- the National Psychiatric Hospital, Fort Canje
by Achal Prabhala
July 28, 2002
Asylum Street, on a quiet road opposite the Berbice High School, houses what is now called the National Psychiatric Hospital, the only institution of its kind in Guyana. The buildings and grounds that it occupies were once camps for Dutch and English armies. Later, it was christened the ‘Lunatic Asylum,’ hence the name of the street on which it is located.
There is still abundant evidence of those times, when psychiatry hadn’t developed to what it is now. On the third floor of the Victoria Building - now in disuse - was the electrical therapy ward, where patients would be subjected to shock therapy.
At one point, aggressive patients were permanently kept in sack-like clothing, which did not allow them to move their arms at all. During recreation, these patients were chained to trees.
It was only in 1999 that the hospital received a facelift. In addition to the new chalets, built some time earlier, a generator was secured and the electrical wiring system updated.
Yet, even today, several buildings that have been condemned (deemed unfit to live or work in) are still in use, the reason being an acute shortage of funds.
One of these condemned buildings is the Occupational Therapy Unit, where residents can choose to learn work-related skills. Hairdressing, sewing, painting, weaving and the production of handicraft are some of the workshops on offer, all administered by a team of just two staff.
It is right next door to the enormous - and beautiful - Victoria Building (circa 1899), now condemned and in disuse, like many of the buildings within the hospital’s spacious acreage. Once, a cricket pitch on the main field was the site of spirited matches. Now it lies under tall grass and plant growth, like the playing field itself. The hospital can no longer afford to employ gardeners and groundsmen.
Harry, a resident in his late sixties, talks of how he played cricket for Guyana - he claims he was part of the West Indies Cricket Team in 1957, but it was hard to verify that - and cannot anymore. He addresses me as “Mr Rampersaud,” though that is not my name. It is something he likes to call any man who looks Indian.
Leila Clarke, administrator of the hospital, explains the problems that she and her staff encounter. Though they maintain approximately 200 residents with a staff of 120, the nurses are desperately in need of training in psychiatric social care.
The hospital functions with just two doctors, who are psychiatrists (Dr Grajales and Dr Rodriguez, both from Cuba). They have no vehicle, not even one to track down wandering residents, or transport them to the New Amsterdam Hospital when they injure themselves or require non-psychiatric medical attention.
Worse, she says, the National Psychiatric Hospital has become something of an old-age home.
There are many residents whom she knows would be happier outside. “Sometimes,” she says, “all some patients need is a little supervision. They would be happier with their families. There are many people here who are capable of working regularly.”
But their families are happier without them. Occasionally, she says, when a resident dies, the family won’t even travel to Berbice to claim the body for burial. They just ask for the death certificate to be sent to them by mail. In that sense, most of the residents of the ‘chalets’ (which is what they call the living units) are long term. It is unlikely that they will ever leave.
In the course of the visit, Sunday Stabroek spoke extensively to a few residents of the hospital. One, a young man who is believed to be sexually obsessed with his mother, says he is very happy there, because people treat him well and he has enough to do. There is nothing really wrong with him, he says. But this is a common refrain, and indeed, even while many residents confidently say this, and are right - in their own way - it is clear that those who are confined in Fort Canje have a reason for being there.
Another man, older and more tired, talks of how he played music for a renowned Indian composer-singer duo. But he has never been outside Guyana, making that claim quite implausible. He is sleepy: it is late in the afternoon, and the sun is shining brightly. Additionally, he - like the other residents - has been sedated.
Each resident receives a sedative dose based on his/her temperament, three times a day.
Nurse Bibi Jafarally, who does the tour of the Male Admissions Ward (which is where residents are broken into the hospital), talks of how financial resources have forced the hospital to mix incoming patients, regardless of their problem.
Thus, recovering alcoholics sleep next to recovering drug addicts, who sleep next to schizophrenics, and so on: “Not,” as she emphasises clearly, “the ideal situation at all.”
Clarke and Jafarally are consistently of the view that the resource crunch is debilitating.
For one thing, the hospital is not equipped to cope with the specialised needs of recovering alcohol and drug addicts, and yet, they are saddled with these people who they can do little for. For another, the nurses are in need of training, to better understand mental illness and its manifestations.
“Many years ago,” Jafarally says, “there might have been beatings going on. It has changed now. But that is why we need training, so that the aides can understand what to expect from the residents, and not get scared when they confront them.” She speaks knowledgeably of psychiatry, having been on a training programme to Belize some years ago.
A source in Georgetown, who was connected with a short-term resident of the hospital some time ago, made the claim that beatings did occur in Fort Canje.
However, when Sunday Stabroek independently spoke to the residents of the hospital, they confirmed that no such thing went on there now. Further, they distinctly expressed their satisfaction over their treatment in general, and the wards, food and facilities in particular.
Food is cooked in an open kitchen that looked clean and smelled satisfactory. The grounds and buildings, though in some disrepair, were yet maintained with dignity.
The wards - or chalets - for both men and women (1/3 of the population is female) were spotless. It was a pleasure to see clean white sheets, airy, sunlit rooms, and to encounter a general feeling of clean, cheerful, calm.
Some of the nurses talked of the enormous workload, and the fact that they were hardly paid enough for the kind of work they were doing. Certainly, the National Psychiatric Hospital in Fort Canje is an institution that performs a vital task, and as certainly, those involved in its functioning are performing work that is very hard.
Yet, how much better the institution would be if families and friends of residents got more involved. The task of removing the “stigma” related to mental illness is something that the hospital’s administrators say they have been unable to tackle. Indeed, there is need for more volunteers to pitch in and spread the good word.