Mali's traditional theater gives psychiatric patients the stage

BAMAKO, Mali (AP) — In the courtyard of a psychiatric ward in Mali’s capital, a small group of patients acts out scenes of a village dispute to the beat of a djembe, a traditional West African drum.

One patient, Mamadou Diarra, cries out to another in the Bambara language, mocking: “You don’t know anything! Just nonsense!”

But both break into smiles, and Diarra dances as he continues launching insults at his fellow performer.

The group is taking part in koteba, a traditional form of theater practiced by Mali's largest ethnic group, the Bambara. It mixes acting, singing and dancing and is usually performed in villages as an outlet to work through problems and an open space for satire.

But here at Point G, one of the largest hospitals in Bamako, koteba is also a way of offering support and a sense of community to people receiving psychiatric care.

Mali has fewer than 50 mental health professionals for a population of more than 20 million, according to a 2022 report by the World Health Organization. People with mental illnesses are often left without treatment and excluded from society.

Though the use of koteba as therapy hasn't been formally studied, Souleymane Coulibaly, a clinical psychologist at the Point G hospital, said the traditional form of theater is uniquely positioned to help people in the psychiatric ward work through their problems.

“Patients who attend koteba leave the hospital more quickly than those who refuse to attend the theater session,” he said.

In the courtyard, Diarra was the star, and other patients gathered as he spoke.

“I’ve never done any kind of theater before. I’ve never danced. But once I started, God gave me the knowledge of these things,” he said.

Adama Bagayoko, 67, the director of the visiting theater troupe, said the weekly performances at Point G are a rare space where patients feel heard and respected.

“We talk to each other, we dance together, we laugh together,” Bagayoko said. “To touch someone shows that we are equal, to listen to them shows that they are important, and what they say is important."

Bagayoko was part of a troupe that brought koteba to the Point G psychiatric ward in 1983, as mental health workers looked for a way to use Mali’s cultural practices to help people receiving psychiatric care.

The first performance was so effective that patients asked the doctors if the actors could return the next day, he said.

Patients and actors have been meeting for koteba performances every Friday since then.

The koteba performances at Point G unfold in three phases, Bagayoko said. First, the troupe plays music to invite patients into the courtyard. Then the troupe asks what the topic or theme of that day's performance should be. After the performance, they sit in a circle and give the floor to any patients who wish to speak.

Because the patients feel at ease, they often tell the actors details about their lives they are not comfortable sharing with their family or doctors, which can help doctors get to the core of any issue they might be dealing with, Bagayoko said.

On a recent Friday, the patients acted out a familiar scene in Mali: A man in a village is accused of stealing. The thief screams and claims he hasn’t stolen anything, while the villagers ask Diarra, playing the village chief, what punishment he deserves.

“Kill him!” Diarra yells amid the screams. But as the angry mob gathers around the man, he escapes and flees.

Bagayoko said the troupe performs other themes proposed by patients including those about women beaten by their husbands, drug problems and alcoholism.

The hospital at Point G is only a short walk from Mali’s political stage — the presidential palace and main military base — where a 2020 military coup has left the country struggling with increased extremist violence and economic hardship. Last month, Islamic militants attacked Bamako for the first time in almost a decade.

But those problems are far away during the koteba performances at the hospital, as Diarra and his fellow patients are immersed in the world they create.

“You know what my problem is? That I see things for what they are,” Diarra said, laughing, during a break.

Bagayoko chimed in: “Okay, we’ll lighten that load for you.”

