Nigerian society celebrates resilience – the ability to cope with adversity. But the growing number of people coming through the doors of the Crisis and Trauma Counselling Centre (CTCC) in the northern city of Kano suggests people sometimes need a little help to get by.
The CTCC opened six months ago in a city hit by five bombings in the past two years by the jihadist group Boko Haram. Out of the roughly 320 clients the centre has seen, 70 percent are as a consequence of those attacks, said clinical psychologist Tukur Muhammad Ali.
Nicholas* is one such case. He is a second-year social studies student and class captain at the Federal College of Education (FCE), struck by the militants in September. Dozens of students were killed in the twin suicide bombing of the two main lecture halls.
For Nicholas and four other students IRIN met at the centre, security still feels inadequate at the FCE. A police car cruises the campus a couple of times a day, but despite complaints by the student union, the entry gates are still manned by the same untrained and ill-equipped guards that failed in September.
“I’m very shaky after the incident,” Nicholas told IRIN, sweat forming on his forehead, despite the cool of the room. “I’m finding it very difficult to cope. Every time I’m in the lecture hall and I hear a loud noise, I jump and become so scared. A lot of students are like me.
“The situation is very, very bad actually. My elder brother advised me to drop from school because of my emotional disorder. Counseling is helping me. They [the counselors] are advising me to continue, that there are always challenges in life; that you have to be courageous … With time, I hope everything will resolve itself,” he said.
Ahmed*, another student, said he tries to avoid reading newspapers, afraid reports of Boko Haram attacks will trigger his nightmares. But he also admitted “when I read a Boko Haram has been killed, I feel happy – and that is not a good feeling to have.”
The CTCC is the first centre in Nigeria to provide free support to people struggling with post-traumatic stress disorder (PTSD). Set up by the philanthropic Murtala Muhammed Foundation, Ali and two counselors offer care in a discreet two-storey building on the outskirts of Kano.
Ali says he and his team try to change the way clients perceive and rationalise their experiences, “for them to understand that there’s nothing wrong with having difficulty in coping with their lives right now … to overcome that anxiety and depression, and guilt that I survived.”
Recognising there is a problem and walking through the centre’s door is the first step.
“The majority of people just try and manage their situation,” Ali said. “There is also a lot of superstitious beliefs, traditional treatments involving chasing jinns [evil spirits] from the body, or reciting Koranic verses to cure mental disorders.”
A new strategy
The CTCC is part of a strategy by the Office of the National Security Advisor (ONSA) to build capacity within Nigeria’s national mental health framework to treat PTSD among both civilians and military personnel. It will draw on the existing primary health care system, eventually training up to 7,000 health workers. A research and advisory Centre for Psychology - part of the new initiative - was launched in August.
“We realized we had to bring on board civil society as the project is so big, so we turned to the Murtala Muhammed Foundation,” Fatima Akilu, director of behavioral analysis at ONSA, told IRIN.
The next step is a trauma centre in Maiduguri, the capital of Borno state, and the stronghold of Boko Haram. ONSA will again partner with the Murtala Muhammed Foundation, with staff drawn from the existing Borno State health system.
The new centre will open in May, according to Nyi Olatunde Onabanjo, programme coordinator for the Foundation. “Right now, for PTSD, we are the go-to guys," he said.
An estimated 13,700 Nigerians have been killed in Boko Haram violence between 2009 and 2014; countless more have been wounded. While those physical injuries will heal, the invisible scars left by those experiences will take far longer.
*Not their real names