/ 1 August 2005

August 05 – 11 2005

Trap of mental illness

Thanks for publishing David Le Page’s brave account of what it means to suffer from bipolar disorder (“Mindful of mania”, July 29). But spare a thought for people who love those who suffer from mental illnesses. We are also caught in the mind-body dualism trap Le Page describes.

Because we are schooled to believe their condition is “emotional”, there’s an expectation that if we offer enough love, support and understanding, the illness will go away. But love can no more “cure” mental illness than it can shrink a tumour or drive out HIV.

Even so, family and friends of the mentally ill often feel terrible guilt and failure. Like relatives of people with HIV/Aids, we must witness suffering we are helpless to prevent or alleviate.

Loving someone whose brain chemistry takes them into strange realms can be exhausting. After shattering episodes involving fabrications, tantrums or recklessness, they breeze back into your life with little memory of scenes still keeping you awake at nights.

Slowly you learn that what seems to be mendacity is delusion or a swiftly shifting apprehension of reality; that wild accusations and apparently wilful misreadings of your best intentions are fuelled by paranoia.

How to cope? Spiritual practice offers comfort. But expect to feel resentment for the broken promises, the bad debts. Grow a thick skin, and set boundaries.

Get yourself a therapist. If this is beyond your resources, find or establish a support group. In bad times, the guidance of an objective expert is helpful, as is the empathy of others in the same position.

Educate yourself, and others.

But finding expert advice for yourself or the sufferer is not easy. Getting decent healthcare seems to demand not only middle-class resources, but also tenacity and assertive-ness. Quiz doctors: How much experience do they have of treating this disorder? Are they prepared to work as part of a team? What follow-up and supplementary resources do they suggest?

In the meantime, Le Page is -correct: if we dismantle the stigma associated with HIV, it will have a knock-on effect for others with poorly understood and stigmatised disorders. — Helen Moffett, Rosebank, Cape Town

The best thing about the M&G is that every now and again it comes up with writing that is so fine that it lives in the mind for days, or weeks. So it was with Le Page’s piece.

He was brave to write about his disorder in a society where there is such terrible stigma. But I suspect that through writing it, he will liberate himself and others.

I would like to read something on where people can go for help; and on what helps and what doesn’t. Le Page mentioned Buddhism — are there other things — nutrition, alternative therapies? How should families or those who love people with bipolar or other mental illnesses help them?

You’ve given us a window; please continue building the house. — Charlene Smith, Johannesburg

Congratulations on publishing Le Page’s courageous and insightful glimpse into the terrifying world of bipolar mood disorder. Our media are still loath to run articles that go against the popular grain of stigmatising those with psychiatric conditions.

With close to nine million South Africans suffering from mental illness — from fairly mild and transient ones to bipolar mood disorder, paralysing anxiety, severe chronic depression (my case) and full-blown schizophrenia — there can be no denying the enormity of the crisis.

When horrifying incidents such as the stabbing of a pensioner in a shopping mall by a schizophrenic woman catapult mental illness into public debate, the stigma kicks into top gear.

My organisation, Dignitas, has hundreds of letters recounting the vicious and subtle ways companies, communities and even NGOs ostracise people who ask for help. Chief among these are the police, where mental conditions precipitated by extremely stressful work are estimated to be as high as 60%.

The South African Police Service offers voluntary counselling, but any member who asks for help has that noted on their record. Instead of being rewarded for trying to be a better police officer, they are labelled weak, unstable, unreliable — and before long, another good cop joins the private sector.

As one former female inspector writes: “Your seniors and colleagues look on you like the people in Jesus’s time looked on lepers.” That is probably why thousands pay to consult private psychiatrists.

Many mental conditions are life-threatening. Professor Lawrence Schlebusch of the Nelson Mandela School of Medicine’s psychiatric department in Durban has tagged our suicide rate as one of the world’s highest.

Yet, when properly diagnosed and treated, most illnesses can be overcome and the sufferer returned to full membership of society. Schle-busch’s colleague, department head Professor Dan Mkhize, brands stigma as the “biggest single obstacle in the path of [South Africa’s] mental wellbeing”.

Every time people like Le Page tell their story and publications like M&G publish them, we take a bite out of that obstacle. — Llewellyn Kriel, Dignitas

Sweet 20 and going strong

Happy 20th birthday, Mail & Guardian! May you continue to produce the excellent work with which you are synonymous.

I well remember how in the early days The Weekly Mail bravely held a light towards the truth despite gaggings, court actions and harassments.

The feeling now is of déjà vu. The way our government and ruling party are reacting to “Oilgate” reminds me so much of the tactics of the previous administration — including the timing of the release of the public protector’s report to avert an immediate M&G backlash.

