Mental Illness Stigma in Africa

Original Article Here:  http://edition.cnn.com/2012/01/31/health/frank-njenga-mental-health/index.html?hpt=hp_c2

(CNN) -- As Kenya's leading psychiatrist, Frank Njenga has been championing the cause of better mental health care on the east African country and the continent for more than three decades.

He's been working tirelessly to bring quality mental health care in a country where mentally disabled people receive little help from the state and face massive stigma from society.

"It's a horrible indictment on what we've done but the truth and reality is that very little has been done systematically and deliberately by government or by ourselves to bring up the level of mental health in this part of the world," says Njenga.

In Kenya, an estimated three million, mostly poor, people live with intellectual and mental disabilities, according to NGO and United Nations figures. At the same time, the ratio of psychiatrists to the population is dismal -- just one psychiatrist to half a million people.

See also: Kenya's mentally ill locked up and forgotten

But Njenga, who is president of the African Association of Psychiatrists, says the problem is even worse in other countries on the continent.

A psychiatrist in Kenya

Lessons of mental healthcare

"It is a major challenge but it is a challenge that is very sadly is spread across the whole of the Africa continent," he says Njenga.

"In fact, Kenya is ironically behind South Africa and perhaps Egypt in the ratios of psychiatrists that are available per population. There are countries in Africa where there is no single psychiatrist to five-six million people."

This has motivated Njenga to dedicate his life helping mental health patients and raising awareness in a continent where mental disorders are often neglected and described as "un-African" and belonging to "people in the West."

Njenga, however, discards such claims as "clear nonsense."

"For as long as you are a self-confessed human being you will continue to suffer human conditions of which mental disorders are an integral part," he says.

Read also: Namibia's 'miracle doctor' brings gift of sight

Njenga describes Africa as "truly the traumatized continent" that's been plagued by wars, human suffering and lethal dictatorships.

"Whether you are looking at Rwanda or southern Sudan or Sierra Leone or DRC, the number of women and children and adults who have suffered severe trauma is greater than any other continent that I can think of."

We are losing far too many men and women to mental illness and therefore to un-productivity by not treating them for mental illness.
Frank Njenga

He underlines the link between good mental health and productivity and calls policy makers to make mental health services a priority in order to help their countries escape poverty.

"There is no health without mental health and there is no economy," says Njenga. "We are losing far too many men and women to mental illness and therefore to un-productivity by not treating them for mental illness."

Born in Kenya, Njenga was inspired as a teenager by the work of psychiatrist Frantz Fanon, writer of "Wretched of the Earth," a seminal book that explores identity and the post-colonial experience.

From then on, Njenga was convinced he wanted to be a psychiatrist. He went on to study psychology throughout medical school in Kenya before moving to the UK for his post-graduate studies at the Maudsley Hospital -- the world's oldest psychiatric hospital.

At the end of this studies, however, Njenga chose not to pursue a career in the UK but to return to his home country, committed to promoting the cause of better mental health in the continent.

"I went to the UK to come back and to come back as a psychiatrist and to make a difference in my homeland and in my continent. That is the reason I left Kenya and that is the reason I came back," he says.

Read also:The Africans giving aid to the world

On his return to Kenya, Njenga embarked on a mission to reduce the social stigma that is attached to going to a psychiatrist or seeing a mental health professional.

In a ground-breaking weekly show called "Frankly Speaking," Njenga spoke with his patients on television, putting the spotlight on tough issues such as schizophrenia and substance abuse -- taboo topics that were usually kept out of public sight.

Today the discussion of mental health issues on this continent is focused and is positive -- about that I feel proud and privileged.
Frank Njenga

"I felt powerful and relaxed I felt at last here I was able to tell it exactly as it was," he says. "Of all the things I have done in this society and community it is the program on television -- Frankly Speaking -- because I spoke frankly as my name is and my patients spoke very frankly indeed."

In his commitment to providing top-notch mental health care, Njenga also helped build a private in-patient psychiatric hospital, the first of its kind in Kenya.

He's also authored several children's books in a bid to build better understanding of mental illness and advocated for an insurance cover for mental health patients as chairman of the largest insurance company in Kenya.

Through awareness and affordable treatment, Njenga has changed how many people in Kenya think about mental health.

"Today the discussion of mental health issues on this continent is focused and is positive -- about that I feel proud and privileged," he says.

What the Bible Says about Church or The Invisible Church and the Visible Church

"What the Bible Says about Church: or "The Invisible Church and the Visible Church"

 There seems to be a lot of misconceptions about the the term "church" or "the church" really means or refers to.

This is not meant to be an exhaustive look at the topic of the Christian Church (much smarter people have written much larger works ) but rather a bit of an overview for the curious or confused  or maybe even ( and hopefully) a refreshing look for the embittered veteran.

