17. Mai 2024

Die folgenden Ausschnitte aus ausgewählten Quellen enthalten Informationen zu oben genannter Fragestellung (Zugriff auf alle Quellen am 17. Mai 2024):

·      Girma, Eshetu et al.: Understanding Mental health stigma and discrimination in Ethiopia: A qualitative study, April 2024
https://www.researchgate.net/publication/380209130_Understanding_Mental_health_stigma_and_discrimination_in_Ethiopia_A_qualitative_study

„In Ethiopia, People still viewed mental health problems as curses from God (Zeleke et al. 2019). Ethiopians have a distinct cultural and traditional understanding of mental illness that primarily links it to spiritual origins, disruptions in the divine-human relationship, and the "curse" or punishment of God on wrong dowers (Jacobsson and Merdasa 1991; Zeleke et al. 2019).Mental illnesses were associated with psycho-cultural inappropriateness, or engaging in taboo (Monteiro and Balogun 2014). The idea of what causes mental illness and how society characterizes those people with mental health condition it creates stigma. This is due to the fear that individuals with mental illness may harm others (Yeshanew et al. 2020).” (Girma, April 2024, S. 6)

„Prevailing community attitudes towards people with mental health conditions included that mental illness could not be cured (with medicine or any other means), that mental health illness can be transmitted, and that the condition is hereditary and that all people with MHCs are assumed to be dangerous and violent. In addition, among service providers there was a concept of shared/contagious psychosis: that the healthcare worker may get sick from long exposure to people with health conditions:

‘As a fresh health worker, I used to fear that maybe the “shared psychosis” is true and that I should change working in the department of mental health services’ (Male service provider, psychiatric nurse, Ethiopian orthodox)” (Girma, April 2024, S. 17-18)

„Courtesy stigma

This reflects the experience stigma and discrimination of caregivers and service providers because of their association or relationship with people with a mental health condition. A female caregiver urban house stated,

‘I rented the house using another person’s name and paid monthly using that person. We moved in at night when the owners were out of the city so that they would not notice’. (Female caregiver Ethiopian orthodox)

Public, institutional and professional stigma

The following section presents the stigmatizing behaviors that the targeted group experiences and anticipates. Service users faced isolation and discrimination from the community (not wanting to go to their house and unwilling to be visited by them), locking them behind doors and holding them in chains by their caregivers/family because of their illness (fear they may come to harm or cause trouble) and most of the time to avoid shame. There were also reports of exclusion from public transportation, as it was anticipated that the illness would cause some disturbance.

I used to be isolated and discriminated by my neighbors and by my husband’s relatives. They do not want me to go to their house and they did not come to visit me either. My neighbors did not allow me to participate in social activities and I felt bad and felt lonely. Even they won’t accept my thoughts and words seriously since they think am crazy. (Female service user, Ethiopian orthodox, depression).

With regard to institutional stigma, for those attending healthcare facilities, an unwelcoming environment for mental health service users was reported, especially in governmental health facilities compared to private institutes and poor law enforcement trend as not treat people with MHCs respectfully and may disregard their complaints. Lack of resources and essential mental health medications, disorganized departments and shortage of health professionals in the psychiatric department were also reported.

‘Yes, there are some challenges especially on the law enforcement, if the patients cause harm the police officers request us to report the patients follow up history in order to confirm if they are mentally ill or not. Nevertheless, most of the time they do not use our report as evidence. Even sometimes the police insult them, they do not accept their complaints’. (Female service provider, protestant, health officer).

Healthcare professionals were also reported to show stigmatizing behaviors toward service users by refusing to engage in conversation with them, not giving them directions in the health compound, giving other patients who are seeking treatment for physical illnesses priority, mistreating them, and failing to give them the attention they need.” (Girma, April 2024, S. 19-20)

·      Hope for Justice: Exploring the links between mental health and human trafficking, 13. Oktober 2023
https://hopeforjustice.org/news/exploring-the-links-between-mental-health-and-human-trafficking/

„Her Excellency Zebidar Bogale from the Ministry of Women and Social Affairs said: ‘Mental disorders frequently lead individuals and families to poverty, homelessness and inappropriate incarceration. Individuals with mental health problems and their families are subject to stigma, discrimination, and victimization, and are vulnerable to violations of their rights as they encounter restrictions to participate in the life of the society. This is because the right to mental health is not well-respected as a human right. Awareness should be raised.‘” (Hope for Justice, 13. Oktober 2023)

·      The Reporter: Mind over matter: The urgency of mental healthcare in Ethiopia, 12. August 2023
https://www.thereporterethiopia.com/35918/