Oilgate is a huge story that makes the Shaik-Zuma affair look like a picnic. I wish you well on your journey into these murky and turbulent waters. Your writers and editors can take courage from our fantastic Constitution, but even more from your paper’s proud pedigree. — Michael de Wit, Noordhoek, Cape Town

Irwin Manoim, in his delightful article “The Mail is still with us”, July 22 on the M&G‘s history, remarked that the newspaper has broadened its scope by including motoring, travel and lifestyle -sections. But as it seems to have done so at the expense of the books pages, can this be a Good Thing? Does anybody at the M&G mind if the books pages have all but disappeared? — Phoebe Theron, The Crags

Farmers not plotting against government

In response to the article and editorial on land in your July 29 edition, my concern, as a farmer’s wife, member of a farming community and someone not raised on a farm, is that one rarely reads articles giving the perspective of commercial farmers, black and white.

Readers must think commercial farmers want to sell their farms to rip off the government, and that they live off the fat of the land and don’t want to share it. This may be true of some farmers, but it concerns me that all may be viewed in this light.

Farmers don’t live in a utopian world where everything comes easily and free of charge. Do urban people know they pay rates in rural areas but don’t have access to the benefits of rates, such as waste collection?

The editor is right to point out that all whites benefited from apartheid. But there is a delicate balance in trying to right historical wrongs without undermining an agricultural system that feeds the country and meets international standards.

Most white farmers today probably didn’t vote for the apartheid government. They may be continuing a family legacy, but they are also doing a job. Most don’t have time to deal with politics and land claims, let alone try to make land reform more difficult or scheme to get their land overvalued.

Something has to be done about the rate of land reform. Let’s get to it — but realistically, considering all parties involved. — Brenda Sykes, Richmond, KwaZulu-Natal

What are varsities meant to do?

It would be gratifying but surprising if President Thabo Mbeki, Minister of Public Enterprises Alec Erwin and Science and Tech-nology Minister Mosibudi Mangena are able to tell the tertiary education sector what it is doing wrong and what it should be doing instead to meet the country’s “social and economic needs” (“Mbeki: varsities must change”, July 29).

There is a large international literature on the relationship between education and development, but it is far from yielding a consensus on what detailed policies are the best.

In the 1960s and 1970s, “national manpower planning” was all the rage as a policy initiative for human resources in developing countries. It is seldom heard of today for good reason: no one could predict with -sufficient accuracy the future demand for educated and trained workers.

A listing of numbers in broad categories like electricians, bricklayers, computer programmers, engineers and so on proved of little help to the schools, universities and training institutes because it was too imprecise and because quality tended to be neglected. There was also no evidence that the pace of development was increased as a consequence.

The problem lies in the too-easy assumption that most jobs require fixed kinds of education and skills for their efficient performance. That is not true. In economic terms, there are “no fixed coefficients” between labour inputs and goods and services outputs in a wide range of intermediate and high-level skills.

Clearly the opposite is the case for a sub-set of specialised skills like those required by surgeons, accountants and airline pilots. But these comprise a distinct minority of kinds of jobs.

The policy problem has two components. First, there is identifying in advance and in sufficient micro-detail the kinds of jobs which will be in demand in the labour market of a developing economy like South Africa. Second, such job characteristics have then to be translated into specified curriculum and course terms for technikons and universities.

There is no evidence that governments elsewhere in the world, as well as historically, have ever been able to solve these two problems satisfactorily.

Given the high margins of error, it makes most sense to offer broad educational and training offerings and concentrate vigorously on raising the quality of graduates. Although they are far from perfect, labour market signals will do the rest. — S Archer, Rondebosch, Cape Town

OD-ing on Danish pastry

After seeing The Swenkers (Reviewed in Friday, July 15) at the Encounters Film Festival, I felt I’d been sold a pup.

I’d understood that this was a South African documentary — not a piece of Danish confectionery, made by Danes with Danish funding.

South Africans can do better than this — we’ve got blood in our veins, not syrup. I felt I’d overdosed on good humour, playfulness, stoicism and soft lighting. A 2005 extension of a 19th-century European take on the Dark Continent and the noble savage.

We were shown clips, purportedly detailing the oral tradition, of one Swenker’s mother telling a story around a fire about bears kidnapping a girl. Bears? In Africa? When the four-year-old boy asked his father, “What is hope?” (playing further havoc with my sugar levels), I was hoping he would ask: “What the hell is a bear?”

And the sound track — Happy Trails by Roy Rogers? Where were our African divas?

Apart from the dehumanisation implicit in this kind of monochromatic characterisation, what concerned me was that people in the audience would think that poverty, patriarchy, the migrant labour system, life in the rural areas, are all actually okay in a soulfully charming way.

Too much sugar is really unhealthy — and not just for our teeth. As the one Swenker said to the woman selling meat (loosely translated): “This really did need some chilli.” — Fiona Wakelin

Appalled

As a 16-year-old growing up in what could be the first truly colour-blind generation in South Africa, I was appalled by Blackman Ngoro’s comments about coloured people (“This Blackman is stupid”, July 22).

Notions of “cultural superiority” give rise to the kind of mentality that resulted in the monster of apartheid.

I am proud to belong to a school where there is little trace of discrimination, and have many friends of all races.

If we can see past skin colour, how can someone with a leadership role make such derogatory racial remarks? What kind of role model is this for the youth? — Amy Buttle, Cape Town

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