Pauline, Future Dressmaker

By Estelle Agboton and Serena Clayton

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Pauline’s plan to become a great dressmaker was something she could never have imagined when she was being beaten to “cure” her delusions and uncontrollable behavior. Born in 1994 in a small city in the north of Benin, Pauline was well-loved by her parents and five siblings. But due to illness and financial hardship, she dropped out of school in third grade and was sent to work as a servant in a family home. After a few years, the family accused her of robbery and sent her to a religious leader to force her to confess. precipitated a mental breakdown. She refused to speak, heard voices and became aggressive. The family sent Pauline back to her parents who took her to evangelical churches and fetish worshipers where she drank herbal teas and was beaten by healers, none of which seemed to help. Pauline’s condition worsened over the next several years until 2015 when her family learned about the work of St. Camille. They took Pauline to St. Camille’s dispensary in her home town where she was evaluated and given medication. Within two weeks, she was markedly improved. She then agreed to enter St. Camille’s residential program in Djougou where she became part of a supportive therapeutic community. She has now graduated to the rehabilitation center at Calavi where she is learning sewing and her plan to become a great dressmaker is within reach.

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Grand opening of the first center in Togo, the Oasis of Love

On the morning of the opening of the Oasis D'Amour (Oasis of Love) in Kpalime, Togo, patients from St. Camille’s centers Benin greeted visitors and dignitaries. The Oasis D’Amour is St. Camille’s first full treatment center in Togo, and patients from Benin had ridden in style in a large air conditioned bus to be part of the day of festivities.

Across the street, a band played; trombones ,trumpets, drums of all shapes and sizes played by musicians of varying ages and heights. Women in bright clothing danced with their children. As the band played, the contingent from Benin joined in and lined up to dance to the doors of the new center.

With St. Camille’s founder, Gregoire Ahongbonon and at the helm, prayers were read and acknowledgements were given before the great pink ribbon was cut.

Five days before the ribbon cutting, the center had opened for patients. On the first day, two people, a man and a woman of indeterminate ages, both dirty, emaciated in ripped clothing appeared at the door. Both appeared disoriented and unable to speak. They had been brought to the center by townspeople who knew they needed help. They were washed, fed, given beds and started on psychotropic medications.

Another woman, Fabienne, came with her father. Fabienne told in heartbreaking emotion, about how she had been chained to a tree in a prayer center all day, even forced to urinate in front of others. She cried with anger and humiliation as she told her story. Gregoire listened intently, took her hand and encouraged her to come to Benin where he promised she could work in the center and get training to become a nurse.

On the day the first patients arrived, the center had hardly been ready for the dignitaries. Men were hammering, sawing and making bricks. There were sinks to install, walls to be painted, and lights to be wired. The entire floor of the church still needed to be tiled. Some 200 men from across Togo and Benin yelled orders and instructions at each other in Fon, Kabiya, Mina, Ewe and French.  

One of those men was 38 year old Ghislain. Ghislain had been a law student at the University of Abomey in Benin when things began going haywire for him. He started to hear voices and became paranoid. He tried to concentrate on his school work, but the voices became too loud and they drowned out his studies. He was only able to finish a year of school. His mother was frightened, and took Ghislain to the hospital. But still he faltered. She then learned of Gregoire's treatment center and brought Ghislain. There he was given medication for his schizophrenia. At first, he said, he felt fatigued and listless, but after two weeks the voices in his head stopped. Ghislain began to work for Gregoire, first doing art projects with other patients. Now five years on, he is in charge of ordering and distributing supplies for the production of the Kpalime center. "It would be very difficult, if I had not met Gregoire, perhaps I would be in the streets, just walking," he says. "I feel gratitude for what he has done for me, because now I can do many things, because I am well." Ghislaine says in the future he would like to return to Benin, get married and have a family. He wants to return to his studies and help those who are in prison or mentally ill. 

Five days later, when the grand opening finally arrived, a procession led by four altar boys stepped over the church threshold. The first carried incense and the last carried a large wooden cross; the floor was tiled, the fans were spinning, and the room was filled with music.

