Joseph Atukunda; The battle with mental health



Joseph Atukunda



By Arthur Mwenkanya Katabalwa

Mental health in Uganda has for a long time been treated with a lot of suspicion and misunderstanding. In many tribal societies it is treated like a taboo. People with mental illnesses are thought of as mad. They are thought of as being possessed by evil spirits or having been affected by supernatural causes and witchcraft okuloga. While traditional healers have tried to bridge the gap in the providence of some form of treatment, there has also been intervention from religious groups especially evangelical Christians trying to "exorcise" those afflicted by evil.

Therefore people with mental illnesses have been excluded from main stream society for a long time. A report by The International Journal of Mental Health Systems found that mental services in Uganda are underfunded. Only 1% of the total health expenditure is spent on mental health and in many cases, treatment is only centred in urban areas. There is one main national referral hospital, Butabika.

Joseph Atukunda was in his last year at high school in 1989when problems started ”I was outgoing at school as you know, an extrovert but all over a sudden I became withdrawn and fearful, lost interest of the things I liked."  For Joseph this was the beginning of depression buthe had no idea what it was. "After holidays I refused to go back to school and tried to even commit suicide"

Atukunda was known amongst others to be one of the best actors at school. At Budo Junior School and at Kings College Budo, he was known to have such great stage experience especially with comedy. He was a school prefect and he was well respected. Yet everything came crushing down around him. He had to learn that depression made him scared and loose interest in things that he liked. Worst still, it made him feel suicidal for no good reason. "The brain is just having a problem and misinterpreting things [but] many people have taken their lives that way."

"They say that its a chemical imbalance, the psychiatrists but to me it was an identity crisis gone wrong. Most people suffer mental illness onset in the late teens as I did and usually this is the time of identity crisis"

Joseph Kahigiriza Atukunda  was born in 1969 in western Uganda.  His late father, Mzee James Kahigiriza,  was the last prime minister of Ankole. He was born into a large family going to Budo Junior School and Kings College Budo for his education. When he dropped out of Budo before his final exams, he went to Nkumba College of Commerce (Now the University) to study accountancy. Because he hadn't finished his A level, he had to rely on his O level results for admission.

One of his friends at high school Philip Miiro recalls the days at Budo "Atusoks (his nick name for Joseph) used to call me "Partner" and we read hard. When books became hard we used to go to point X to mourn our low marks. But we worked hard". Miiro and Atukunda both studied Physics, Chemistry and Biology. They both dreamt of becoming doctors. "One day, Muddu (a biology teacher) gave each of us  1.5 out of 20 for our biology essays. That was a very low moment in our lives". Miiro was sad to see his friend succumb to mental illness leaving him to struggle on alone through to the end.

To Atukunda, this was a major blow "I could not continue with my studies and go on to University and after surviving the suicide attempt it was understood that I was developing some mental illness and I was treated by Prof. Bosa at mulago with ECT. This is electric shocks through the brain and its believed to help in severe depression when life is at risk of suicide".

When he got better, he went to Mbarara to rest but then got manic depression while trying to act a play and direct it about mental illness. "When I got manic, I was then diagnosed with Bipolar disorder and treated for the mania again at Mulago. Bipolar had bouts of depression followed by mania but also sometime of being normal."

One of the lowest points in his battle against this illness was in 2003 "I had a manic episode and I was taken by the police to Butaibka (national psychiatric hospital). On arrival at the hospital, I was injected, stripped naked and put in a very cold isolation room" Atukuda was so depressed that he started hallucinating he was in hell. The room never had a toilet and on occasion, food was brought before it had been cleaned.  "Apart from isolating you from the rest of the patients as you may be very dangerous, the psychiatrists maintain that it also has some therapeutic effect of cooling you down when manic." In this room, he maintained that even though it was unpleasant it made him come back to his senses   "you are thankful for all that was done to restore you."

When he was first diagnosed, he was taken to traditional healers "I can't really say whether I was helped or not by the traditional healers but some professionals think traditional healers help for those who believe in them. The body is self-healing and Jesus told many people that your faith has healed you. Some people who believe in traditional healers think positively after seeing one and foster wellness to themselves. On the other hand western medications have a lot of side effects and are quite addictive to an extent that when you stay on them very long it becomes a guarantee that you get a relapse the moment you discontinue medication."

"The psychiatrists say we have to remain on medication for life but some books I have read like Anatomy of an Epidemic by Robert Whitaker are really against medication and convince the readers that it seems pharmaceutical companies are out to hook people and somehow convince the psychiatrists to encourage and keep people on medication. Please read this book and see what am talking about. We users are left in a dilemma whether to discontinue medication or not but this is largely an individual choice and like Rev. Bombo (RIP) used to tell us, you can't escape the consequences of your choice."

His family especially his wife have handled his illness with a lot of understanding "They are simply taking it easy" Atukunda now works for heartsounds Uganda mental health service user-led Community-Based Organisation helping other people with mental problems "Now that I have made it a vocation and some of our survival comes from my working in mental health it is much easier on them. My wife runs a catering service and I have given her business on many occasions cooking for our workshops. We have agreed with our donors that we give her business as she works with service users and carers in form of occupational therapy. She gets very frightened and encourages me to go for medication and if I get worse she convinces me to go for admission."

Mental health services are improving he maintains "we service users are coming in openly to talk about the illness things are getting better, stigma is being combated. The service users should be consulted on how they wish to be treated and our experience with the illness put to use."

There are many challenges that still face companies like Heartsounds "We two funded projects running, the donor requirement that administrative costs should not exceed 10 or 15% of the total budget leaves most of our administrative costs not covered as we are beginners and are getting small funding. Our salaries as full time workers are still very low yet some of us already have families to look after, we are failing to pay our utility bills and as we talk our power has been disconnected at our resource centre, we are just lucky that I own the premises where our resource centre is housed otherwise we would also be having a problem of rent."

Joseph Atukunda still battles his mental health but with much more optimism now than ever before. recently, he was in The United Kingdom on a Commonwealth funded trip to further enhance his skills in helping out people like him who have had the misfortune of having mental health problems.