7(C). Dilapidation

English

The building and infrastructure are in a deplorable state.

Zambian Parliamentary Committee on Health, Community Development and Social Welfare

In 2010 the Parliamentary Committee on Health, Community Development and Social Welfare described the general condition and infrastructure of psychiatric facilities as dilapidated.134 Apart from Chainama Hills Hospital acute wards and newly-built Livingstone facility, monitors found that psychiatric units at other hospitals (Ndola, Kabwe and Chipata) were not maintained and had the oldest-looking facilities in the hospital compared to non-psychiatric wards. The Parliamentary Committee reported that Ndola psychiatric unit (built in 1932) was in a deplorable state: the building had huge cracks and broken windows. Some of the wards had been closed for over 20 years, awaiting renovation. Monitors saw all these during their visits and both acute and non-acute patients were locked in one large dormitory of roughly 7 meters by 25 meters.

Photo: Chipata psychiatric hospital, 26 October 2012. © MDAC.Photo: Chipata psychiatric hospital, 26 October 2012. © MDAC.

Services vary considerably across the country’s psychiatric facilities. “Closed wards” are locked, staff control entry and exit of patients who were not allowed to stay with carers or relatives. On “open wards”, patients and relatives walked around freely, coming and going. Relatives were expected to stay at the hospital to care for their loved ones. Open wards had seclusion rooms that could be locked. The few patients who arrive alone were expected to call for their relatives. The hospital’s role was to contain the patient and administer medication, while relatives provided other care and support, and ensured that patients did not escape. A clinical officer talked to monitors about the revolving door nature of psychiatric admission: patients were given “medicine and some sort of care, but nothing to prepare them for living outside.”

At Ndola, male patients had no access to outdoor space and were only allowed out of the ward once a week for something called “occupational therapy”, which meant watching television. The barred windows allowed little natural light to come into the room. Only a few of the windows opened minimally to let in fresh air. There were run-down toilets and washing facilities which afford no privacy. A concentrated smell of urine, faeces and body odour filled the air.

Like other psychiatric units, there was no children’s ward but in October 2012, monitors were informed that children (including boys) were admitted to the female ward with their carers. In January 2014 monitors were able to look into the in seclusion room at Ndola male ward. They saw a child of approximately 12 years old with an intellectual disability. Staff informed them that the boy had hit other patients. He was placed in seclusion reportedly to save him from being beaten up by other patients.

Open wards of other facilities were problematic. At Kabwe hospital, both the male and female open wards lacked a sink, everyone had to share one outdoor ground tap. At Chipata, the toilets in the male ward had reportedly not been flushable since 2001. The only acceptable washing facilities monitors found on their visits were in the “F Ward” at Chainama Hospital.

Photo: One of the two toilets used by 45 patients at Ndola closed male ward. Toilets have no privacy (no doors, and an open window), 24 October 2012. © MDAC.Photo: One of the two toilets used by 45 patients at Ndola closed male ward. Toilets have no privacy (no doors, and an open window), 24 October 2012. © MDAC.

Photo: Toilet in the male psychiatric ward in Chipata hospital. 26 October 2012 © MDACPhoto: Toilet in the male psychiatric ward in Chipata hospital. 26 October 2012 © MDAC


134 The Committee visited Kabwe General Hospital, Ndola Central Hospital, Mansa General Hospital, Kitwe Central Hospital (which only provided outpatient mental health services) and Chainama Hills Hospital to check on infrastructure, drug supply and mental health staffing levels.

RSS Find us on facebook MDAC is on Twitter Company profile of MDAC on LinkedIn MDAC youtube channel Google plus close