Gregoire tells the audience to remember that the mentally ill are no different from anyone else—they are people who have an illness that, like any other illness, requires treatment. He exhorts community members to actively support the Oasis d’Amour because it will allow the community to care for the mentally ill with dignity and respect.

Every seat in the church is taken.  As the temperature reaches upwards of 90 degrees, one woman lays down on the cool church floor behind the last row of seats. More than a hundred chairs had been set up outside, nearly all of them were filled. It is here, in a plastic chair, Gregoire sits. He gets to his knees and prays and then returns to his seat. As the services plays out inside, he closes his eyes for a moment of much deserved rest. Tomorrow he will be back on the road looking for new opportunities to serve the “forgotten of the forgotten.”

Naked Man in Market: A Personal Reflection

By Serena Clayton

Imagine that you are walking down the street and you see a homeless person, unwashed, clearly disturbed, yelling to himself as he careens around the sidewalk.

Most of us will carefully navigate around him, look away, cross the street. No matter how much sympathy we feel, we tend to move away from this man, not towards him, but a little part of us knows that this is not the person we want to be.

The St. Camille Association, that I went to visit in West Africa, is a group of dedicated people that does exactly what no one wants to do—walk towards homeless, mentally unstable individuals. They seek out the most challenging people on the planet and take on all of their physical, psychological, and social problems until they can care for themselves, which, in some cases, is never.

One rarely hears about mental illness in Africa, but it occurs at the same rate as in the U.S., the difference being that there are no safety net services whatsoever. Seriously mentally ill people are often naked, walking or lying on the side of the street. In the worst cases they are put in cages or chained to trees or walls for years.

St. Camille is changing social norms in a way that we in America could learn from. In Benin their treatment and rehabilitation centers have become well known enough that when police, clergy, or neighbors see mentally ill people on the street, they know they can help by bringing them to St. Camille. Entire camps where people were chained to trees have been cleared.

On a personal note, I saw that St. Camille not only restores the humanity of the mentally ill, it enabled me to be the person I want to be.

On the last day of our trip (when we were supposed to be tourists) Rachel and I saw a naked man in Lome, the capital of Togo. I gave him food, and Rachel insisted we buy him pants. Our efforts attracted attention and soon people were offering to take us to meet his family. At first I was skeptical – how would this family in Lome get to the treatment center two hours away? But then I realized that St. Camille stops at nothing and would come to their house to pick him up. So we went to their house to talk to his father. His son has been sick most of his life, and the family has tried everything so they were motivated to call St. Camille. We don’t know if they did, but we left feeling we had offered everything we could. It was literally the only time I have passed a person on the street in America or Africa and felt good about my actions.

Jane's Journey from Nigeria to St. Camille

Jane is one of those beautiful African women who looks like she belongs on the ramp in Paris.

She has a long neck, flawless skin and this super adorable gap between her teeth that was all the rage for awhile back in the 80's.

Originally from Nigeria, she brought four children into this world but unfortunately had to see two of them leave it.

Jane came to the Calavi mental health center about 8 months ago. She says the voices in her head were tormenting her and shouting at her without rest. She felt that her husband was working with a witch to harm her and he was plotting to cut her head off.

She is not clear when the voices inside her head began, but she says it was long before her second and third child died.

She mentions it was a priest who found her in the street, weak, dirty and confused and brought her to the "Oasis of Love" at Calavi in Benin. She has not seen her 10 year old or one year since she arrived at the center and fears that if they saw her now they would reject her.

Jane says she's found some comfort at Calavi cooking and breaking open ground nuts with her friend and fellow patient, Victorienne.

Jane gets two injections to control her delusions twice a month and she takes pills on a daily basis.

She says she still hears voices sometimes but they don't come as often and they are not as strong.

Rose

By Rachel Berger

Sometimes you just fall in love for no real reason at all. Or at least not a reason that makes any sense when you are trying to explain using proper, sophisticated words.

That is what happened to me at Avrankou, St. Camille's first mental health treatment center in Benin.

It was love at first sight when I saw Rose, rocking her bad ass white chef hat. It also doesn't hurt that Rose is singing and dancing to welcome us. In addition, she has a smile that would force you to wear sunglasses in hell and her cheekbones are the highest you have ever seen.

