She heard the voice of God, but it wasn’t Him

BY DR. NELLY M’MBOGA

Kanini sat between her anxious parents totally unaware of her surrounding and the concern she was causing. She had a distant look in her eyes, talked to herself and giggled with unseen companions. She ignored the hand I proffered, having decided that I was like her parents, thinking I was going to prevent her from embarking on her mission.

Kanini’s medical history started in Tiwala High School, a private boarding school outside Nairobi,where she had been studying for three and a half years. Instead of githeri (a maize and beans combination popular in Kenya) that she was used to at home, the Muhindi school owner fed the students on maize mixed with pea pods, while Kanini took the peas (grown in the school garden) for herself. When the students complained of their diet, they were told to be thankful that they had a meal as the rest of the Ukambani countryside was starving.

Kanini’s illness started when she could not concentrate in class. Her literature teacher noticed and commented on this. Unable to sleep one night she started singing praise hymns, until it became disruptive. When asked to explain, she confided that she had been hearing voices telling her she was chosen to preach the good news. This went on for one week until one night she had heard from God himself, commanding her to go out and preach. According to the voice of God, she was wasting time in school and needed to go out and preach. She was trying to escape from the dormitory when the matron was summoned. Even after talking to the matron and nurse, Kanini was determined to embark on her new mission. There was no time to waste. She was therefore detained in the school clinic, until her parents were summoned.

The headmistress had simply told Kanini’s parents that she was ill and needed to come home. Her parents visited the school and found a defiant and articulate Kanini who seemed impatient to leave, and embark on her mission to preach. As soon as she was told her parents were coming, she had become cooperative. However as soon as she saw them, she calmed down. The headmistress advised them to get her to the hospital as soon as possible, but Kanini violently refused, so they took her to her pastor in the local church.

Church elders were mobilized to pray for Kanini, and exorcise any demons. After one week of prayer, when she seemed a little better, she agreed to go to hospital. In the meantime, Kanini’s father was a worried man after people told him that if he took his daughter to a government hospital, she would be referred to the government-run psychiatric hospital. Most people who wound up there never came out sane according to popular belief. So Kanini’s father sold two of his prize cows, received a loan from his work place and arranged for her to see a private psychiatrist in Nairobi.

Kanini improved significantly on the medicines the psychiatrist prescribed, but slept too much because she had been put on anti-depression drugs, which had side effects. She also developed a severe headache which interfered with her progress. By the time she came to the clinic in Kibera, she was better, although she still heard occasional commands and answered the voices. Her resolve to go out to preach seemed to have weakened.

I examined Kanini and found nothing physically wrong with her. She had no signs of a physical brain disorder; her body was symmetrically functional, but she seemed tense. She was alert to every movement I made and suspicious to the point of being paranoid. In fact, her symptoms pointed to a type of schizophrenia, which is thought to be a chemical imbalance disorder in which reality is distorted.

People affected experience unreal stimuli otherwise known as hallucination. “Auditory hallucination,” for example, means that the patient hears voices which are not really there. “Visual hallucination” means that the patient sees things which are not really there. Some patients experience powerful smells that are not really there etc.

Schizophrenia is said to have a genetic component. The childhood psychosocial environment can also influence its development, as can social or recreational drugs, and unusual stresses. Increasingly, the role of nutrition is gaining prominence, a neurotransmitter known as dopamine has been found to be depleted in certain areas of the brain (e.g. the substantia nigra), which is also known as the “pleasure centre.” Drugs of addiction are said to stimulate this area, creating pleasurable feelings.

Dopamine is a compound made from tyrosine, an amino acid made in the brain from the essential amino acid phenylalanine. Cheese is rich in the latter. Unfortunately, it is a dairy product that many people of African extraction are unable to eat in significant amounts because of dairy intolerances. This explanation simplifies a very complex problem involving many other nutrient deficiencies, including those of fat soluble vitamins and immunity-related minerals such as zinc. Because of the many variations in nutrient deficiencies, there are different manifestations of the same problem. Variants of schizophrenia are therefore recognized. Kanini’s schizophrenia is among the common variants.

Untreated schizophrenia can have a grave prognosis. It can progress to frank psychosis (madness), endanger the life of the patient (through self-harm), or the livers and or property of others (for example,  unreal voices can order the affected to execute certain acts). Once a schizophrenic patient’s balance is restored however, there is lack of recollection of the events.

Kanini has the potential to heal completely if she is able to access the necessary treatment. In our set up, poverty often stands in the way of proper treatment. This is why it is much cheaper in the long-term for us to try and fulfill our children’s proper nutritional needs. Africans need to start paying attention to the escalating spectacle of drug abuse, low functioning persons, even frank psychosis on the continent. There is a reason why nutritional balance is treasured in thriving communities. Nutritional healing involving the issues described in this episode are complex, and are discussed in detail in my second book, “Maize is Killing Africans.”

Dr. Nelly’s journal continues next week.

---

This series was inspired by Dr. Nelly’s experience working in Kibera slums as a consultant pediatrician with research interest in malnutrition. The characters and events are fictional. Dr. Nelly’s work can be viewed at http://www.nutritionafrica.com. All rights reserved. Reach Dr. Nelly M’mboga at dr_nelly@hotmail.com.

Source: Eafricainfocus.com