As is often helpful in defining something, let’s talk about what it is NOT.

The Church is not a building. It is not a steeple and stained glass. It is not bricks and mortar or wood or crystal.

The Church, as the Bible lays it out, is in fact – people.  Human beings.  And to be more specific , human beings who have met Jesus Christ in a very personal way. Who, through reason and experience,  have put their faith in Him, and Him alone, for the redemption of their souls ( this obviously implies that they have first also come to acknowledge their need for redemption).

It has been rightly said that the Church is not an organization, it is an organism. 

 In other words, it is made up of people in community and fellowship centered on the Person of Jesus Christ. And, like spokes in a wheel, the closer these people get to Christ, the closer they get to each other.

The Greek word used in the Bible for church is “ekklesia”  which literally means “called out ones”.

Strong’s Greek Dictionary:

1)      a gathering of citizens called out from their homes into some public place, an assembly

d) in a Christian sense

1) an assembly of Christians gathered for worship in a religious meeting

4) the whole body of Christians scattered throughout the earth

5) the assembly of faithful Christians already dead and received into heaven

Notice the first two Christian definitions – one is a singular gathering at a specific location which we shall refer to as the “local church”.

The other is all Christians ( i.e. true believer’s in Jesus Christ) throughout the world. We refer to this as the “Universal Church” and this term often includes the third group -  those already in Heaven – amongst its number.

Vine’s Expository Greek Dictionary expands on the concept of a “Local” and a “Universal” Church:

(a) (Universal) to the whole company of the redeemed throughout the present era, the company of which Christ said, "I will build My Church," Mat 16:18, and which is further described as "the Church which is His Body," Eph 1:22; 5:23,

(b) (Local) in the singular number (e.g., Mat 18:17, RV marg., "congregation"), to a company consisting of professed believers, e.g., Act 20:28; 1Cr 1:2; Gal 1:13; 1Th 1:1; 2Th 1:1; 1Ti 3:5, and in the plural, with reference to churches in a district.

An interesting thing to note is that the word “catholic” simply means “universal” and so the early church was simply called the Catholic Church.

However, throughout history and especially during the time of the reformation ( in the 15^th century) , there were those who believed that the “catholic” (more specifically the Roman Catholic)  church had strayed from Biblical teaching, imposed its own rules and at times became corrupt. 

When we think of the terms “The Church” or the “Roman Catholic Church” as portrayed throughout history and even in today’s view – we must realize that this is not necessarily a true or accurate representation of “the Ekklesia” . 

One way theologians make this distinction about the Church is that of the “visible Church” and the “invisible Church”.

As we have established above, the church is made up of all true believing humans. Though we can see the outward lifestyles and confessions of people, we cannot see their inward heart and therefore cannot know in an absolute way who is and is not part of this Biblical, “ invisible Church”.

The visible Church, on the other hand,  would be the official organization, the building etc… but just because it is concrete in nature, or official with the government, does not mean it is real in spirit. 

The “visible Church” is often what we hear of in the history books and the media but it is not necessarily reflective of Jesus’ teachings.

There are no doubt many true believers in the visible church but there are also false Christians – fakers, phonies, posers. 

Ghandi noted this when He said “ “I like your Christ, I do not like your Christians. Your Christians are so unlike your Christ.”

If you are a Christian, let this not be said of you  - we should all strive to be LIKE Christ.

Thankfully the Bible assures us that

2Ti 2:19 Nevertheless the solid foundation of God stands, having this seal: "The Lord knows those who are His," and, "Let everyone who names the name of Christ depart from iniquity."

and this is the sum of the Invisible Church

This is not to say we cannot objectively judge a person’s lifestyle and the sincerity of their faith – but our measurements are inevitably finite.

Today we are aware of the distinctions between the Roman Catholic Church, the Eastern Orthodox Church ( much of Greece)  the mainline Protestant churches ( i.e. Anglican, United, …) and the Evangelicals you hear so much about in the States but who have really existed for many years in many forms and in many countries ( Baptist, Pentecostal, Mennonite Brethren, Alliance etc….)

(By the way for full disclosure, I would fall under the “Evangelical” category. For more on this term see :   )

You may be surprised to learn that of all the ceremonies, customs  and traditions that can be found in churches , the only two that Jesus  instituted  absolutely were baptism and communion ( also known as “The Lord’s Supper” or the “Eucharist” )

(*Note – Most Protestant and Evangelical churches believe that the bread and wine ( or grape juice) of communion are symbolic of Jesus’ broken body and shed blood while the Roman Catholic Church and some others believe it literally becomes Jesus’ flesh and blood … as I said, I heartily take the Evangelical view as I believe it to be the Biblical one.)