„One of the greatest impediments to addressing mental health in Ethiopia is the persistence of stigma and misconceptions. Psychological disorders are often misunderstood, with some ascribing them to frailty of character, corrupt morals, or even possession by evil spirits. These misconceptions foster a culture of shame and silence, preventing individuals from openly discussing their struggles and seeking appropriate care.” (The Reporter, 12. August 2023)

·      The Transmitter: Remembering Zemi Yenus: An ambassador for autism in Africa, 15. Juni 2021
https://www.thetransmitter.org/spectrum/remembering-zemi-yenus-an-ambassador-for-autism-in-africa/

„Prior to the establishment of the Joy Center, children with autism in Ethiopia would often remain hidden away at home due to severe stigma. Zemi worked tirelessly to change this. She was a pioneer in speaking openly about her child’s autism and educating others about the condition. She appeared several times in the local media with Jojo to increase autism acceptance and awareness. […]

Many parents my colleagues and I have spoken to feel stigmatized by their family and neighbors anytime they go on the street with their autistic child or their child with intellectual disability. Although parents talk about positive reactions and support they have received from their own family and community around them, they say some of their family members are embarrassed to be associated with their child. Parents have told us that their child’s condition is sometimes seen as something they brought because of their sin, as punishment from God or as a curse or possession by evil spirits. Parents, especially mothers, are often blamed for their child’s autism in Ethiopia. Autistic children sometimes are forced to leave public buses, and taxis are not happy to take them. Sometimes it is also difficult for parents to find rental accommodation because as soon as landlords know about their child’s condition, they force them to leave.

Most autistic children in Ethiopia do not attend school; often they are not accepted at mainstream schools or are expelled.” (The Transmitter, 15. Juni 2021)

·      DFAT – Department of Foreign Affairs and Trade: DFAT Country Information Report Ethiopia, 12. August 2020
https://www.dfat.gov.au/sites/default/files/country-information-report-ethiopia.pdf

„Despite these efforts, mental illness carries significant social stigma. Those suffering from mental illness face discrimination in employment, education and housing. Traditional attitudes about mental illness discourage victims from seeking professional treatment and discussing their illness openly. Mental health services are available, particularly in Addis Ababa and other major urban areas, but local sources told DFAT the average person is often unaware of their existence. Mental health services are scarce in rural areas, where most of the population lives but where health infrastructure is limited. Private mental health clinics operate in Addis Ababa (including the Sitota Center for Mental Health Care), although these are financially prohibitive for the average person. There is one dedicated psychiatric hospital in Addis Ababa (St. Amanuel Mental Specialized Hospital).

Sources told DFAT that most Ethiopians eschew the notion of seeking professional services to treat mental illness, preferring traditional treatment methods (e.g. use of holy water) instead.” (DFAT, 12. August 2020, S. 14)

·      HRW – Human Rights Watch: Living in Chains. Shackling of people with psychosocial disabilities worldwide, Oktober 2020
https://www.hrw.org/sites/default/files/media_2020/10/global_shackling1020_web_2.pdf

„Human Rights Watch has found evidence of people with psychosocial or intellectual disabilities being shackled in Afghanistan, Argentina, Armenia, Bangladesh, Benin, Bolivia, Brazil, Brunei, Burkina Faso, Cambodia, Chile, China, Colombia, Côte d'Ivoire, Dominican Republic, Democratic Republic of Congo, East Timor, Ecuador, Egypt, El Salvador, Ethiopia, Ghana, Guatemala, Haiti, Honduras, India, Indonesia, Iraq, Israel, Japan, Jordan, Kenya, Laos, Liberia, Mexico, Morocco, Mozambique, Nicaragua, Nigeria, Oman, Pakistan, Palestine, Paraguay, Peru, Philippines, Russia, Saudi Arabia, Senegal, Sierra Leone, Somalia, South Africa, South Sudan, Sudan, Tajikistan, Tanzania, Thailand, Togo, Turkey, Uganda, Yemen, and Zimbabwe.” (HRW, Oktober 2020, S. 6)

„For example, many people in countries such as Afghanistan, Bangladesh, Burkina Faso, Egypt, Ethiopia, Ghana, Guatemala, India, Indonesia, Iraq, Kenya, Mexico, Morocco, Mozambique, Nigeria, Oman, Pakistan, Palestine, Peru, Philippines, Saudi Arabia, Senegal, Sierra Leone, Somalia, including in Somaliland, Sudan, and Yemen believe that psychosocial disabilities are the result of possession by evil spirits or witchcraft.” (HRW, Oktober 2020, S. 33)

·      Addis Standard: Analysis + Interview: Do We Care? The Challenges of Addressing Autism in Ethiopia, 8. Oktober 2020
https://addisstandard.com/do-we-care-the-challenges-of-addressing-autism-in-ethiopia/

„Autism to Ethiopian context has been treated poorly as the children with these disorders are often isolated and hidden from society predominantly due to superstitious reasoning leading them to poor health and nutrition problems.” (Addis Standard, 8. Oktober 2020)

·      Anadolu Agency: Ethiopia's mentally ill stay in the shadows, 20. Dezember 2018
https://www.aa.com.tr/en/africa/ethiopias-mentally-ill-stay-in-the-shadows/1344078

„On a bright windy morning, many men and women chained by the ankle were quietly sitting in the compound of St. Urael, one of the Ethiopian Orthodox churches that provide holy water.

