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Friday, 10 April, 1998, 05:38 GMT 06:38 UK
Shackled day and night in Nigeria
In chains
Every inmate in a traditional Nigerian mental hospital is chained up
Modern psychiatric hospitals do exist in Nigeria, but few people can afford the treatment they offer. Those that cannot are locked away in institutions where they are continuously shackled and routinely beaten. Unique access to one of Nigeria's primitive mental institutions has been secured by the BBC's correspondent in Lagos, Hilary Andersson:

Bridget Juwah and patient
Bridget Juwah finds a vagrant mentally ill man
On the streets of Lagos, the mentally ill squat unattended, taking refuge from the taunts and scorn of their society.

Bridget Juwah, Head of Mental Health Foundation, scours the city in a lonely crusade to try to help. Thanks to her one man at least will see the inside of a modern mental institution. Few others are so lucky.

The vast majority of the mentally ill end up in traditional mental hospitals, in shackles.

It's commonly believed here that mental illness is evil and that the afflicted have been possessed by bad spirits.

Dr Malamo
Dr Malamo: a healer like his father and grandfather
The gods have to be appeased by rituals carried out here by Doctor Malamo, a traditional healer whose father and grandfather taught him his trade. He makes his medicine from herbs and leaves.

The inmates are fiercely beaten on arrival and disciplined with force for months after. They're incarcerated in hot, damp cells with no light, and because all this is considered acceptable by the community, there's no chance of escape.

Traditional hospital
Treatment at a traditional mental hospital
Every inmate is chained by the foot day and night, and the rusting metal often leads to infection, but their wounds are left to fester.

Doctors say victims often leave places like this with gangrene and have to have limbs amputated.

Here they don't believe the patients can reason and all communication is by force.

People who came here in need of help are treated like criminals. Their families have brought them to places like this to get rid of an embarrassment.

Hospital ward
Most patients cannot afford Nigeria's modern hospitals
Nigeria's government-owned mental institutions make a stark contrast. Here the training is highly professional, the facilities simple, but adequate. The problem is that a few days' treatment at this hospital can cost an average person's monthly salary, and most just can't afford it.

The fact that not everyone here believes in modern medicine anyway makes traditional clinics seem more acceptable.

Anthony Ikesuwi
Anthony Ikesuwi's songs of freedom
Anthony Ikesuwi has been locked in his small cell for three months. His song is a prayer that one day things will get better, for his life is in ruins.

He says he was brought to this traditional clinic against his will and that he's not mentally ill at all. He may want to find a way out of this nightmare, but the fact is it's been this way for centuries.

BBC News
Mental Health Foundation head, Bridget Juwah: "The patient becomes a vagrant." (16")
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