Praying for a Cure

Chained and Abandoned in West Africa

By Gian Paolo Mendoza, Linda Givetash and Maura Forrest

There are only four working psychiatrists in the West African nation of Togo, serving a population of more than 6 million people. As is the case in many low-income countries, the lack of mental health care means most Togolese never receive any treatment at all.

Instead, many people with mental illness are abandoned by their desperate families or sent to prayer centres where they end up chained, sometimes for a week or two, other times for months or even years.

An organization called Saint-Camille-de-Lellis has spent the past two decades working to change that. At their centres in neighbouring Benin, patients are given food, clothing, a place to live and medication for their illnesses. Although Saint-Camille’s practice is heavily based on medicating patients, without any additional psychotherapy, it has created access to treatment where there was none before.

Saint-Camille’s founder, Grégoire Ahongbonon, has been successful in getting care for patients who had previously been chained in Benin, and he claims that these centres have all but disappeared in his country. But in Togo, prayer centres are still common, and the options for people with mental illness are grim.

Peddlers of hope

There are hundreds of people praying and singing loudly in the open-walled prayer hall at Jesus is the Solution. Their leader, Pastor Paul Noumonvi, is the only one wearing a dark suit and a gold watch.

People come to Noumonvi’s prayer centre because he promises to cure any affliction. He makes his money from their donations – a small price to pay for “divine healing.”

“Some come who don’t have children and they come so that God will give them children,” Noumonvi said. “Others suffer from poverty. Others are sick with cancer, hepatitis, AIDS, other diseases. So they come and pray, and by the grace of God, they find a cure.”

Noumonvi is an evangelical pastor in Togo, one of the poorest countries in the world. He told us he was inspired to establish his prayer centre 12 years ago, after God spoke to him. He now runs daily prayer gatherings that sometimes attract thousands.

Paul Noumonvi has run this prayer centre for at least 12 years.
Paul Noumonvi has run this prayer centre for at least 12 years.

Worship is the most visible part of Noumonvi’s operation. But hidden behind the prayer hall, 153 men and women with undiagnosed mental disorders are kept chained to trees. They, too, have been promised a cure.

There are no trained medical staff at Noumonvi’s centre. Patients receive no treatment other than prayer, which Noumonvi believes can heal any illness.

“Some will come here and be healed today, some in three days, some in a week, and some in two or three months, or two or three years,” he said.

Prayer centres like Jesus is the Solution exist across West Africa, and they appeal to people in desperate situations. Though Noumonvi’s centre is far larger than most, it’s not uncommon to find people with mental illnesses kept in shackles at these centres. Their families leave them there when they don’t know what else to do.

In countries like Togo, where mental health funding is largely absent, prayer centres are one of few treatment options. Their existence speaks to a lack of resources and to the stigma that surrounds mental disorders. Still, if conditions at these prayer centres can be improved, they could play an important role in the treatment of mental illness.

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A treatment for witchcraft

In Togo, many families are unable to care for their loved ones with mental illnesses, and medical treatment can be prohibitively expensive.

People are turning to the prayer centres because they promise to deliver what nobody else will, said Noah Katcha, a Togolese cultural tour guide.

“The pastors promise that God can solve all your problems,” he said. “People think they better go there and see the prophet or the pastor if they can solve the problem for them.”

But there is also a widespread belief that mental illness is a form of bewitchment that faith healers can cure.

“I would say 80 per cent believe that the source of the mental sickness is from the devil,” said Katcha. He, like many other university-educated people, subscribes to some form of that belief.

As an example, he explained that many people believe students who do well in school are often cursed with mental illness as punishment for their success. “If inadvertently you get the sickness, we will say it must be from somebody in the family who is envying you who is trying to bewitch you.”

A woman kneels at a prayer centre a few miles away from Paul Noumonvi’s.
A woman kneels at a prayer centre a few miles away from Paul Noumonvi’s.

Togo is far from the only country where prayer centres are operating.

In 2012, Human Rights Watch published a report documenting similar centres in neighbouring Ghana. The organization visited eight prayer centres, where treatment included chaining and forced fasting.

Joojo Cobbinah, a Ghanaian broadcast journalist, said it’s difficult to estimate how many prayer centres exist. Many of them function independently of any particular religious denomination, so they’re not registered and are largely unsupervised.

“They have so many prayer centres,” Cobbinah said. “You cannot count them. It’s like counting the number of local eateries you have.”

Cobbinah has also visited prayer centres in Burkina Faso and Ivory Coast, and said they exist in many other West African countries.

Despite their abundance, prayer centres occupy a legal grey zone. The practice of chaining violates the United Nations Convention on the Rights of Persons With Disabilities, which most West African countries have ratified, including Togo and Ghana. The Convention states that “the existence of a disability shall in no case justify a deprivation of liberty.” The U.N. has also published a set of principles for the protection of people with mental illnesses. The recommendations are not legally binding, but they state explicitly that physical restraint “shall not be prolonged beyond the period which is strictly necessary,” and that a patient who is restrained “shall be kept under humane conditions” and under regular supervision.

But Julian Eaton, one of Togo’s four psychiatrists, said the prayer centres themselves are not explicitly illegal, and there is very little oversight of their practices.

“The gap between law on paper and implementation is very wide here, especially in terms of rights,” he said, adding that the “mystique” surrounding mental illness makes authorities “reluctant to challenge religious or traditional experts.”

Working together

In Ghana, however, one organization is trying to improve conditions in prayer centres.

BasicNeeds Ghana, a branch of the U.K.-based mental health organization BasicNeeds, is currently working with about 40 Ghanaian prayer centres. Founder Chris Underhill said their strategy is to ask the pastors and prayer centre managers what they need, rather than telling them how they should change.

“Faith healers, in general, have quite a large problem,” he said. “People come along, they leave their family members there, and they bugger off again. And they don’t come back. So the prayer centre people are then stuck with having to look after that individual.”

After BasicNeeds helps the centres find resources like food and blankets for the patients, they often gain the trust of the healers. Underhill said that’s when they can start to talk about human rights abuses, and about the importance of medical treatment alongside prayer. He said some prayer centres are no longer chaining people, and are referring some patients to hospitals, because of the relationship with BasicNeeds.

Underhill believes that faith healers have an important role to play in mental health care, if the abuse can be stopped. He said that people with mental illnesses often want to understand their illnesses in terms that are cultural, not medical.

“In the case of traditional healing, an explanation is often offered for why the person is unwell,” he said. “And the explanation is often satisfying, even if it may not seem scientific.”

At Jesus is the Solution in Togo, Pastor Noumonvi said he would provide better care to his patients if he had more resources.

“If I can find lodging, that is good,” he explained. “If rain falls, they suffer. But this is where they sleep.”

Whether Noumonvi is actually looking to improve conditions is difficult to say. He has been operating for 12 years, and he has yet to put a roof over more than a handful of his patients’ heads.