‘They wanted her to confess to witchcraft’: ending the chilling effects of dementia stigma in Nigeria
EOn a Sunday morning in January 2020, Dr. Temitope Farombi was told that a woman in her 70s was in trouble and that she had to come quickly. Farombi, a neurologist, found the woman topless on the street in Ibadan, Nigeria, surrounded by a group of fifteen people who beat her with sticks.
“They wanted her to confess to witchcraft,” says Farombi. “If she didn’t confess, they would beat her even more.”
Farombi approached the crowd and showed her identity card stating that she was a doctor at the Ibadan University College hospital. “I wasn’t afraid, my only goal was to save the old woman from being lynched,” she says.
The woman, disheveled and disheveled, had knocked on someone’s door and demanded to be let in, Farombi heard. The owner of the house believed that an evil spirit had visited and called on the community for help.
Farombi suspected that the woman suffered from dementia. She explained that the woman was not a witch and asked if anyone had ever encountered an older person who had strayed and lost. Many had. This was a symptom of a medical condition, she added. The crowd dispersed and Farombi tended to the woman.
In Nigeria and other countries in Africa, people with dementia are often accused of witchcraft. Symptoms such as forgetting basic details and changes in behavior are seen as evidence of harm. People have been set on fire, stoned, beaten to death and buried alive. Often it is underprivileged and marginalized people in society, and especially women, who are targeted.
It is impossible to know how many attacks are taking place as most go unreported, but the UN estimates that they were at least 20,000 victims of “harmful practices” in 60 countries between 2009 and 2019 – including children. The target group included people with albinism, disabilities and mental health problems. The UN Human Rights Commissioner expects numbers to increase.
NCDs are simply that; Unlike a virus, for example, you cannot contract them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioral factors. The main types are cancer, chronic respiratory diseases, diabetes and cardiovascular disease – heart attacks and strokes. About 80% are preventable, and all are increasing and spreading inexorably around the world as aging populations and lifestyles, pressured by economic growth and urbanization, make unhealthy living a global phenomenon.
NCDs, once seen as diseases of the rich, now have a hold on the poor. Disease, disability, and death are perfectly designed to create and increase inequality—and if you’re poor, you’re less likely to receive an accurate diagnosis or treatment.
Investment in tackling these common and chronic conditions, which kill 71% of us, is incredibly low, while the costs to families, economies and communities are staggeringly high.
In low-income countries, NCDs – typically slow and debilitating diseases – see a fraction of the money needed being invested or donated. Attention remains focused on the threats of communicable diseases, but cancer death rates have long surpassed the death tolls from malaria, tuberculosis and HIV/AIDS combined.
‘A Common Condition’ is a Guardian series reporting on NCDs in the developing world: their prevalence, solutions, causes and consequences, and telling the stories of people living with these diseases.
Tracy McVeigh, editor
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The human toll of non-communicable diseases (NCDs) is enormous and rising. These diseases end the lives of about 41 million of the 56 million people who die each year – and three-quarters of them are in the developing world.
NCDs are simply that; Unlike a virus, for example, you cannot contract them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioral factors. The main types are cancer, chronic respiratory diseases, diabetes and cardiovascular disease – heart attacks and strokes. About 80% are preventable, and all are increasing and spreading inexorably around the world as aging populations and lifestyles, pressured by economic growth and urbanization, make unhealthy living a global phenomenon.
NCDs, once seen as diseases of the rich, now have a hold on the poor. Disease, disability, and death are perfectly designed to create and increase inequality—and if you’re poor, you’re less likely to receive an accurate diagnosis or treatment.
Investment in tackling these common and chronic conditions, which kill 71% of us, is incredibly low, while the costs to families, economies and communities are staggeringly high.
In low-income countries, NCDs – typically slow and debilitating diseases – see a fraction of the money needed being invested or donated. Attention remains focused on the threats of communicable diseases, but cancer death rates have long surpassed the death tolls from malaria, tuberculosis and HIV/AIDS combined.
‘A Common Condition’ is a Guardian series reporting on NCDs in the developing world: their prevalence, solutions, causes and consequences, and telling the stories of people living with these diseases.
Tracy McVeigh, editor
The African Union has published guidance for parliamentarians over witchcraft accusations last year, following the 2021 adoption of a UN resolution on the eradication of harmful practices linked to accusations of witchcraft.
The term “witchcraft” was introduced by European colonialists to refer to indigenous beliefs and practices, but has evolved over time under the influence of Christianity, Islam and other religions. Accusations of witchcraft and subsequent attacks may result from the belief that the suspect has caused or may cause harm using supernatural powers he is said to possess.
Accusing someone of witchcraft in Nigeria is illegal, punishable by up to two years in prison. However, according to Leo Igwe, the founder of Advocacy for Alleged Witches, the law is rarely enforced. “People believe that a witch’s view is seen as something that should not be accommodated or protected by the law,” he says.
When Farombi went to the police after rescuing the attacked woman, no action was taken. “The police do not know that such cases occur,” she says. “There is no structure, no welfare system. They told us to take her everywhere.”
After she calmed down, the woman began to name places she could remember. Farombi found the house where she grew up. Family members did not know she was in town because she had moved to another state. Farombi spoke to the family about dementia and the woman now lives safely with one of her children.
More than 55 million people worldwide suffer from dementia, and more than 60% of them live in low- and middle-income countries. Almost 10 million new cases are recorded annually and are the seventh leading cause of death worldwide.
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However, ignorance surrounding the condition is pervasive. In Nigeria, many people have never heard of dementia, says Farombi. “There is a huge knowledge gap at the community level about what dementia is,” she says. “Families often feel ashamed and lock their relatives in or out, or dump them in spiritual centers to pray for them, in the hope that evil spirits will be released.” Some people visit traditional healers who, at best, delay diagnosis and at worst perpetuate harmful myths, Farombi says.
After treating people with dementia at her clinic who showed signs of abuse and seeing videos of elderly people accused of witchcraft, Farombi founded a Brain Health Initiative Nigeriawhich provides community outreach, runs support groups for caregivers and has a hotline.
Josephine Anenih, former Minister of Women Affairs in Nigeria, founded the Alzheimer’s Foundation after discovering in 2011 that her younger brother had been diagnosed with the condition in Germany. She had never heard of Alzheimer’s. “Ignorance is the problem,” she says. “Many geriatricians don’t even know how to deal with (dementia).”
She built the Ignatius Akubude Center, named after her brother, in her hometown of Amawbia, in southern Nigeria, which organizes activities for the elderly and provides medical care.
The two organizations are part of a coalition pushing the government to adopt a national dementia plan. “That’s where we can start talking about how to care for people with dementia, how to support caregivers and how to create dementia-friendly communities,” says Anenih.
Igwe added: “If information and awareness about dementia is spread, it can help us drastically reduce and end its abuses.”