Wednesday, February 1, 2012

the mental health ward

It's Workday Wednesday, saved for a rainy day Thursday!

I’ve been feeling this strange sensation that I haven’t felt in a long time. What was it? And then I realized I was cold.

Rainy season is in full swing in Windhoek. I woke up to the rain. Why did I bother curling my hair or wearing a suit? I was drenched within minutes of stepping outside. The rain was coming down hard and the streets were flooded everywhere. The taxi cab I was riding in had no air conditioning or defroster so the windows were fogging up, and the cab driver had to keep wiping off the windshield with a towel. It made for an unexpectedly exciting, maybe a little life-threatening, drive to work.

I arrived absolutely soaked at work, where I discovered I had thirty minutes to read a 75 page document before my colleague R was whisking me away to a meeting with the Ministry of Health to discuss our views on the proposed Mental Health Act, the said 75 page document I had to read.

The rain was still coming down hard as R and I drove around the Central State Hospital campus, desperately trying to find the mental health centre where our meeting was supposed to be held. It’s a huge hospital campus, one of the largest ones in Namibia, and it seems a lot larger when you’re lost in it, late for a meeting. It doesn’t seem like they really want patients to find their way around the campus to get the service they need. Either the buildings aren’t labeled at all, or the signs that should be helpful in directing people are hidden behind bushes. Not to mention that the rain made it hard for anyone to see anything, including the potholes all over the roads. I can only imagine how painful those potholes must feel for anyone riding in an ambulance.

We stopped at the main building, where the reception smelled kind of funny. Not, like, body fluids or disease kind of funny, but more like something was cooking and delicious. I have no idea why a hospital reception would smell like that.

Visually it was a bleak dark place, as hospital waiting rooms often are. I tried to envision myself seeking medical treatment here. “Are there other places to go if people want to…you know, pay more money?” I asked.

“You mean, if I needed medical attention,” answered R, who has medical insurance. “Yes. There are private hospitals.”

I wrinkled my nose. I try to avoid political rants but this kind of stuff makes it hard to avoid the ugly side of two-tiered health care: it was obvious that most of the people in this dark (but delicious smelling) waiting room were mostly poor and black.

Eventually we found the mental health centre, and joined the meeting in progress, where I silently discovered

1. I smelled like wet dog, which was odd, because I am not a dog

2. The rain had not washed off my temporary tattoo, still poking out from my short-sleeve Preloved designer blazer (wet, dryclean-only).

Sometimes I am so classy I can’t deal with myself.

These meetings have been an interesting exercise in legal drafting. After its Independence, Namibia inherited a lot of the old laws from the apartheid regime, grossly in need of being updated. The Namibian government has been slowly writing new better legislation, often with the help of my organization, and today we were concentrating on writing a new Mental Health Act, one that would treat mental illness and mental disability adequately, respect the international guidelines of the WHO, and remove the stigma in taking it seriously. It made sense to work on the mental health bill at the mental health centre, but I have to admit it was a bit of an odd setting, holding a consultation meeting against the sounds of people crying in the halls.

It’s interesting to see the challenges that the government faces in writing these bills, because there are often conflicts between setting admirable social goals versus making realistic commitments the state can keep. It is about balancing the rights of patients with the limited resources of the state. I was shocked to learn, for example, that there are seven psychiatrists in the entire country. This is something that we had to keep in mind when writing provisions about psychiatric assessments.

At one point in the meeting, a man dropped by unexpectedly and told us we were doing very important work. He actually said a lot more than that, but by then my morning coffee was wearing off and I missed a bit of it, mainly because I was wondering who he was. After he left, we asked one of the people at the meeting who the man was. Turns out it was the Minister of Health.

Thankfully we took a break for lunch, and I met up with Andrew, who works on the hospital campus. He picked me up in his car in front of the maternity ward building (hmmm...) and we went for a quick bite at Fresh & Wild. Then it was back to work in the mental health centre conference work, for legislating, legislating, legislating.

After many hours of discussion and debate, five o’clock was approaching and I had to excuse myself because I had to meet someone in Katutura soon. I left the conference room and tried to find my way out through the long halls. That’s when I realized that everything had been closed down and I was locked in. Locked in the mental health wing of the hospital.

I tried calling out and shaking the doors, and then the gates. But not too hard because I was afraid of setting off the alarm. I wasn’t actually that confident that I would be able to convince any security guards that I wasn’t a patient trying to break out. Eventually I had to wander back to the conference room, where they were still hard at work, and one of the Ministry of Health people had to let me out. Freedom! Freedom! And then, as I began walking down the road to hail a taxi, it began to rain again.