REHAB FROM HELL – THE AFRICA RETREAT CENTRE

We pulled up into the gate and my sister’s kids came running behind the car to meet us. I pushed open the passenger door. The little one jumped into my lap. I held her head into my chest affectionately, unable to voice my gladness to see her past the giant lump that sat unmoving in my throat. I was angry. At my sister Stella who drove the car to pick me up, and the family that had kept me locked up in arguably the worst rehabilitation facility for sixty-two days in the first place.

“We thought we were doing the best thing for you,” Stella had defended when we had discussed the subject of my displeasure before. “We want you to be happy. There’s no way we could have kept you there if we knew you were being mistreated,” she had added, just before I broke down in tears at the whole affair.

Two months ago I was drudging through a nasty dark depression. I had attempted to take my life numerous times, and I was teetering on the verge of succeeding. My family was at a loss, fearing to lose me and not knowing at all how to help me. Hope appeared, via a Nakasero Hospital Psychiatrist who was seeing me at the time. He recommended an elite rehabilitation centre where I was to go and spend one month in residential treatment.

We arrived at the Africa Retreat Centre (ARC) on a Thursday, escorted by Stella, my brother Edgar and his wife, a friend from my time with the military in Somalia, and a Nakasero Hospital nurse. The center’s Head of Clinical Counselling and their nurse received and admitted me. It wasn’t long before orientation was over and the experience began to come apart threatening to take everyone with it.

The facility was located at the edge of the city, in Bukoto, just shortly after Oryx petrol station on the Kabira Road. A triple block of structures housed in two separate gates, one where the girls resided and the other where the boys did and where we spent all of our days.

In the first ten days, the treatment was so unbearable I attempted suicide nine separate times, preferring to be dead than to be in this place. When all my methods didn’t work, I pulled out the final stop in the toolkit: glass. I would swallow enough of it at bedtime, and surely I would be dead long before dawn.

It didn’t work. I was still alive when I woke up that morning. I wasn’t given medical attention then, and three weeks later when I began to bleed from the rectum with every bowel movement, I wasn’t allowed to see a doctor then either. Eventually, I stopped eating because eating became too painful. When I ate, on some very few occasions, I purged.

For a time I needed to use panty liners every day because I was oozing a foul discharge from the rectum. I wasn’t allowed to see a doctor then too, because — I imagine — to let me see a doctor then would be to admit (on the side of the center) that I should have seen a doctor the other times too.

I could tell after just three weeks that this center was about making money from the desperate families of ill patients who knew nowhere else to go and didn’t care much about the state in which these patients were held.

A petition I started and passed around decried the mistreatment of the facility and sought the government’s arm in regulation and protection of vulnerable groups in places of treatment such as this. We were sixteen patients in the center at that time. Fourteen of us signed it.

Of the sixteen patients who were present at the time, eight had been referrals from Nakasero Hospital and two had come referred by Entebbe Lakeside Hospital, a private clinic belonging to Dr. Musisi Ssegane, the Head of Psychiatry at Nakasero Hospital. Whether these referring doctors received a commission per each patient forwarded to ARC is unclear. What’s evident is the frequency with which Nakasero doctors sent patients here.

For a mental health facility, therapy was hard to come by. During my two months with them, I saw a Psychiatrist once in a therapy session where she asked preliminary questions about me and I answered to populate my file, and saw her thrice more for less than fifteen minutes each time to discuss issues I had that required a Physician.

I saw three other counsellors, each one not seeing me a second time after I detailed my issues in more preliminary Q&A sessions. Suffice to say, I did not have any therapy sessions that helped me during my entire two-months’ stay.

The center, advertised eloquently as a place of medical and therapeutic treatment, had a young nurse of very little experience as its sole medical officer. She struggled to circuit patients, pricking many times before she succeeded, gave me an overdose once, administered injections that got infected, and once gave me a shot that collapsed my vein.

