Possessed. Demonized. Outcast. Sounds like the latest horror flick? Unfortunately, for many in The Gambia suffering from readily recognizable psychological disorders, it is a way of life.

The social labels that one carries throughout life has the power to shape our thoughts, direct our actions, and ultimately form the very fabric of our lives. It's a depressing thought, and yet we see it everyday in our comfortable lives. We see the guy in the subway muttering obscenities to himself and brand him as crazy. We scorn people scrabbling for food on TV and call them looters. We see a well-dressed gentleman and fawn over him as a successful person. Never mind what circumstances led to these images. Whether Crazy Subway Guy is actually a schizophrenic who was deprived of his medication by dwindling federal funds. Or whether the so-called looters had no other choice for survival and no sight of help. Or whether the rich guy had appropriated all of his funds illegally. What matters is what society has labeled them.

In The Gambia, society's branding of -- and therefore their reaction to -- people with mental disorders is even more severe. People suffering from such disorders as bipolar disorder, epilepsy, and schizophrenia are treated horrifically, labelled as possessed by evil spirits and cruelly cast out of society. Disorders that modern medicine has diagnosed as treatable, or at least controllable, are leading to lives filled with unending harrassment, unnecessary pain, and unfair deprivation.

The World Health Organization, in fact, in its 2002-2005 Cooperation Strategy Report on the Gambia, has cited mental health as one of the emerging health challenges and concerns in the area, with "a need to develop a mental health programme and ensure its integration into primary health care." In a 2002 research study conducted by Rosalind Coleman, Louie Loppy, & Gijs Walraven, they identified a treatment gap for people in the Gambia with epilepsy, in large part due to the societal conception that epilepsy is a spiritual affliction, prevalence of belief in contagion, and fears of unexplained phenomena.

The need to sensitize the public in the Gambia about these disorders, and the need for proper treatment, is evident. As pointed out by the WHO strategy report, the best method to provide support is through community-based programs, by effectively combining both traditional healing and conventional health care systems. "At the community level, the first point of contact for seeking health care is usually the traditional healer... There would be benefits if traditional healers were adequately sensitized and utilized as the new village health workers or community health workers."

HEP is working in conjunction with Campama Mental Hospital in the Gambia to encourage public awareness and education programs on psychological disorders such as epilepsy, schizophrenia, and bipolar disorder. Our objective is to establish clinics in the community level which could provide medication and education to the villages. However, in order to promote these social programs and stop the poor treatment of the mentally ill, we need help in funding, particularly for medicines, transportation for clinicians, and infrastructure.

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