By Vivian Onyebukwa
Dr. Memuna Yusuf Kadiri is a mental health physician, and a neuropsychiatry advocate and coach. Her interest in medicine started at an early age after an interesting experience she had when she was admitted in the hospital as a sick child. Though she eventually achieved her aspiration especially in mental health, her father initially was not enthusiastic about the path she had chosen because of the ignominy associated with being a psychiatrist. But today her father has turned out to be one of her greatest admirers. In this interview, she spoke about mental health issues and health generally.
At what point in life did you decide to study medicine?
At about the age of five or six! I fell ill and was admitted in the hospital. Apparently, I was a bit unconscious. That was my first time of being admitted. When I woke up, I saw people in white overalls, looking very neat. They included the doctor and nurses. I felt we were in heaven. So I said I would like to be like them. My father told me that to be able to do so, to become a medical doctor, I would need to study sciences. When I got into secondary school, I was able to study hard and passed my sciences. That’s how I got into medical school. That has been the journey. I felt that the medical doctor and nurses brought me back to life. They were like God-sent. So for me, I want to save lives.
But the experience does not fully explain why you decided to specialise in the psychiatric part of the course?
I knew I wanted to do something regarding the brain. So at medical school, when I was posted to the psychiatric section, it struck a chord within me. I have this attribute of people listening to me, and I am a very likeable person. It was during the posting that I realised what we were taught about behaviour and personality. Then, you would see someone that they brought from the street, and the person eventually would get better. I said to myself that I would like to touch lives in a very positive manner by doing psychiatry medicine professionally. When I became a medical doctor and decided to major in mental health, my father called a family meeting. I come from a fairly large polygamous home. My father said that nobody is mental in our family, and people would be calling him father of a mad doctor. Even some of my friends did not want to get close to me because of the stigma associated with the profession. So it took a lot of efforts to convince them that there is no wrong in being a psychiatrist. They even got my husband involved. But right now, every member of my family, friends and fans online, are psychiatrists by association. They just feel that this mental case is not as bad as it is being portrayed by the ignorant in our society. This understanding was achieved by the way I was telling them about it with humour, breaking it down in a very relatable way. Now, my father is a proud father of a psychiatric doctor. He is even referring people to me when they need medical assistance. He has embraced it, saying that people need to know much about the area. At 70, he has known so well about the area, even though he himself is not a psychiatric doctor.
Tell us some of the experiences you have had as a mental health expert.
Let me start from Yaba. When I was at Psychiatric Hospital, Yaba, every day we attended to no fewer than 10 to 15 new patients. Yaba is one of the oldest psychiatric hospitals in Nigeria. It had over 500 beds then for admission. I think it should be more now because they built more amenities. So, you see people from different backgrounds. There is nothing like rich people can’t get mental illness. We saw from the very poor to the very rich, battling anxiety, depression, and substance abuse. There were wards that had like 80 beds. The drug ward was always full. While there, I realised that I might finish and not get a job after studying for about 14 or 15 years because of the embargo on employment then. Again, I wanted to do a lot of mental advocacy and awareness. If you are in a government parastatal, it may be difficult because you have to take permission.
How did you come about the idea of setting up your own hospital for psychiatric patients?
When I saw the increasing number of patients coming to seek medication at Yaba, I decided to set up my own thing. So I registered Pinnacle Medical Services a year before I left Yaba, though on a small note like a clinic, not a hospital. We have grown with the fact that we have seen different kinds of patients. I have had to do a lot to be able to reach my patients. I have been able to act like an event planner, and aunt from England. I wore aso ebi like a family member just to be able to reach my intending patients. I have had to wear different types of caps just to have a rapport with my patient. I have acted like a hotel manager who would be able to get the patient, check him in, settle him down, and then create a rapport, so that when you now trust me, you would now know who really I am. I have done things like a CIA or FBI kind of person. I have assumed all manner of positions of different jobs not related to medicine. I once dressed up as an engineer, wore a cap like an architect because the person was a project manager on a site. So I had to wear an architectural uniform. I read a lot online. I am very knowledgeable on several things to understand the person I want to speak with. My experiences had been ups and down. But the good thing is that I am happy when somebody comes from a point of no hope to get better. It has been a pleasant ride, and because I love what I do, it is not stressful for me. A lot of people think it is, but I enjoy it because I see life change every day. I see the huge impact my team and I are making in the lives of people.
When you play certain roles to get to your patients, how do they feel when they eventually realise the real person that you are?
They stay because they have already built a rapport, and they are happy that I took all that stress to get to them. I planned someone’s 50th birthday as an event planner just to get to her. I had to understudy the major event planning companies in Nigeria, to know what and how they do things. By the time she understood that I was not an event planner but a medical doctor who tried to reach out to her, she was surprised that I had to go through all that stress. She is still a friend till today. She is better now. She said that I went above and beyond the call of duty just to reach her. Maybe there are cases that they might not have agreed with, but at the end of the day, they do. They are open, welcoming and happy that I was able to reach out.
