This Girl

She appears at the unit at least once a month in the most deplorable condition; severely malnourished, bruised, filthy and in a seemingly catatonic stupor.  Sometimes she is brought in by law enforcement or a Good Samaritan, or in rare cases she voluntarily shows up on our doorstep.  Since she refuses to speak, or perhaps cannot speak, we do not know anything about her identity or case history.  We just bathe her, give her clean clothes, food and a bed.  Due to her unusual circumstances, we bypass hospital protocol and admit her as an in-patient without an attendant (i.e. family member/caregiver).

On several occasions, we have tried to initiate a conversation with her.  In these instances, she either remained mute and avoided eye contact or reacted violently.  In more desperate circumstances, we used food as an incentive to encourage interaction.  All attempts remained unsuccessful.  After 2 to 3 days she usually just disappears from the ward.  Since patients are not under lock down, they can voluntarily (without permission) discharge themselves.

As a therapist, and more so as a humanitarian, I find her case disturbing.  As long as she poses no discernible threat to herself or the public, there is no law in Uganda that enables us to keep her against her will.  This is the conundrum of our profession; you can’t force somebody to accept help.  The best you can do is restore a semblance of human dignity while they are in your care.