Zimbabwe is a fledgling country in Southern Africa with a population of around 15 million people. It has a rich but chequered history of human rights violations, economic mismanagement, and political violence all perpetrated mostly by the state. The country suffered brutality under colonial rule from 1890 until 1980, when she gained her independence which only came after a protracted war of liberation. In 2021, the country will commemorate 41 years post independence. During this long and arduous course, Zimbabwe has been exposed to brutality, violence, injustice, theft, state induced thuggery, unfair labour practices, loss of incomes, poverty destruction of homes, disease outbreaks and hostile climatic and weather conditions. Zimbabweans have been exposed to hostile environment for a long time where structural, physical, emotional and psychological violence has become the norm, where the abnormal has become normal. Can anybody wonder why Zimbabwe scored dismally on the “happiness index,” thereby having the tag of infamy where Zimbabweans were said to be among the unhappy people in the world?
WHAT IS MENTAL HEALTH?
Mental health, defined by the World Health Organization, is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.
Mental health disorders affect people across the political, racial, gender and age divide. A research conducted by Counselling Services Unit (CSU) a few years back found out that about 60 percent of Zimbabweans suffer or have suffered from some form of mental condition. However around 2005, the number of people suffering from the problem was about 40% yet 7 years latter, figures had risen to more than 60 percent, a meteoric rise in the number of people suffering from mental conditions. This is further backed by Gwanzura, Simunyu and Patel who in 1997 found out that 68% of the urban population suffers or exhibit signs and symptoms of Common mental disorder while one in every four people who use primary care facilities and a third of those attended to by traditional practitioners suffer from some form of common mental disorder symptoms.
These figures paint a scary scenario where more than half the population is essentially walking “insane” which calls for urgent intervention. Poor or failure to support people with mental health problems will result in society paying heavily, whether in healthcare, workforce, quality of life, or actual lives lost. Ensuring access to a variety of services and supports that enable citizens to contribute to society should be an adopted and supported by all.
Zimbabwe on paper should rank as one of the leading countries in Sub Saharan Africa with a progressive mental health policy and legislation. The government put in place the Mental Health Act, Mental Health Policy, and Mental Health Strategy to guide and regulate mental health in the country. The major challenge has been implementation bedeviled by funding gaps, training, and staffing capacity.
CAUSES OF MENTAL HEALTH PROBLEMS
There are as many causes for mental health problems, ranging from social conditions to drug and substance abuse, so looking after mental health can preserve a person’s ability to enjoy life. Doing this involves reaching a balance between life activities, responsibilities, and efforts to achieve psychological resilience.
Conditions such as stress, depression, and anxiety can all affect mental health and disrupt a person’s life for ever if left unattended to. Everyone has some risk of developing a mental health disorder, no matter their age, sex, income, or ethnicity.
Social and financial circumstances, biological factors, and lifestyle choices can all shape a person’s mental health. A large proportion of people with a mental health disorder have more than one condition at a time.
It is important to note that good mental health depends on a delicate balance of factors and that several elements such as personal, environmental and even political can work together to contribute to disorders.
In Zimbabwe and Africa in general, it is generally believed and for a good reason that everything begins and ends with politics. It is politics that defines and determines who gets what and who doesn’t. More than anything else it is the politics that can make the ultimate difference.
Partisan politics in Zimbabwe has been the biggest contributor to the increase in mental health conditions in the country. Firstly, because the nation has been existing under a polarized political environment for over a century, where various forms of abuse such as murder, rape, looting, torture, hunger, loss of earnings, displacement have all been perpetrated against citizens. The period after 1980 (post independence) has also been marked by the same polarized political trajectory where politically sanctioned murders, torture and violence against citizens have been the orders of the day. From 1981 to 1987, there was a civil war in the southern part of the country commonly referred to as Gukurahundi, which left more than 20000 dead and many more maimed physically and psychologically. Nothing has been done up to now to properly rehabilitate these survivors and the mental wounds persist up to day. The spike in mental health problems from 2000 can be directly traced back to politics. After the Zanu PF government lost a constitutional referendum and parliamentary elections in 2000, the Robert Mugabe government took a political decision to invade White-owned farms and business which resulted in deaths, destruction and loss of jobs and livelihoods for over a million people. The country then went into a deep economic and social crisis from which the country has never recovered from, causing unprecedented social and economic upheaval. Zanu PF since 1985 has made sure elections are always violent, using war veterans and youths as shock troopers, and voters have been subjected to murder and torture to the extent that in 2008 more than 300 people were killed and many people suffer from primary and secondary psychological trauma. This phase has caused the upsurge in mental health conditions where more than 65% of urban dwellers now suffer from one form of mental disorder. The youths, because they have nothing to do are hooked on drugs and other antisocial activities, are affected not only individually but also end up affecting those around them such as parents and guardians. Natural disasters such cyclones and COVID-19 have added a new dimension to the problem, yet those occupying political spaces dismally fail to perform their public duties. Due to political expedience, local authorities cannot offer service delivery in cities as the political masters play Russian roulette with citizens lives.
THE ECONOMY, PEACE, AND JUSTICE
It does not require rocket science to appreciate that mental health is best nurtured when citizens are economically productive and enjoy peace and justice. It is the duty of the state to facilitate citizens' enjoyment of these through progressive policies that support economic growth, reduce poverty and inequality, and provide security to the people through a nonpartisan police force and independent judiciary and strong institutions. Because the government puts political expedience ahead of development, Zimbabwe's economy is now one of the most informalized in the world according to ILO. Poverty levels have increased, livelihoods impoverished, homes demolished through anti people policies such as Murambatsvina where the government destroyed people s houses in the cities and this continues even up to now. Due to droughts, the World Food Program says that 8 million Zimbabweans are food insecure. Many people fail to access relief food donated by WFP and other development partners because structures in charge of distribution have been accused of distributing on partisan lines where non-Zanu PF members are systematically denied the food, further raising mental health concerns. Most institutions of the state are captured by the ruling elites and therefore are not at the service of citizens.
Zimbabwe has very progressive mental health policies, however implementation of these policies has been the problem. The government is responsible for allocating resources towards mental health, yet this is one of the least funded areas if ever it is funded at all. There are less than 5 occupational therapist working in the public sector in the country and less than five psychologists the whole country. Without resources, the policies however progressive will remain on paper and not at all of any use. This lack of political will to allocate enough resources towards mental health is partly due to the fact that political elites don’t think they can get any political traction from investing and supporting mental health in the country. It should be noted that effective mental health is cross cutting, and should not be located under the ministry of health alone. A functional economy, strong institutions, livelihoods, security of citizens, inclusive policies, and citizen participation all play a role in promoting healthy mental state while the opposite causes mental health stressors.
Mental health is a product of multiple factors such as the environment, gender, technological, political, and economic. In Zimbabwe, politics has been the biggest influencer and contributor to the current situation where more than 60% of the population suffers from one or more forms of mental health disorder because it is political considerations that have caused trauma among citizens. If we can transform the politics, Zimbabweans will be happy again.