Boko Haram leaves Nigeria a lifetime of mental trauma

September 25, 2016

The soldier clutched his book with both hands. He shouted his name, rank and Nigerian Army number to no-one in particular. He stood up straight and ended every reply with a bark of "sah" (sir).

But his eyes were fixed to a slowly cranking ceiling fan in the hospital ward—the thousand yard stare of someone who had seen too much and didn't want to remember.

The soldier said he was caught up in a Boko Haram ambush and colleagues were killed. A bullet hit him in the leg and he hadn't seen combat since.

Instead, he saw the inside of beer bottles, the smoke of cannabis joints, then the drug dependency ward of the Federal Neuro-Psychiatric Hospital in Maiduguri.

Nurses said he was violent and abusive when he was admitted, but after a week he calmed down.

"In times of war, when we are fighting war, it's very good for a man to be a man, to boast that he is a man, to fight the enemy," he said, trying to explain his state of mind.

"But unfortunately due to the ways of the enemies that come to you or due to the ways you meet the enemy, or due to the way you kill him, (or) you deal with the command..."

His voice trailed off and he apologised. "At times that's how we fell into (a) battle that we don't expect in our life... ."

'Drastic surge'

At least 20,000 people have been killed since the start of the in 2009 but doctors at the hospital say they've treated nearly three times as many for its psychological effects.

That figure is likely to only be the tip of the iceberg: the hospital is the only psychiatric facility in northeast Nigeria—an area bigger than that of the United Kingdom.

In all, 2.6 million people have fled for their lives: many have seen loved ones killed and their homes destroyed. Women and young girls have been kidnapped and raped. Children have been orphaned.

Francis Zamdai, a nurse in charge of the drug dependency ward, said addiction has affected everyone, from government officials and military officers to farmers and the unemployed.

"Before the insurgency... we used to admit sometimes 20, 25 (patients). But with the eruption of the insurgency we used to have 50, 60, above that," he told AFP.

Consultant psychiatrist Dr Ibrahim Adam Mshelia described the increase in cases since the fighting began as a "drastic surge".

"Over 58,000 patients have been seen in the hospital that are related to the insurgency," he said.

"Common causes we see... are , depression, , psychosis, anxiety disorders like phobia and panic disorder."

Lifetime effects

The hospital is tucked away behind high walls and iron gates in a quiet housing estate off the Baga Road, whose market has been a frequent target for Boko Haram's bombs and suicide bombers.

Out-patients wait on rows of benches for consultations; nurses in starched white uniforms—the women in matching hijabs—leaf through paperwork.

A special unit to treat children and teenagers has been opened, backed by the International Organization for Migration, packed with toys, board games and with cartoon characters on the walls.

In-patients sleep or sit silently on their beds in the wards or play pool and table-tennis in the occupational therapy unit.

Treatment and rehabilitation for those affected, however, is likely to be needed long after they have been discharged.

"Even after the end of insurgency the effect... will continue to linger. We are looking to 30 to 50 years," said Mshelia.

Some 1.5 million people have sought safe haven in Maiduguri. They will eventually leave but doctors fear that those who have managed to cope so far could break down when they return home.

Meanwhile, levels of drug use are said to be rising in Borno state, exacerbated by porous borders, lack of law enforcement and a desperate, damaged population seeking to deaden pain and fear.

They include use of drugs such as cocaine, heroin and methamphetamine, which were previously unheard of in the state, said Mshelia.

Overstretched

The scant provision for mental health services in northeast Nigeria and the scale of the insurgency has left financial and human resources stretched to the limit at the hospital.

Outside, female victims of sexual and psychological violence at the hands of Boko Haram have received some counselling in the camps. But there is agreement more needs to be done for everyone.

UN Secretary-General Ban Ki-moon in May 2015 called on Nigeria to "scale up the provision of medical and psychosocial support".

For the soldier, a passage in his book is supposed to provide comfort and support for life's spiritual battle between good and evil, right and wrong.

"Blessed be the Lord my strength, which teacheth my hands to war, and my fingers to fight," it reads.

But it's a real-life battle he has struggled to cope with—and wishes had never happened at all.

"I wanted to be with my family, in peace," he said.

Explore further: 49,000 kids dying of malnutrition linked to Boko Haram: UN

Related Stories

49,000 kids dying of malnutrition linked to Boko Haram: UN

July 19, 2016
Some 49,000 children will die of malnutrition in areas once cut off by northeastern Nigeria's Islamic extremist uprising if they don't get treatment, the U.N. children's agency warned Tuesday.

WHO confirms 3rd case of polio in Nigeria, Rotary Club says

September 5, 2016
The World Health Organization has confirmed a third case of polio in an area of Nigeria newly liberated from Boko Haram Islamic extremists, the Rotary Club said Monday, amid fears the disease could resurge in neighboring ...

Cholera kills 16 at Boko Haram displaced camps in NE Nigeria: MSF

September 16, 2015
Sixteen people have died in a cholera outbreak at three camps for those made homeless by Boko Haram violence in northeast Nigeria, the medical charity Medecins Sans Frontieres said on Wednesday.

Nigeria reports third polio case in restive north: WHO

September 5, 2016
Nigeria has reported its third polio case in the northeastern state of Borno, the World Health Organization (WHO) said Monday, warning more cases could appear in a major health setback.

Nigeria reports first 2 cases of polio in years, WHO says

August 11, 2016
Nigeria has reported the first two cases of polio after more than two years, in an area newly liberated from Islamic extremists who attacked polio vaccinators in the past, the government and the World Health Organization ...

Recommended for you

Researchers find increased risk of birth defects in babies after first-trimester exposure to lithium

June 18, 2018
Researchers from the Icahn School of Medicine at Mount Sinai found an elevated risk of major congenital malformations in fetuses after first-trimester exposure to lithium, in the largest study ever to examine the risk of ...

Changing room playlist could give World Cup teams the edge

June 18, 2018
Blasting out Rihanna or Kanye West could give World Cup squads that crucial psychological edge over rival teams, suggests research from Brunel University London.

Gut microbes may contribute to depression and anxiety in obesity

June 18, 2018
Like everyone, people with type 2 diabetes and obesity suffer from depression and anxiety, but even more so. Researchers at Joslin Diabetes Center now have demonstrated a surprising potential contributor to these negative ...

Nature programmes could put a spring in your step

June 18, 2018
New research shows that watching TV programmes such as the BBC's Springwatch and Countryfile might actually be good for you.

Helicopter parenting may negatively affect children's emotional well-being, behavior

June 18, 2018
It's natural for parents to do whatever they can to keep their children safe and healthy, but children need space to learn and grow on their own, without Mom or Dad hovering over them, according to new research published ...

Why you should eat popcorn with chopsticks – and other psychological tricks to make life more enjoyable

June 18, 2018
It happens fast. You crack open a bottle of your favorite drink and put it to your lips. The delicious flavor is nearly overwhelming. But a minute later, you're barely noticing the taste as you drink it.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.