Chris Hani Baragwanath Hospital’s Child Psychiatry ward currently has four children between the ages of 5 and 10 who are in-patients. The unit can accommodate up to 10. According to the head of the Child Psychiatry unit at Bara Hospital, Dr Helen Clark, about 15 to 20 new children come per week for a first time evaluation. Clark acknowledges that the number has increased from previous years.
‘Parents are becoming more aware of their children. One of the reasons that mental illness does not get detected in children is because parents don’t know their children well enough or they don’t see the signs’, she says.
This change of behaviour has had a ripple effect on to the nearby community.
‘We get a lot of referrals by word of mouth, we get referrals from your neighbour if they went to the clinic and they tell somebody who tells another person. There is definitely awareness within the community’, says Clark.
Twenty-four year old Nwabisa Xalanga from White City Jabavu, Soweto, has a 6 year-old daughter with autism. When she gave birth her baby, Sisanda, could not breathe normally. A few weeks later, doctors informed her that part of her daughter’s brain was completely damaged. The condition delayed Sisanda’s speech and physical growth. It was only when she was a year and 6 months old that doctors were able to diagnose her. Being a young mother at the time, Nwabisa was heartbroken at the diagnosis and concerned for her child’s future.
‘I was so heartbroken, I could not believe it. Now, I am still young, but then I was 18 years old. I was really heart-broken knowing that my child may never talk and at the time did not even walk. I can’t explain it… I was scared at the same time. But the great thing that kept me going is the love for my baby. That was it’.
Nwabisa says with Autism, her little Sisanda developed unusual behavioural problems.
‘She did not talk, she made a lot of noise, she cries, she also laughs alone for no apparent reason. She likes screaming, she is disturbed by almost everything around her; if there is noise and it’s too loud, she will cry or when she is in a large group of people she cries. It’s like she is living in her own world’.
Sisanda is now attending speech therapy lessons to help improve her communication skills. She is only able to use gestures to communicate with her family. When the doctors told her of her daughter’s condition, Nwabisa thought it was the end of the world.
But, eventually, she was able to deal with it. Her biggest challenge now is society’s reaction towards her daughter.
‘When I’m walking in the street people will stare and ask: ‘What’s wrong with your baby?’ If she is screaming, people tend to treat her like she is crazy. Then you have to explain yourself when they ask ‘what’s wrong with’ her. I tell them it’s autism and still have to explain what that is. But, at the same time I enjoy that because it gives the other person knowledge to recognise if their child could have autism or not’, she says.
Nwabisa loves her daughter and little Sisanda is lucky that her mother cares for her. In Dr Helen Clark’s child unit at Bara Hospital, the majority of in-patients are abandoned. Three of the four children come from children’s homes, while the other was brought in by her grandparent following the death of her mother. According to Dr Clark the 5 year old girl is also autistic and does not communicate much.
‘She does not communicate, she makes special exception to granny but with anybody else she doesn’t communicate at all’.
Clark says it is often very difficult to diagnose a child with a mental disorder because children are not as communicative as adults. She explains that at times they have to use non-verbal communication with them, such as drawings and body language. She says it is vital that caregivers are given the correct information about their child. ,
‘The first thing is to sit and explain to a caregiver what is wrong with the child because that is what they came for. Sometimes that is their biggest misperception… something they don’t understand about the child. The parents just don’t see how the condition is affecting all aspects of the child. Once the caregivers understand the condition and accept it, they begin to be more receptive to the interventions you’re going to suggest’, said Clark.
Head of the Child and Adolescent Unit at the Charlotte Maxeke Academic Hospital, Dr Lynda Albertyn, says the environment in which a child lives can play a role in their growth and mental stability.
‘People should think very carefully before having children. Children do their best with loving parents ‘ two, preferably – in a stable home where mothers and fathers have time for their children. Treat them gently with love and lots of encouragement. Those are the sort of things that make for happy people’, says Albertyn.