So I am more than delighted when Rose begins to follow us as we tour Avrankou, which, as the very serious director would like you to know, was established in 2004 and has treated more that 15,600 inpatients and outpatients.

It is Rose who runs interference for me when I stop to video the women cooking something boiling in two large pots and when I run around to the other side of the wall to see how they feed wood into the stove from a small hole in the wall.

Again, it is Rose who gets a broom to clean a cement step which I suggest we sit on. When we eventually walk across the road to eat, Rose holds my hand. I tell Rose how my grandmother and one of my closest friends are both named Rose, which Rose of Avrankou says makes us sisters.

Then as we (the visiting guests) eat in a large clean white room with a fan and below a photo of Gregoire with one of those flyover Popes (you know the one's between Vatican II and the people's pope, Francis), Rose waits outside in the atrium. (For the record, this wasn't my party, or I would have had her eat fish and chicken and rice with us.)

When we finish lunch, I plop down on a wooden bench next to Rose as the others discuss important affairs.

The truth is, Rose and I are blabbing about nothing so much I never ask her all my journalist questions; how did you get here, what was happening in your head, how is your life now.

We share handfuls of baby powder and when Rose gets so much on her face that she looks like a zombie, we laugh and I brush it off and give her a big hug just because she makes me so happy.

And then she says I love you and I say I love you back and I really mean it.

I hope somehow, somewhere we will meet again because I really did fall for that girl.

Fabienne's Trauma from Chains in a Camp

Treatment Not Chains takes its name from the inhumane practice of chaining mentally ill people to trees in “prayer” centers. On Monday, we got a firsthand glimpse into how this practice deeply affects people, even those who spend only a few months under these conditions, a short time compared to those who live there for years. The new treatment center in Togo opened its doors to patients on Monday, and one of them, Fabienne (whose name has been changed for privacy purposes) had been sent to a prayer center 8 years ago, shortly after her bipolar disorder began. Although she came to the center fully composed and beautifully dressed, Fabienne began crying and shouting during her intake interview.

 “Every morning they would take me to that mango tree and put a chain around my ankle and just leave me there. They chained me up! Every day they hit me and mistreated me and it makes me crazy when I think about it. Even when I needed to go to the bathroom, they would just bring me a pot and I would have to do it right there in front of everyone. Can you imagine? How can you take an educated person and have them go the bathroom in front of everyone like that? That is no way to cure a person. It hurts me when I think about how they treated me,” she said. 

The anguish in her voice was so excruciating, tears started coming out of my eyes without my even realizing. Even Gregoire, who has seen many horrible things, was tearing up. When we talked with her father afterwards, it appeared that sending her to this prayer center had not been an agonizing decision or the result of any particularly strong belief, but simply one in a series of steps he had taken to try to address his daughter’s mental illness.

Fabienne went to eat lunch at the center and when I chatted with her afterwards, she told me that she lived nearby and would not be coming to live at the center because her case was not that serious. It was clear that she didn’t want to be identified as someone similar to some of the more visibly mentally ill people who would soon be filling the center. Soon after, something surprising happened. Gregoire convinced her to leave with us that afternoon to go to a treatment center in Benin where no one would know her and she could get some space from her problematic relationships at home. He told her that next year he would send her to school and she could study to be a nurse if she wished to. She and her father were both in agreement. We left for lunch and Gregoire told her to be there when we returned. 

 After lunch she had packed her bags but then changed her mind and said she needed more time to think about it (a reasonable reaction given that she had just met Gregoire and his three crazy white sidekicks a few hours earlier). Gregoire was not daunted. He took her back to her house to talk to her father. After a short time, she reemerged and got in the car. It was a 5+ hour ride back to Benin with Fabienne squeezed in the back seat between me and Rachel. During the drive, Gregoire had her call her priest and her sister so she wouldn’t feel disconnected and would get reassurance about her decision. 