One thing they all agree on is The Trinity – in other words, a Triune God  - Father, Son and Holy Spirit. 

Dr. Wayne Grudem in his Systematic Theology gives a point form definition of this incredibly important but sometimes hard to be understood doctrine.

1)      God is the Persons

2)      Each Person is fully and equally God

3)      There is one God

That is a very brief summary of what a systematic and contextual look at Scripture clearly teaches.

And as this doctrine implies, the Son – Who is Jesus Christ – is fully and equally God.

Referred to as the “Deity” of Jesus, this teaching is at the heart and foundation of Christianity . 

In true Christianity , Jesus Christ is no less than the Almighty Creator God.

This is indeed the dividing line between what is “Christian” and what is not.

Speaking of Jesus Christ and the Church, Paul writes:

Eph 2:17 And He came and preached peace to you who were afar off and to those who were near
Eph 2:18 For through Him we both have access by one Spirit to the Father.
Eph 2:19 Now, therefore, you are no longer strangers and foreigners, but fellow citizens with the saints and members of the household of God,
Eph 2:20 having been built on the foundation of the apostles and prophets, Jesus Christ Himself being the chief cornerstone,
Eph 2:21 in whom the whole building, being fitted together, grows into a holy temple in the Lord,
Eph 2:22 in whom you also are being built together for a dwelling place of God in the Spirit.

Another 2 defining marks of a true Christian church is that it believes and teaches the Bible as the sole and infallible Word of God and that it is attempting to function as a church by having communion and baptizing believers ( the latter would be the difference between an independent Bible study and a church in progress).

This would be true of both the local independent church around the corner or a large international organization claiming to be Christian.

Mat 16:15 He said to them, "But who do you say that I am?"
Mat 16:16 Simon Peter answered and said, "You are the Christ, the Son of the living God."
Mat 16:17 Jesus answered and said to him, "Blessed are you, Simon Bar-Jonah, for flesh and blood has not revealed [this] to you, but My Father who is in heaven.
Mat 16:18 "And I also say to you that you are Peter, and on this rock I will build My church, and the gates of Hades shall not prevail against it.

Eph 1:22 And He (God the Father)  put all things under His (Jesus’ )feet, and gave Him to be head over all things to the church,
Eph 1:23 which is His body, the fullness of Him who fills all in all.

It’s important to note that it was Jesus , Himself , who founded the Church  and Who is it’s Head. and bid us partake in this particular form of community.  So to say we love Jesus and then refuse to go to any type of Biblical Christ-honouring church is really just hypocritical.

Many say that their church is “the outdoors” or “nature”.  To be sure, taking in Creation can indeed be a worshipful experience – incredibly so actually. I can attest to that personally.

 However, that alone is not enough. It is not community and it is not what Jesus’ meant when he founded the church.  

Act 2:42 And they continued steadfastly in the apostles' doctrine and fellowship, in the breaking of bread, and in prayers.
Act 2:43 Then fear came upon every soul, and many wonders and signs were done through the apostles.
Act 2:44 Now all who believed were together, and had all things in common,
Act 2:45 and sold their possessions and goods, and divided them among all, as anyone had need.
Act 2:46 So continuing daily with one accord in the temple, and breaking bread from house to house, they ate their food with gladness and simplicity of heart,
Act 2:47 praising God and having favor with all the people. And the Lord added to the church   daily those who were being saved.

You can see that in the first verse we see 4 hallmarks of the church – “they continued steadfastly in”:

1)      The apostles' doctrine (i.e. The teaching and explaining and life application of the Bible)

2)       and fellowship (community, meeting together, being accountable to one another and loving each other)

3)       in the breaking of bread (communion)

4)      and in prayers (praying together as a group for each other and all those in the world etc…)

Well, much more could be said but for the sake of simplicity and readability I think I will leave things there. Please feel free to comment if you see anything that doesn’t fit Biblically or is missing .

The Lake - My Grandma's Poetry

The Lake

by Hilda Harder on Friday, January 27, 2012 at 9:06pm

Beside the lulling, lapping lake I sit
And stare at great expanse of sky and water.
Awed by the glories in the girth of it,
And I made small in size
Another pebble on the shore.
Is there a God who masterminds it all,
And balances within His hand, this earthly ball?
Idle hand sifts sand o'er idle hand,
And there between my fingers, an agate caught
Whose opal centre gleams glistening in the sun.
So life must be strained, lest all be naught,
And the last great pearl of life remain unfounded,
And life at it's end be void and vacant ground.

I wrote that many years ago and have since found the answer. Those who search will find I feel sure!! Hilda.

Shawn McDonald Testimony

The Kite

Sometimes what we perceive as limitations are, in fact, the key to our success.