A part-time Psychiatrist visited once a week on Wednesdays from Butabika Hospital, stayed for two hours from three o’clock to five o’clock, spending only about ten minutes on each patient, leaving many unseen for several weeks. She was the Psychiatrist and the Physician. She was the only doctor who came to the facility to see patients.

Patients’ information was kept loosely. It was common practice that the nurse and the counsellors freely shared confidential information about other patients in trying to drive points home. The centre on occasion brought in external parties to speak with us or do handiwork, never disclosing who they were before they arrived.

Several times several of us met with people we knew from the outside. This, in the end, worked to our advantage, because through them, we were able to get word outside about the center’s deeply concerning practices.

COVID-19 brought the facility to a standstill. We woke up to play cards and other board games all day, substituting our previous addictions with gambling. Things didn’t change much even when the lockdowns lifted. We still played cards all day long, and on occasion a counsellor came in to talk about something we mostly already knew and weren’t learning from.

On multiple occasions, we spent a good forty or so minutes arguing and framing the topic of discussion because a counsellor had come in with an elementary proposition none of us would allow. These exercises were mandatory. The counsellors used aggressive means to enforce this, taking away phone privileges (we were allowed to make one call every week strictly to family members), visitation privileges, confiscating or withholding food, or physical assault.

A female patient was lifted out of her bed by two male counsellors and plopped into a waiting chair at the end of a brief car ride from one side of the center to the other, kicked in the back severally (she had a known back injury), and generally humiliated.

The center wasn’t short of drama. Retaliating over the above incidence of unjustified physical assault, we had maintained our positions in the common room after dinner was served and refused to go to our respective sleeping quarters, insisting that the center apologise and call the patient in question’s parents so she would speak with them to let them know what was really going on when the gates closed on our family members.

It was a peaceful protest. Rather than talk us down as therapists might be expected to, the center called armed policemen to break us up. We told the police of the center’s malpractices. They were horrified and insisted they would return the following day to record our statements. They didn’t return. Everybody thought me naive for believing that the officers would do the right thing. They had clearly been paid off, the others agreed with each other.

We remained locked up for extended periods against our will, up to five or six months for some patients. If one acted out or became too vocal about their rights and the rights of others, they were threatened with extended stays — if they were lucky. Otherwise, they were usually subdued with strong injections that made them sluggish sloths of their former selves. For me, they denied my family access to me for two months, citing volatile “emotions”, as I have now been told by my family.

As the writer I am, I wrote all through my stay at the center. I documented their numerous abuses journalistically, cautioning them and calling them to book on occasion by mouth and long letters, letting them know that we were not sick enough to not be watching when people entrusted to care for a vulnerable group were meting all manner of incredulous abuse unchecked.

It didn’t matter. It didn’t matter beyond making an enemy out of the center’s authorities and putting a target on my back. On three occasions they ransacked my suitcases looking for what I imagine were my notes on their violence against their patients. Once they body-searched me.

In a frantic effort to protect my work, I sealed up all my notes into an envelope I handed to a departing patient and pleaded with them to take it out and keep it safe for me. I didn’t think they were capable of it to outrightly break the law and confiscate work I had made clear to them in a June 9th letter that was journalistic work.

Anyway, they intercepted the envelope and held it hostage. That same night they descended on me in my bed asleep at night, three gentlemen, a female counsellor and a nurse, and punched an antipsychotic injection into me.

The Head of Clinical Counselling led that night’s operation, steaming from his mouth of alcohol and cigarettes. He came to me days later, his face black with shame and false remorse, and apologised profusely.

He went on to inform me that my envelope of work was in his possession, and he imagines I won’t be needing to press the matter of my assault any further (I had already dished out a series of letters holding him to account). I told him I wouldn’t, if he would return my work to me intact. He promised he would. I have now left the center, but he still hasn’t given it back to me.

In a file where the welfare discussions at the facility were minuted in community meetings dating as far back as 2018, previous patients decried intimidation by the center’s staff and management, noted anger outbursts from staff towards patients, the use of privileged patient information to intimidate them, breaches of confidentiality, unethical searches of patients’ property, and distasteful quality of food.