Followers of the church strongly believe the water heals every disease and exorcises demons. The water is blessed by priests clutching crosses and given to the sick, who drink it as a tonic.

Inside a small room, dozens of men and women were being rinsed in the water. Some were wailing, while others were speaking in many local dialects.

Father Kinfe Michael, who administers the water, told Anadolu Agency that most of the mentally ill who had been receiving it had been treated at mental health hospitals for some time.

‘When their conditions don’t change, families bring their loved ones to us, and many had been freed of demons and the state of being bewitched,’ he claimed.

After undergoing a long recovery in churches and hospitals, patients often encounter a hostile domestic environment that denies them their basic rights.

‘They are ... discriminated against in employment, promotion, education, and housing, and some are denied the opportunity to vote, get married, and have a family. They also don’t find appropriate treatments,’ said the mental health strategy paper.” (Anadolu Agency, 20. Dezember 2018)

·      Mitiku, Elezebet: My experiences with the mental health stigma in Ethiopia, University of St. Thomas (Hg.), April 2018
https://threesixty.stthomas.edu/mental-illness-and-my-community-my-experiences-with-the-mental-health-stigma-in-ethiopia/

„I started to notice a difference between our church back home and this one when I saw a small section of people in the front being segregated from the rest of the people. They were ‘possessed.’ They were crying, screaming, fainting, getting sick and yelling at the deacons. The deacons hit them with this big necklace of beads. Then the priest started bringing the possessed people on stage one by one.

One person had stolen his family and friends’ money. Another person was a local actor suffering from drug abuse. Their stories made them sound like characters in movies. It was very foreign to me. My siblings and I were puzzled, but everybody else just sat in silence. Shaking their heads. Tearing up. Praying for the demonic spirits to leave the victims’ bodies and to better themselves as people.” (Mitiku, April 2018)

·      The Independent: Why many autistic children in Africa are hidden away and go undiagnosed, 14. Dezember 2017
https://www.independent.co.uk/news/long_reads/autism-children-africa-hidden-diagnosis-autistic-mental-disability-a8106106.html

„The 8-year-old girl’s head drooped like a wilted flower as she sat slumped in a wooden chair in her neighbor’s kitchen. Her wrists were swollen from the dingy white shoelace that bound them behind her back. The girl’s mother, Aberu Demas, wept as she untied her child.

Earlier that day, Demas had arrived unannounced at the Joy Center for Autism in Addis Ababa, Ethiopia. A single mother living on the outskirts of town, Demas didn’t know what autism was or if her daughter, Fekerte, had it, but she was desperate for help. Fekerte could not speak or feed herself, and Demas had no family or friends to look after the girl when she needed to work or run errands. Afraid that Fekerte would wander off and drown in the river behind the houses, Demas felt she had no choice but to tie her up.

It had taken Demas about an hour to get to the center by bus. And because she didn’t have an appointment, she had to wait about three hours until Zemi Yenus, the center’s founder, could see her. The center was at maximum capacity, so when they finally met, Yenus told Demas she could only put Fekerte on the waiting list. Demas began to cry, and confessed that she had left her daughter tied up and alone.

Yenus did a quick calculation: By the time Demas got home, Fekerte would have been restrained for at least six hours, with no food, water or bathroom breaks. That was the end of the meeting: Yenus immediately drove Demas home to free Fekerte, and reassured the woman that she would make room for the girl at her school. Fekerte wasn’t the first child Yenus had seen in that state — or the last.

In the 10 years since then, Yenus says she has encountered hundreds of children locked away or tied up — although the situation has improved slightly. Like Demas, many parents resort to these extreme measures because they have no other choice. Others hide their children, fearing stigma, which is pervasive in many parts of Africa and casts disabilities as the sign of a curse or possession by a spirit.” (The Independent, 14. Dezember 2017)

·      CRPD – Committee on the Rights of Persons with Disabilities: Concluding observations on the initial report of Ethiopia [CRPD/C/ETH/CO/1], 4. November 2016
https://www.ecoi.net/en/file/local/1269568/1930_1482329905_g1624695.pdf

„The Committee is deeply concerned by reports of the use of coercive measures, including physical restraint and seclusion, of adults and children with psychosocial and/or intellectual disabilities, and that corporal punishment is lawful at home.” (CRPD, 4. November 2016, S. 5)