambique in the 17th Century. In 1959, a new hospital Influlene was established closer to the capital city. Mozambique
had been a Portuguese colony until 1975 when it gained independence. The greater Maputo area had, the, three psychiatric hospitals, but as a result of the country’s change of government, the Portuguese specialists had to leave
Mozambique, taking their expertise with them. The patients were returned to their homes. In 1980 Infulene remained as the only mental hospital, until some time later when another mental hospital was established in Nampula
Province. Infulene failed under Maputo’s Health Administration.
The Inaugural speech given by the head of government promised help for all, regardless of color or creed. At the time of independence there were separate
wards for black patients and white patients. Not all blacks would use the beds offered to them. The patients separated into the different wards according to what they were accustomed to in life and not according to skin
color. Before independence Infulene was self-sustaining with its community cultivated fields and orchards. The hospital harvested tomatoes, cabbages, lettuces, carrots and spices. In the l980’s this land was taken into
other use, after which the patients could no longer cultivate their own food. For the duration of the 80’s Mozambique was in the throes of civil war, and most of the patients were army soldiers, who alternated between the hospital
and the army. Most of the current patients are there because of the misuse of drugs.
Infulene has 250 patient beds, and three wards are named after trees. Acacia is the rehabilitation unit for both sexes. The
reception ward for acute male patients is called Pine, while the women’s ward is called Mulberrytree. Patients partake in communal work in the wards, laundry and kitchen. The work gives the patients a sense of self worth, which
cannot be taken for granted with mental health patients. Visits by close ones, and keeping in contact with them, is part of their treatment. Even neighbors could be invited to visit with family if it would help the patient’s
issues and their future. There is a shortage of staff that specialized in psychiatry. Infulene’s Chief Psychiatrist from 1989 to 1995, Custodia Mandhlate, was the only psychiatric specialist in Mozambique. While in
office, Custodia held discussion groups twice a week, when she would converse with everyone individually, the session would end happily with singing and dancing. Custodia Mandhlate left to take on WHO duties, and was replaced by a
psychologist Adao Marcos.
Four nuns, of the order “Irmaos Hospitaleras ao. Sagrado Coracao de Jesus”, who had returned from Portugal, started charity work at the Infulene in October 1989. They started an activity and
occupational therapy ward and called it Palm. In their care they have a patient’s daughter, who has lived all of her five years at Infulene. She is called Little-Custodia. Another patient has recently given birth to a
baby, which is also now in the nun’s care. The baby was baptized and named after Sister Fernanda.
The hospital building is in poor condition, doors and windows are broken, locks are missing, and there almost no mattresses or
bed linen. Plumbing and electricity work sporadically. There is a shortage of laboratory equipment and the X-ray equipment is not in working condition. The hospital has a large laundry room where linen and patient’s
clothing are washed by hand in cold water. Soap is rare. Food runs out before the last week of every month and has to be begged for from various charity organizations. The prescribing of medication depends on what is
available at the time. Influene has been a protégé of Kellokoski Mental Hospital since 1987. Kellokoski has sent supplies as aid to Infulene. Nurse Anna Ritta Jyrkinen has done educational co-operative work with Infulene
since 1989, when she visited there for the first time, on a work cum study cum teaching trip.
In the1996 annual report, Custodia Mandhlate stated “In this decade it is no longer acceptable that a psychiatric hospital is
treated as a second class institution, and that financial and personnel resources are allocated to it only when other hospitals can spare it.”
An interviewer enters the gates to the mental hospital with a Swazi prince. In the
passage outside the reception a mother is breast feeding her baby that is in a sling made from a scarf. A man sitting next to her is fiddling with an empty cigarette box. There are men hanging around in the darkest corners of
the courtyard, who are just barely discernible by the whites of their teeth when they smile. The writing on the wall says “There is no roses in my Garden.”
The prince introduces himself as Prince John number 627G382N.
Somebody in the family had leave Swaziland to go to help Frelimo in Mozambique. Prince John was the one to go.
On arrival in Maputo, he was arrested by immigration officials and his baggage was confiscated. Despite
Frelimo’s effort to help him he did not get residency permission. Then in 1987 he landed up in hospital. He walks with pride yet greets others with a gentle superiority. The safari suit he is wearing looks neatly ironed
and his jersey does not look as if it had come from charity aid. He tells of his father who was the King of Swaziland, and of the palace where he has not been in many years.
In the Mulberry tree ward, Martha kicks the tripod
of my camera and comes right up to my face, demanding to know what I am doing there. The Prince explains to Martha that they should treat me with respect as the interviewer had come all the way from Finland to meet them.
Prince John was born in April 1952, the later of twins into the Royal Swazi family, which had many children. His twin brother is a Saudi Arabian Prince. Prince John attended school in Swaziland, then moved to England and then
onto the United States of America. At university he studied anatomy, anthropology, geology, physics, biology, philosophy and Texas sciences.
A beautiful woman is lying on an iron bed, when the Prince approaches her she pulls
herself together and straightens her lacy white blouse. On the uncovered foam mattress one can see the stains of many a sweaty night. An old woman on an adjacent bed reveals a bit of naked skin from under her blanket, her
blanket reeks of stale sweat and the smell of her medicine that has evaporated through her skin.
The Prince speaks of the hospital’s nuns with respect. He says that they are the only ones who understand the people in his
social class. The only thing he does not like about the nuns is that they tried to feed him a bewitched person’s flesh. It is customary for the villagers to bring it to the hospital in the belief that the eater will forget the
truth. Suddenly the Prince announced that he had to leave as he had another important meeting. Then he waited in the foyer for some hours for someone to fetch him. A nurse informs me that he has waited everyday, for five
years, to be fetched. Prince John reads an English language newspaper while he waits he puts it down in his lap and then straightens the corners, of the wrinkled old paper, all the while staring straight out of the glass doors.
He had actually traveled from Lusaka to Tete, Mozambique, where he had worked as a Frelimo agent. He got ill while traveling from Tete to Maputo.
Later, I find the Prince in the crafts section, where he sits everyday sewing
Father Christmases onto pillowcases. He claims to have gotten ill in U.S.A. that it came via the television. He was found, confused, near to the South African border, and nobody knew who he was or where he came from. Even
though he spoke English well and Portuguese poorly, he was still sent here instead of Swaziland.
I was sitting with Prince John in the front garden, when the monsoon clouds brought the darkness with them. The heavens poured
rain on us. We look at the stars, which are unfamiliar to me, but Prince John knows them well.
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