What are some of the causes of mental ill-health among people?
The three top causes we have globally are: anxiety, depression and substance abuse. But at Yaba, for eight women out of ten, the cause was more of relationship issues. Out of the 10 clients that came in, eight were women. It is not because men don’t have issues. It is because women speak out early, unlike men. That is why I tell women to train their boys in such a way that they would be able to speak out, seek help on time. Drug abuse is so high among our youths, so a lot has to be done aside awareness and all that. Parents should try and bring up their children well so that when they mingle with other children they would influence them positively.
There was a report recently that 60 million Nigerians are mad. What’s your reaction on this?
Yes, 60 million Nigerians are mentally unstable because one out of four will have mental illness in their life time. So, it is not like it is a rare occurrence. That they will have a mental illness does not mean that they must. It just means that there is a reason later in life that you may have, because you may lose a loved one, have financial crises, go through relationship challenges or marriage issues. Or, you may have a work-related issue. And let’s not forget, as a child, there are certain issues that may have happened, that were not within your control, such as divorce from your parents, death of one or both of your parents, domestic violence, child sexual abuse, or a violent history of someone that has a mental history within your family. Those things were not within your control, but they happened. That is why the World Health Organisation (WHO), was saying that, one out of every four people in the world, will have a mental illness, and Nigeria is one of them. We are the most populous black race in the world, with a population of more than 200 million people.
Does suicide have anything to do with depression?
Very well! The most established cause of suicide that is mental-health related is depression and drug abuse. That does not mean that people cannot be suicidal due to other reasons. For instance, people who are more vulnerable are people facing racism, migration, and refugees. Some people can also be suicidal when they are experiencing chronic pain, or having a debilitating illness, so they feel hopeless, worthless and helpless. It is a symptom of depression. So there is a strong correlation between depression and suicide. Suicide is preventable. Talking about it does not mean that the person wants to kill himself. In fact, talking about it helps the individual. Some people get depressed not because they offended anyone. Their depression could be as a result of family history. When someone gets depressed, the ultimate goal is to get the person to get back to normal and functional. Talking and listening to that person non-judgmentally is also very important. Not every depressed or mental person would need to take medication or be admitted. Counselling, psychotherapy, are there to help that individual. Be with them. Support them in whatever they are doing. But there are things you must not do to even get there. You should be able to do certain things for yourself. Know what your risk factors are. Know what preventive measures you should take. No matter what you do, some people would still have mental health issues because of family history.
What can we do to avoid depression?
To avoid depression, connect with the right set of people. Not everybody is your friend. Not everybody would like you. And not everybody you would like. Be able to rest. Be productive, not busy. Why do we have e-commerce? Buy items online. Find time to sleep. Rest. Eat right, properly and adequately. Do exercises; it is a cheap code to managing a lot of mental illnesses because when you exercise, it helps to release feel-good hormones. It helps to keep the individual up and running and manage mild cases of depression.
Does sex also has anything to do with mental health?
Sex is another feel-good hormone. Cuddling and sex are good. I said it in a gathering of women sometime ago, and how important it is in our mental health. I said that women are likely to be more depressed than men. If you are a married woman, you are likely to be more depressed than even the single woman. These are the four characteristics- If one or both of your parents died when you were very young; if you have three children or more who are from the ages of 14 years and below; if you are unemployed and you are just walking around the home environment and not interacting with people, and if your husband is not a friend or confidant. If you have two out of this four, you are already likely to be depressed. As a married woman, it is already legal. So, why are you making things difficult for yourself? Have that conversation with your spouse. Communicate while you are at it. Tell him how you want it. Ask him what position you should take. Talk. Tell him where to feel or touch you.
What can the government do to help people out of depression?
The government should pass the mental-health bill. That new bill will help to ingrain mental health in our primary healthcare. If someone has a mental health problem the next place they take the individual is Yaba. But Yaba is a tertiary institution. The secondary hospitals are general hospitals, while the primary institutions are the primary health centres. People should go there first. You don’t have to jump from Ajah to Yaba. Again, health financing is also very important. There are areas that need serious equipment and laboratories. Health financing should be paramount to the government. The government should also make life easier for Nigerians. Pray that the Nigerian condition will never affect your mental health because it can happen and that will mess you up. Roads are bad, no electricity, there is insecurity, inflation, and so on. With all these, won’t there be anger in the land? Even being a Nigerian is a problem. Government should sit up and do the right thing. Invest in major sectors such as health, education, agriculture, and insecurity. See the mass exodus of doctors in the country. Most doctors and even professors are moving out of the country.