By Dr. Nicholas Aribino
It is indeed true that wisdom begins with the realization that one doesn’t know. Failure to acknowledge that one doesn’t know is the beginning of arrogance and arrogance is deleterious to growth and development. In Zimbabwe the ignorance wave seems to be everywhere like a spirit, especially when it comes to the characterization of people who are assumed to be mentally ill as being ZIMCARE. People who seem to have lost touch with reality in Zimbabwe are unfortunately labelled as ZIMCARE, but the 64-million-dollar question is; Does ZIMCARE mean mental illness or psychosis? The panacea to the ignorance disease is education and it is the purpose of this opinion piece to tell apart the concepts -intellectual disability and mental illness and in the process walk through my Zimbabwean counterparts about the ABC of ZIMCARE.
ZIMCARE is an abbreviation for Zimbabwe Cares. It is an organization that educates and cares for children and adults with intellectual disabilities or challenges in Zimbabwe and in terms of institutional representation at national and subnational levels has 14 centres across Zimbabwe. Of those 14 centres, 11 are for learners with intellectual disabilities and three are adult workshops for persons with intellectual disabilities who are taught daily living skills, practical and vocational skills like gardening, carpentry (e.g coffin making), pottery and weaving. The 11 centres for learners with intellectual disabilities just focus on imparting basic literacy and numeracy skills, social skills and skills in different areas of gifting in the sporting arena. Both children and adults in ZIMCARE centres are not presented for any formal examinations because they will never be book-smart because of their condition of intellectual disability that will be unpacked anon. These children and adults in ZIMCARE are taught to be street-smart, their street-smartness should stand out in their communities when they can embark on livelihoods projects. The history of ZIMCARE is identified with the merging of four organisations in 1981and these organisations were SASCAM (Salisbury Association for the Care of African Mentally Handicapped), MAMSAC (Midlands Association for the Mentally Sub-Normal Children), Hopelands Trust and Sibantubanye Day Care. These four organisations’ common denominator was that of educating and caring for the most vulnerable children and adults with intellectual disabilities in different geographical locations. However, what may need fleshing out is that the Hopelands Trust solely dealt with whites with intellectual disabilities. SASCAM again is another erroneous classification for people who are assumed to be mentally ill in Zimbabwe, which is again wrong if we take into account the historization of ZIMCARE and its constituent parts. The focus now will be on distinguishing intellectual disability from mental illness.
Intellectual disability by definition is what was traditionally referred to as mental retardation. Intellectual disability describes a person whose intellectual and adaptive skills are significantly below the average for a typical person of his or her chronological age. People with intellectual disabilities are not homogeneous but heterogeneous in outlook because the condition of intellectual disability exists in a continuum, that is from mild to profound. This type of disability may be due to pre-natal, peri-natal or post -natal factors. Maternal and paternal factors are also said to have a hand in causing intellectual disability as scientific inquiry claims that women below the age of 20 and those ones above the age of 35 are at risk of giving birth to children with intellectual disabilities. Males whose ages are upward of age 55 are also at risk of contributing to the birth of children with intellectual disabilities. Children and adults with intellectual disabilities may show some the following physical and behavioural traits; sluggish physical and cognitive growth, difficult retaining information, inability to follow simple routines, changes in routine and coping with novel situations are usually confusing and upsetting, short attention span, inability to stay focused on an activity, limited communication skills, delayed development of vocabulary and syntax, lack of age-appropriate self-help skills, unawareness of surroundings or failing to tell a public space from a private space leading to engaging in activities that may be inappropriate for the public space like masturbation, rubbing their genitalia, developmental progress may be up one day and down the next and showing delayed social-emotional behaviours. Intellectual disability usually comes with co-diagnosis, that is one primary condition co-existing with another condition. For example, a person with an intellectual disability may also have cerebral palsy or a health-related condition like epilepsy. The case for comorbidity (co-diagnosis) is also supported by wide scale research which reveals that 35% of persons with intellectual disabilities also have mental illness.
From the foregoing, it is necessary to split hairs now between intellectual disability and mental illness. Both intellectual disability and mental illness are neither ZIMCARE nor SASCAM. Mental illness is not the same as intellectual disability, because the former is a disease of the brain that disrupts the emotional, psychological and social domains of a person and in the process disrupts how a person feels, thinks and acts. The words mental illness are often misunderstood. Sometimes people misuse the word mental to describe someone they think is stupid, bad or evil. For the record, mentally ill people are neither bad, evil nor stupid; they have a disease and are in pain. Essentially, mental illness speaks to mental health challenges that are often caused by personality disorders, stress, use and abuse of substances, anxiety, depression leading to visual, auditory and olfactory hallucinations. Mental illness can be episodic, that is irregular in terms of its occurrence and its prognosis is favourable when a combination of intervention measures such medication, counselling and social support are considered. Whilst mental illness disrupts the way a person feels, thinks, behaves and acts, it has nothing to do with diminished intellectual functioning that is constant as is evidenced in people with intellectual disabilities. Despite the fact that people with intellectual disabilities may have attention deficit hyperactive disorder, that may require medication to tone down their super-charged personalities, they have no disease of the brain. The fact that people with intellectual disabilities may not understand private and public spaces and activities attendant to such spaces lead people to stigmatize and label as being mentally ill. The most important thing about people with mental illness that sets them apart form people with intellectual disability is that they are not mentally challenged (retarded); many of them are very intelligent.
In summation, this opinion piece has indicated that putting people with intellectual disabilities and mental illness in the same basket is like comparing apples with computers. It is hoped that this article will help to change the attitudes of the so called typical (normal) Zimbabweans towards people with intellectual disabilities and mental illness, as both these categories of people are human beings that are equal to every Zimbabwean in terms of human dignity and rights.
Dr. Nicholas Aribino : ZIMCARE Trust Country
Director and is writing in his own capacity.
Contact : +263715617095