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Adama Bagayoko, director of the theater troupe that has been performing with patients at the psychiatric ward of the Point G hospital, stands in the hospital's courtyard in Bamako, Mali, Friday, Sept. 20, 2024. (AP Photo/Moustapha Diallo)

Mamadou Diarra, right, dances with other patients at Bamako's Point G hospital psychiatric ward in the hospital's courtyard in Bamako, Mali, Friday, Sept. 20, 2024. (AP Photo/Moustapha Diallo)

Patients at Bamako's Point G psychiatric ward act out scenes at the psychiatric ward of the Point G hospital in Bamako, Mali, Friday, Sept. 20, 2024. (AP Photo/Moustapha Diallo)

Patients at Bamako's Point G psychiatric ward play instruments in the hospital's courtyard in Bamako, Mali, Friday, Sept. 20, 2024. (AP Photo/Moustapha Diallo)

Patients at Bamako's Point G psychiatric ward act out scenes at the psychiatric ward of the Point G hospital in Bamako, Mali, Friday, Sept. 20, 2024. (AP Photo/Moustapha Diallo)

NEW YORK (AP) — Thousands of New York City nurses returned to the picket lines Tuesday as their strike targeting some of the city’s leading hospital systems entered its second day.

Union officials say roughly 15,000 nurses walked off the job Monday morning at multiple campuses of three hospital systems: NewYork-Presbyterian/Columbia, Montefiore Medical Center and Mount Sinai.

The affected hospitals have hired droves of temporary nurses to try to fill the labor gap. Both nurses and hospital administrators have urged patients not to avoid getting care during the strike.

New York City, like the U.S. as a whole, has had an active flu season. The city logged over 32,000 cases during the week ending Dec. 20 — the highest one-week tally in at least 20 years — though numbers have since declined, the Health Department said last Thursday.

Roy Permaul, an intensive care unit nurse who was among those picketing in front of Mount Sinai's flagship campus in Manhattan, said he and his colleagues are prepared to walk off the job as long as needed to secure a better contract.

But Dania Munoz, a nurse practitioner at Mount Sinai, stressed that the union’s fight wasn’t just about better wages.

“We deserve fair pay, but this is about safety for our patients, for ourselves and for our profession,” the 31-year-old Bronx resident said. “The things that we’re fighting for, we need. We need health care. We need safety. We need more staffing.”

The New York State Nurses Association said Tuesday that none of the hospitals have agreed to additional bargaining sessions with the union since their last meetings on Sunday.

It also complained that Mount Sinai, which operates seven hospitals, unlawfully fired three nurses hours after the strike started and improperly disciplined 14 others who had spoken out about workplace violence or discussed the union and contract negotiations with their colleagues.

Mount Sinai spokespersons said Tuesday the claims were “not accurate” and that they would provide more information later. Mt. Sinai has said approximately 20% of its nurses reported for work on the first day of the strike rather than picketing.

Meanwhile, Montefiore Medical Center said it has “not canceled even one patient’s access to care” during the work stoppage. The city Emergency Management Department said it hasn’t seen major impacts to patient care so far.

The hospital system also criticized unionized nurses for seeking “troubling proposals” such as demanding that nurses not be terminated, even if found to be compromised by drugs or alcohol while on the job.

The union said Montefiore was “blatantly mischaracterizing” one of its basic workplace proposals, which would have added protections for nurses dealing with substance use disorders and which has already been adopted in other hospitals around the state.

The labor action comes three years after a similar strike forced medical facilities to transfer some patients and divert ambulances.

As with the 2023 labor action, nurses have pointed to staffing issues as a major flashpoint, accusing the big-budget medical centers of refusing to commit to provisions for safe, manageable workloads.

The private, nonprofit hospitals involved in the current negotiations say they’ve made strides in staffing in recent years and have cast the union’s demands as prohibitively expensive.

On Monday, the city's new mayor, Zohran Mamdani, stood beside nurses on a picket line outside NewYork-Presbyterian, praising the union’s members for seeking “dignity, respect and the fair pay and treatment that they deserve.”

Nurses strike in front of Montefiore Hospital in the Bronx borough of New York, Tuesday, Jan. 13, 2026. (AP Photo/Seth Wenig)

Nurses strike in front of Montefiore Hospital in the Bronx borough of New York, Tuesday, Jan. 13, 2026. (AP Photo/Seth Wenig)

Nurses strike outside New York-Presbyterian Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)