Given its reported patient to staff ratios of over one hundred to one, it’s not surprising that I was able to walk through the gates of Butabika Mental Institution in Kampala, past the institution’s administrative building, by the signs demanding visitors make themselves known and plunk myself down outside the women’s intake ward completely without so much as a second glance from anyone. It’s only slightly more shocking that I was able to talk to patients for over an hour completely unquestioned by anyone.
I was at Butabika to do a story on patient conditions, which, according to former patients and staff, run the gambit from critical under-resourcing to patient abuse. “Helen,” a former patient who has been in and out of the hospital several times, was strangled by security guards with a bed sheet as a form of restraint and placed, naked, into solitary confinement for over 24 hours. A nurse told of staff beatings of patients that resulted in broken bones and a dangerous shortage of meds.
As soon as I sat down on a little bench under a tree outside the women’s intake ward, half a dozen patients crowded around me. In ill-fitting teal hospital gowns, some poked their faces through bars of the iron fence around the ward; others came outside to where I was sitting. Before I even opened my mouth to tell them I was there to do research on patient conditions, they had already started talking. By virtue of my skin and being an outsider, I was someone to complain to, someone who might have the power to Do Something to alleviate the grinding indignities of their daily lives.
“I’m so tired of it here; I’m so tired of it here,” complained one woman. Another wanted shoes. “Like those,” she said pointing at my sandals. “Muzungu, for me I admire to be like you, so smart (well-dressed),” said one of them. “And to produce many children. But I don’t know if I can manage.” There were requests for phone cards; someone wanted me to take a letter to her family.
Uniformed nurses periodically rushed between wards, too busy or unconcerned to stop and challenge my presence there. An eskari (security guard) came over and stood by me and the little knot of patients that swarmed around me; he didn’t question me when I said I was there to do research, ask where I was from or whether or not I had clearance from the administration. Despite the fact that Butabika houses patients considered criminally insane as well as children, patients roamed the facility seemingly unfettered. A couple of male patients strolled by and greeted us as we were talking.
Before I left one of the female patients crawled up in the dirt outside the ward and crouched down so low that she was half kneeing in front of me. Her hair was wild and matted. Her eyes, the lids half closed, rolled up to show just the whites. She didn’t seem even cognisant of where she was, but she choked out a question. “Can I . . . have . . . a drink of water?” “I don’t have any,” I said. But she caught me in the lie, pointing at the bottle which I had forgot was sitting at my feet. “But the Bible says, ‘I was hungry and you gave me something to eat, I was thirsty and you gave me a drink . . .’” Such a small favour- compared to the deluge of requests I’d faced earlier- and one I could do so easily. I left the bottle for her on my way out.
Jocelyn Edwards 