Introduction

Dementia is one of the growing, if not one of the leading, mental health issues in Botswana, yet it remains undiagnosed due to a lack of formal national policies and guidelines that are specific to dementia. It is not just a single disease but a group of conditions like Alzheimer’s that affect memory, causing confusion, memory loss, and forgetfulness.

Cultural Misconceptions and Stigma

Dementia is not witchcraft. It is not a spiritual punishment. It is a neurological condition. Botswana is beginning to recognize this disease as a legitimate mental health concern due to the incessant cultural stigma that has long been hidden and silenced. It is also often misinterpreted as normal aging or just “getting old”. We must confront the myths and change the narrative. There have been extreme cases where behavioural changes have been wrongly recognised and condemned hence those affected suffer in the shadows of fear and misunderstanding.

Mental Health Gaps in the Health System

Botswana’s healthcare system has only recently begun integrating dementia as a mental health priority and reports suggest that dementia-related cases in Botswana are being extricated from outpatient visits for mental health. The reliable and specific data on this disorder remains limited in the country.  2019, Botswana’s National Health Statistics listed 7.2% of those outpatient patients as having “unspecified dementia”. Progress to recognise dementia as a growing mental disorder in Botswana is still early stage hence there is limited diagnostic infrastructure. There is no direct or corresponding term for “dementia” therefore, the lack of screening tools that are language inclusive to Setswana makes it difficult to detect dementia in its early stages. There is limited access to trained neurologists, psychologists, and geriatric care services. Due to this, Health Workers in primary healthcare often fail to detect and diagnose dementia due to little or no training. Botswana’s leading psychiatric Hospital in Lobatse for psychiatric and psychological care operates nationally but it does not necessarily offer inclusive care for patients suffering from dementia and conditions similar to that such as Alzheimer’s.

The Burden on Families and Caregivers

In most cases, the care of the patient mainly falls on family members who are not well equipped to understand Dementia or how to manage it hence they are not able to provide care for such patients. Caregivers often suffer in silence, dealing with emotional strain, financial stress, and social judgment.

Need for Policy and Support Structures

Social protection services, caregiver support, and community-based education must be expanded.  A national health policy ensures that dementia is treated as a serious and growing public health concern, not just a private or family issue. It provides a framework for action and sets clear goals for early detection, diagnosis, treatment, and care and awareness campaigns. It is such policies and support structures that protect human rights and dignity, support families and caregivers, build an inclusive, age-friendly society, ensure equitable access to services, promote research and data collection and help guide funding and resource allocation- ensure that resources are dedicated to dementia care, awareness and prevention instead of being lost in the broader mental health budget since there are many. 

Role of Community Leaders and Traditional Healers

Bridging cultural and medical approaches can foster trust that helps overcome deep-rooted stigma. Doing this will correct harmful myths about dementia without dismissing cultural beliefs that people are still clinging tightly to and help reduce fear and discrimination within the community. Many people still trust traditional healers especially those in rural areas. If healers are educated about dementia and are involved in awareness efforts they can refer patients to proper care rather than unintentionally reinforcing stigma. In conclusion, this could be done to reduce harmful practices while honouring tradition.

Youth Engagement and Intergenerational Advocacy

Young people are essential in the sense that they can challenge harmful beliefs passed down through generations. Their access to education, social platforms, and open-mindedness make them ideal for changing the outdated narrative about dementia. Early exposure to dementia awareness also helps to shape career choices and advocacy roles. If the youth is engaged, they may become future researchers and policy leaders who are committed to transforming mental healthcare in Botswana.

Conclusion

Recently, several organizations have been established to promote awareness and understanding of dementia. One such initiative was launched in 2021, and it aims to educate communities about dementia and encourage people to see it for what it truly is, rather than fear what they don’t understand. The goal is to raise awareness, reduce stigma, and provide meaningful purpose to those affected. By 2025, many more groups have emerged to champion this cause since it seems some people still do not understand dementia. It is not a real condition a curse, nor a call for execution.

Social Media: https://www.facebook.com/phemelo.bdisang