Mentally Ill in Africa, And Kept in Chains

people. Nearly all were chained by their ankles to trees, the group reported in 2012.

In Western countries, hundreds of thousands of people with psychosis or other severe mental health problems land in prison. In Indonesia and other parts of Asia, restraints — like shackles or even cages — are also common.

Surveys, like one by psychiatrists at the University of Ibadan in Nigeria, put the prevalence of schizophrenia, characterized by hallucinations and delusions, at 0.5 to 2.5 percent, roughly the same as the global prevalence. That is at least a million people in countries where chaining is common, like Togo, Ghana and Nigeria.

Chaining people against their will violates the United Nations’ disability rights convention, which most West African countries, including Togo, Ghana and Nigeria, have ratified. But religious feeling is strong in this part of the world, and the pastors who run the camps preach that, through them, God can heal almost any ailment — especially ones thought to be essentially spiritual, like psychosis.

At Jesus Is the Solution, Paul Noumonvi, a charismatic pastor, has built a retreat that includes an open-air church the size of an airplane hangar, cabins, an outdoor “ward” for residents with mental illnesses and, down the road, his spacious house.

Mr. Noumonvi said the camp had been in operation for 12 years and that praying for people with mental problems was a service he offered. Each family is required to provide food, cleanup and a chain. He said the camp currently held 175 people.

“Many of these people already have tried other things, like traditional healers, herbs and drugs, but the problem didn’t go away,” he said. “We believe a spell has been cast on them. It can be witchcraft — this is the cause of the illness. When a person is reasonable again, acting normally, rationally, we say, ‘O. K., this person is healed.’ ”

Mr. Gbedjeha, the eldest of five, was his family’s rock. When his younger brother Komlan quit trade school, Mr. Gbedjeha persuaded him to persist and to become a motorbike mechanic. When an aunt was using his sisters as housekeepers, he made sure they were sent back home to the family village.

“He was so important to us, because he fought for us all the time,” his sister Akossiwa said.

So his siblings were deeply shaken when he began having serious mental problems in his early 30s. They gathered in their home village — Djagblé, just outside the capital — with other relatives. The elders favored traditional healers who used herbal concoctions and spells to drive away evil spirits.

But Komlan and his sisters knew that their older brother, who had studied to be a pastor, would not agree to traditional methods. So they suggested a compromise: Why not use his Christian faith in the service of recovery? The family had heard about Jesus Is the Solution, about 160 kilometers north. The elders agreed — but not Mr. Gbedjeha. “We had to capture him,” Komlan said.

One night in December 2012, when Mr. Gbedjeha was at a sister’s home, acting bizarrely, she dissolved a strong sedative into his soup, and he fell into a deep sleep. Komlan and two friends tied him up. At Jesus Is the Solution, the camp secretary registered Mr. Gbedjeha as a patient and told Komlan the family would be responsible for his care and feeding. The youngest sibling, Akossiwa, who was unmarried, reluctantly agreed to mind him.

And there was one more requirement.

“The chain,” Komlan said. “He told us we had to buy our own chain.”

At the camp, Mr. Gbedjeha was restless and intensely watchful. Once, in a rage, he threw urine at his sister. She slugged him. “Being in chains,” she said, “he couldn’t do anything more than stare back in anger.”

That is until he broke free.

After weeks on the run, Mr. Gbedjeha arrived at his home village. An uncle spotted him, and he was welcomed back. But soon, Mr. Gbedjeha moved back to Lomé, and the aggression and the demons returned.

This time, Komlan was determined to get his brother to a medical facility. In March, a mutual friend lured Mr. Gbedjeha into his car with the promise of a job. He and Komlan took Mr. Gbedjeha to a small Roman Catholic mental health clinic near the capital.

When they arrived, the clinic’s director, Brother Emmanuel Agbedzinou, a psychiatric nurse, rushed over and demanded that Mr. Gbedjeha be unbound.

“This is a human being, and you treat him like that?” Brother Agbedzinou recalled saying. But he relented when Komlan said that Mr. Gbedjeha was too aggressive to consent to treatment.

After a week of daily drug treatment, Mr. Gbedjeha grew calmer, but by then, his family had run out of money. In April, he moved back to Lomé.

Mr. Gbedjeha recalled the trauma of being kidnapped and taken to the clinic and insisted he was sane. “I am not mad,” he said. Then he pulled some herbs from his pocket. “This is to help me think clearly,” he explained, “and keep the demons away.”

Mr. Gbedjeha is now back in his home village, working with his uncle selling water. He has stabilized on medication.

It is good to have him back, Komlan said, but “no one knows what is coming next.”