In Senegal many women refuse to take mentally disabled children on public transport; families hide children with mental or neurological disorders, and some parents disown them outright. Such is the stigma of having a child with these widely misunderstood illnesses.
"In Senegal people simply regard children with such conditions as 'abnormal', whatever the disability - mental or physical," said Ngor Ndour, a psychologist specializing in mental disorders in children.
"While it might be somewhat simpler to explain that a child is deaf, it is complicated to explain mental disorders because people automatically see a mystical aspect – the child is 'abnormal', possessed, half-man, half-animal," said Ndour, a former director of Senegal's only public school for children with mental and neurological disorders.
The World Health Organization (WHO) notes that around the globe people with mental disorders and neurological conditions like epilepsy face discrimination and rights violations.
According to the latest WHO global burden of disease statistics, from 2004, 13.4 million people in Africa had unipolar depressive disorders, 7.7 million epilepsy, 2.7 million bipolar affective disorder and 2.1 million schizophrenia.
Ndour said in many cases the mother thinks a mentally disabled child is her fault, and the father often flees. This is what happened to Mariama Bodian, mother of Seynabou, an eight-year-old girl simply described by her mother as "psychotic".
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"[Her father] left us as soon as he knew the child had a mental disability - she was four months old," Bodian told IRIN. "We have not heard from him since."
In the small rented room in the capital, Dakar, where she lives with Seynabou, Bodian said: "The father did not come to terms with our daughter's disorder. He does not help us financially - he no longer communicates with us."
Astou Ndong is also raising two sons alone because her husband left when Abdoulaye, who has epilepsy and is now 11, was born. "[The father] was ashamed of Abdoulaye and told me to go to the village with him so we could hide the child," she told IRIN.
"But I didn't want to. I love my child, I want to help him, and I knew that for school and healthcare he would be better off here in the city," Ndong said. Her refusal meant her husband sends them no money, and she earns a meagre living as a trader.
The shame attached to mental and neurological disorders is a strong force, said Dakar hairdresser Ibrahim Gueye, the father of a child with a severe learning disability.
"In Senegalese society it is quite difficult to have a child with a mental disorder. The prevailing belief is that it is a curse; it is difficult to get family and friends to accept such a child."
Another common belief is that the mother was unfaithful in the marriage, and a child with such a condition is a punishment from God, said Dominique Ndeki, director of the Education and Training Centre for the Mentally Disabled (CEFDI), Senegal's only public school for these children.
Ndeki said one day a family brought a six-year-old boy to register at CEFDI. "They told me it was the first time he had been out of the house; they had been hiding him."
Hiding mentally ill children is common, and may even be an improvement over the past. Ndeki recalled hearing stories, when he was a boy, of mentally disabled children deliberately being drowned.
Both Seynabou and Abdoulaye attend CEFDI, and although the city offers more by way of education and healthcare than the rural areas, facilities are still inadequate.
Photo: Aurélie Fontaine/IRIN
|Youths at Centre Aminata Mbaye, one of five private schools for mentally disabled people in Senegal|
The education ministry has no national statistics on the number of mentally handicapped children, but Ndeki said in 2009 CEFDI had to turn away 54 of the 81 children who applied from all over the country because the facility could not accommodate any more new students. When registration for the 2010-11 academic year opened, 20 families came to register children in just two days.
Senegal has five private institutions for mentally handicapped children – four in Dakar and one in the northern city of Saint Louis - but many families cannot afford them.
CEFDI, which takes children with Down's syndrome, epilepsy, and a variety of other disorders, has two specialists and three other teachers, who have not been trained to teach mentally or neurologically disabled children, to educate 109 students from four to 20 years old, according to Ndeki.
Saliou Sène, an elementary school superintendent, said there were plans to train teachers in the care and education of mentally disabled children; the education ministry said at present Senegal had no facilities to provide such training.
Claude Sarr, director of the Aminata Mbaye Centre for mentally disabled young people, a private centre, said better facilities and training were linked to broader acceptance on the part of families with affected children.
"Awareness is difficult, but little by little it's improving," he said. "Parents [of these children] must mobilize to help raise awareness among the authorities."