BEHIND CLOSED DOORS OF THE "MWENDA ZIMU"

 

Your fresh attire and cologne can’t give enough of the people on the sidewalks of the Nairobi CBD, a break from sneaking in, a turn, to look back at who just passed. Even the mama mboga (grocery business lady vendor) is surprised who you’re going to meet. The lady you’ve reserved a table for, is with no doubt going to melt even when you step into the doors of the Java or if you’re an exotic guy, Ocean Basket or whichever new cuisine spot, has recently been popped up in the leafy suburbs, because, you are that much cultured of a man.

Suddenly there’s this chatter from across the road, in the silence of the walk towards the restaurant. The stench of waste is not to be missed even from that dog being walked by a rich fellow on the well paved road. Were your plans to be that suave and dapper guy, just a dream you had last night? To your surprise, all this, is, only from one fellow, adorned in torn clothes, bags of rubbish and seemed to only to have seen a bathroom, from the drainage on the side of the road. Guess what? The fellow is walking towards you and is telling you how he’s about to travel to the sun and the president is about to save us all from the stars he’ll collect. Is it you being crazy or him being crazy? Hopefully your lady for date hasn’t seen this from the window.

If you’ve traversed the many regions of Nairobi, there’s not been a shortage of the people we have commonly known or termed as “Mwenda Zimu”. Characterized by their irrational chatter and lack of hygiene, whoever sees them on the road, simply arm themselves to the teeth, with anything they have or run away to the speed of sprinters, of a 100m dash. Often the case of problems, around areas within the city, at times, they’ve been beaten and chased like flies from making noise in car parks, estates, bus stops and walks past various buildings.

“Huyo amerogwa…” (This one has been cursed…)

“Aki watoto wetu, ni bhangi tu na mihadarati…” (Oh gosh, our children, the cause must be drugs…)

“Shetani naye, halali, hizi pepo nazo ziko, mpeleke kwa pastor…” (The devil doesn’t sleep, his demons are present, take him to a pastor…)

Have these phrases been common whenever you see, the said “Mwenda Zimu?” Or you’re wondering if the end times are near? As Kenyan’s we’ve found all manner of reasons to get to this explanation. If it’s not a demonic possession, its marijuana, if not, it’s probably witchcraft.

But in totality, who really does take care or account of these “Mwenda Zimu” people running around? Do they just appear from the sky? At this point, the anthems of mental health start to ring and everyone scuffles their phone in the pocket and searches for the symptoms on Google. On matters on the ground, many of us have faced those times of turmoil and wonder if it’s you alone, as you see many of your peers circumnavigate the vicinity of Nairobi like they are breathing blessings through the air.

Be it you, a friend, family member or work colleague, either navigating a season of trials or simply a diagnosis of mental illness/disorder. The walls tend to creep in. Matters in regards to counselling, psychotherapy or visiting a psychiatrist are hidden better than a drug peddlers stock, in people’s lives.

Circling back to our “Mwenda Zimu”, who may be a case of constant gossip in the neighbourhood or market, is someone who could have been rich or poor, educated or illiterate, male or female. Or do we believe they are people who appear from books of fables or the script writer’s imagination? Everything starts from somewhere as they say.

Once a simple calm person, the day arrives where they suddenly change and you immediately go into shock. They don’t seem to be clean, talk in things you seem not to understand and fled home or stray at odd hours of the night. Is the following, familiar with anyone you know or have you experienced it before? Whatever the case, you are not to be blamed, that is why we are here to talk.

A common case of the said “Mwenda Zimu” is Schizophrenia disorder. Did you find it among the results on the Google search when puzzled about our Mwenda Zimu? Let me explain further. As we had mentioned earlier there’s a lot of myth and stigma around mental health but we are here to clear it up.

Schizophrenia is often defined by abnormality in one or more of these following, five domains, which are, delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behaviour (including catatonia) and negative symptoms.

Hallucinations

Hallucinations are perception-like experiences that occur without an external stimulus. They are vivid and clear, with the full force and impact of normal perceptions and usually under involuntary control.

Auditory hallucinations are often the most common and are experienced as voices, whether familiar or unfamiliar to the individual and are seen as different from their own thoughts.

The voices could be one or multiple people talking at once, in their mind either instructing or engaging in some sort of dialogue. Individuals at times, seem to be talking to themselves, but is a result of the talk going on with the voices.

Delusions

These are fixed beliefs that are amenable to change, in the light of conflicting evidence. They tend to take the shape of various forms which include, persecutory, referential, somatic, religious and grandiose.

Persecutory delusions take the shape of suspicion in which they will believe people, institutions or organizations are out to harm them in malicious ways. These are often the most common. For example, one might believe that they are under watch by the police or intelligence services, and have to protect themselves.

