Most of us are familiar with food banks and soup kitchens, where donated food goes to feed hungry people in the community. Yet we rarely talk about the connection between mental illness and hunger and how access to food can do more than just provide a full stomach. Numerous studies have shown a link between poor intestinal health and an increase in mental illness -- though which is the cause and which the effect remains up for debate. Whether hunger causes mental illness or the illness makes people more susceptible to hunger isn't really the issue. It's difficult (if not impossible) to heal the brain without healing the body as well.
At the Shekhinah Clinic in Tamale, Ghana, feeding people and helping those with mental illness are not separate tasks. In 1989 Dr. David Abdulai founded the clinic with the intention of doing better than other centers for the mentally ill in Ghana, which often have more in common with prisons than with care facilities. The following year he started a meals-on-wheels program that feeds 150 destitute people in the community. According to their website, approximately 2,500 people are treated in their wards, and 20,000 receive outpatient care. The impact of this center and its food program was so large that it inspired writer Katrina Moore, who has an M.A. in food studies from New York University, to create a documentary called Under the Mango Tree that the Shekhinah Clinic could use for fundraising and outreach.
Currently in its final stages of editing, the documentary will run at about 25 minutes and will show both the patients and the caretakers at the clinic.
"I spent five weeks in Ghana and, when I came home, spent more time talking about this place where I'd been for two hours," Moore said. "What they do is unique both for the location and in general." Shekhinah is not an NGO but is run entirely by local people. More incredibly, the clinic's founder, Dr. Abdulai, lost both parents and 10 siblings to poverty-related diseases before the age of 10. He survived on the streets of Tamale and managed to put himself through high school and medical school with the help of people in healthcare industries and the Catholic diocese. According to Moore, the assistance of these groups created his desire to give back to the community -- as so many had given to him.
Dr. Abdulai speaks with a patient at Shekhinah Clinic (credit: Marshall Langohr)
The Ghanian people often believe that mental illness is caused by witchcraft. "Families will kick out someone who can't contribute to the household, so many of these people end up homeless and have nowhere to go," said Moore. The majority of Ghana's psychiatric hospitals are placed in urban areas and the better-developed south. In the north, where the Shekhinah clinic is located, people with disabilities are often left to fend for themselves. According to multiple reports by Human Rights Watch, the conditions in many psychiatric clinics or "prayer camps" run by religious organizations are abysmal. Prolonged restraint, electroshock therapy without anesthesia, beatings, sleep deprivation, and prolonged fasts are common. It's within this culture of mental-health treatment that the Shekhinah clinic becomes even more remarkable.
Dr. Abdulai does not force anyone to stay at the clinic. People come and go as they please, and it's open to anyone who needs health care, not just people with mental illness. The food program, an afterthought in most developed nations, is central to their success with patients and the community. Before the clinic opened, homeless men would steal things and harass women working in the local Ghanaian markets. Now that these men are fed, they have no need to steal. "It's created this peace between women in the markets and this population," Moore said. People are calmer after receiving one of Shekhinah's heavy meals, and many just sleep. Good food, as it turns out, makes people want to stay at the clinic without restraints.
Preparing soup at Shekhinah Clinic (credit: Marshall Langohr)
Though this is just one clinic, its success could lead to others taking Shekinah's lead. Tamale happens to be the third-largest city in Ghana, and the fastest-growing in all West Africa. As the city continues to grow, perhaps other countries will take note of Shekinah's successes and hardships. It's easy to continue a tradition of stigma against the mentally ill when they're forced to steal to provide themselves with food and water. A decrease in hunger-related crimes is a small but important step toward important community acceptance.
In 2012 Ghana passed the biggest piece of major mental-health reform since 1972. The new act hopes to improve access to in- and outpatient mental-health care, regulate mental-health practitioners, promote voluntary treatment, and combat the stigma against mental illness. Better treatment, of course, is important, yet it's imperative that countries not attempt to prescribe medicine and treatment at the cost of basic necessities like food and shelter. The basic outreach of a meals-on-wheels program to 150 Tamale residents is the difference between struggle within the community and aiding the acceptance of Ghanaians with mental-health issues. The impact of these community-based programs is dependent on their ability to market themselves to their nation and to the international community. Hopefully Moore's film will bring viewers one step closer to that goal.
To learn more about Under the Mango Tree, visit the Indiegogo page.
This post was published first on Food Politic.