4(B). Mental health in Zambia
There are no official estimates of the number of people with mental health issues in Zambia,17 and nor is there a system for the routine collection of data. This hampers the development of services and breaches Article 31 of the Convention on the Rights of Persons with Disabilities, in which Zambia has undertaken to “collect appropriate information, including statistical and research data, to enable them to formulate and implement policies”. It is not only statistics which are lacking; academia and media have also shown little interest in people with mental health issues too.
People with mental health issues in Zambia are more likely than others to be denied education and be unemployed or in a low income job.18 Gender-based violence for women with mental health issues is prevalent, as women are economically dependent on their spouses and can be forced to live in abusive relationships.19 Sexual abuse of girls is also a problem: over 6,000 girls were reportedly victims of sexual abuse (“defilement”20) in the period 2010–2013.21 The Human Rights Commission has attributed the failure to reduce the rate to culture, early marriages and traditional healers.22 A 2011 UN report refers to an increase in the number of cases of sexual violence against girls and citing a figure of one in ten women having experienced sexual violence.23 A UN expert committee on women’s rights has also expressed concern about widespread rape and defilement, pointing out that it happens in the public sector including in places of detention, and on private property including the home.24 This report echoes those findings.
The World Health Organization (WHO) estimates that 80% of people with epilepsy live in developing regions,25 but there are no recent statistics on numbers of people with epilepsy in Zambia.26 Chainama Hills Hospital estimates that it provided services to 1,500 people with epilepsy in 2013.27 Similarly there is a lack of data on substance abuse, with Chainama Hills Hospital reporting that it provided services to 1,800 people for alcohol-related abuse and 500 for other substances in 2013.28
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17 The Mental Health and Poverty Project in 2008 estimated that about 2,667 patients per 100,000 population were admitted annually to the only tertiary referral psychiatric hospital and units across the country. Jason Mwanza et al., Mental Health Policy Development and Implementation in Zambia: A situation analysis. (WHO Mental Health & Poverty Project, 30 March 2008).
18 Ibid.
19 John Mayeya et al, “Zambia mental health country profile”, International Review of Psychiatry 16 (2004):63–72.
20 Section 138 of the Zambian Penal Code creates states that the offence of defilement will have been committed by “any person who unlawfully and carnally knows any child commits a felony and is liable, upon conviction, to a term of imprisonment of not less than 15 years and may be liable to imprisonment for life”.
21 “Over 6000 Zambian girls defiled between 2010-2013”, Lusaka Times, 23 July 2013, available online at: http://www.lusakatimes.com/2013/07/23/over-6000-zambian-girls-defiled-between-2010-2013/ (last accessed: 08.07.2014).
22 Ibid.
23 UN Human Rights Council, Report of the Special Rapporteur on violence against women: mission to Zambia, Rashida Manjoo, 2 May 2011, A/HRC/17/26/Add.4, 7.
24 UN Committee on the Elimination of Discrimination against Women, Concluding Observations: Zambia, 19 September 2011, CEDAW/C/ZMB/CO/5–6.
25 World Health Organization, Fact sheet N˚999: Epilepsy, October 2012.
26 A 2004 study looking at epilepsy prevalence in rural Zambia finds an unadjusted prevalence of 14.5/1000. See Gretchen L. Birbeck and Ellie M. Kalichi, “Epilepsy prevalence in rural Zambia: a door-to-door survey”, Tropical Medicine & International Health, 9 (2004): 92–95.
27 Statistics from the report office of Chainama Hills Hospital, 25 February 2014.
28 Ibid.