Referential delusions take the shape of beliefs that cues from their environment, gestures and comments are all directed, talking or communicating with them. For example, one might believe that news anchors reporting news may be talking about them.

Grandiose delusions involve the individual believing that they have exceptional wealth, fame and status. For example, the individual might believe they are creator of the nine planets and can influence presidents of the world to his will. Erotomanic delusions involve the individual having a belief that someone famous or an individual they know is romantically interested or in love with them.

Nihilistic delusions take the shape of the individual believing that a major catastrophe is about to occur. For example, burning of the world.

Delusions tend to seem bizarre and not understandable to the general public and others around the individual. These thoughts tend of this nature, often express an outside force controlling one’s mind or body.

Type of these expressions include thought withdrawal, which involves the belief that one’s thoughts are being “removed” by an outside force. Thought insertion, which involves the insertion of alien thoughts into one’s mind. Delusions of control, which involves the thoughts that one’s body is being manipulated or controlled by an outside force.

Disorganized thinking (speech)

The behaviour from disorganized thinking involves the individuals speech switching from one topic to another, often seems as derailment or loose associations. Answers to questions may be unrelated or of a very completely different nature. In severe cases the speech may complete incomprehensible or unknown. Mildly severe cases disorganized speech is at time common and nonspecific. All in all, this makes communication with the individual increasingly difficult.

Abnormal motor behaviour

Abnormal motor behaviour manifests itself, in many ways from child-like silliness to unpredictable agitation. Problems are often noted when the individual partakes in goal-direct objectives. Catatonic behaviour is observed, and defined by lack of response to the environment. This takes the form of resistance to instructions to maintaining rigid and bizarre poses and gestures.

Other features that stereotyped movements with this behaviour include, staring, grimacing, mutism and echoing of speech.

Negative symptoms

Such behaviours are often displayed as diminished emotional expression and avolition.

Diminished emotional expression, includes reduction in expressions in the face, eye contact, intonation of speech (prosody) and movements of the hand, head and face that give emotional emphasis to speech. Avolition, is a decrease in motivated self-initiated purposeful activities, which involves the individual, sitting for long periods of time and show little interest in participating in work or social activities.

Other negative symptoms include alogia, anhedonia and asociality. Alogia, is manifested by diminished speech output, Anhedonia, is the decreased ability to experience pleasure from positive stimuli or degradation in the recollection of pleasure previously experienced and Asociality, refers to the apparent lack of interest in social interactions and may be associated with avolition, but can be a manifestation of limited opportunities for social interaction.

Other aspects that occur as a result of an individual going through the disorder, although, could be aspects of other mental disorders, is the lack of attention to one’s hygiene.

They say, a sane person, looks insane to the insane person, while the insane person looks insane to the sane person. Who is sane in the end? As you can see, the “mwenda zimu” has reasons for his “madness”, he/she didn’t fall from the sky. Circling back to our myth and stigma of mental illness, where do our witchcraft, religion and drug misconceptions fall? Maybe until the drug abuse.

Schizophrenia hasn’t been exactly been concluded how it occurs but it has been learnt that predisposed genetics, environmental factors and traumatic events in early childhood place the individuals at risk of the disorders appearing in one’s life. Some drugs have been known to affect the brain after long term usage, and give rise to the disorder.

We’ve concluded that the “Mwenda Zimu” definitely has reasons for his own making. So what happens if you are Schizophrenic or get to know a loved one or someone who is? It’s a very puzzling experience, will you still have friends? Family? Spouse? Marriage and kids? All the questions of your existence are swimming in the mass of your brain in the cluster of the millions of nerves it is made up of. Don’t fret. A proper prescription of the right medication, which is followed religiously for the patient, together with psychotherapy and psychoeducation to begin for you and your loved ones, will be a strong saviour.

They say it takes a village. Indeed, this path to walk is not for you alone. Support systems are necessary. Through these techniques, it guides the individual and the families and friends within the social life of the patient, to be educated about ways to integrate themselves into society and learn more about the disorder as well as how to handle many other aspects of social life. A therapy session doesn’t seem like just a reason to talk about someone being insane right?

Coming to the conclusion of all this, we can say that there’s more than meets the eye when we meet our “Mwenda Zimu”. A big reason as to why our friend on the streets or roadside markets, finds themselves there, is because their symptoms do not allow them to be fully functioning members of society, be it, in school, friendships, work, marriages and interacting with others. Some families simply give up trying to take care of the schizophrenic, due to the expense or shame/stigma and at times, they wander away from home due to their auditory hallucinations or delusions telling them what to do and never appear at home again.

However, like we said it takes a village right? Let’s all grab some educational material on mental disorders and let’s know how to help those we can help. Until next time. Check on each other.