It also detailed patients’ meetings about denied external communication, unclear program dates and arbitrary extensions, denied and delayed medications, multiple requests for doctors that were not honoured, recording of patients without their permission for promotional materials, and misinformation of family members about patients’ behaviour and program compliance and progress.

After my Counsellor Martin Githaiga sexually violated me, physically assaulted me, and intimidated me to not pursue the above charges by ransoming my journalistic notes, he was neither fired nor suspended. Between the time of the incidents and when my family finally got me out of the program, I was made to interface with him a total of thirty-six times.

Martin Githaiga slept in the same house with us the female patients. I don’t know why but such was the case. At the end of the program, I was the only female patient left and for a week, I slept with my bed pulled up against the door, genuinely fearing what he might do in retaliation.

I was a publicly suicidal patient. I knew it wasn’t beyond him to harm me and pass it off as a suicide. I was fighting for my work and fearing for my life, with no visible support from the center’s management to check this man’s sick behaviour. I didn’t get my work back, but I’m grateful that I left with my life.

We want help for our loved ones, and many times we do not know where to go to get it. Our generation is more socially and politically aware of mental health matters, more than our parents were. Even then, we are not beyond deceit, and sometimes we find ourselves bound in elaborate moneymaking schemes passing themselves off as having the solutions we seek desperately and urgently.

We must know, when we make decisions about where our people end up, the difference between the help they so need, and the help that is before us. Those two occurrences must never be used interchangeably.

All the above is well and agreed. But how does one know truly what the true nature is of the help presenting before them? Here are a few quick guide notes (this list is by no means exhaustive):

1. The facility must have an open-door policy, patient consent being supreme, or must state very clearly what their exceptions to this rule are (the exception usually only being in a lifesaving situation where consent is deferred to a secondary party).

2. External communication in phone calls and visitations must be freely given to patients, including the right to call law enforcement in a situation where they feel genuinely threatened or severely aggrieved.

3. Nutrition must be adequate, balanced, and of high quality, incorporating fruits and vegetables at every meal. Food must never be used as a tool for punishment or to enforce “discipline”.

4. Patients, unless out of their right mind, must retain the right to decline medications that aren’t life-saving.

5. Any rehabilitation facility falls under medical care and must have a full-time Physician, Psychiatrist, Psychologists, and a nurse, all within a reasonable ratio to the number of patients admitted at any given time.

6. Minimum therapy hours for an inpatient must be no less than 3 hours per week, with a qualified professional (Counsellor, Psychologist, or Psychiatrist).

7. The center must be regulated by the government, through the Ministry of Health, and must have proof of regular inspections by relevant Ministry officials.

8. Ground space as a ratio to patient numbers must not fall below four square feet per patient. Exercise grounds must be provided.

9. If animals such as dogs or cats are present at the facility, the center must bear relevant licencing and inspection certificates from relevant government authorities.

10. Overall treatment durations must make sense. For example, holding a patient as an inpatient for three months over marijuana use of three months is evidently excessive.

11. Monthly treatment costs must not vary unreasonably with the costs of similar government facilities. (Do due diligence!)

12. All staff, including support staff such as guards and cleaners, must undergo regular mental health care/management training.

13. Believe the people who are getting treatment in these centers. Due diligence at the beginning is extremely important, and when your loved ones inform you that a place is bad for them after they have tried it, BELIEVE THEM!

14. Ask about their expertise. An addiction center has no business accepting a trauma patient, for instance.

15. Ask them blantly if Martin Githaiga, a Kenyan national (for whom it is my greatest hope that he gets court-martialled and deported) works there. If he does, go in the opposite direction.

16. If possible, don’t let it be the Africa Retreat Centre.

Remember, there’s a difference between the help you need for your loved ones and the help that is good for them. Keep your loved ones safe!

Have you been to a mental health treatment center? Would you recommend it for your loved ones? What was your experience?

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