The Kite

 by John Newton

Once upon a time a paper kite 

mounted to a wondrous height,

Where, giddy with its elevation, 

it thus expressed self admiration:

“See how yon crowds of gazing people 

admire my flight above the steeple;

How they would wonder if they knew 

all that a kite like me could do!

Were I but free, I’d take a flight 

and pierce the clouds beyond their sight;

But, ah, like a poor prisoner bound,

 my string confines me to the ground.

I’d brave the eagle’s towering wing 

might I but fly without a string.”

It tugged and pulled, while thus it spoke, 

to snap the string.

At last it broke.

Deprived at once of all its stay, 

in vain it tried to soar away.

Unable its own weight to bear, 

it fluttered downward through the air.

Unable its own course to guide, 

the winds soon plunged it in the tide.

Ah, foolish kite, thou hadst no wing, 

how couldst thou fly without a string?

Oh, Lord, I see

 how much this kite resembles me!

Forgetful that by Thee I stand, 

impatient of Thy ruling hand;

How oft I’ve wished to break the lines 

Thy wisdom for my lot assigns.

How oft indulged a vain desire

 for something more, or something higher.

But for Thy grace and love divine ,

a fall thus dreadful had been mine!

****

2Cr 12:8 Concerning this thing I pleaded with the Lord three times that it might depart from me.

2Cr 12:9 And He said to me, "My grace is sufficient for you, for My strength is made perfect in weakness." Therefore most gladly I will rather boast in my infirmities, 

that the power of Christ may rest upon me.

2Cr 12:10 Therefore I take pleasure in infirmities, in reproaches, in needs, in persecutions, in distresses, for Christ's sake. For when I am weak, then I am strong.    

"Courageous" - Movie Review

Not that I consider myself a great movie critic but for both my Christian and non - Christian friends, I like to give a bit of a glimpse into what a faith-based production , like this one, is all about and what you can expect.

As mentioned, this is a faith based production and as such it has an inherent uphill battle to climb in the sense of budget and finding quality actors.  But I think most would agree that  faith-based movie productions are getting better and better all the time.

The first one that really blew me away (compared to my expectations) was Fireproof ( the same folks produced this movie as well) . Then there is "To Save a Life", probably the best one to date.

Don't forget other great Christian inspired movies like "Luther" (bio-pic of Martin Luther, 15th century church reformer played by Joseph Feinnes) and Soul Surfer ( also a bio of a young girl who overcame the odds and found her ultimate success in God).

What I enjoy about some of the Christian movies coming out now, besides the improvement of production and acting, is that they seem a lot more real to life - genuine struggles, wrestling with God etc...

Anyways - back to this particular movie - Courageous - which is now available on Blu-Ray, DVD, and through most cable companies.

Courageous is essentially about fatherhood.. and by implication parenthood in general.

But it does focus on the man, and particularly the father, because the producers perceive ( as do I) a general lack of maturity, responsibility and understanding on the part of fathers in today's world.  There also seems to be a lack of support for them, a lack of role models, or even a safe place to just be honest and transparent about the issues they are facing.

I took my youth group to see this movie in an actual theatre ( believe it or not) and it was thoroughly enjoyed by all and discussion ensued afterwards on the topic.

At first I was a bit concerned because some of the kids there did not have fathers in their life or had fathers that were not particularly great - and I didn't want them to feel singled out or feel like they couldn't make it in this life because of this lack of father presence.

However the writers of this movie were smart enough to realize the human condition and the society we live in. Although the importance of the affect a father has on their child is seriously highlighted, they seem to cover almost all the bases when they deal with such topics as:

> The regret of not spending quality time with your child

> The shame a father feels when he can't provide properly for his family

> The fear a young man feels when he accidentally  impregnates a girl  - and  the flight response that ensues.

> The emotional struggles and of a grown man still holding deep bitterness towards his father for not being there for him when he was young and the mighty power of forgiveness.

> The challenge to break the cycle of poor fathering and be there for your child in the here and now

> The realization that all of us men can be a mentor to someone who doesn't have a father in their life - a father to the fatherless so to speak.

This movie views fatherhood from the perspective of all members of the family and all generations - and I really appreciated that.

I think you will genuinely laugh and cry during this film and that's the way it should be.

For my non-Christian friends, this movie does preach the Gospel at times and is unapolegetic for that ( it also pokes holes in some Christian's hypocrisy) . But even if you have misgivings about any "religiousness" in the movie, I think you will enjoy watching it and going on the journey that the men in this film travel.

Because these are not just Christian problems - they are human problems. I think that you will be able to identify with at least one of the characters and , even if  only for the family issues faced or emotional healing of it all, I think you just might be glad you watched it.