 Fabienne was quiet during the drive but responded to questions and helped me recover a bit of my Mina, the language of southern Togo. Gregoire continued to talk to her about the training she would receive and how she would be able to help others. I was simultaneously impressed, moved and apprehensive about how this decision was playing out. We would certainly have expected a lot more information and discussion before packing someone up and taking them from their parent to an unseen facility in another country. But Gregoire was convinced that her relationship with her father would continue to impede her recovery and that it is best to seize the moment to make a change. He has 20 years of experience in this work, and this couldn’t be a more different culture so I resisted the impulse to even formulate an opinion about the whole thing.

 Arriving close to midnight, Gregoire introduced Fabienne to a young woman who, like her, is well educated.  She struggled with her mental illness for many years but was stabilized at the center and is now playing a large role in its operation. There were smiles and kisses; Fabienne was happy that she would get started on new meds that night. It looked promising. 

We learned the next day that Fabienne was anxious and wanting to go home. She wasn’t just home sick but had a financial concern. Apparently someone was sending her father $12 a month to pay for her two medications. She was forgoing one of them so she could keep $5 each month for spending money. She was afraid that if this benefactor heard that she was in a free treatment center, he/she would stop sending the money. Gregoire assured her that she would have everything she needed, and he would give her the $5 a month, saying “aren’t you worth more than $5?”

 The end of this story remains to be seen.

 

 

Narcisse's Sudden Illness and Slow but Steady Recovery

It's our second full day in West Africa and we have plenty of ground to cover. Gregoire proposes a 5:00 a.m. start and while both Serena and Dr. Benoit seem enthusiastic, I am a bit skeptical and attempt a polite demure. Gregoire softens and a more civilized time is agreed upon- 6:00 a.m.

And so it is, I am stumbling around the Center at Calavi on a Sunday morning trying not to be noticed as I peak in at the open air room where patients are gathered to sing their prayers amid their own artwork.  I take several pictures and head back to where I left Serena and the good doctor only to realize I have lost them. I turn a corner to find a striking, dark elegant man buttoning his white shirt. He sits on a grand staircase, which like so many here goes apparently nowhere but up. He politely ignores my clumsy French and directs me towards my crew. I thank him and ask if I can take his picture, he agrees and sits up straight for the portrait.

Later when I share the photo with Gregoire he nods and says, "Ah yes, this is Narcisse." Gregoire says Narcisse is a man in his late 50's who for many years lived a productive life working as a chauffeur. His religion directed him to serve as an assistant to his priest. Narcisse had six children and a wife to whom he was married for many years.

But about three years ago, things began to go haywire for Narcisse. He began to confuse his identity with that of Saint Francis. As his sense of reality frayed, the lure of the biblical world grew. One day, Gregoire was called in to help by one of Narcisse's neighbors. When Gregoire found Narcisse he was naked and lying at the feet of a statue of Jesus. 

Gregoire, who is a pragmatic man, and not beyond telling a small lie when it serves a greater purpose, told Narcisse that a bishop needed to speak with him immediately.

Gregoire guided Narcisse into his car and to the center at Calavi. 

With therapy and medication Narcisse returned to his elegant and distinguished self, the man I met sitting on the stairs.

Narcisse's marriage however, did not survive his mental health crisis.

But today Narcisse lives and works at Calavi. He is again an engaged and active member of his community, controlling his own life and serving as an example for others who face their own mental health challenges.

He is visited regularly by his children and grandchildren.

 

A Culture of Acceptance

Yesterday we visited a St. Camille center outside of Cotonou.  We were greeted at the door by a crowd of some twenty patients clapping "Bon arrive chers amis, bon arrive mes amis." Welcome dear friends. What a beautiful welcome!

We joined about 150 patients and family members, in a large cement room as Grégoire and Dr. Benoit Desroches of Quebec discussed mental illness.  Grégoire emphasized the need to change attitudes about mental health. Dr. Desroches discussed the causes of mental illness pointing out it was not contagious or due to supernatural causes. Many of the patients stood up and told their stories of struggling with mental illness and relapses. There was a lot of discussion, and even a call and response chant, about the importance of taking one's medication and staying on the treatment plan. 
We saw how important art and music are to the rehabilitation process at St. Camille and met many young and creative people who are contributing to these processes. 

With most of the staff at the center, including the director, being former patients who have their illness under control, the culture at the center is one in which mental illness is viewed without stigma as a challenge of daily life like any other.