A Cure for Darkness by Alex Riley

Author:Alex Riley
Language: eng
Format: epub
Publisher: Scribner
Published: 2021-04-13T00:00:00+00:00

Kufungisisa

Following in the footsteps of researchers in Uganda and Nigeria, the reality of depression in Zimbabwe was revealed a decade after it gained independence in 1980. Between 1991 and 1992, Melanie Abas, her husband and colleague, Jeremy Broadhead, and a team of local nurses and social workers visited two hundred households in Glen Norah, a low-income, high-density district in southern Harare. They contacted church leaders, housing officials, traditional healers, and other local organizations, gaining their trust and their permission to interview a large number of residents. They wanted to know whether depression even translated into the local Shona language. What if there was no word for depression? Could this be another reason why this so-called Western disease had been so neglected in sub-Saharan Africa? Through discussions with traditional healers and local health workers, her team found that kufungisisa, or “thinking too much,” was the most common descriptor for emotional distress. This is very similar to the English word rumination, which describes the negative thought patterns that often lie at the core of depression and anxiety. “Although all of the [socioeconomic] conditions were different,” Abas says, “I was seeing what I recognized as pretty classical depression.”

It wasn’t just a case of thinking too much, however. There was also the lack of sleep and loss of appetite. A loss of interest in once enjoyable activities. And a deep sadness (kusuwisisa) that is different from a normal state of sadness (suwa). Using culturally appropriate terms such as kufungisisa to help identify mental suffering, Abas and her team found that depression was nearly twice as common in Harare as in a similar community in Camberwell, South London. In direct contrast to the previous surveys that found a rate of one in every four thousand (0.001 percent), Abas’s community surveys found that it was closer to one in every five people (20 percent).

As with the epidemiological studies in the U.S. and England, Abas wondered whether stressful life events were associated with depression in Harare. Even if the words were different, did the same social triggers transcend cultural and national boundaries? Adopting the methods of George Brown and Tirril Harris, famed sociologists who studied the relationship between life events and depression in Camberwell, she found a strong pattern emerge from her surveys. “[We found] that, actually, events of the same severity will produce the same rate of depression, whether you live in London or whether you live in Zimbabwe,” she says. “It was just that, in Zimbabwe, there were a lot more of these events.” Poverty, malnutrition, unemployment, cholera, HIV: all took their toll. In particular, HIV and depression fit together into a tight spiral that slowly twists toward mortality. Not only are people who are HIV positive twice as likely to be depressed than an HIV-negative person, but the depression then makes the virus more lethal. The same is true for poverty: it is both a trigger for depression and made worse by being depressed.

These cyclic relationships were also an opportunity. Would treating the depression,

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